Department of Psychology Psychopathology and Clinical Intervention, University of Zürich, Switzerland.
Israel Center on Addiction (ICA), Netanya, Israel; Hadassah School of Public Health and Community Medicine, Hebrew University, Jerusalem, Israel.
Addict Behav. 2021 Jul;118:106889. doi: 10.1016/j.addbeh.2021.106889. Epub 2021 Mar 9.
Exposure to trauma is considered a risk factor for the development of addictive disorders. Currently, there is a knowledge gap concerning specific links between types and levels of exposure to traumatic events and addiction.In this study we explored the associations between interpersonal trauma and risk of addictive behaviors, stratified by type of trauma (physical, weapon, sexual assault, and combat) and level of exposure (direct/indirect), focusing on a wide range of substances and behaviors. Data from an online representative sample of 4025 respondents were collected, including the Life Events Checklist (LEC-5), substance use disorders and behavioral addictions metrics, and sociodemographic data. Substantial differences were found between specific types of trauma and risk of addiction. Among those exposed to sexual assault, the risk of alcohol use disorder was found to 15.4%, 95%CI[14.4-16.4%], compared to 12.1%,95%CI[11.3-12.8] among those exposed to combat-related trauma. Both direct and indirect exposure to trauma were found to be significantly related with risk of addiction. While direct exposure was most highly associated with addictions across several types of trauma, in the case of combat-related trauma, indirect exposure was more highly associated with alcohol and pornography addiction (14.5%,95%CI[13.2-15.8%] and 10.0%, 95%CI[6.3-15.0%], respectively) compared to direct exposure (10.7%,95%CI[9.9-11.6%] and 7.4%, 95%CI[4.7-11.6%], respectively). Our findings emphasize the strong association between all types of trauma and the risk of several specific substance and behavioral addictions. Specifically, the role of indirect exposure to trauma is highlighted.
创伤暴露被认为是成瘾障碍发展的一个风险因素。目前，关于创伤类型和暴露程度与成瘾之间的具体联系，我们的知识还存在空白。在这项研究中，我们探讨了人际关系创伤与成瘾行为风险之间的关联，根据创伤类型（身体、武器、性侵犯和战斗）和暴露程度（直接/间接）进行了分层，重点关注了广泛的物质和行为。这项研究的数据来自于一个在线具有代表性的 4025 名受访者的样本，包括生活事件检查表（LEC-5）、物质使用障碍和行为成瘾指标以及社会人口统计学数据。我们发现，特定类型的创伤与成瘾风险之间存在显著差异。在那些遭受性侵犯的人中，酒精使用障碍的风险为 15.4%，95%CI[14.4-16.4%]，而在那些接触过与战斗相关的创伤的人中，酒精使用障碍的风险为 12.1%，95%CI[11.3-12.8]。直接和间接暴露于创伤都与成瘾风险显著相关。虽然直接暴露与多种类型的创伤相关的成瘾最为相关，但在与战斗相关的创伤的情况下，间接暴露与酒精和色情成瘾的相关性更高（分别为 14.5%，95%CI[13.2-15.8%]和 10.0%，95%CI[6.3-15.0%]）相比之下，直接暴露的相关性更低（分别为 10.7%，95%CI[9.9-11.6%]和 7.4%，95%CI[4.7-11.6%]）。我们的研究结果强调了所有类型的创伤与多种特定物质和行为成瘾风险之间的强烈关联。特别是，间接暴露于创伤的作用得到了强调。
