Center for Innovation to Implementation, Department of Veterans Affairs Health Care System, Palo Alto, California.
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.
J Stud Alcohol Drugs. 2021 May;82(3):395-400. doi: 10.15288/jsad.2021.82.395.
Growing up with an adult with an alcohol use disorder (AUD) is common and negatively affects adult functioning. This study examined two questions concerning the lived experience of growing up in a home with AUD.
The first question asked how adults entering AUD treatment (n = 402) who had this lived experience (58%) compared to those who did not (42%) on indicators of alcohol use severity. Patients with lived experience reported alcohol use at a younger age, more times having been arrested and charged, and greater risk for future substance use. The second question examined concordance between patients and their concerned others on this lived experience (n = 277 dyads) and patients' treatment outcomes 3 months later. The associations between patients' lived experience and better treatment outcomes were stronger when patients' concerned others had a concordant lived experience. When patient-concerned other dyads reported concordant lived experiences at baseline, patients had lower substance use and risk scores at the 3-month follow-up than when the dyads reported discordant lived experiences with regard to growing up in a home with AUD; effect sizes were small.
Concordance and discordance on this lived experience could be considered in treatment planning for patients with AUD and their concerned others. Providers could ask about each member's childhood and aim interventions at helping dyads discuss their childhoods in ways that validate each other's needs and provide emotional support, without stigmatization. Delivery may consider relationship type (spousal or other) and be in educational or treatment sessions that include the dyad or one member.
在患有酒精使用障碍（AUD）的成年人身边长大是很常见的，这会对成年人的功能产生负面影响。本研究探讨了与在 AUD 家庭中长大的生活经历有关的两个问题。
第一个问题是询问有这种生活经历（58%）的进入 AUD 治疗的成年人（n=402）与没有这种生活经历（42%）的成年人相比，在酒精使用严重程度的指标上有何不同。有生活经历的患者报告称，他们开始饮酒的年龄更小，被捕和被指控的次数更多，未来使用其他物质的风险更大。第二个问题是检查患者及其有关人员（n=277 对）对这种生活经历的一致性，以及 3 个月后患者的治疗结果。当患者的有关人员有共同的生活经历时，患者的生活经历与更好的治疗结果之间的关联更强。当患者-有关人员对在 AUD 家庭中长大的经历报告一致时，与报告不一致时相比，患者在 3 个月随访时的物质使用和风险评分更低，效应大小较小。
在 AUD 患者及其有关人员的治疗计划中，可以考虑这种生活经历的一致性和不一致性。治疗师可以询问每个成员的童年经历，并旨在通过干预措施帮助夫妻双方以相互认可需求和提供情感支持的方式讨论他们的童年经历，而不会产生污名化。治疗可能会考虑关系类型（配偶或其他），并在包括夫妻双方或一方的教育或治疗会议中进行。
