Gerhardt Sarah, Eidenmueller Katharina, Hoffmann Sabine, Bekier Nina K, Bach Patrick, Hermann Derik, Koopmann Anne, Sommer Wolfgang H, Kiefer Falk, Vollstädt-Klein Sabine
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Department of Biostatistics, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Front Psychiatry. 2022 Apr 14;13:866019. doi: 10.3389/fpsyt.2022.866019. eCollection 2022.
Childhood maltreatment (CM) leads to detrimental mental health outcomes, such as substance use disorders (SUD). This study examined prevalence and severity of all five types of CM with respect to specific substances and sex in treatment-seeking individuals with SUD. The influences of type of CM and symptoms of depressiveness, anxiety, and perceived stress on substance craving at admission as well as craving reduction during SUD treatment were examined.
= 546 patients in treatment for SUD and = 109 individuals in opioid maintenance treatment filled out questionnaires regarding CM (Childhood Trauma Questionnaire) and psychopathologies. Substance craving was assessed throughout treatment using the Mannheim Craving Scale. Group differences in CM, type of substance and sex were examined. General linear models were applied to examine influences on substance craving.
Higher prevalence and severity of all five subtypes of CM were observed in individuals with SUD compared to the general population. Women were more severely affected by emotional and sexual abuse than men. Patients with cannabis use disorder reported more severe experiences of emotional abuse compared to all other substances. Craving at admission to treatment was influenced by emotional abuse, however, symptoms of depressiveness, anxiety, and perceived stress contributed to craving at admission or craving reduction during treatment.
CM relates to SUD and should be incorporated in prevention and treatment of SUD. Underlying mechanisms of the association might relate to impairments in processing and regulation of stress, emotions, and interpersonal relations following a history of CM.
童年期虐待（CM）会导致有害的心理健康后果，如物质使用障碍（SUD）。本研究调查了在寻求物质使用障碍治疗的个体中，所有五种类型的童年期虐待在特定物质和性别方面的患病率及严重程度。研究还考察了童年期虐待类型以及抑郁、焦虑和感知压力症状对入院时物质渴望以及物质使用障碍治疗期间渴望减少的影响。
546名接受物质使用障碍治疗的患者和109名接受阿片类药物维持治疗的个体填写了关于童年期虐待（儿童创伤问卷）和精神病理学的问卷。在整个治疗过程中使用曼海姆渴望量表评估物质渴望。考察了童年期虐待、物质类型和性别的组间差异。应用一般线性模型来考察对物质渴望的影响。
与一般人群相比，物质使用障碍患者中所有五种童年期虐待亚型的患病率和严重程度更高。女性在情感虐待和性虐待方面比男性受影响更严重。与所有其他物质相比，患有大麻使用障碍的患者报告的情感虐待经历更严重。入院时的渴望受情感虐待影响，然而，抑郁、焦虑和感知压力症状在入院时的渴望或治疗期间的渴望减少中起作用。
童年期虐待与物质使用障碍相关，应纳入物质使用障碍的预防和治疗中。这种关联的潜在机制可能与童年期虐待史后应激、情绪和人际关系的处理及调节受损有关。
