From the Department of Psychiatry, Yale School of Medicine, New Haven, CT (ASM, EAS, AJ, MNP, RHP); US Department of Veterans Affairs National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT (EAS, MNP, RHP); US Department of Veterans Affairs, National Center on Homelessness Among Veterans, Tampa, FL (EAS); Child Study Center, Yale School of Medicine, New Haven, CT (MNP); Department of Neuroscience, Yale University, New Haven, CT (MNP); Wu Tsai Institute, Yale University, New Haven, CT (MNP); Connecticut Mental Health Center, Yale School of Medicine, New Haven, CT (ASM, AJ, MNP); Connecticut Council on Problem Gambling, Wethersfield, CT (MNP); and Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT (RHP).
J Addict Med. 2024;18(4):432-436. doi: 10.1097/ADM.0000000000001306. Epub 2024 Mar 9.
US veterans report more adverse childhood experiences (ACEs) than nonveterans, and a greater number of ACEs has been linked to substance use disorders (SUDs). To date, however, no study has examined whether specific ACEs may be linked to SUDs in this population in a sex-related fashion.
We analyzed data from the National Health and Resilience in Veterans Study, a nationally representative survey of 4069 US veterans. ACEs, current alcohol use disorder (AUD), and current drug use disorder (DUD) were assessed using validated self-report measures.
Being raised in a household with people with SUDs was independently associated with current AUD. Childhood sexual abuse and having an incarcerated family member were independently associated with current DUD. Sex moderated associations with specific ACEs. Specifically, female veterans who had experienced physical neglect in childhood or were raised with a mentally ill family member in the home were more likely to endorse current AUD and DUD, whereas male veterans who experienced sexual abuse in childhood or who were raised in a home with someone who used substances were more likely to endorse current AUD and DUD.
Results underscore the importance of targeted and sex-sensitive interventions in addressing potentially unresolved childhood traumas as part of treatment efforts for SUDs in veterans.
与非退伍军人相比，美国退伍军人报告了更多的不良童年经历（ACEs），并且更多的 ACEs 与物质使用障碍（SUD）有关。然而，迄今为止，尚无研究以性别相关的方式检查特定 ACE 是否与该人群中的 SUD 有关。
我们分析了来自全国退伍军人健康和韧性研究的数据，这是一项针对 4069 名美国退伍军人的全国代表性调查。使用经过验证的自我报告措施评估 ACE、当前酒精使用障碍（AUD）和当前药物使用障碍（DUD）。
在有 SUD 患者的家庭中长大与当前 AUD 独立相关。儿童期性虐待和有被监禁的家庭成员与当前 DUD 独立相关。性别调节与特定 ACE 的关联。具体而言，经历过童年期身体忽视或在有精神疾病家庭成员的家庭中长大的女性退伍军人更有可能出现当前 AUD 和 DUD，而经历过童年期性虐待或在有物质使用障碍的家庭中长大的男性退伍军人更有可能出现当前 AUD 和 DUD。
结果强调了针对退伍军人 SUD 治疗工作中潜在未解决的儿童创伤进行有针对性和性别敏感干预的重要性。
