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住院酗酒患者中的身体和性虐待及相关精神障碍

Physical and sexual abuse and associated mental disorders among alcoholic inpatients.

作者信息

Windle M, Windle R C, Scheidt D M, Miller G B

机构信息

Research Institute on Addictions, Buffalo, NY 14203, USA.

出版信息

Am J Psychiatry. 1995 Sep;152(9):1322-8. doi: 10.1176/ajp.152.9.1322.

Abstract

OBJECTIVE

The purpose of this study was to investigate the adult psychiatric correlates of childhood abuse among alcoholic inpatients.

METHODS

The 802 patients, who included 321 women, were admitted to one of five New York State alcohol treatment inpatient centers. Each patient was interviewed, and sexual and physical abuse history, DSM-III diagnosis, and other characteristics were recorded.

RESULTS

The overall prevalence of reported childhood abuse was 59% for women and 30% for men. Family history of alcoholism was associated with higher levels of physical and sexual abuse. Gender differences in types of childhood abuse (i.e., sexual abuse only, physical abuse only, dual abuse) were evident; 49% of the women and 12% of the men reported sexual abuse (with or without physical abuse), 33% of the women and 24% of the men reported physical abuse (with or without sexual abuse), and 23% of the women and 5% of the men reported dual abuse. Abuse status, and especially dual abuse, was associated with higher rates of antisocial personality disorder and suicide attempts among women and men, with generalized anxiety disorder among women, and with major depression among men.

CONCLUSIONS

The findings highlight the long-term associations between sexual and physical abuse and adult coexisting mental disorders among alcoholic inpatients. Addressing unresolved intrapsychic trauma associated with childhood abuse may increase the efficacy of treatment outcomes and reduce relapse rates among alcoholics.

摘要

目的

本研究旨在调查成年住院酗酒者童年期受虐情况与精神疾病之间的关联。

方法

802名患者(其中包括321名女性)入住纽约州五个酒精治疗住院中心之一。对每位患者进行访谈,并记录其性虐待和身体虐待史、DSM-III诊断结果及其他特征。

结果

报告的童年期受虐总体患病率女性为59%,男性为30%。酗酒家族史与更高程度的身体和性虐待相关。童年期受虐类型(即仅遭受性虐待、仅遭受身体虐待、双重虐待)存在明显的性别差异;49%的女性和12%的男性报告遭受过性虐待(无论是否伴有身体虐待),33%的女性和24%的男性报告遭受过身体虐待(无论是否伴有性虐待),23%的女性和5%的男性报告遭受过双重虐待。受虐状况,尤其是双重虐待,与女性和男性中反社会人格障碍及自杀未遂的较高发生率相关,与女性中的广泛性焦虑障碍相关,与男性中的重度抑郁症相关。

结论

研究结果突显了性虐待和身体虐待与成年住院酗酒者并存精神障碍之间的长期关联。处理与童年期受虐相关的未解决的内心创伤可能会提高治疗效果并降低酗酒者的复发率。

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