Kelleher K, Chaffin M, Hollenberg J, Fischer E
University of Arkansas for Medical Sciences, Little Rock.
Am J Public Health. 1994 Oct;84(10):1586-90. doi: 10.2105/ajph.84.10.1586.
The purpose of this study was to compare the frequency of substance use disorders and symptoms between adults reporting child physical abuse or neglect and individually matched control subjects in a community sample.
In a nested case-control study, 169 adults reporting physical abuse of a child and 209 adults reporting neglect of a child from 11,662 individuals successfully interviewed in a probabilistic survey in four communities were individually matched with control subjects drawn from the participants. Case subjects were compared with control subjects on the number of alcohol- or drug-related symptoms and disorder diagnoses as determined by symptoms from the Diagnostic Interview Schedule.
Respondents reporting either physical abuse or neglect of children were much more likely than their matched control subjects to report substance abuse or dependence. These differences persisted after potential confounding variables were controlled for.
Parental substance abuse and dependence, independent of confounding factors, are highly associated with child maltreatment. Inconsistent results in previous studies may have arisen from reliance on referred samples and unstandardized assessment methods. Agencies involved in the care of abused or neglected children and their families should consider incorporating routine substance abuse evaluations with treatment, or referral for treatment, where indicated.
本研究旨在比较社区样本中报告遭受过儿童身体虐待或忽视的成年人与个体匹配的对照对象之间物质使用障碍及症状的出现频率。
在一项巢式病例对照研究中,从四个社区概率抽样调查成功访谈到的11662名个体中,169名报告虐待儿童的成年人和209名报告忽视儿童的成年人分别与从参与者中抽取的对照对象进行个体匹配。根据诊断访谈表的症状确定,将病例对象与对照对象在酒精或药物相关症状数量以及障碍诊断方面进行比较。
报告虐待或忽视儿童的受访者比其匹配的对照对象更有可能报告物质滥用或依赖。在控制了潜在的混杂变量后,这些差异依然存在。
父母的物质滥用和依赖与儿童虐待高度相关,且不受混杂因素影响。以往研究结果不一致可能是由于依赖转诊样本和未标准化的评估方法。参与照料受虐待或被忽视儿童及其家庭的机构应考虑在有指征时将常规物质滥用评估与治疗相结合,或转介进行治疗。