The associations between problem drinking and early-life adverse experiences

This study examined the associations between early-life adverse experiences and later-life problem drinking and alcohol dependency. Based on previous findings it was expected to find a positive gradient relationship between early-life adverse experiences and level of problematic drinking. The study data was retrieved from the 2007 Adult Psychiatric Morbidity Survey (APMS 2007), a cross-sectional survey of psychiatric morbidity in 7,403 randomly assigned adults, aged ≥16 years and living in private households in England. Problematic alcohol use was defined according to the Alcohol Use Disorders Identification Test (AUDIT) total score. Adverse childhood experiences were defined in accordance with the Centers for Disease Control and Prevention ACE study (Felitti et al., 1998). The variable abuse was computed from sexual abuse and physical abuse. The variable household challenges was computed from serious illness, injury or assault to a close relative, death of an immediate family member and violence in the home. Linear regression was applied to examine associations between the AUDIT total score and the variables age, sex and education in model 1, adding abuse to model 2 and household challenges to model 3. The results from model 1 accounted for 12.5% of the variance of the AUDIT score (p < .001), adding abuse, the proportion of explained variance increased to 13.1% (p < .001). The variable household challenges was not a statistically significant predictor. Contrary to expectations, the regression model reveals a negligible effect size of the main predictors. However, a significant relationship was found by examining the variable characteristics as a percentage of the sample, overall and by a grouped discriminating AUDIT score of hazardous (AUDIT 8+) and harmful (AUDIT 16+) drinking, abuse (F(2, 7267) = 23.07, p < .001) and household challenges (F(2, 7337) = 9.55, p < .001). The results confirm the predictive value of early-life adverse experiences on the development of later-life problematic alcohol use, suggesting a need for further examination, in addition to the development of both intervention and prevention. Keywords: problematic alcohol use, addiction, adverse childhood experience, abuse, household challenges.Í þessari rannsókn eru tengsl áfalla í barnæsku við þróun áfengisvanda síðar á lífsleiðinni skoðuð. Í ljósi fyrri rannsókna var tilgátan sú að fram kæmi jákvætt stigvaxandi samband milli áfengisvanda og áfalla í æsku. Rannsóknargögnin voru unnin upp úr „the Adult Psychiatric Morbidity Survey“, þversniðsrannsókn frá 2007 sem metur geðrænan vanda hjá 7.403 slembivöldum einstaklingum, 16 ára og eldri, sem búa í eigin húsnæði á Englandi. Áfengisvandi var skilgreindur í samræmi við heildarskor á prófinu the Alcohol use Disorders Identification Test (AUDIT). Áföll í æsku voru skilgreind að fyrirmynd Centers for Disease Control and Prevention eins og hún kemur fram í upprunalegu ACE rannsókninni (Felitti o.fl., 1998). Breytan misbeiting (e. abuse) var sett saman úr breytunum kynferðisleg misbeiting (e. sexual abuse) og líkamleg misbeiting (e. physical abuse). Breytan erfiðleikar á heimili (e. household challenges) var sett saman úr breytunum alvarleg veikindi, slys eða árás á náin ættingja (e. serious illness, injury or assault to a close relative), dauðsfall náins ættingja (e. death of an immediate family member) og heimilisofbeldi (e. violence in the home). Tengsl áfalla í æsku og áfengisvanda voru metin með línulegri aðhvarfsgreiningu. Heildarskor AUDIT prófsins var skoðað í tengslum við breyturnar aldur, kyn og menntun í þrepi 1, breytunni misbeiting var bætt við í þrepi 2 og breytunni erfiðleikar á heimili í þrepi 3. Þrep 1 skýrir 12,5% breytileika AUDIT skorsins (p < 0,001), þrep 2 skýrir 13,1% breytileikans (p < 0,001), erfiðleikar á heimili reyndust ekki spá marktækt fyrir um breytileikann. Niðurstöður leiddu í ljós mun minni áhrifastærð megin áhrifabreyta en spáð hafði verið. Þegar eiginleikar gagnanna voru skoðaðir út frá viðmiðunarmörkum AUDIT prófsins um áhættusama- (e. hazardous) (AUDIT 8+) og skaðlega- (e. harmful) (AUDIT 16+) neyslu áfengis, komu hinsvegar fram marktæk tengsl við bæði misbeitingu (e. abuse) (F(2, 7267) = 23.07, p < .001) og erfiðleikar á heimili (e. household challenges) (F(2, 7337) = 9.55, p < .001). Niðurstöðurnar staðfesta að áföll í æsku spá fyrir um þróun áfengisvanda síðar á lífsleiðinni. Þær benda einnig til þess að þörf sé á frekari rannsóknum, auk þróunar inngripa og forvarnaraðgerða. Lykilorð: áfengisvandi, fíkn, áföll í æsku, misbeiting, heimilisofbeldi