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The risk for persistent adult alcohol and nicotine dependence: the role of childhood maltreatment

Authors

  • Jennifer C. Elliott,

    1. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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  • Malka Stohl,

    1. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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  • Melanie M. Wall,

    1. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
    2. New York State Psychiatric Institute, New York, NY, USA
    3. Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
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  • Katherine M. Keyes,

    1. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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  • Renee D. Goodwin,

    1. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
    2. Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY), Queens, NY, USA
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  • Andrew E. Skodol,

    1. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
    2. Department of Psychiatry, University of Arizona College of Medicine, Tucson, AZ, USA
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  • Robert F. Krueger,

    1. Department of Psychology, University of Minnesota, Minneapolis, MN, USA
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  • Bridget F. Grant,

    1. Laboratory of Epidemiology and Biometry, National Institute of Alcohol Abuse and Alcoholism, Rockville, MD, USA
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  • Deborah S. Hasin

    Corresponding author
    1. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
    2. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
    3. New York State Psychiatric Institute, New York, NY, USA
    • Correspondence to: Deborah S. Hasin, Department of Psychiatry, Columbia University College of Physicians and Surgeons, 1051 Riverside Drive #123, New York, NY 10032, USA. E-mail: dsh2@columbia.edu

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Abstract

Background and Aims

Alcohol and nicotine dependence are associated with considerable morbidity and mortality, especially when cases are persistent. The risk for alcohol and nicotine dependence is increased by childhood maltreatment. However, the influence of childhood maltreatment on dependence course is unknown, and is evaluated in the current study.

Design

Physical, sexual and emotional abuse, and physical and emotional neglect, were evaluated as predictors of persistent alcohol and nicotine dependence over 3 years of follow-up, with and without control for other childhood adversities.

Setting

National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).

Participants

NESARC participants completing baseline and follow-up who met criteria at baseline for past-year alcohol dependence (n = 1172) and nicotine dependence (n = 4017).

Measurements

Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS) measures of alcohol/nicotine dependence, childhood maltreatment and other adverse childhood experiences (e.g. parental divorce).

Findings

Controlling for demographics only, physical, sexual and emotional abuse and physical neglect predicted 3-year persistence of alcohol dependence [adjusted odds ratio (AOR) = 1.50–2.99; 95% CI = 1.04–4.68] and nicotine dependence (AOR = 1.37–1.74; 95% CI = 1.13–2.11). With other childhood adversities also controlled, maltreatment types remained predictive for alcohol persistence (AOR = 1.53–3.02; 95% CI = 1.07–4.71) and nicotine persistence (AOR = 1.35–1.72; 95% CI = 1.11–2.09). Further, a greater number of maltreatment types incrementally influenced persistence risk (AOR = 1.19–1.36; 95% CI = 1.11–1.56).

Conclusions

A history of childhood maltreatment predicts persistent adult alcohol and nicotine dependence. This association, robust to control for other childhood adversities, suggests that maltreatment (rather than a generally difficult childhood) affects the course of dependence.

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