title: Growing up with parental alcohol abuse: exposure to childhood abuse, neglect, and household dysfunction.
abstract: OBJECTIVE
  This study is a detailed examination of the association between parental alcohol abuse (mother only, father only, or both parents) and multiple forms of childhood abuse, neglect, and other household dysfunction, known as adverse childhood experiences (ACEs).
  
  
  METHODS
  A questionnaire about ACEs including child abuse, neglect, household dysfunction, and exposure to parental alcohol abuse was completed by 8629 adult HMO members to retrospectively assess the relationship of growing up with parental alcohol abuse to 10 ACEs and multiple ACEs (ACE score).
  
  
  RESULTS
  Compared to persons who grew up with no parental alcohol abuse, the adjusted odds ratio for each category of ACE was approximately 2 to 13 times higher if either the mother, father, or both parents abused alcohol (p < 0.05). For example, the likelihood of having a battered mother was increased 13-fold for men who grew up with both parents who abused alcohol (OR, 12.7; 95% CI: 8.4-19.1). For almost every ACE, those who grew up with both an alcohol-abusing mother and father had the highest likelihood of ACEs. The mean number of ACEs for persons with no parental alcohol abuse, father only, mother only, or both parents was 1.4, 2.6, 3.2, and 3.8, respectively (p < .001).
  
  
  CONCLUSIONS
  Although the retrospective reporting of these experiences cannot establish a causal association with certainty, exposure to parental alcohol abuse is highly associated with experiencing adverse childhood experiences. Improved coordination of adult and pediatric health care along with related social and substance abuse services may lead to earlier recognition, treatment, and prevention of both adult alcohol abuse and adverse childhood experiences, reducing the negative sequelae of ACEs in adolescents and adults.
authors.affiliation: National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341-3717, USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Dube
authors.forename: R F
authors.initials: RF
authors.lastname: Anda
authors.forename: V J
authors.initials: VJ
authors.lastname: Felitti
authors.forename: J B
authors.initials: JB
authors.lastname: Croft
authors.forename: V J
authors.initials: VJ
authors.lastname: Edwards
authors.forename: W H
authors.initials: WH
authors.lastname: Giles
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D002140:California / Q000453:epidemiology; D015984:Causality; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D016241:Child of Impaired Parents / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data*; D006801:Humans; D008016:Life Change Events; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011795:Surveys and Questionnaires; D013995:Time