Childhood physical and sexual abuse and subsequent alcohol and drug use disorders in two American-Indian tribes.
OBJECTIVE
The purpose of this study was to examine the relationship of childhood physical and sexual abuse to subsequent lifetime alcohol or drug use disorders among American Indians (AIs) by using cross-sectional and retrospective data collected from a structured epidemiological interview.


METHODS
A sample of 3,084 AIs from two tribal populations-Southwest and Northern Plains--participated in a large-scale, community-based study. Participants were asked about traumatic events and family history and were administered standard diagnostic measures of substance use disorders.


RESULTS
Prevalence of childhood physical abuse was approximately 7% for both tribes, and childhood sexual abuse was 4%-5%, much higher for females. The Northern Plains tribe had higher prevalences of substance use disorders. Childhood physical abuse had a significant main effect in bivariate models of substance dependence, but remained significant only in the multivariate models of substance dependence for the Northern Plains tribe. Correlates of disorder were psychiatric and medical comorbidity, parental alcohol problems and adult experience of physical attacks.


CONCLUSIONS
Childhood physical abuse had a stronger effect than childhood sexual abuse on lifetime substance dependence. Childhood sexual abuse, on the other hand, was more associated with lifetime substance abuse. Females more commonly experienced childhood abuse but were less likely than males to develop substance use disorders. Although additional covariates reduced the main effect on disorder, results provide clinical guidance to constellations of risk factors and expand the population at risk to include males.
Libby
Anne M
AM
American Indian and Alaska Native Programs, Department of Psychiatry, University of Colorado Health Sciences Center, Aurora, Colorado, USA. anne.libby@uchsc.edu
Orton
Heather D
HD
Novins
Douglas K
DK
Spicer
Paul
P
Buchwald
Dedra
D
Beals
Janette
J
Manson
Spero M
SM
D000293:Adolescent; D000328:Adult; D019973:Alcohol-Related Disorders / Q000453:epidemiology; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data; D002650:Child Abuse, Sexual / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015205:Northwestern United States / Q000453:epidemiology; D016017:Odds Ratio; D044382:Population Groups / Q000706:statistics & numerical data; D012189:Retrospective Studies; D015206:Southwestern United States / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology*