title: Disentangling the complex association between childhood sexual abuse and alcohol-related problems: a review of methodological issues and approaches.
abstract: This review describes and evaluates methodological approaches aimed at unraveling the association between childhood sexual abuse (CSA) and later misuse of alcohol, which is complicated by the significant overlap between factors that elevate risk for CSA exposure and those that increase risk for problem alcohol use. We critique methods used to distinguish direct effects of CSA events on alcohol-related outcomes from the effects of risk factors frequently present in families in which CSA exposure occurs (e.g., parental alcohol-related problems). These methods include measurement and adjustment for potentially confounding factors and the use of co-twin designs. The findings across methodological approaches provide support for a CSA-specific risk for alcohol misuse, despite the significant contribution of family background factors to overall risk, but much work remains to be done before a comprehensive model for this association can be proposed. Additional directions for research, including the incorporation of measured genes and the use of longitudinal designs, are proposed to further efforts to model the pathways from CSA to alcohol-related problems.
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8134, Saint Louis, Missouri 63110, USA. sartorc@psychiatry.wustl.edu
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Sartor
authors.forename: Arpana
authors.initials: A
authors.lastname: Agrawal
authors.forename: Vivia V
authors.initials: VV
authors.lastname: McCutcheon
authors.forename: Alexis E
authors.initials: AE
authors.lastname: Duncan
authors.forename: Michael T
authors.initials: MT
authors.lastname: Lynskey
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology; D019973:Alcohol-Related Disorders / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D015986:Confounding Factors, Epidemiologic; D004812:Epidemiologic Methods; D006801:Humans; D012307:Risk Factors
references.citation: J Stud Alcohol. 1997 May;58(3):264-71
references.pmid: 9130218
references.citation: J Adolesc Health. 2006 Apr;38(4):444.e1-10
references.pmid: 16549308
references.citation: Am J Psychiatry. 2001 Nov;158(11):1878-83
references.pmid: 11691695
references.citation: Am J Prev Med. 2000 Feb;18(2):151-8
references.pmid: 10698246
references.citation: J Am Acad Child Adolesc Psychiatry. 1997 Dec;36(12):1744-51
references.pmid: 9401336
references.citation: Drug Alcohol Depend. 2007 Jul 10;89(2-3):139-44
references.pmid: 17227698
references.citation: Alcohol Clin Exp Res. 1996 Dec;20(9):1528-33
references.pmid: 8986199
references.citation: Addiction. 1996 Apr;91(4):565-81
references.pmid: 8857382
references.citation: J Stud Alcohol. 2001 Jul;62(4):486-93
references.pmid: 11513226
references.citation: Am J Drug Alcohol Abuse. 2004 Nov;30(4):799-821
references.pmid: 15624550
references.citation: Biol Psychiatry. 2007 Mar 1;61(5):609-16
references.pmid: 16920076
references.citation: J Consult Clin Psychol. 2000 Feb;68(1):19-30
references.pmid: 10710837
references.citation: Child Abuse Negl. 1997 Dec;21(12):1177-90
references.pmid: 9429770
references.citation: Child Abuse Negl. 1996 Aug;20(8):709-23
references.pmid: 8866117
references.citation: Alcohol Clin Exp Res. 1994 Oct;18(5):1091-9
references.pmid: 7847589
references.citation: Psychol Med. 1997 Nov;27(6):1381-96
references.pmid: 9403910
references.citation: JAMA. 1999 Nov 3;282(17):1652-8
references.pmid: 10553792
references.citation: Clin Psychol Rev. 2002 Feb;22(1):27-77
references.pmid: 11793578
references.citation: Arch Gen Psychiatry. 2004 Sep;61(9):897-903
references.pmid: 15351768
references.citation: Br J Psychiatry. 1993 Dec;163:721-32
references.pmid: 8306113
references.citation: Science. 2002 Aug 2;297(5582):851-4
references.pmid: 12161658
references.citation: J Am Acad Child Adolesc Psychiatry. 2003 Jun;42(6):710-9
references.pmid: 12921479
references.citation: Alcohol Clin Exp Res. 1999 Jul;23(7):1136-44
references.pmid: 10443978
references.citation: J Child Psychol Psychiatry. 2007 Mar-Apr;48(3-4):224-44
references.pmid: 17355397
references.citation: Women Health. 2001;33(1-2):163-80
references.pmid: 11523637
references.citation: Br J Psychiatry. 1996 Sep;169(3):355-60
references.pmid: 8879723
references.citation: J Stud Alcohol. 1995 Mar;56(2):207-17
references.pmid: 7760568
references.citation: J Stud Alcohol. 1997 May;58(3):272-9
references.pmid: 9130219
references.citation: Psychol Med. 2006 Oct;36(10):1473-83
references.pmid: 16854248
references.citation: Psychiatr Serv. 2002 Aug;53(8):1001-9
references.pmid: 12161676
references.citation: Child Abuse Negl. 2003 Jun;27(6):625-39
references.pmid: 12818611
references.citation: Am J Public Health. 2001 May;91(5):753-60
references.pmid: 11344883
references.citation: Child Abuse Negl. 2003 Dec;27(12):1409-25
references.pmid: 14644058
references.citation: Ann N Y Acad Sci. 2004 Jun;1024:182-212
references.pmid: 15265782
references.citation: Pediatrics. 2006 Sep;118(3):933-42
references.pmid: 16950983
references.citation: Am J Psychiatry. 1994 May;151(5):707-15
references.pmid: 8166312
references.citation: Med J Aust. 1997 Jan 20;166(2):65-8
references.pmid: 9033559
references.citation: Psychol Med. 2004 Nov;34(8):1519-30
references.pmid: 15724882
references.citation: J Am Acad Child Adolesc Psychiatry. 1996 Oct;35(10):1355-64
references.pmid: 8885590
references.citation: Arch Gen Psychiatry. 2002 Feb;59(2):139-45
references.pmid: 11825135
references.citation: Arch Womens Ment Health. 2004 Apr;7(2):111-21
references.pmid: 15083346
references.citation: Clin Psychol Rev. 2003 Jul;23(4):537-71
references.pmid: 12788109
references.citation: Aust N Z J Psychiatry. 2006 Feb;40(2):156-63
references.pmid: 16476134
references.citation: J Trauma Stress. 2006 Dec;19(6):949-59
references.pmid: 17195983
references.citation: Arch Gen Psychiatry. 2000 Oct;57(10):953-9
references.pmid: 11015813
references.citation: J Abnorm Psychol. 2002 Aug;111(3):411-24
references.pmid: 12150417
references.citation: Twin Res Hum Genet. 2006 Aug;9(4):523-30
references.pmid: 16899159
references.citation: Alcohol Alcohol Suppl. 1991;1:137-40
references.pmid: 1845529
references.citation: J Stud Alcohol. 1997 Jul;58(4):414-27
references.pmid: 9203123
references.citation: Addict Biol. 2004 Sep-Dec;9(3-4):205-12
references.pmid: 15511714
references.citation: J Stud Alcohol Suppl. 1993 Sep;11:109-17
references.pmid: 8410952
references.citation: Alcohol Clin Exp Res. 1996 Dec;20(9):1577-81
references.pmid: 8986206
references.citation: Alcohol Clin Exp Res. 2008 Apr;32(4):632-8
references.pmid: 18331380
references.citation: Br J Addict. 1988 Jul;83(7):831-9
references.pmid: 3207941
references.citation: Clin Psychol Rev. 2006 Mar;26(2):128-48
references.pmid: 16412541
references.citation: Child Abuse Negl. 2001 Dec;25(12):1627-40
references.pmid: 11814159
references.citation: Lancet. 2001 Aug 11;358(9280):450-4
references.pmid: 11513908
references.citation: Nat Neurosci. 2004 Aug;7(8):847-54
references.pmid: 15220929
references.citation: Addiction. 1998 Sep;93(9):1365-73
references.pmid: 9926542
references.citation: Psychol Med. 2000 May;30(3):529-44
references.pmid: 10883709
references.citation: Annu Rev Pharmacol Toxicol. 2008;48:257-76
references.pmid: 17883328
references.citation: Biol Psychiatry. 1998 Jan 15;43(2):139-45
references.pmid: 9474446
references.citation: Psychol Med. 2000 Jan;30(1):41-52
references.pmid: 10722174
references.citation: Arch Gen Psychiatry. 1993 Jan;50(1):36-43
references.pmid: 8422220
references.citation: Child Abuse Negl. 2007 Mar;31(3):211-29
references.pmid: 17399786
references.citation: J Am Acad Child Adolesc Psychiatry. 1996 Oct;35(10):1365-74
references.pmid: 8885591
references.citation: Psychol Bull. 1987 Sep;102(2):204-18
references.pmid: 3310059
references.citation: Arch Gen Psychiatry. 2003 Sep;60(9):929-37
references.pmid: 12963675
references.citation: Rev Neurosci. 2006;17(3):279-307
references.pmid: 16878401
references.citation: Alcohol Clin Exp Res. 1981 Spring;5(2):207-15
references.pmid: 7018299
references.citation: Alcohol Alcohol. 1998 Nov-Dec;33(6):592-601
references.pmid: 9872346
references.citation: Drug Alcohol Depend. 2002 Aug 1;67(3):227-34
references.pmid: 12127193
references.citation: Child Abuse Negl. 1993 May-Jun;17(3):383-92
references.pmid: 8330225
references.citation: Mol Psychiatry. 2006 Oct;11(10):903-13
references.pmid: 16801953
references.citation: Acta Paediatr. 2000 Mar;89(3):310-9
references.pmid: 10772279
references.citation: Arch Gen Psychiatry. 2003 Dec;60(12):1256-64
references.pmid: 14662558
references.citation: Reprod Toxicol. 2007 Jul;24(1):9-19
references.pmid: 17561370
references.citation: Child Abuse Negl. 1999 Jun;23(6):579-92
references.pmid: 10391515