title: Genetic moderators and psychiatric mediators of the link between sexual abuse and alcohol dependence.
abstract: OBJECTIVE
  This study used a case-control female sample to test psychiatric mediators and genetic moderators of the effect of sexual abuse on later alcohol dependence. The study also tested differences between alcohol dependent women with or without a history of sexual abuse on variables that might affect treatment planning.
  
  
  METHODS
  A case-control design compared 192 treatment-seeking alcohol dependent women with 177 healthy population controls. All participants were assessed for alcohol-related behaviors, sexual abuse history, psychiatric problems, and personality functioning. Markers were genotyped in the CRHR1, MAO-A and OPRM1 genes.
  
  
  RESULTS
  The association of sexual abuse with alcohol dependence was limited to the most severe category of sexual abuse involving anal or vaginal penetration. Of the five psychiatric disorders tested, anxiety, anorexia nervosa, and bulimia met criteria as potential mediators of the abuse-alcohol dependence association. Severe sexual abuse continued to have an independent effect on alcohol dependence status even after accounting for these potential mediators. None of the candidate genetic markers moderated the association between sexual abuse and alcohol dependence. Of alcohol dependent participants, those with a history of severe abuse rated higher on alcoholism severity, and psychiatric comorbidities.
  
  
  CONCLUSIONS
  Sexual abuse is associated with later alcohol problems directly as well as through its effect on psychiatric problems. Treatment-seeking alcohol dependent women with a history of abuse have distinct features as compared to other alcohol dependent women.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA. William.Copeland@duke.edu
authors.forename: William E
authors.initials: WE
authors.lastname: Copeland
authors.forename: Asa
authors.initials: A
authors.lastname: Magnusson
authors.forename: Mona
authors.initials: M
authors.lastname: Göransson
authors.forename: Markus A
authors.initials: MA
authors.lastname: Heilig
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology* / Q000628:therapy; D015415:Biomarkers; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology / Q000235:genetics / Q000523:psychology / Q000628:therapy; D008875:Middle Aged; D012307:Risk Factors; D012742:Sex Offenses / Q000523:psychology / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000235:genetics / Q000523:psychology / Q000628:therapy
chemical_list: D015415:Biomarkers