title: Combined role of childhood maltreatment, family history, and gender in the risk for alcohol dependence.
abstract: BACKGROUND
  Studies of the relationship between childhood maltreatment and alcohol dependence have not controlled comprehensively for potential confounding by co-occurring maltreatments and other childhood trauma, or determined whether parental history of alcohol disorders operates synergistically with gender and maltreatment to produce alcohol dependence. We addressed these issues using national data. Method Face-to-face surveys of 27 712 adult participants in a national survey.
  
  
  RESULTS
  Childhood physical, emotional and sexual abuse, and physical neglect were associated with alcohol dependence (p<0.001), controlling for demographics, co-occurring maltreatments and other childhood trauma. Attributable proportions (APs) due to interaction between each maltreatment and parental history revealed significant synergistic relationships for physical abuse in the entire sample, and for sexual abuse and emotional neglect in women (APs, 0.21, 0.31, 0.26 respectively), indicating that the odds of alcohol dependence given both parental history and these maltreatments were significantly higher than the additive effect of each alone (p<0.05).
  
  
  CONCLUSIONS
  Childhood maltreatments independently increased the risk of alcohol dependence. Importantly, results suggest a synergistic role of parental alcoholism: the effect of physical abuse on alcohol dependence may depend on parental history, while the effects of sexual abuse and emotional neglect may depend on parental history among women. Findings underscore the importance of early identification and prevention, particularly among those with a family history, and could guide genetic research and intervention development, e.g. programs to reduce the burden of childhood maltreatment may benefit from addressing the negative long-term effects of maltreatments, including potential alcohol problems, across a broad range of childhood environments.
authors.affiliation: Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, NY 10032, USA.
authors.forename: M C
authors.initials: MC
authors.lastname: Fenton
authors.forename: T
authors.initials: T
authors.lastname: Geier
authors.forename: K
authors.initials: K
authors.lastname: Keyes
authors.forename: A E
authors.initials: AE
authors.lastname: Skodol
authors.forename: B F
authors.initials: BF
authors.lastname: Grant
authors.forename: D S
authors.initials: DS
authors.lastname: Hasin
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D002648:Child; D002649:Child Abuse / Q000145:classification / Q000523:psychology / Q000706:statistics & numerical data*; D016241:Child of Impaired Parents; D003625:Data Collection; D015987:Effect Modifier, Epidemiologic; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007406:Interview, Psychological; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult