title: The risk for persistent adult alcohol and nicotine dependence: the role of childhood maltreatment.
abstract: OBJECTIVE
  Alcohol and nicotine dependence are associated with considerable morbidity and mortality, especially when cases are persistent. The risk for alcohol and nicotine dependence is increased by childhood maltreatment. However, the influence of childhood maltreatment on dependence course is unknown, and is evaluated in the current study.
  
  
  METHODS
  Physical, sexual and emotional abuse, and physical and emotional neglect, were evaluated as predictors of persistent alcohol and nicotine dependence over 3 years of follow-up, with and without control for other childhood adversities.
  
  
  METHODS
  National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).
  
  
  METHODS
  NESARC participants completing baseline and follow-up who met criteria at baseline for past-year alcohol dependence (n = 1172) and nicotine dependence (n = 4017).
  
  
  METHODS
  Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS) measures of alcohol/nicotine dependence, childhood maltreatment and other adverse childhood experiences (e.g. parental divorce).
  
  
  RESULTS
  Controlling for demographics only, physical, sexual and emotional abuse and physical neglect predicted 3-year persistence of alcohol dependence [adjusted odds ratio (AOR) = 1.50-2.99; 95% CI = 1.04-4.68] and nicotine dependence (AOR = 1.37-1.74; 95% CI = 1.13-2.11). With other childhood adversities also controlled, maltreatment types remained predictive for alcohol persistence (AOR = 1.53-3.02; 95% CI = 1.07-4.71) and nicotine persistence (AOR = 1.35-1.72; 95% CI = 1.11-2.09). Further, a greater number of maltreatment types incrementally influenced persistence risk (AOR = 1.19-1.36; 95% CI = 1.11-1.56).
  
  
  CONCLUSIONS
  A history of childhood maltreatment predicts persistent adult alcohol and nicotine dependence. This association, robust to control for other childhood adversities, suggests that maltreatment (rather than a generally difficult childhood) affects the course of dependence.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Elliott
authors.forename: Malka
authors.initials: M
authors.lastname: Stohl
authors.forename: Melanie M
authors.initials: MM
authors.lastname: Wall
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Keyes
authors.forename: Renee D
authors.initials: RD
authors.lastname: Goodwin
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Skodol
authors.forename: Robert F
authors.initials: RF
authors.lastname: Krueger
authors.forename: Bridget F
authors.initials: BF
authors.lastname: Grant
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Hasin
mesh_terms: D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000706:statistics & numerical data*; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014029:Tobacco Use Disorder / Q000453:epidemiology*; D055815:Young Adult
keywords: Abuse; alcohol; child; chronic; course; dependence; maltreatment; neglect; nicotine; persistence