title: The impact of childhood emotional abuse on violence among people who inject drugs.
abstract: OBJECTIVE
  Childhood emotional abuse is a known risk factor for various poor social and health outcomes. While people who inject drugs (IDU) report high levels of violence, in addition to high rates of childhood maltreatment, the relationship between childhood emotional abuse and later life violence within this population has not been examined.
  
  
  METHODS
  Cross-sectional data were derived from an open prospective cohort of IDU in Vancouver, Canada. Childhood emotional abuse was measured using the Childhood Trauma Questionnaire. We used multivariate logistic regression to examine potential associations between childhood emotional abuse and being a recent victim or perpetrator of violence.
  
  
  RESULTS
  Between December 2005 and May 2013, 1437 IDU were eligible for inclusion in this analysis, including 465 (32.4%) women. In total, 689 (48.0%) reported moderate to severe history of childhood emotional abuse, whereas 333 (23.2%) reported being a recent victim of violence and 173 (12.0%) reported being a recent perpetrator of violence. In multivariate analysis, being a victim of violence (adjusted odds ratio = 1.49, 95% confidence interval 1.15-1.94) and being a perpetrator of violence (adjusted odds ratio = 1.58, 95% confidence interval 1.12-2.24) remained independently associated with childhood emotional abuse.
  
  
  CONCLUSIONS
  We found high rates of childhood emotional abuse and subsequent adult violence among this sample of IDU. Emotional abuse was associated with both victimisation and perpetration of violence. These findings highlight the need for policies and programmes that address both child abuse and historical emotional abuse among adult IDU.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lake
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
authors.forename: Huiru
authors.initials: H
authors.lastname: Dong
authors.forename: Sabina
authors.initials: S
authors.lastname: Dobrer
authors.forename: Julio
authors.initials: J
authors.lastname: Montaner
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
mesh_terms: D000328:Adult; D001955:British Columbia / Q000453:epidemiology; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014754:Violence / Q000706:statistics & numerical data*
keywords: emotional abuse; injection drug use; trauma; violence