title: Alcohol misuse and associations with childhood maltreatment and out-of-home placement among urban two-spirit American Indian and Alaska Native people.
abstract: This study examined associations between alcohol misuse and childhood maltreatment and out-of-home placement among urban lesbian, gay, and bisexual (referred to as two-spirit) American Indian and Alaska Native adults. In a multi-site study, data were obtained from 294 individuals who consumed alcohol during the past year. The results indicated that 72.3% of men and 62.4% of women engaged in hazardous and harmful alcohol use and 50.8% of men and 48.7% of women met criteria for past-year alcohol dependence. The most common types of childhood maltreatment were physical abuse among male drinkers (62.7%) and emotional abuse (71.8%) among female drinkers. Men and women reported high percentages of out-of-home placement (39% and 47%, respectively). Logistic multiple regressions found that for male drinkers boarding school attendance and foster care placement were significant predictors of past-year alcohol dependence. For female drinkers, being adopted was significantly associated with a decreased risk of past-year drinking binge or spree. Dose-response relationships, using number of childhood exposures as a predictor, were not significant. The results highlight the need for alcohol and violence prevention and intervention strategies among urban two-spirit individuals.
authors.affiliation: Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 North Martin Avenue, P.O. Box 245209, Tucson, AZ 85724, USA. nyuan@email.arizona.edu.
authors.forename: Nicole P
authors.initials: NP
authors.lastname: Yuan
authors.affiliation: School of Public Health, University of Washington, 1959 NE Pacific Street, Box 357660, Seattle, WA 98195, USA. bonduran@u.washington.edu.
authors.forename: Bonnie M
authors.initials: BM
authors.lastname: Duran
authors.affiliation: Indigenous Wellness Research Institute, School of Social Work, University of Washington, 4101 15th Avenue NE, Box 354900, Seattle, WA 98105, USA. kw5@u.washington.edu.
authors.forename: Karina L
authors.initials: KL
authors.lastname: Walters
authors.affiliation: Indigenous Wellness Research Institute, School of Social Work, University of Washington, 4101 15th Avenue NE, Box 354900, Seattle, WA 98105, USA. pearsonc@u.washington.edu.
authors.forename: Cynthia R
authors.initials: CR
authors.lastname: Pearson
authors.affiliation: Indigenous Wellness Research Institute, School of Social Work, University of Washington, 4101 15th Avenue NE, Box 354900, Seattle, WA 98105, USA. tecamp@u.washington.edu.
authors.forename: Tessa A
authors.initials: TA
authors.lastname: Evans-Campbell
mesh_terms: D000293:Adolescent; D000300:Adoption / Q000208:ethnology / Q000523:psychology*; D000328:Adult; D000413:Alaska / Q000208:ethnology; D000437:Alcoholism / Q000453:epidemiology / Q000208:ethnology*; D001727:Bisexuality / Q000523:psychology; D002648:Child; D002649:Child Abuse / Q000208:ethnology*; D005260:Female; D005581:Foster Home Care / Q000523:psychology* / Q000706:statistics & numerical data; D018452:Homosexuality, Female / Q000523:psychology; D006801:Humans; D007198:Indians, North American / Q000208:ethnology*; D008297:Male; D014481:United States / Q000208:ethnology