title: Gender differences in the effects of childhood adversity on alcohol, drug, and polysubstance-related disorders.
abstract: To examine gender differences in the associations between childhood adversity and different types of substance use disorders and whether gender moderates these relationships.
  
  
  
  We analyzed data from 19,209 women and 13,898 men as provided by Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to examine whether gender moderates the associations between childhood adversity and DSM-IV defined lifetime occurrence of alcohol, drug, and polysubstance-related disorders. We used multinomial logistic regression, weighted to be representative of the US adult civilian, noninstitutionalized population, and we calculated predicted probabilities by gender, controlling for covariates. To test which specific moderation contrasts were statistically significant, we conducted pair-wise comparisons corrected for multiple comparisons using Bonferroni's method.
  
  
  
  For each type of substance use disorder, risk was increased by more exposure to childhood adversity, and women had a lower risk than men. However, moderation effects revealed that with more experiences of childhood adversity, the gender gap in predicted probability for a disorder narrowed in relation to alcohol, it converged in relation to drugs such that risk among women surpassed that among men, and it widened in relation to polysubstances.
  
  
  
  Knowledge regarding substance-specific gender differences associated with childhood adversity exposure can inform evidence-based treatments. It may also be useful for shaping other types of gender-sensitive public health initiatives to ameliorate or prevent different types of substance use disorders.
authors.affiliation: Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA), 11075 Santa Monica Blvd., 200, Los Angeles, CA, 90025, USA. laevans@ucla.edu.|Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E. Young Drive South, 36-071 CHS, 951772, Los Angeles, CA, 90095-1772, USA. laevans@ucla.edu.|Department of Veterans Affairs (VA) Health Service Research and Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Bldg 206, Rm 250, Los Angeles, CA, 90073, USA. laevans@ucla.edu.|Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts, 325 Arnold House, 715 North Pleasant St., Amherst, MA, 01003-9304, USA. laevans@ucla.edu.
authors.forename: Elizabeth A
authors.identifier: http://orcid.org/0000-0002-3478-9957
authors.initials: EA
authors.lastname: Evans
authors.affiliation: Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA), 11075 Santa Monica Blvd., 200, Los Angeles, CA, 90025, USA.
authors.forename: Christine E
authors.initials: CE
authors.lastname: Grella
authors.affiliation: Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E. Young Drive South, 36-071 CHS, 951772, Los Angeles, CA, 90095-1772, USA.
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Upchurch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019973:Alcohol-Related Disorders / Q000453:epidemiology*; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Alcohol, drug, and polysubstance-related disorders; Childhood adversity; Gender differences; National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)