Pathways to substance-related disorder: A structural model approach exploring the influence of temperament, character, and childhood adversity in a national cohort of prisoners
Pathways to substance-related disorder: A structural model approach exploring the influence of temperament, character, and childhood adversity in a national cohort of prisoners
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DOI：
10.1093/alcalc/agm183
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发表时间：
2008-05-01
影响因子：
2.8
通讯作者：
Gasquet, Isabelle
中科院分区：
文献类型：
--
作者：
Lukasiewicz, Michael;Neveu, Xavier;Gasquet, Isabelle
目标：使用Cloninger的人格模型，我们的目的是指定更多的生物学决定的变量，气质和性格和更多的环境驱动的影响，童年逆境中的成瘾发展的相对影响，并比较酗酒者中发现的模式与吸毒成瘾者中发现的。方法：我们研究了一组囚犯，在药物滥用的高风险和过去的童年逆境的历史。使用分层随机策略，我们选择了（一）23所不同类型的监狱在法国，（二）998名囚犯。每名囚犯都由两名精神科医生进行评估，一名初级精神科医生使用结构化访谈（MINI 5 plus），一名高级精神科医生使用开放式临床访谈完成程序。采访结束时，临床医生会面并就诊断清单达成一致。Cloninger的气质和性格清单被用来衡量个性。结构方程模型，已主张解开复杂的危险因素的各自的影响，被使用。结果：“新奇寻求”气质是一个关键的脆弱性因素，无论是酗酒者和吸毒者，在相同的比例。性格和童年的逆境只在药物滥用的发展中发挥了重要作用。结论：在监狱人口中，一个常见的生物负载因素，新奇的寻求被发现在酒精和药物相关的障碍的核心，而环境负载因素在药物问题中发挥更大的作用。
Aims: Using Cloninger's model of personality, we aimed to specify the relative influence of the more biologically determined variables, temperament and character and more environmentally driven influence, childhood adversity in the development of addiction; and to compare patterns found among alcoholics with those found among drug addicts. Methods: We studied a group of prisoners, at a high risk of substance abuse and past history of childhood adversity. Using a stratified random strategy we selected (i) 23 prisons among the different types of prison in France, (ii) 998 prisoners. Each prisoner was assessed by two psychiatrists-one junior, using a structured interview (MINI 5 plus), and one senior, completing the procedure with an open clinical interview. At the end of the interview the clinicians met and agreed on a list of diagnoses. Cloninger's Temperament and Character Inventory was used to measure personality. Structural equations models, which have been advocated to disentangle the respective influence of complex risk factors, were used. Results: the "novelty seeking" temperament was a crucial vulnerability factor, for both alcoholics and drug addicts, in the same proportion. Character and childhood adversity played a significant part only in the development of drug abuse. Conclusions: In a prison population, a common biological loaded factor, novelty seeking is found both at the core of alcohol- and drug-related disorder whereas environmentally loaded factors play a greater role in drug problems.