Does childhood sexual abuse have an effect on young adults' nicotine disorder (dependence or withdrawal)? Evidence from a birth cohort study
Does childhood sexual abuse have an effect on young adults' nicotine disorder (dependence or withdrawal)? Evidence from a birth cohort study
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DOI：
10.1111/j.1360-0443.2006.01732.x
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发表时间：
2007-04-01
期刊：
影响因子：
6
通讯作者：
Bor, William
中科院分区：
文献类型：
--
作者：
Al Mamun, Abdullah;Alati, Rosa;Bor, William
目的通过一项前瞻性队列研究，探讨儿童性虐待（CSA）与青少年尼古丁障碍之间是否存在独立关联的证据，并探讨这种关联的机制。设计出生队列研究，随访21年。澳大利亚布里斯班两大产科医院之一。昆士兰大学妊娠研究涉及了一个前瞻性的出生队列，该队列以人口为基础，涉及7223名单身妇女，这些妇女的母亲在1981年至1984年第一次产前检查时登记。目前的队列包括一个由2571名青年组成的亚组，他们在21年的随访中完成了终身版的综合国际诊断访谈-计算机版（CIDI-Auto）。根据诊断与统计手册第IV版（DSM-IV）诊断标准测量尼古丁障碍，并在21岁时获得CSA测量值，包括回顾性强奸自我报告。结果2571名青少年中，有16.6%的人符合药物依赖（12.8%）或戒断（8.5%）的标准。15.5%的受访者报告了非插入性性虐待，8.0%的受访者报告了插入性性虐待。对于任何类型的性虐待，包括非插入式、插入式和16岁前的自述强奸，年轻人的尼古丁紊乱率明显高于没有经历过CSA的年轻人。这种关系是独立的，在调整了一系列潜在的混杂因素和中介因素后，这种关系显得直接。结论CSA与青少年尼古丁障碍有关。这些结果扩大了这一领域研究结果的公共卫生意义，并强调了不仅要加强公共卫生努力来解决经历过CSA的人的物质使用问题，而且要进行早期干预，以便在早期阶段针对新出现的危险行为。
Aims To examine whether there is evidence of an independent association between childhood sexual abuse (CSA) and nicotine disorder in youth and to explore the mechanisms underlying this association in a prospective cohort study. Design Birth cohort study followed-up to 21 years. Setting One of two major obstetric hospitals in Brisbane, Australia. Participants The Mater-University of Queensland Study of Pregnancy involves a prospective birth cohort from a population-based sample involving 7223 singletons whose mothers were enrolled between 1981 and 1984 at the first antenatal visit. The present cohort consisted of a subgroup of 2571 youth who completed the life-time version of the Composite International Diagnostic Interview-computerized version (CIDI-Auto) at the 21-year follow-up. Measurements Nicotine disorder was measured based on Diagnostic and Statistical Manual version IV (DSM-IV) diagnostic criteria and measures of CSA, including retrospective self-reports of rape, were obtained at 21 years. Results Of 2571 young adults, 16.6% met the criteria for either dependence (12.8%) or withdrawal (8.5%). Non-penetrative sexual abuse was reported by 15.5% of respondents and 8.0% reported penetrative sexual abuse. For any types of sexual abuse including non-penetrative, penetrative and self-reported rape before age 16 years, young adults had significantly higher rates of nicotine disorder than young adults who did not experience CSA. This relationship was independent and appeared direct after adjustment for a range of potential confounding and mediating factors. Conclusions This study shows that CSA is associated with young adult nicotine disorder. The results extend the public health significance of findings in this area and highlight the importance of not only intensifying public health efforts to address substance use problems among those who have experienced CSA, but of early intervention, so that emerging risky behaviours may be targeted in the earliest stages.