Gender differences in the effects of childhood adversity on alcohol, drug, and polysubstance-related disorders
Gender differences in the effects of childhood adversity on alcohol, drug, and polysubstance-related disorders
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DOI：
10.1007/s00127-017-1355-3
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发表时间：
2017-07-01
影响因子：
4.4
通讯作者：
Upchurch, Dawn M.
中科院分区：
文献类型：
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作者：
Evans, Elizabeth A.;Grella, Christine E.;Upchurch, Dawn M.
研究童年逆境与不同类型物质使用障碍之间关联的性别差异，以及性别是否调节了这些关系。我们分析了全国酒精及相关疾病流行病学调查（NESARC）第二阶段（2004-2005）提供的19209名女性和13898名男性的数据，以检验性别是否能调节童年逆境与DSM-IV定义的酒精、药物和多种物质相关疾病的终生发生率之间的关联。我们使用多项逻辑回归，加权以代表美国成年平民，非机构人口，我们按性别计算预测概率，控制协变量。为了检验哪些特定的适度对比具有统计学意义，我们使用Bonferroni的方法进行了两两比较，对多重比较进行了校正。对于每种类型的物质使用障碍，童年逆境的暴露越多，风险就会增加，女性的风险比男性低。然而，适度效应表明，童年逆境经历越多，与酒精有关的失调预测概率的性别差距就会缩小，与毒品有关的性别差距就会趋同，因此女性的风险超过男性，与多种物质有关的性别差距就会扩大。关于与童年逆境暴露相关的物质特定性别差异的知识可以为循证治疗提供信息。它也可能有助于形成其他类型的对性别问题敏感的公共卫生倡议，以改善或预防不同类型的药物使用障碍。
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.