Associations Among Childhood Household Dysfunction, Sexual Orientation, and DSM-5 Alcohol, Tobacco and Other Substance Use Disorders in Adulthood: Evidence From a National U.S. Survey.
Associations Among Childhood Household Dysfunction, Sexual Orientation, and DSM-5 Alcohol, Tobacco and Other Substance Use Disorders in Adulthood: Evidence From a National U.S. Survey.
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DOI：
10.1097/adm.0000000000000641
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发表时间：
2020
影响因子：
5.5
通讯作者：
Boyd CJ
中科院分区：
文献类型：
--
作者：
McCabe SE;Hughes TL;West BT;Evans-Polce R;Veliz P;Dickinson K;Hoak S;Boyd CJ
这项研究检查了儿童家庭功能障碍与成年后DSM-5酒精，烟草和其他物质使用障碍之间的关系，这些障碍跨越性取向亚组（例如，女同性恋/男同性恋、双性恋和异性恋）。患病率估计是基于全国酒精和相关疾病流行病学调查（NESARC-III）数据，这些数据是从36，309名美国成年人的全国代表性样本中进行的结构化诊断面对面访谈中收集的。多变量回归分析被用来研究儿童期家庭功能障碍和成年期过去一年的物质使用障碍之间的关联。性少数群体，特别是性少数群体妇女，报告说儿童家庭功能障碍的发生率较高（例如，父母/家庭物质相关问题史）和成人DSM-5酒精、烟草和物质使用障碍。多变量分析的结果表明，父母/家庭物质相关问题的童年历史与性少数人群比异性恋者更大的去年物质使用障碍的几率相关，并且这种历史可能会缓和性取向亚组之间的差异。相对于纯异性恋妇女，性少数妇女患药物使用障碍的风险（即，没有同性吸引力或行为的异性恋妇女）仍然很高，即使考虑到家庭功能障碍。相比之下，性少数男性和纯异性恋男性之间没有这种差异。性少数群体更有可能有儿童家庭功能障碍，这反过来又与成年后患DSM-5酒精，烟草和物质使用障碍的风险较高有关，特别是在性少数群体妇女中。照顾在功能失调家庭中长大的个人的医疗保健提供者应仔细评估物质使用障碍的风险，并根据需要进行干预。
This study examined the associations between childhood household dysfunction and adulthood past-year DSM-5 alcohol, tobacco, and other substance use disorders across sexual orientation subgroups (e.g., lesbian/gay, bisexual, and heterosexual). Prevalence estimates were based on National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III) data collected from structured diagnostic face-to-face interviews in a nationally representative sample of 36,309 U.S. adults. Multivariable regression was used to examine associations between childhood household dysfunction and past-year substance use disorders in adulthood. Sexual minorities, particularly sexual minority women, reported higher rates of childhood household dysfunction (e.g., parental/household history of substance-related problems) and adulthood DSM-5 alcohol, tobacco, and substance use disorders. Results of multivariable analyses indicated that childhood histories of parental/household substance-related problems were associated with greater odds of past-year substance use disorders among sexual minorities than heterosexuals, and that such histories may moderate differences among sexual orientation subgroups. The risk of substance use disorders among sexual minority women relative to exclusively heterosexual women (i.e., heterosexual-identified women without same-sex attraction or behavior) remained high, even when accounting for household dysfunction. In contrast, there were no such differences between sexual minority men and exclusively heterosexual men. Sexual minorities are more likely to have childhood household dysfunction which in turn is associated with a higher risk of developing DSM-5 alcohol, tobacco, and substance use disorders in adulthood, especially among sexual minority women. Healthcare providers who care for individuals raised in dysfunctional households should carefully assess risk for substance use disorders and intervene as needed.