Adverse childhood experiences, personality psychopathology, and alcohol disorders

不良童年经历、人格精神病理学和酒精障碍

• 批准号: 7634668
• 负责人: DEBORAH S HASIN
• 金额: $ 71.22万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-15 至 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7634668
• 关键词: Accounting; Address; Adolescent; Affect; Alcohol abuse; Alcohol dependence; Alcoholism; Alcohols; Behavior; Biological; Biometry; Boston; Childhood; Cognition; Comorbidity; Complex; DSM-IV; DSM-V; Data; Data Analyses; Dependence; Development; Disease; Disease remission; Drug Addiction; Education; Emotional; Emotions; Epidemiologic Studies; Epidemiology; Ethnic Origin; Etiology; Extramural Activities; Family; Family history of; Gender; Genetic Variation; Grant; Head; Heavy Drinking; Individual; Investigation; Joints; Knowledge; Laboratories; Missouri; Modeling; Nicotine; Participant; Patients; Personality; Personality Disorders; Pharmaceutical Preparations; Prevention; Preventive Intervention; Principal Investigator; Psychopathology; Race; Relative (related person); Research; Research Personnel; Resources; Risk; Risk Factors; Scientific Advances and Accomplishments; Scientist; Sexual abuse; Societies; Specificity; Structure; Surveys; Symptoms; Universities; Washington; Work; alcohol use disorder; anti social; disability; disorder control; disorder risk; drinking; emerging adult; experience; high risk; maltreatment; neglect; outcome forecast; physical abuse; public health relevance; therapy development

DESCRIPTION (provided by applicant): Alcohol use disorders (AUDs) are prevalent in U.S. society and associated with much disability, comorbidity and harm to individuals, their families and society. Thus, understanding the risk factors for the occurrence and persistence of AUDs is vital for prevention and intervention. Because AUDs are complex disorders, key risk factors must be investigated in an integrated manner. One such risk factor is adverse childhood/adolescent experiences (ACEs): maltreatment in the form of emotional or physical abuse or neglect, or sexual abuse. Studies suggest that these experiences affect normal development and are associated with later drinking and AUDs. However, many questions remain about these relationships. Another key risk factor is personality psychopathology, persistent maladaptive behaviors, emotions and cognitions from early adulthood, included in DSM-IV as ten Personality Disorders (PDs). Unfortunately, these are also prevalent in our society. Prior smaller studies suggest that ACEs are related to PDs or their symptoms, while other such studies suggest that PDs or PD symptoms are related to AUDs. However, the joint impact of these two key risk factors on AUDs has not been studied. Further, aside from antisocial PD, large epidemiologic studies have never previously addressed how the full range of DSM-IV PDs relates to AUDs. Finally, risk factors for occurrence can differ from factors affecting prognosis. Very little is known about how ACEs and the full range of PDs affect the persistence of AUDs. To examine these issues, this study will combine an unprecedented set of resources. Responding to PAR-08-005, extramural and intramural investigators will collaborate in analysis of data from 34,653 participants in Waves 1 (2001- 2002) and 2 (3 years later) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). These participants were assessed for major DSM-IV Axis I disorders, all DSM-IV Axis II PDs, different types of ACEs, and many additional important covariates. Groundwork will consist of thoroughly investigating the relationship of ACEs to PDs and the structure of PD symptomatology, about which there are many questions. The findings from this groundwork will then inform investigation of how ACEs and PDs relate to the occurrence and persistence of AUDs, controlling for Axis I disorders, family history of alcoholism, and other important covariates. PUBLIC HEALTH RELEVANCE: The new knowledge from this study will be vital for (1) better identification of individuals at high risk for AUDs; (2) education of clinicians working with patients with alcohol use disorders, potentially stimulating new treatment development; (3) development of DSM-V; (4) developing more refined studies of etiology incorporating biological (e.g., genetic) variation in the search for causes of AUDs and their persistence.

描述（由申请人提供）：酒精使用障碍（AUD）在美国社会普遍存在，与许多残疾、合并症以及对个人、家庭和社会的伤害有关。因此，了解 AUD 发生和持续的危险因素对于预防和干预至关重要。由于 AUD 是一种复杂的疾病，因此必须以综合的方式调查关键的危险因素。其中一个风险因素是不良的童年/青少年经历（ACE）：以情感或身体虐待或忽视或性虐待形式的虐待。研究表明，这些经历会影响正常发育，并与后来的饮酒和澳元相关。然而，这些关系仍然存在许多问题。另一个关键的危险因素是人格精神病理学、成年早期的持续不良适应行为、情绪和认知，这些都被 DSM-IV 列为十种人格障碍 (PD)。不幸的是，这些在我们的社会中也很普遍。先前的小型研究表明 ACE 与 PD 或其症状相关，而其他此类研究表明 PD 或 PD 症状与 AUD 相关。然而，这两个关键风险因素对澳元的联合影响尚未得到研究。此外，除了反社会性帕金森病之外，大型流行病学研究以前从未探讨过 DSM-IV 的所有帕金森病与 AUD 之间的关系。最后，发生的危险因素可能与影响预后的因素不同。关于 ACE 和各种 PD 如何影响 AUD 的持久性，人们知之甚少。为了研究这些问题，这项研究将结合前所未有的资源。为了响应 PAR-08-005，校外和校内调查人员将合作分析国家酒精及相关疾病流行病学调查 (NESARC) 第 1 波（2001-2002 年）和第 2 波（3 年后）的 34,653 名参与者的数据。这些参与者接受了主要 DSM-IV Axis I 疾病、所有 DSM-IV Axis II PD、不同类型的 ACE 以及许多其他重要协变量的评估。基础工作包括彻底研究 ACE 与 PD 的关系以及 PD 症状学的结构，对此存在许多问题。这项基础工作的结果将为调查 ACE 和 PD 与 AUD 的发生和持续性之间的关系提供信息，并控制 Axis I 疾病、酗酒家族史和其他重要协变量。 公共卫生相关性：本研究的新知识对于以下方面至关重要：(1) 更好地识别 AUD 高风险个体； (2) 对与酒精使用障碍患者一起工作的临床医生进行教育，有可能刺激新的治疗方法的开发； (3)DSM-V的开发； (4) 开展更精细的病因学研究，将生物（例如遗传）变异纳入寻找 AUD 的原因及其持续性。