Prospective investigation of psychological and affective pathways from childhood trauma to psychosis-like experiences in a UK birth cohort

Abstract

with childhood maltreatment and sex on the risk for alcohol dependence. Using national data with extensive measures, we address these issues: (1) Do childhood sexual abuse, physical abuse, emotional abuse, physical neglect, and emotional neglect predict adult lifetime DSM-IV alcohol dependence, controlling for co-occurring maltreatments and other childhood traumas? (2) Are these relationships synergistically modified by parental alcoholism history? Method: Face-to-face interviews of 27 712 adult participants in the National Epidemiological Survey on Alcohol and Related Conditions were conducted. Results: Childhood physical, emotional, and sexual abuse, and physical neglect were associated with alcohol dependence (P b .001), controlling for demographics, co-occurring maltreatments, and other childhood trauma. A significant (P b .05) synergistic relationship between parental history and physical abuse was found in the entire sample (AP, 0.21), and between parental history and sexual abuse (AP, 0.31) and emotional neglect (AP, 0.26) in women. In other words, the risk of alcohol dependence given both parental history and the maltreatment was higher than what would be expected given the additive effect of each alone. Conclusions: Childhood maltreatments independently increased the risk of alcohol dependence, underscoring the importance of early identification and prevention and suggesting the need to develop and incorporate alcohol preventative components, such as cognitive restructuring, in maltreatment interventions. Importantly, the effect of physical abuse on alcohol dependence may depend on genetic vulnerability as suggested by the effect of parental history of alcoholism, whereas the effects of sexual abuse and emotional neglect may depend on this vulnerability among women. Thus, maltreatment may have a long-term negative impact, which may depend on genetic vulnerability and sex. Findings can be used to guide genetic studies and intervention development.