Child Physical and Sexual Abuse: A Comprehensive Look at Alcohol Consumption Patterns, Consequences, and Dependence From the National Alcohol Survey
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Background: Previous research has documented a relationship between child sexual abuse and alcohol dependence. This paper extends that work by providing a comprehensive description of past year and lifetime alcohol consumption patterns, consequences, and dependence among women reporting either physical and sexual abuse in a national sample. Methods: This study used survey data from 3,680 women who participated in the 2005 U.S. National Alcohol Survey. Information on physical and sexual child abuse and its characteristics were assessed in relation to 8 past year and lifetime alcohol consumption measures. Results: Child physical or sexual abuse was significantly associated with past year and lifetime alcohol consumption measures. In multivariate analyses, controlling for age, marital status, employment status, education, ethnicity, and parental alcoholism or problem drinking, women reporting child sexual abuse vs. no abuse were more likely to report past year heavy episodic drinking (ORadj = 1.7; 95% CI 1.0 to 2.9), alcohol dependence (ORadj = 7.2; 95% CI 3.2 to 16.5), and alcohol consequences (ORadj = 3.6; 95% CI 1.8 to 7.3). Sexual abuse (vs. no abuse) was associated with a greater number of past year drinks (124 vs. 74 drinks, respectively, p = 0.002). Sexual child abuse was also associated with lifetime alcohol–related consequences (ORadj = 3.5; 95% CI 2.6 to 4.8) and dependence (ORadj = 3.7; 95% CI 2.6 to 5.3). Physical child abuse was associated with 4 of 8 alcohol measures in multivariate models. Both physical and sexual child abuse were associated with getting into fights, health, legal, work, and family alcohol–related consequences. Alcohol-related consequences and dependence were more common for women reporting sexual abuse compared to physical abuse, 2 or more physical abuse perpetrators, nonparental and nonfamily physical abuse perpetrators, and women reporting injury related to the abuse. Conclusion: Both child physical and sexual abuse were associated with many alcohol outcomes in adult women, even when controlling for parental alcohol problems. The study results point to the need to screen for and treat underlying issues related to child abuse, particularly in an alcohol treatment setting.Keywords:
Alcohol Dependence
Physical abuse
Alcohol abuse
Child sexual abuse
Marital status
Physical abuse
Childhood abuse
Psychological abuse
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Alcohol Dependence
Alcohol abuse
Alcohol use disorder
Credence
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Child abuse accounts for over 1% of visits to pediatric emergency departments (EDs), and injuries related to abuse have higher morbidity and mortality than accidental injuries. Recognizing child abuse and neglect in the ED is challenging but critical to prevent recurrent episodes of abuse and long-term physical and emotional sequelae. This review defines child abuse and neglect and explores historical and physical examination findings, assessment and diagnosis, treatment, disposition, and outcomes for victims of child abuse. Figures show x-rays demonstrating common fracture patterns associated with abusive injury and an algorithm for evaluation of nonaccidental trauma in the ED. Tables list key historical elements in the evaluation for abuse or neglect, bruising characteristics suggestive of abuse, fractures that are specific for abuse, and recommended laboratory evaluation for suspected abuse. This review contains 4 figures, 5 tables, and 36 references. Key words: child abuse, child neglect, nonaccidental trauma, sexual abuse
Physical abuse
Psychological abuse
Accidental
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The childhood experience of physical abuse is believed to be associated with parental child abuse. However, not all parents with a childhood history of abuse are abusive, indicating that factors such as social support may buffer the effects of childhood abuse. To examine the role of social support in the discrimination of physical child abusers and nonabusers, the Childhood Social Network Questionnaire (CSNQ) and the Child Abuse Potential (CAP) Inventory were given to matched groups of physical child abusers with a childhood history of physical abuse, nonabusers with a childhood history of physical abuse, and nonabusers without a childhood history of physical abuse. Overall, CSNQ factors and the CAP abuse scale each distinguished between physical child abusers and nonabusers. The CAP abuse scale, however, provided the highest classification rates, and the rates were not improved by the addition of social support factors. In contrast to expectations, none of the social support factors distinguished between physical child abusers with a childhood history of physical abuse and the group of nonabusers with a childhood history of physical abuse.
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Abstract Child physical abuse is an all‐too‐common form of child maltreatment, second only to neglect. There are varying definitions of child physical abuse, but the most important point is that a child has sustained tissue injury. This can range from bruises to fractures to life‐threatening or fatal head trauma. Determining the incidence and prevalence of physical abuse is difficult for many reasons; national datasets almost certainly do not provide an accurate picture. There are multiple risk factors for child physical abuse, but children can be abused without any risk factors present. Diagnosing child physical abuse requires a thorough medical assessment including a detailed history, complete physical examination, and often ancillary studies such as labs and radiology studies. Abusive head trauma is the leading cause of death in abused children, and often leads to long‐term neurodevelopmental delays. Physically abused children may have short‐ and long‐term medical and mental health problems as a result of their experiences.
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Physical health
Head trauma
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Physical abuse
Psychological abuse
Child neglect
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Physical abuse
Psychological abuse
Child neglect
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Child abuse accounts for over 1% of visits to pediatric emergency departments (EDs), and injuries related to abuse have higher morbidity and mortality than accidental injuries. Recognizing child abuse and neglect in the ED is challenging but critical to prevent recurrent episodes of abuse and long-term physical and emotional sequelae. This review defines child abuse and neglect and explores historical and physical examination findings, assessment and diagnosis, treatment, disposition, and outcomes for victims of child abuse. Figures show x-rays demonstrating common fracture patterns associated with abusive injury and an algorithm for evaluation of nonaccidental trauma in the ED. Tables list key historical elements in the evaluation for abuse or neglect, bruising characteristics suggestive of abuse, fractures that are specific for abuse, and recommended laboratory evaluation for suspected abuse. This review contains 4 figures, 4 tables, and 37 references. Key words: child abuse, child neglect, nonaccidental trauma, sexual abuse
Physical abuse
Psychological abuse
Accidental
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Child abuse accounts for over 1% of visits to pediatric emergency departments (EDs), and injuries related to abuse have higher morbidity and mortality than accidental injuries. Recognizing child abuse and neglect in the ED is challenging but critical to prevent recurrent episodes of abuse and long-term physical and emotional sequelae. This review defines child abuse and neglect and explores historical and physical examination findings, assessment and diagnosis, treatment, disposition, and outcomes for victims of child abuse. Figures show x-rays demonstrating common fracture patterns associated with abusive injury and an algorithm for evaluation of nonaccidental trauma in the ED. Tables list key historical elements in the evaluation for abuse or neglect, bruising characteristics suggestive of abuse, fractures that are specific for abuse, and recommended laboratory evaluation for suspected abuse. This review contains 4 figures, 4 tables, and 37 references. Key words: child abuse, child neglect, nonaccidental trauma, sexual abuse
Physical abuse
Psychological abuse
Accidental
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Background: Alcohol dependence and abuse are defined as separate disorders. However, relatively few data are available about whether the same characteristics predict both syndromes. Methods: Complete data were available from the 15 year follow-up of 411 men who originally had been evaluated from a university population at about age 20. Both baseline data gathered prospectively and the retrospective ratings in six domains of life functioning were analyzed for their relationship to the development of alcohol abuse or dependence during the follow-up. Results: Baseline characteristics of a family history of substance use disorders, the quantity and frequency of drinking, the history of alcohol-related problems, and the level of response to alcohol all predicted future alcohol abuse or dependence, but only an alcoholic second-degree relative or a first-degree drug-dependent family member differentially predicted dependence. Logistic regression analyses revealed that similar baseline characteristics combined to predict dependence and, separately, abuse. When the domains of functioning during the 15 years were included, positive alcohol expectancies, poor coping mechanisms, low level of social support, and drinking in the environment contributed to both dependence and abuse, although the relationship was stronger for dependence. Conclusions: The predictors and correlates of alcohol abuse and dependence in this group of men were similar. Further research in additional populations and on other drugs is needed to determine if the two syndromes overlap sufficiently to be combined.
Alcohol Dependence
Alcohol abuse
Substance dependence
Alcohol use disorder
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