Child sexual and physical abuse and alcoholism: a review

OBJECTIVE: To examine possible relations between child sexual or physical abuse and adult alcoholism. METHOD: Studies reviewed included prospective studies, retrospective studies on the prevalence of child sexual or physical abuse in alcoholics and nonalcoholics, and retrospective studies in mental health clients and in population samples comparing the prevalence of alcohol use disorders in abused and nonabused subjects. RESULTS: Prospective studies do not indicate a significant association between child sexual or physical abuse and alcoholism. In contrast, studies among alcoholic women do suggest a relationship. Also, a significantly higher prevalence of alcohol problems in abused women than in nonabused women is found in population samples. The results of studies among mental health clients are inconclusive. In addition, several methodological limitations should be taken into consideration when evaluating results of the available studies. CONCLUSIONS: Current evidence is insufficient to draw conclusions about relationships between child sexual or physical abuse and alcoholism among men. Among females, however, there is a higher likelihood of alcohol problems if they were sexually or physically abused as children.     

Sex role identity in female alcoholism.

Compared 28 alcoholic women with 28 matched controls on a variety of masculinity-femininity measures (e.g., Franck Drawing Completion Test). The alcoholics were expected to earn more masculine scores than the controls on measures which tap relatively unconscious levels of sex role identity. On 2 measures of conscious femininity, the alcoholics were typically feminine. On the 3rd, a measure of attitudes toward motherhood, the alcoholics were more feminine than the controls. On a questionnaire measure of sex role style, the alcoholics gave more assertive, masculine responses than the controls, and the scores for alcoholics on a projective measure of unconscious masculinity-femininity were more masculine than those for the controls. The medical histories of the alcoholics contained a higher incidence of obstetrical and gynecological disorders than did the histories of the controls. The relationship between sex role identity disturbance and the psychological function of alcoholic women's excessive drinking is discussed. (22 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is alcoholism different from other substance abuse?

Replies to an article by G. E. Vaillant and E. S. Milofsky (see record 1982-30620-001), which argued that the psychological characteristics of alcoholics are the result and not the cause of alcoholism and that genetics has a large role in the etiology of the disorder. It is contended that an overall measure of the degree of harmful reliance an individual has on one substance is required to make an accurate statement about the relationship between personality and environmental factors and substance abuse, an approach not taken by Vaillant and Milofsky. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Estimating a population in need of alcoholism services: a new approach

A new approach for estimating a population at risk of alcoholism and problem drinking is discussed. Its advantages include specification of planning-relevant social-demographic characteristics of a population at risk and the identification of a population base in terms of which alcoholism programs, services, and resources can be comparatively evaluated.     

Sexual assault and mental disorders in a community population.

In a cross-sectional probability survey of 3,132 household adults representing two Los Angeles communities, lifetime diagnoses of nine major mental disorders were compared between those who reported that they had been sexually assaulted at some time in their lives and those who reported no sexual assault. Sexual assault predicted later onset of major depressive episodes, substance use disorders, and anxiety disorders. Those who were assaulted in childhood were more likely than those first assaulted in adulthood to report the subsequent development of a mental disorder. Demographic characteristics of gender, age, Hispanic ethnic background, and education, however, were generally unrelated to the probability of developing any specific disorder after being assaulted. Finally, major depression, drug abuse or dependence, antisocial personality, and phobia were all associated with a higher probability of subsequent sexual assault. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual abuse within the marital relationship

OBJECTIVE: The pathophysiology of pulmonary fibrosis in patients with systemic sclerosis (SSc) is poorly understood, but a number of recent studies have demonstrated an inflammatory process involving the lower respiratory tract. The objective of the present study was to determine the concentrations of several cytokines in the bronchoalveolar lavage (BAL) fluid of patients with SSc and to assess whether the enhanced expression of certain cytokines is associated with the presence of alveolitis. METHODS: BAL was performed on patients with SSc (with or without alveolitis) and on normal control subjects. Lyophilized BAL fluid samples were assayed by enzyme-linked immunosorbent assay for tumor necrosis factor alpha (TNF alpha), interleukin-1alpha (IL-1alpha), IL-4, IL-6, IL-8, macrophage inflammatory protein 1alpha (MIP-1alpha), and RANTES. RESULTS: There were significant differences between groups in the BAL fluid concentrations of TNF alpha (P = 0.0005, with levels in SSc patients with alveolitis higher than those in normal controls), IL-8 (P = 0.006, with levels in both SSc groups higher than those in normal controls), MIP-1alpha (P = 0.009, with levels in SSc patients with alveolitis higher than those in SSc patients without alveolitis and than those in normal controls), and RANTES (P = 0.03, with levels in SSc patients without alveolitis higher than those in normal controls). With the exception of RANTES, the highest levels were detected in SSc patients with alveolitis. CONCLUSION: Each of these cytokines, either alone or in combination, may play an important role in the pathogenesis of pulmonary fibrosis in SSc.     

Sexual abuse trauma among Chinese survivors

OBJECTIVE: As an initial effort to examine Chinese sexual abuse trauma in relation to the cultural construction of sexual victimization of women, this study applies Finkelhor and Browne's (1985) traumagenic dynamics model to examine post-abuse trauma among Chinese child and adolescent survivors in Taiwan. In analyzing sexual abuse trauma in the context of Chinese patriarchal familialism and cultural fetish for female chastity, this study attempts to explore cultural constructional process of sexual abuse in Chinese society. METHOD: This study conducted in-depth interviews with 19 survivors of, and three social workers on, sexual abuse in Taiwan. These interviews were guided by a semi-structured questionnaire on sexual abuse incidents and post-abuse responses/concerns, and had generated a total of 84 pages of written reports, which serve as the text-data for the analysis. RESULTS: This study identifies sexual stigmatization and senses of disempowerment and betrayal as the most pervasive trauma complex among Chinese sexual abuse survivors in Taiwan. This study found that, in addition to lowering self-esteem, sexual stigmatization results in polarized sexuality among adolescent survivors, as manifested in aversion to and preoccupation with sexuality. The abuse-induced disempowerment is manifested in the survivors' fear for personal safety and heightened sense of vulnerability to re-victimization. The sense of betrayal results in interpersonal difficulties as manifested in self-imposed isolation from others and/or suspicious attitudes toward others, which further impair the survivor's efficacy in meeting her abuse-induced clinging need. CONCLUSIONS: Overall, this study observes similar traumatic symptoms between Chinese survivors and their American counterparts as documented in the literature. Nevertheless, this study observes the sexual stigmatization represents the most prevailing post-abuse trauma among Chinese sexual abuse survivors, and reflects the patriarchal fetish for female chastity in the Chinese cultural construction of sexual victimization.     

Sexual abuse of boys. Examples of a group-oriented treatment

Although the sexual abuse of boys is much less written and talked about than the sexual abuse of girls, it is thought that one of three victims of abuse is a boy. This article sums up the symptoms and reactions seen in male victims. Whereas women usually react with depression and guilt, men react more with anger. Psychosomatic symptoms are often seen, as well as sexual problems such as homophobia or exaggerated masculinisation. As many as 30-50% of male rapist and child molesters have been molested as children. This makes it important to establish a therapeutic dialogue with these men about what they have been through, so as to avoid the development of such behaviour if possible. Experience from the treatment of male adults who were sexually abused in childhood is described, and placed in relation to the existing literature on the subject.     

Graduate professional psychology training in alcoholism and substance abuse: 1984.

Replicated J. O. Selin and S. Svanum's (see record 1982-12935-001) survey with 98 directors of psychology training to assess the current situation regarding training in alcoholism and substance abuse offered by American Psychological Association-approved clinical and counseling psychology programs. Findings reveal no discernable differences in quantity or quality of offerings between the clinical and counseling programs surveyed. Consistent with Selin and Svanum's results, it was found that students received only minimal training in the area of alcoholism and substance abuse. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality patterns and alcohol abuse in a state hospital population.

Administered an alcohol abuse questionnaire, designed to measure severity of abuse, to 136 male psychiatric patients. Responses were studied in relation to mmpi profile patterns derived by empirical profile cluster analysis methods and to mmpi patterns derived by S. Goldstein and J. Linden (see pa, vol. 44:3819). It was found that ss with different mmpi profile patterns differed in levels of self-reported alcohol abuse. Most severe self-report alcohol abuse was associated with anxiety and depression, and lower abuse scores were associated with psychopathy and poor impulse control. Alternative interpretations of the findings are considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Drug abuse in an obstetric population of a midsized city

Drug abuse during pregnancy has attracted national attention, but most studies are from large cities. This study is concerned with the indigent pregnant patients in a midsized city in the southeastern United States. In a 23-month study, 2,442 patients were delivered of neonates. Using specific criteria, 511 patients were tested for drug abuse. A positive test was identified in 156 (31%), cocaine being the most common agent. During 2 months of random testing, 15 patients (16%) had positive drug screens. Comparison of drug-positive pregnant patients with general obstetric patients identified many adverse obstetric and perinatal outcome data. Drug-positive patients weighed less, were older, were prone to not seek prenatal care, and were more likely to deliver prematurely and have a growth-retarded infant. Drug abuse in this population had significant impact on the health of the patient and her unborn infant.     

Job satisfaction and turnover in a female clerical population.

Job-satisfaction questionnaires were administered to a sample of 350 female clerical workers. After a lapse of 5 mo. 31 girls had quit, 26 of whom had completed the questionnaire. These 26 girls reported significantly less satisfaction with their jobs than the 319 girls who remained on the job. An explanation of this finding in terms of the difficulty of finding a new job, economic pressures to remain on present job, and condition of the labor market is offered. The relationship between satisfaction and turnover is not regarded as general. The data from the subsequent 7-mo study indicate that job-satisfaction scores continue to exhibit a significant relationship to turnover over a 12-mo period. Even after a 12-mo period the terminators had reported lower job satisfaction at the time of the assessment than those who were still with the company. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol dependence and abuse in three groups at varying familial alcoholism risk.

Three groups of young men varying in familial alcoholism risk were compared for lifetime and current Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) diagnoses. A withdrawal gate diagnostic model (WGM) requiring withdrawal for a dependence diagnosis was also evaluated. Extremely high lifetime DSM-IV diagnostic rates were found for all groups (≥78%), with the highest rate in the highest risk group. Similar group differences obtained for individual criteria or symptoms. Although lifetime diagnostic rates were similar for the WGM and DSM-IV, virtually all cases of dependence were preceded by abuse for the WGM, unlike DSM-IV. The findings underline the importance of distinguishing degrees of familial alcoholism risk. The WGM model temporal onset findings versus DSM-IV and the high lifetime diagnostic rates obtained suggest some limitations of the DSM-IV diagnoses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual abuse and the subsequent development of alcohol problems

The literature on sexual abuse and alcohol problems has been reviewed. Various methodological issues are relevant in determining whether there is merely an association or also a causal relationship. These include the definition of sexual abuse, the degree and timing of abuse, the methods of data collection, sample selection, the presence or absence of control groups, possible recall bias, difficulties with prospective studies for this subject, and the definition of alcohol misuse or dependence. Results with community and victim samples are conflicting, but studies on samples of problem drinkers suggest an association between severe alcohol problems and previous sexual abuse, at least in women. The association may be especially strong for earlier and more severe forms of sexual abuse. Possible mechanisms for an association were examined and are: (1) sexual abuse as a cause of alcohol misuse; (2) alcohol misuse predisposing people to sexual assault; (3) sexual assault and alcohol misuse both resulting from another factor; (4) sexual abuse predisposing to other conditions associated with alcohol misuse; and (5) an artefactual association. Regardless of the role of sexual abuse in causing alcohol problems, the available evidence suggests that victims of sexual abuse may present to services with more problematical patterns of drinking and more concurrent psychiatric disorder.     

Alcohol abuse, alcoholism, and damage to the immune system--a review

Chronic alcohol abuse exacts a major social and medical toll in the United States and other Western countries. One of the least appreciated medical complications of alcohol abuse is altered immune regulation leading to immunodeficiency and autoimmunity. The consequences of the immunodeficiency include increased susceptibility to bacterial pneumonia, tuberculosis, and other infectious diseases. In addition, the chronic alcoholic often has circulating autoantibodies, and recent investigations indicate that the most destructive complications of alcoholism, such as liver disease and liver failure, may have a component of autoimmunity. Current research on altered cytokine balance produced by alcohol is leading to new insights on the regulation of the immune system in the chronic alcoholic. There is also recent development of exciting new techniques designed to improve or restore immune function by manipulation of cytokine balance. Although much remains to be learned, both in the abnormalities produced by alcohol and in the techniques to reverse those abnormalities, current progress reflects a rapidly improving understanding of the basic immune disorders of the alcoholic.     

American productivity: The devastating effect of alcoholism and drug abuse.

Asserts that a number of factors have contributed to a general productivity slowdown in the US since World War II. These include (1) current labor laws that have created an adversarial atmosphere between management and labor, (2) increases in the price of energy since the oil embargo of 1973, and (3) a proliferation of government regulations throughout the 1970's, especially in the areas of consumer product safety, pollution control, and occupational safety, that have resulted in the diversion of capital investment into equipment that does not necessarily increase output. (PsycINFO Database Record (c) 2010 APA, all rights reserved)