Skip to main content
Top
Published in: BMC Women's Health 1/2019

Open Access 01-12-2019 | Research article

History of childhood abuse is associated with less positive treatment outcomes in socially stable women with alcohol use disorder

Authors: Fides Schückher, Tabita Sellin, Ingemar Engström, Kristina Berglund

Published in: BMC Women's Health | Issue 1/2019

Login to get access

Abstract

Background

To examine the relationship between treatment outcome, as measured according to change in alcohol consumption, and a history of childhood abuse (emotional, physical, sexual) in socially stable women undergoing treatment for alcohol use disorder (AUD).

Methods

Participants were assessed using the Addiction Severity Index and the Mini International Neuropsychiatric Interview at the beginning of treatment (n = 75), end of treatment (n = 59) and 12 month follow-up after treatment (n = 57). Self-report data on alcohol consumption were obtained at all three time-points using the Alcohol Habits Inventory-Revised 2. Self-report data on childhood maltreatment were obtained at the beginning of treatment using the Childhood Trauma Questionnaire-short form. Study outcomes were changes in alcohol consumption (grams of pure alcohol per week), risk-drinking and reported abstinence.

Results

Of the 75 women enrolled, 38 (50.7%) reported a history of childhood abuse and the rest did not. Both groups showed a significant improvement in all three outcomes at the end of treatment and at 12-month follow-up. At the end of treatment, a significant inter-group difference was found for reported abstinence (non-abused group, 39.3% vs abused, 12.9%; p < 0.05). At 12-month follow-up, significant inter-group differences were observed for all treatment outcomes, with superior outcomes being found for the non-abused group, including a higher proportion of women with reported abstinence (55.6% vs 13.3%; p < 0.01).

Conclusion

The present findings suggest that an evaluation of a possible history of childhood abuse is warranted in all women seeking treatment for AUD, irrespective of social stability. In terms of clinical practice, the results suggest that additional interventions may be warranted in this population.
Literature
1.
go back to reference World Health Organization. Global status report on alcohol and health 2018. Geneva: WHO; 2018. World Health Organization. Global status report on alcohol and health 2018. Geneva: WHO; 2018.
2.
go back to reference Leeb R, Paulozzi L, Melanson C, Simon T, Arias I. Child maltreatment surveillance: uniform definitions for public Healthand recommended data elements. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control: Atlanta; 2008. Leeb R, Paulozzi L, Melanson C, Simon T, Arias I. Child maltreatment surveillance: uniform definitions for public Healthand recommended data elements. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control: Atlanta; 2008.
3.
go back to reference Gerdner A, Allgulander C. Psychometric properties of the Swedish version of the childhood trauma questionnaire-short form (CTQ-SF). Nord J Psychiatry. 2009;63(2):160–70.CrossRef Gerdner A, Allgulander C. Psychometric properties of the Swedish version of the childhood trauma questionnaire-short form (CTQ-SF). Nord J Psychiatry. 2009;63(2):160–70.CrossRef
4.
go back to reference Zlotnick C, Johnson DM, Stout RL, Zywiak WH, Johnson JE, Schneider RJ. Childhood abuse and intake severity in alcohol disorder patients. J Trauma Stress. 2006;19(6):949–59.CrossRef Zlotnick C, Johnson DM, Stout RL, Zywiak WH, Johnson JE, Schneider RJ. Childhood abuse and intake severity in alcohol disorder patients. J Trauma Stress. 2006;19(6):949–59.CrossRef
5.
go back to reference Fergusson DM, McLeod GF, Horwood LJ. Childhood sexual abuse and adult developmental outcomes: findings from a 30-year longitudinal study in New Zealand. Child Abuse Negl. 2013;37(9):664–74.CrossRef Fergusson DM, McLeod GF, Horwood LJ. Childhood sexual abuse and adult developmental outcomes: findings from a 30-year longitudinal study in New Zealand. Child Abuse Negl. 2013;37(9):664–74.CrossRef
6.
go back to reference Oberleitner LM, Smith PH, Weinberger AH, Mazure CM, McKee SA. Impact of exposure to childhood maltreatment on transitions to alcohol dependence in women and men. Child Maltreat. 2015;20(4):301–8.CrossRef Oberleitner LM, Smith PH, Weinberger AH, Mazure CM, McKee SA. Impact of exposure to childhood maltreatment on transitions to alcohol dependence in women and men. Child Maltreat. 2015;20(4):301–8.CrossRef
7.
go back to reference Huang MC, Schwandt ML, Ramchandani VA, George DT, Heilig M. Impact of multiple types of childhood trauma exposure on risk of psychiatric comorbidity among alcoholic inpatients. Alcohol Clin Exp Res. 2012;36(6):1099–107.CrossRef Huang MC, Schwandt ML, Ramchandani VA, George DT, Heilig M. Impact of multiple types of childhood trauma exposure on risk of psychiatric comorbidity among alcoholic inpatients. Alcohol Clin Exp Res. 2012;36(6):1099–107.CrossRef
8.
go back to reference Schwandt ML, Heilig M, Hommer DW, George DT, Ramchandani VA. Childhood trauma exposure and alcohol dependence severity in adulthood: mediation by emotional abuse severity and neuroticism. Alcohol Clin Exp Res. 2013;37(6):984–92.CrossRef Schwandt ML, Heilig M, Hommer DW, George DT, Ramchandani VA. Childhood trauma exposure and alcohol dependence severity in adulthood: mediation by emotional abuse severity and neuroticism. Alcohol Clin Exp Res. 2013;37(6):984–92.CrossRef
9.
go back to reference Gilbert R, Widom CS, Browne K, Fergusson D, Webb E, Janson S. Burden and consequences of child maltreatment in high-income countries. Lancet. 2009;373(9657):68–81.CrossRef Gilbert R, Widom CS, Browne K, Fergusson D, Webb E, Janson S. Burden and consequences of child maltreatment in high-income countries. Lancet. 2009;373(9657):68–81.CrossRef
10.
go back to reference Etain B, Aas M, Andreassen OA, Lorentzen S, Dieset I, Gard S, et al. Childhood trauma is associated with severe clinical characteristics of bipolar disorders. J Clin Psychiatry. 2013;74(10):991–8.CrossRef Etain B, Aas M, Andreassen OA, Lorentzen S, Dieset I, Gard S, et al. Childhood trauma is associated with severe clinical characteristics of bipolar disorders. J Clin Psychiatry. 2013;74(10):991–8.CrossRef
11.
go back to reference Simpson TL, Miller WR. Concomitance between childhood sexual and physical abuse and substance use problems. A review. Clin Psychol Rev. 2002;22(1):27–77.CrossRef Simpson TL, Miller WR. Concomitance between childhood sexual and physical abuse and substance use problems. A review. Clin Psychol Rev. 2002;22(1):27–77.CrossRef
12.
go back to reference Lown EA, Nayak MB, Korcha RA, Greenfield TK. Child physical and sexual abuse: a comprehensive look at alcohol consumption patterns, consequences, and dependence from the National Alcohol Survey. Alcohol Clin Exp Res. 2011;35(2):317–25.CrossRef Lown EA, Nayak MB, Korcha RA, Greenfield TK. Child physical and sexual abuse: a comprehensive look at alcohol consumption patterns, consequences, and dependence from the National Alcohol Survey. Alcohol Clin Exp Res. 2011;35(2):317–25.CrossRef
13.
go back to reference Magnusson A, Lundholm C, Goransson M, Copeland W, Heilig M, Pedersen NL. Familial influence and childhood trauma in female alcoholism. Psychol Med. 2012;42(2):381–9.CrossRef Magnusson A, Lundholm C, Goransson M, Copeland W, Heilig M, Pedersen NL. Familial influence and childhood trauma in female alcoholism. Psychol Med. 2012;42(2):381–9.CrossRef
14.
go back to reference Schuckher F, Sellin T, Fahlke C, Engstrom I. The impact of childhood maltreatment on age of onset of alcohol use disorder in women. Eur Addict Res. 2018;24(6):278–85.CrossRef Schuckher F, Sellin T, Fahlke C, Engstrom I. The impact of childhood maltreatment on age of onset of alcohol use disorder in women. Eur Addict Res. 2018;24(6):278–85.CrossRef
15.
go back to reference Potthast N, Neuner F, Catani C. The contribution of emotional maltreatment to alcohol dependence in a treatment-seeking sample. Addict Behav. 2014;39(5):949–58.CrossRef Potthast N, Neuner F, Catani C. The contribution of emotional maltreatment to alcohol dependence in a treatment-seeking sample. Addict Behav. 2014;39(5):949–58.CrossRef
16.
go back to reference Elliott JC, Stohl M, Wall MM, Keyes KM, Goodwin RD, Skodol AE, et al. The risk for persistent adult alcohol and nicotine dependence: the role of childhood maltreatment. Addiction. 2014;109(5):842–50.CrossRef Elliott JC, Stohl M, Wall MM, Keyes KM, Goodwin RD, Skodol AE, et al. The risk for persistent adult alcohol and nicotine dependence: the role of childhood maltreatment. Addiction. 2014;109(5):842–50.CrossRef
17.
go back to reference Young-Wolff KC, Kendler KS, Prescott CA. Interactive effects of childhood maltreatment and recent stressful life events on alcohol consumption in adulthood. J Stud Alcohol Drugs. 2012;73(4):559–69.CrossRef Young-Wolff KC, Kendler KS, Prescott CA. Interactive effects of childhood maltreatment and recent stressful life events on alcohol consumption in adulthood. J Stud Alcohol Drugs. 2012;73(4):559–69.CrossRef
18.
go back to reference Greenfield SF, Brooks AJ, Gordon SM, Green CA, Kropp F, McHugh RK, et al. Substance abuse treatment entry, retention, and outcome in women: a review of the literature. Drug Alcohol Depend. 2007;86(1):1–21.CrossRef Greenfield SF, Brooks AJ, Gordon SM, Green CA, Kropp F, McHugh RK, et al. Substance abuse treatment entry, retention, and outcome in women: a review of the literature. Drug Alcohol Depend. 2007;86(1):1–21.CrossRef
19.
go back to reference Walitzer KS, Dearing RL. Gender differences in alcohol and substance use relapse. Clin Psychol Rev. 2006;26(2):128–48.CrossRef Walitzer KS, Dearing RL. Gender differences in alcohol and substance use relapse. Clin Psychol Rev. 2006;26(2):128–48.CrossRef
20.
go back to reference Adamson SJ, Sellman JD, Frampton CM. Patient predictors of alcohol treatment outcome: a systematic review. J Subst Abus Treat. 2009;36(1):75–86.CrossRef Adamson SJ, Sellman JD, Frampton CM. Patient predictors of alcohol treatment outcome: a systematic review. J Subst Abus Treat. 2009;36(1):75–86.CrossRef
21.
go back to reference Greenfield SF, Kolodziej ME, Sugarman DE, Muenz LR, Vagge LM, He DY, et al. History of abuse and drinking outcomes following inpatient alcohol treatment: a prospective study. Drug Alcohol Depend. 2002;67(3):227–34.CrossRef Greenfield SF, Kolodziej ME, Sugarman DE, Muenz LR, Vagge LM, He DY, et al. History of abuse and drinking outcomes following inpatient alcohol treatment: a prospective study. Drug Alcohol Depend. 2002;67(3):227–34.CrossRef
22.
go back to reference Sacks JY, McKendrick K, Banks S. The impact of early trauma and abuse on residential substance abuse treatment outcomes for women. J Subst Abus Treat. 2008;34(1):90–100.CrossRef Sacks JY, McKendrick K, Banks S. The impact of early trauma and abuse on residential substance abuse treatment outcomes for women. J Subst Abus Treat. 2008;34(1):90–100.CrossRef
23.
go back to reference Pirard S, Sharon E, Kang SK, Angarita GA, Gastfriend DR. Prevalence of physical and sexual abuse among substance abuse patients and impact on treatment outcomes. Drug Alcohol Depend. 2005;78(1):57–64.CrossRef Pirard S, Sharon E, Kang SK, Angarita GA, Gastfriend DR. Prevalence of physical and sexual abuse among substance abuse patients and impact on treatment outcomes. Drug Alcohol Depend. 2005;78(1):57–64.CrossRef
24.
go back to reference Charney DA, Palacios-Boix J, Gill KJ. Sexual abuse and the outcome of addiction treatment. Am J Addict. 2007;16(2):93–100.CrossRef Charney DA, Palacios-Boix J, Gill KJ. Sexual abuse and the outcome of addiction treatment. Am J Addict. 2007;16(2):93–100.CrossRef
25.
go back to reference SOU 2011:35. Bättre insatser vid missbruk och beroende : individen, kunskapen och ansvaret : slutbetänkande. Vol. 1. [in Swedish] Stockholm: Socialdepartementet. SOU 2011:35. Bättre insatser vid missbruk och beroende : individen, kunskapen och ansvaret : slutbetänkande. Vol. 1. [in Swedish] Stockholm: Socialdepartementet.
26.
go back to reference American Psychiatric Association. Diagnostic and statistical manual of mental disorders : DSM-IV. 4th ed. Washington, D.C.: American Psychiatric Assoc; 1994. American Psychiatric Association. Diagnostic and statistical manual of mental disorders : DSM-IV. 4th ed. Washington, D.C.: American Psychiatric Assoc; 1994.
27.
go back to reference McLellan AT, Kushner H, Metzger D, Peters R, Smith I, Grissom G, et al. The fifth edition of the addiction severity index. J Subst Abus Treat. 1992;9(3):199–213.CrossRef McLellan AT, Kushner H, Metzger D, Peters R, Smith I, Grissom G, et al. The fifth edition of the addiction severity index. J Subst Abus Treat. 1992;9(3):199–213.CrossRef
28.
go back to reference Makela K. Studies of the reliability and validity of the addiction severity index. Addiction. 2004;99(4):398–410 discussion 1-8.CrossRef Makela K. Studies of the reliability and validity of the addiction severity index. Addiction. 2004;99(4):398–410 discussion 1-8.CrossRef
29.
go back to reference Nyström S, Zingmark D, Jäderland A. ASI-manualen: anvisningar till ASI Grund och ASI Uppföljning [in Swedish]. Stockholm: Socialstyrelsen; 2009. Nyström S, Zingmark D, Jäderland A. ASI-manualen: anvisningar till ASI Grund och ASI Uppföljning [in Swedish]. Stockholm: Socialstyrelsen; 2009.
30.
go back to reference Lecrubier Y, Sheehan DV, Weiller E, Amorim P, Bonora I, Sheehan KH, et al. The MINI international neuropsychiatric interview (MINI): a short diagnostic structured interview: reliability and validity according to the CIDI. EuroPsychiatry. 1997;12(5):224–31. Lecrubier Y, Sheehan DV, Weiller E, Amorim P, Bonora I, Sheehan KH, et al. The MINI international neuropsychiatric interview (MINI): a short diagnostic structured interview: reliability and validity according to the CIDI. EuroPsychiatry. 1997;12(5):224–31.
31.
go back to reference Sheehan D, Lecrubier Y, Sheehan K, Janavs J, Weiller E, Keskiner A, et al. The validity of the MINI international neuropsychiatric interview (MINI) according to the SCID-P and its reliability. Euro Psychiatry. 1997;12(5):232–41.CrossRef Sheehan D, Lecrubier Y, Sheehan K, Janavs J, Weiller E, Keskiner A, et al. The validity of the MINI international neuropsychiatric interview (MINI) according to the SCID-P and its reliability. Euro Psychiatry. 1997;12(5):232–41.CrossRef
32.
go back to reference Bernstein DP, Fink L. Childhood trauma questionnaire; a retrospective self-report. Manual Swedish version. Pearson: Stockholm; 2011. Bernstein DP, Fink L. Childhood trauma questionnaire; a retrospective self-report. Manual Swedish version. Pearson: Stockholm; 2011.
33.
go back to reference Wennberg P, Bergman H, Berglund M. The AVI-R2: an inventory for a differentiated diagnosis of alcohol problems. Nord J Psychiatry. 2014;68(4):266–9.CrossRef Wennberg P, Bergman H, Berglund M. The AVI-R2: an inventory for a differentiated diagnosis of alcohol problems. Nord J Psychiatry. 2014;68(4):266–9.CrossRef
34.
go back to reference Bergman H, Wennberg P, Hammarberg A, Hubicka B. Alkoholvaneinventoriet, reviderad version 2: Ett frågeformulär för bedömning vid alkoholproblem. Manual-under omarbetning [in Swedish]. Stockholm: Karolinska Institutet; 2018. Bergman H, Wennberg P, Hammarberg A, Hubicka B. Alkoholvaneinventoriet, reviderad version 2: Ett frågeformulär för bedömning vid alkoholproblem. Manual-under omarbetning [in Swedish]. Stockholm: Karolinska Institutet; 2018.
35.
go back to reference Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG. The alcohol use disorders identification test. Guidelines for use in primary care second ed. World Health Organization. Department of Mental Health and Substance Dependence: Geneva; 2001. Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG. The alcohol use disorders identification test. Guidelines for use in primary care second ed. World Health Organization. Department of Mental Health and Substance Dependence: Geneva; 2001.
36.
go back to reference Andréasson S, Allebeck P. editors. Alkohol och hälsa: En kunskapsöversikt om alkoholens positiva och negativa effekter på vår hälsa [in Swedish]. Stockholm: Statens folkhälsoinstitut; 2005. Andréasson S, Allebeck P. editors. Alkohol och hälsa: En kunskapsöversikt om alkoholens positiva och negativa effekter på vår hälsa [in Swedish]. Stockholm: Statens folkhälsoinstitut; 2005.
37.
go back to reference Rosen CS, Ouimette PC, Sheikh JI, Gregg JA, Moos RH. Physical and sexual abuse history and addiction treatment outcomes. J Stud Alcohol. 2002;63(6):683–7.CrossRef Rosen CS, Ouimette PC, Sheikh JI, Gregg JA, Moos RH. Physical and sexual abuse history and addiction treatment outcomes. J Stud Alcohol. 2002;63(6):683–7.CrossRef
38.
go back to reference Meyer A, Wapp M, Strik W, Moggi F. Association between drinking goal and alcohol use one year after residential treatment: a multicenter study. J Addict Dis. 2014;33(3):234–42.CrossRef Meyer A, Wapp M, Strik W, Moggi F. Association between drinking goal and alcohol use one year after residential treatment: a multicenter study. J Addict Dis. 2014;33(3):234–42.CrossRef
39.
go back to reference Berger L, Brondino M, Fisher M, Gwyther R, Garbutt JC. Alcohol use disorder treatment: the Association of Pretreatment use and the role of drinking goal. J Am Board Fam Med. 2016;29(1):37–49.CrossRef Berger L, Brondino M, Fisher M, Gwyther R, Garbutt JC. Alcohol use disorder treatment: the Association of Pretreatment use and the role of drinking goal. J Am Board Fam Med. 2016;29(1):37–49.CrossRef
40.
go back to reference Mann K, Aubin HJ, Witkiewitz K. Reduced drinking in alcohol dependence treatment, what is the evidence? Eur Addict Res. 2017;23(5):219–30.CrossRef Mann K, Aubin HJ, Witkiewitz K. Reduced drinking in alcohol dependence treatment, what is the evidence? Eur Addict Res. 2017;23(5):219–30.CrossRef
41.
go back to reference Rees CA. Understanding emotional abuse. Arch Dis Child. 2010;95(1):59–67.CrossRef Rees CA. Understanding emotional abuse. Arch Dis Child. 2010;95(1):59–67.CrossRef
Metadata
Title
History of childhood abuse is associated with less positive treatment outcomes in socially stable women with alcohol use disorder
Authors
Fides Schückher
Tabita Sellin
Ingemar Engström
Kristina Berglund
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2019
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-019-0857-4

Other articles of this Issue 1/2019

BMC Women's Health 1/2019 Go to the issue