Association of Childhood Abusewith Adult Alcohol and Drug Problems
The Association of Childhood Abuse with Adult Alcohol and Drug Problems The systematic, strategically-informed treatment of alcohol and other drug (AOD) abuse (here the term abuse is intended generically, rather than to denote a specific set of diagnostic criteria) has undergone dramatic changes over the last twenty years or so. ... This paper will contain an examination of some research data published within the last four years concerning a particularly high profile and controversial dual diagnosis issue: the nature of the association, if any, between childhood abuse and the development of adult AOD problems. ... Please note that the question of the effect of childhood abuse on the development of adult psychological problems other than AOD abuse, such as posttraumatic stress disorder (PTSD), will not be discussed here: the size limitations of this essay do not permit it. For some representative studies that deal with the connection between childhood abuse and adult PTSD, see Herman, J. ... Some conventional wisdom on childhood abuse and AOD problems Many popular books have been written over the past fifteen years that make claims for a cause-and-effect relationship between childhood abuse and adult psychopathology of every imaginable kind, particularly adult AOD abuse. ... In either case, the belief of the existence of a direct causal relationship between childhood abuse and adult AOD problems is simply the application of Freudian psychodynamic theory to the disease concept of addiction. ... In 1983, George Vaillant published The Natural History of Alcoholism, a work reflecting the outcome of a long-term research project examining, among other things, the premorbid psychosocial characteristics of adult alcoholic men. ... Vaillant caused great perplexity among psychodynamic theorists by claiming that his carefully-gathered data revealed no consistent psychological markers for adult alcoholism. ... A look at some recent studies Before proposing etiological theories or clinical interventions, a look at some important recent studies on the relationship between childhood abuse and AOD problems is appropriate. ... Swett and Halpert (1994) have published a study of 88 consecutive adult female admits to a psychiatric inpatient unit. Among the assessment instruments applied was the Michigan Alcohol Screening Test (MAST). 76% of these patients reported a history of childhood abuse, and 38% of the abuse survivors scored high (greater than or equal to 7) on the MAST. The authors refer to a study of the general adult American population, which reported that only 7% of its subjects scored greater than or equal to 7 on the MAST; they conclude that the reported history of abuse was "predictive" of high MAST scores. ... In examining the phenomenon of female alcohol abuse, the authors came up with some significant data pointing to a relationship of some kind between childhood sexual abuse and adult drinking problems in women. They found that over twice as many women with a history of problem drinking reported childhood sexual abuse as women without a history of alcohol problems.