Alcohol Misuse and Associations with Childhood Maltreatment and Out-of-Home Placement among Urban Two-Spirit American Indian and Alaska Native People

Abstract

This study examined associations between alcohol misuse and childhood maltreatment and out-of-home placement among urban lesbian, gay, and bisexual (referred to as two-spirit) American Indian and Alaska Native adults. In a multi-site study, data were obtained from 294 individuals who consumed alcohol during the past year. The results indicated that 72.3% of men and 62.4% of women engaged in hazardous and harmful alcohol use and 50.8% of men and 48.7% of women met criteria for past-year alcohol dependence. The most common types of childhood maltreatment were physical abuse among male drinkers (62.7%) and emotional abuse (71.8%) among female drinkers. Men and women reported high percentages of out-of-home placement (39% and 47%, respectively). Logistic multiple regressions found that for male drinkers boarding school attendance and foster care placement were significant predictors of past-year alcohol dependence. For female drinkers, being adopted was significantly associated with a decreased risk of past-year drinking binge or spree. Dose-response relationships, using number of childhood exposures as a predictor, were not significant. The results highlight the need for alcohol and violence prevention and intervention strategies among urban two-spirit individuals.

Adverse Childhood Experiences and the Presence of Cancer Risk Factors in Adulthood: A Scoping Review of the Literature From 2005 to 2015

“…Among men, incarcerated household member (Strine et al, 2012), parental rejection (Schellekens et al, 2013), household member with problem drinking (Young et al, 2006), and negative life events scores (Schellekens et al, 2013) were also associated with problematic alcohol-related behaviors. In one study, out-of-home placement (e.g., foster care) was associated with adult alcohol dependence among urban, gay/bisexual male American Indians and Alaskan Natives (AI/AN) (Yuan, Duran, Walters, Pearson, & Evans-Campbell, 2014). However, in the same study being adopted decreased the risk of later binge drinking in a sample of urban, lesbian/bisexual female AI/AN (Yuan et al, 2014).…”

“…In one study, out-of-home placement (e.g., foster care) was associated with adult alcohol dependence among urban, gay/bisexual male American Indians and Alaskan Natives (AI/AN) (Yuan, Duran, Walters, Pearson, & Evans-Campbell, 2014). However, in the same study being adopted decreased the risk of later binge drinking in a sample of urban, lesbian/bisexual female AI/AN (Yuan et al, 2014). Women who experienced CM developed alcohol dependence earlier than women who did not (Oberleitner, Smith, Weinberger, Mazure, & McKee, 2015), and among lesbian women, neglect (Hughes, McCabe, et al, 2010), CSA (Gilmore et al, 2014; Hughes, Johnson, Wilsnack, & Szalacha, 2007), and CPA (Hughes et al, 2007) were associated with alcohol-related problems.…”

Research on alcohol and other drug (AOD) use among sexual minority women: A global scoping review

“…Even fewer studies have examined AOD among Native American or Asian SMW. In a study of lesbian, gay, and bisexual (two-spirit) Native Americans, Yuan and colleagues [80] found that 72% of men and 62% of women engaged in hazardous drinking; 51% of men and 49% of women met criteria for past-year alcohol dependence. In the only study of AOD use among Asian SMW (other than Cochran and Mays' study of Latina and Asian SMW described above) Dibble and colleagues analyzed data from a sample of midlife Asian, Pacific Islander, and Native Hawaiian lesbian women [81].…”

“…Asian American SMW also had lower odds of adult rape and lower peak drinking. A study [80] of two-spirit persons found that about half of the sample met criteria for alcohol dependence; among past-year women drinkers the most common type of childhood maltreatment was emotional abuse (72%).…”

Review: Genetic and environmental risk factors for alcohol use disorders in American Indians and Alaskan Natives

“…Increased psychopathology, including alcohol/drug use and suicidal behavior has been associated with boarding school attendance, and children of boarding school attendees also have increased psychopathology . One study has found that among urban AI/AN individuals, boarding school attendance and foster care were predictors of AUD in male drinkers . However it should be noted that another study in 1,000 individuals from a large AI tribe found that individuals with AUD were no more likely to have attended boarding school than individuals without AUD …”