Disentangling the Complex Association Between Childhood Sexual Abuse and Alcohol-Related Problems: A Review of Methodological Issues and Approaches

Abstract

ABSTRACT. This review describes and evaluates methodological approaches aimed at unraveling the association between childhood sexual abuse (CSA) and later misuse of alcohol, which is complicated by the signifi cant overlap between factors that elevate risk for CSA exposure and those that increase risk for problem alcohol use. We critique methods used to distinguish direct effects of CSA events on alcohol-related outcomes from the effects of risk factors frequently present in families in which CSA exposure occurs (e.g., parental alcohol-related problems). These methods include measurement and adjustment for potentially confounding factors and the use of co-twin designs. The fi ndings across methodological approaches provide support for a CSA-specifi c risk for alcohol misuse, despite the signifi cant contribution of family background factors to overall risk, but much work remains to be done before a comprehensive model for this association can be proposed. Additional directions for research, including the incorporation of measured genes and the use of longitudinal designs, are proposed to further efforts to model the pathways from CSA to alcohol-related problems. (J. Stud.

Neighborhood Disadvantage and Adolescent Substance Use Disorder

“…Childhood temperament, drinking motives, and externalizing symptomatology are among mechanisms identified to underlie this risk (Goldstein, Flett, & Wekerle, 2010; Oshri, Rogosch, Burnette, & Cicchetti, 2011). Although child maltreatment often co-occurs with additional environmental risk factors (i.e., parental substance use disorder (SUD), poverty, neighborhood crime, and domestic violence; Coulton, Corbin, Su, & Chow, 1995; Drake & Pandey, 1996; Dube et al, 2001; Manly, Oshri, Lynch, Herzog, & Wortel, 2013; McGuigan & Pratt, 2001), there is support for the unique direct effect of maltreatment on subsequent SUDs (Sartor, Agrawal, McCutcheon, Duncan, & Lynskey, 2008; Shin et al, 2010). …”

Women's Sex-Related Dissociation: The Effects of Alcohol Intoxication, Attentional Control Instructions, and History of Childhood Sexual Abuse

“…A CSA history increases risk for alcohol abuse (Sartor et al, 2008), and alcohol use is associated with dissociation among those with a CSA history (Klanecky et al, 2012). However, the association between acute alcohol intoxication and sex-related dissociative experiences is unknown.…”

“…Dissociation is a disruption in the perceptions of oneself and the environment and conditions that increase attentional focus may mitigate dissociation. Women with CSA histories have high rates of alcohol use (see Sartor, Agrawal, McCutcheon, Duncan, & Lynskey, 2008 for a review) and alcohol intoxication can result in a phenomenological state similar to dissociation (Klanecky, McChargue, & Bruggeman, 2012). Scant attention has been devoted to investigating sex-related dissociation until recently (e.g., Bird, Seehuus, Clifton, & Rellini, 2013; Hansen, Brown, Tsatkin, Zelgowski, & Nightingale, 2012) and no studies have investigated associations among CSA severity, alcohol intoxication, attentional control instructions, and sex-related dissociation.…”

The role of distress intolerance in the relationship between childhood sexual abuse and problematic alcohol use among Latin American MSM

“…As explained by Polusny and Follette (1995), CSA survivors tend to engage in a wide range of maladaptive coping strategies, including substance use, risky sexual behaviors, and self-injury, in order to suppress and distract themselves from the intense, aversive internal experiences associated with abuse-related affective states and memories. Of particular relevance to the present research, numerous studies utilizing both community and clinical samples have documented increased alcohol consumption and elevated rates of alcohol-related problems among women with CSA histories relative to their non-abused counterparts (see Sartor et al, 2008, for a review). Furthermore, young adult women with CSA histories were more likely to engage in alcohol use as a means to alleviate emotional distress than their non-abused peers (Goldstein et al, 2010; Hannan et al, 2015).…”