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History of childhood abuse is associated with less positive treatment outcomes in socially stable women with alcohol use disorder
Örebro University, School of Medical Sciences. University Health Care Research Center.
Örebro University, School of Medical Sciences. Örebro University Hospital. University Health Care Research Center.ORCID iD: 0000-0002-5030-6353
Örebro University, School of Medical Sciences. University Health Care Research Center.ORCID iD: 0000-0002-3227-2487
Department of Psychology,University of Gothenburg, Göteborg, Sweden.
2019 (English)In: BMC Women's Health, E-ISSN 1472-6874, Vol. 19, no 1, article id 159Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
BMC , 2019. Vol. 19, no 1, article id 159
Keywords [en]
Adult women, Alcohol use disorder, Childhood abuse, Treatment outcome
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:oru:diva-79099DOI: 10.1186/s12905-019-0857-4ISI: 000502718200002PubMedID: 31830964Scopus ID: 2-s2.0-85076488310OAI: oai:DiVA.org:oru-79099DiVA, id: diva2:1385717
Note

Funding Agency:

University Health Care Research Center, Region Örebro County, Sweden

Available from: 2020-01-15 Created: 2020-01-15 Last updated: 2023-08-28Bibliographically approved
In thesis
1. Alcohol use disorder in socially stable women receiving outpatient treatment: Individual characteristics of importance for onset age and treatment outcome
Open this publication in new window or tab >>Alcohol use disorder in socially stable women receiving outpatient treatment: Individual characteristics of importance for onset age and treatment outcome
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Socially stable women with alcohol use disorder (AUD) are seldom studied separately and are often marginalized in treatment of substance abuse. The overall aim of this thesis was to examine variables of importance in relation to age at onset of AUD and treatment outcome.

Study I, which included 338 men and women being treated for AUD, showed that women had a significantly later onset and shorter duration in excessive alcohol use as well as less weekly pure alcohol intake than men. Participants with earlier onset of excessive alcohol use reported significantly more psychiatric symptoms and more immature personality traits than those with later onset. 

Study II-IV included 75 women with AUD receiving outpatient treatment. Of the participants, 68% reported a history of childhood maltreatment. Emotional abuse and their mother’s alcohol and/or substance problems were independent predictors of earlier age at onset of AUD. In Study III treatment outcome was measured as a change in alcohol consumption. A more positive change, especially with regard to abstinence, was found in women who did not report childhood abuse. Study IV showed that, at 12month follow up, most of the participants had reached their end-oftreatment goal either abstinence or low-risk drinking. However, those with a goal of abstinence at the end of treatment showed significantly less risk drinking than those with low-risk drinking as a goal. The most important predictor of abstinence at the 12-month follow up was having abstinence as an end –of –treatment goal. 

These results indicate the importance of identifying and addressing childhood trauma in treating socially stable women with AUD. Focusing on motivational changes during treatment may also be of importance, especially in patients with relapses, as abstinence still is the most stable treatment option.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2020. p. 84
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 223
Keywords
AUD, women, childhood maltreatment, onset age, treatment outcome, goal of treatment
National Category
General Practice
Identifiers
urn:nbn:se:oru:diva-85257 (URN)978-91-7529-355-4 (ISBN)
Public defence
2020-11-12, Örebro universitet, Campus USÖ, hörsal C1, Södra Grev Rosengatan 32, Örebro, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2020-08-31 Created: 2020-08-31 Last updated: 2020-10-22Bibliographically approved

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Schückher, FidesSellin Jönsson, TabitaEngström, Ingemar

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