Genetic moderators and psychiatric mediators of the link between sexual abuse and alcohol dependence

• Published in: Drug and alcohol dependence Vol. 115; no. 3; pp. 183 - 189
• Main Authors: Copeland, William E, Magnusson, Åsa, Göransson, Mona, Heilig, Markus A
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.06.2011; Elsevier
• Subjects: Addictive behaviors; Adult; Adult and adolescent clinical studies; Alcohol dependence; Alcoholism; Alcoholism - epidemiology; Alcoholism - genetics; Alcoholism - psychology; Alcoholism - therapy; Alcoholism and acute alcohol poisoning; Biological and medical sciences; Biomarkers; Case-Control Studies; Comorbidity; Female; General aspects; Genetics; Helpseeking; Humans; Medical sciences; Medicin och hälsovetenskap; Mental Disorders - epidemiology; Mental Disorders - genetics; Mental Disorders - psychology; Mental Disorders - therapy; Middle Aged; Moderators; Psychiatric comorbidity; Psychiatric disorders; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Risk Factors; Sex Offenses - psychology; Sex Offenses - statistics & numerical data; Sexual abuse; Substance-Related Disorders - epidemiology; Substance-Related Disorders - genetics; Substance-Related Disorders - psychology; Substance-Related Disorders - therapy; Toxicology; Women; Genetics; Alcohol dependence; Sexual abuse; Psychiatric comorbidity; Human; Drug addiction; Alcoholism; Victimology; Alcoholic beverage; Concomitant disease; Addiction; Dependence; Mental disorder; Mediator
• ISSN: 0376-8716; 1879-0046; 1879-0046
• DOI: 10.1016/j.drugalcdep.2010.10.024

Abstract Background/objective This study used a case–control female sample to test psychiatric mediators and genetic moderators of the effect of sexual abuse on later alcohol dependence. The study also tested differences between alcohol dependent women with or without a history of sexual abuse on variables that might affect treatment planning. Methods A case–control design compared 192 treatment-seeking alcohol dependent women with 177 healthy population controls. All participants were assessed for alcohol-related behaviors, sexual abuse history, psychiatric problems, and personality functioning. Markers were genotyped in the CRHR1, MAO-A and OPRM1 genes. Results The association of sexual abuse with alcohol dependence was limited to the most severe category of sexual abuse involving anal or vaginal penetration. Of the five psychiatric disorders tested, anxiety, anorexia nervosa, and bulimia met criteria as potential mediators of the abuse-alcohol dependence association. Severe sexual abuse continued to have an independent effect on alcohol dependence status even after accounting for these potential mediators. None of the candidate genetic markers moderated the association between sexual abuse and alcohol dependence. Of alcohol dependent participants, those with a history of severe abuse rated higher on alcoholism severity, and psychiatric comorbidities. Conclusion Sexual abuse is associated with later alcohol problems directly as well as through its effect on psychiatric problems. Treatment-seeking alcohol dependent women with a history of abuse have distinct features as compared to other alcohol dependent women.