Adverse childhood experiences, mental health, and excessive alcohol use: Examination of race/ethnicity and sex differences

Child Abuse Negl. 2017 Jul:69:40-48. doi: 10.1016/j.chiabu.2017.04.004. Epub 2017 Apr 28.

Abstract

Responses from N=60,598 interviews from the 2010 Behavioral Risk Factor Surveillance System (the 10 states and the District of Columbia that included the optional Adverse Childhood Experience (ACE) module) were used to test whether associations between childhood adversity and adult mental health and alcohol behaviors vary by race/ethnicity and sex. ACE items were categorized into two types - household challenges and child abuse. Outcomes were current depression, diagnosed depression, heavy drinking and binge drinking. Logistic regression models found ACEs significantly associated with depression and excessive alcohol use, but sex did not moderate any relationships. Race/ethnicity moderated the relationship between ACEs and heavy drinking. In stratified analyses, compared to those not exposed to ACEs, non-Hispanic blacks who experienced either type of ACE were about 3 times as likely to drink heavily; Non-Hispanic whites who experienced child abuse or both ACE types were 1.5-2 times as likely to drink heavily; and Hispanics who experienced household challenges or both ACE types were 1.2 and 11 times as likely to report heavy drinking. ACEs impact depression and excessive alcohol use similarly across men and women. With the exception of heavy drinking, ACEs appear to have the same association with excessive alcohol use across race/ethnicity. It may be prudent to further investigate why the relationship between ACEs and heavy drinking may differ by race/ethnicity such that prevention strategies can be developed or refined to effectively address the needs of all sub-groups.

Keywords: Adverse childhood experiences; BRFSS; Child abuse; Heavy drinking; Household challenges; Race/ethnicity.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Adult Survivors of Child Abuse / psychology
  • Adult Survivors of Child Abuse / statistics & numerical data
  • Adult Survivors of Child Adverse Events / psychology*
  • Adult Survivors of Child Adverse Events / statistics & numerical data
  • Alcohol Drinking / epidemiology
  • Alcohol Drinking / ethnology
  • Alcohol Drinking / psychology*
  • Behavioral Risk Factor Surveillance System
  • Child
  • Child Abuse / ethnology
  • Child Abuse / psychology
  • Depressive Disorder / epidemiology
  • Depressive Disorder / ethnology
  • Depressive Disorder / psychology*
  • Ethnicity
  • Female
  • Hispanic or Latino / psychology
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Life Change Events
  • Logistic Models
  • Male
  • Mental Health
  • Middle Aged
  • Racial Groups / ethnology
  • Sex Distribution
  • United States / epidemiology
  • Young Adult