describes the prevalence of child abuse by type and other characteristics. Any child abuse was reported by 25% of women. Any CPA (with or without CSA) was reported by 19% of women and any CSA (with or without CPA) by 12%. (It is noteworthy that 52.5% of women reporting CSA also reported CPA. Thirty-four percent of women reporting CPA also reported CSA). The primary 3 category child abuse variable is described. CPA exclusively was reported by 12% and CSA (with or without CPA) by 12% of women. A 4 category composite variable show that only 6% of women reported experiencing CSA only and 7% report both CPA and CSA.
Two or more perpetrators were reported by 30% of women with any CPA, and 23% of women with any CSA. Mean age for first CPA and CSA was 7.2 years old and 9.4 years old respectively. For CPA, parents were most commonly reported as the perpetrator (75%). For CSA, non family members were the most common perpetrators (60%).
describes alcohol consumption patterns by the 3 category child abuse status. Percents and crude odds ratios are presented. Both CPA and CSA were associated with a higher prevalence of alcohol misuse compared to no abuse. In general, women reporting CSA reported the highest prevalence of each alcohol measure, followed by women reporting CPA and then no abuse. There were significant differences between physically and sexual abused women for past year and lifetime alcohol consequences and lifetime alcohol dependence. CSA, compared to no abuse, placed women at greater risk for current heavy episodic drinking, and current and lifetime alcohol dependence and consequences. CPA was also significantly associated with current intoxication, dependence and consequences (trend, p=.06) and with lifetime alcohol dependence and consequences. Women who reported either type of child abuse were significantly more likely to also report parental alcoholism or problem drinking.
Multivariate results were consistent with bi-variate results (). Compared to women with no abuse history, lifetime alcohol-related consequences (2+) were more common in women reporting CPA (ORadj=2.1, 95% CI 1.5–3.0) and CSA (ORadj=3.5, 95% CI 2.6–4.8) compared to no abuse. Lifetime alcohol dependence was also more common among women with CPA (ORadj=2.1, 95% CI 1.4–3.1) and CSA (ORadj=3.7, 95% CI 2.6–5.3) compared to no abuse, even when controlling for key predictors for alcohol misuse, such as demographic factors and parental alcoholism. In the ANOVA model, the same pattern emerged with higher drinking volume among those with sexual abuse compared to no abuse. There were not significant differences between the physical and sexual abuse groups for volume.
presents categories of alcohol-related consequences by type of child abuse among ever drinkers. Getting into alcohol related fights were the most common lifetime alcohol-related consequences with 37% of sexually abused women, 25% of physically abused women and 13.1% of women without child abuse reporting fights (p<.001). Consequences with the law, work and family problems were all highly significant and followed the same pattern. In separate analyses of each of the 15 alcohol consequences (data not shown) all consequences showed a similar gradient where women with a history of CSA were significantly more likely to report each consequence and each of the five categories of consequences compared to CPA and compared to no abuse.
Increased alcohol consequences may be the result of abused women drinking more, but could also reflect interpersonal difficulties among abused women with resultant trouble with the law, home, work or fights. In order to assess this possibility we performed an additional multivariate model (data not shown) to predict lifetime consequences (as in ), but this time controlling for total volume of drinking to determine whether increased consequences are related to increased volume of alcohol consumption in abuse women. In this model CPA and CSA predicted lifetime consequences (ORadj=2.0; 95% CI 1.4–2.9) and ORadj =3.4; 95% CI 2.5–4.6) respectively with similar odds ratios as the model without alcohol volume, signifying that the consequences are not solely due to increased consumption of alcohol. However, alcohol volume was also a significant predictor of consequences.
In order to assess characteristics of abuse most associated with lifetime alcohol-related consequences and alcohol dependence, analyses were conducted for the 885 women reporting any child abuse (). Two composite abuse variables were examined to provide more fine-tuned information about type of abuse and lifetime alcohol consequences and dependence. Analyses with the 3 category primary composite variable used throughout the paper showed that women reporting CSA (with or without CPA) were significantly more likely to report lifetime alcohol consequences (ORadj=1.7) and lifetime alcohol dependence (ORadj=1.8) compared to women reporting CPA alone. Further analyses used the 4-tiered categorization of child abuse that showed women reporting both CPA and CSA were 3.3 times more likely to report consequences and at least 2.5 times more likely to report dependence compared to women reporting a single type of abuse. There were no significant differences in lifetime alcohol outcomes between CPA only and CSA only. Multivariate analyses could not be performed due to small numbers in the exclusive categories.
Among women reporting any child abuse (n= 885), characteristics of child abuse and their association with having 2+ lifetime alcohol-related consequences or lifetime alcohol dependence, bi-variate and multivariate models.
Having two or more CPA perpetrators was associated with increased risk for both lifetime alcohol outcomes in multivariate models. Physical abuse perpetrated by non-parental family members or non-family was significantly associated with both lifetime alcohol outcomes in multivariate models whereas CPA by a parent was not associated with lifetime alcohol outcomes. For women reporting CSA, type of and number of perpetrators did not predict lifetime alcohol outcomes. Injury as a result of child abuse was a significant predictor for lifetime alcohol dependence. Age at first CPA or CSA was not associated with either alcohol outcome.