Hostname: page-component-77c89778f8-cnmwb Total loading time: 0 Render date: 2024-07-19T06:06:15.390Z Has data issue: false hasContentIssue false

Accounting for the association between childhood maltreatment and alcohol-use disorders in males: a twin study

Published online by Cambridge University Press:  29 March 2010

K. C. Young-Wolff*
Department of Psychology, University of Southern California, Los Angeles, CA, USA
K. S. Kendler
Virginia Institute for Psychiatric and Behavioral Genetics, Departments of Psychiatry and Human Genetics, Virginia Commonwealth University, Richmond, VA, USA
M. L. Ericson
Department of Psychology, University of Southern California, Los Angeles, CA, USA
C. A. Prescott
Department of Psychology, University of Southern California, Los Angeles, CA, USA
*Address for correspondence: K. C. Young-Wolff, M.A., Department of Psychology/SGM 501, University of Southern California, 3620 So. McClintock Avenue, Los Angeles, CA90089-1061, USA. (Email:



An association between childhood maltreatment and subsequent alcohol abuse and/or dependence (AAD) has been found in multiple studies of females. Less is known about the association between childhood maltreatment and AAD among males, and the mechanisms that underlie this association in either gender. One explanation is that childhood maltreatment increases risk for AAD. An alternative explanation is that the same genetic or environmental factors that increase a child's risk for being maltreated also contribute to risk for AAD in adulthood.


Lifetime diagnosis of AAD was assessed using structured clinical interviews in a sample of 3527 male participants aged 19–56 years from the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders. The sources of childhood maltreatment–AAD association were estimated using both a matched case–control analysis of twin pairs discordant for childhood maltreatment and bivariate twin modeling.


Approximately 9% of participants reported childhood maltreatment, defined as serious neglect, molestation, or physical abuse occurring before the age of 15 years. Those who experienced childhood maltreatment were 1.74 times as likely to meet AAD criteria compared with males who did not experience childhood maltreatment. The childhood maltreatment–AAD association largely reflected environmental factors in common to members of twin pairs. Additional exploratory analyses provided evidence that AAD risk associated with childhood maltreatment was significantly attenuated after adjusting for measured family-level risk factors.


Males who experienced childhood maltreatment had an increased risk for AAD. Our results suggest that the childhood maltreatment–AAD association is attributable to broader environmental adversity shared between twins.

Original Articles
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Anda, RF, Felitti, VJ, Bremner, JD, Walker, JD, Whitfield, C, Perry, BD, Dube, SR, Giles, WH (2006). The enduring effects of abuse and related adverse experiences in childhood: a convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience 256, 174186.CrossRefGoogle ScholarPubMed
Andrews, JA, Hops, H, Duncan, SC (1997). Adolescent modeling of parent substance use: the moderating effects of the relationship with the parent. Journal of Family Psychology 11, 259270.Google Scholar
Bensley, LS, Spieker, SJ, Van Eenwyk, J, Schoder, J (1999). Self-reported abuse history and adolescent problem behaviors: II. Alcohol and drug use. Journal of Adolescent Health 24, 173180.CrossRefGoogle ScholarPubMed
Berg-Nielsen, TS, Vikan, A, Dahl, AA (2002). Parenting related to child and parental psychopathology: a descriptive review of the literature. Clinical Child Psychology and Psychiatry 7, 529552.Google Scholar
Brewin, CR, Andrews, B, Gotlib, IH (1993). Psychopathology and early experience: a reappraisal of retrospective reports. Psychological Bulletin 113, 8298.CrossRefGoogle ScholarPubMed
Campo, AT, Rohner, RP (1992). Relationships between perceived parental acceptance–rejection, psychological adjustment and substance abuse among young adults. Child Abuse and Neglect 16, 429440.Google Scholar
Chassin, L, Curran, PJ, Hussong, AM, Colder, CR (1996). The relation of parent alcoholism to adolescent substance use: a longitudinal follow-up study. Journal of Abnormal Psychology 105, 7080.Google Scholar
Clark, DB, Lesnick, L, Hegedus, AM (1997). Trauma and other adverse life events in adolescents with alcohol abuse and dependence. Journal of the American Academy of Child and Adolescent Psychiatry 36, 17441751.CrossRefGoogle ScholarPubMed
Cotton, N (1979). The familial incidence of alcoholism. Journal of Studies on Alcohol 40, 89–116.CrossRefGoogle ScholarPubMed
Dervic, K, Grunebaum, MF, Burke, A, Mann, JJ, Oquendo, MA (2006). Protective factors against suicidal behavior in depressed adults reporting childhood abuse. Journal of Nervous and Mental Disease 194, 971974.CrossRefGoogle ScholarPubMed
Dinwiddie, S, Heath, AC, Dunne, MP, Bucholz, KK, Madden, PAF, Slutske, WS, Bierut, LJ, Statham, DB, Martin, NG (2000). Early sexual abuse and lifetime psychopathology: a co-twin control study. Psychological Medicine 30, 4152.Google Scholar
Dong, M, Anda, RF, Dube, SR, Giles, WH, Felitti, VJ (2003). The relationship of exposure to childhood sexual abuse to other forms of abuse, neglect, and household dysfunction during childhood. Childhood Abuse and Neglect 27, 625639.CrossRefGoogle ScholarPubMed
Dong, M, Anda, RF, Felitti, VJ, Dube, SR, Williamson, DF, Thompson, TJ, Loo, CM, Giles, WH (2004). The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction. Child Abuse and Neglect 28, 771784.CrossRefGoogle ScholarPubMed
Dube, SR, Anda, RF, Felitti, VJ, Croft, JB, Edwards, VJ, Giles, WH (2001). Growing up with parental alcohol abuse: exposure to childhood abuse, neglect, and household dysfunction. Child Abuse and Neglect 25, 16271640.Google Scholar
Dube, SR, Anda, RF, Felitti, VJ, Edwards, VJ, Croft, JB (2002). Adverse childhood experiences and personal alcohol abuse as an adult. Addictive Behaviors 27, 713725.CrossRefGoogle ScholarPubMed
Dunn, MG, Tarter, RE, Mezzich, AC, Vanyukov, M, Kirisci, L, Kirillova, G (2002). Origins and consequences of child neglect in substance abuse families. Clinical Psychology Review 22, 10631090.Google Scholar
Eaves, LJ, Eysenck, HJ, Martin, NG, Jardine, R, Heath, AC, Feingold, L, Young, PA, Kendler, KS (1989). Genes, Culture and Personality: An Empirical Approach. Oxford University Press: London.Google Scholar
Endicott, J, Andreasen, N, Spitzer, RL (1978). Family History Research Diagnostic Criteria. Biometrics Research, New York State Psychiatric Institute: New York.Google Scholar
Famularo, R, Kinscherff, R, Fenton, T (1992). Parental substance abuse and the nature of child maltreatment. Child Abuse and Neglect 16, 475483.Google Scholar
Fergusson, DM, Horwood, LJ, Lynskey, MT (1996 a). Childhood sexual abuse and psychiatric disorder in young adulthood: II. Psychiatric outcomes of childhood sexual abuse. Journal of the American Academy of Child and Adolescent Psychiatry 35, 13651374.Google Scholar
Fergusson, DM, Horwood, LJ, Lynskey, MT (1996 b). Childhood sexual abuse and psychiatric disorder in young adulthood: I. Prevalence of sexual abuse and factors associated with sexual abuse. Journal of the American Academy of Child and Adolescent Psychiatry 35, 13551364.Google Scholar
Freisthler, B, Merritt, DH, LaScala, EA (2006). Understanding the ecology of child maltreatment: a review of the literature and directions for future research. Child Maltreatment 11, 263280.Google Scholar
Galaif, ER, Stein, JA, Newcomb, MD, Bernstein, DP (2001). Gender differences in the prediction of problem alcohol use in adulthood: exploring the influence of family factors and childhood maltreatment. Journal of Studies on Alcohol and Drugs 62, 486493.Google Scholar
Gibb, BE, Wheeler, R, Alloy, LB, Abramson, LY (2001). Emotional, physical, and sexual maltreatment in childhood versus adolescence and personality dysfunction in young adulthood. Journal of Personality Disorders 15, 505511.Google Scholar
Hasin, DS, Stinson, FS, Ogburn, E, Grant, BF (2007). Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry 64, 830842.CrossRefGoogle ScholarPubMed
Holmes, SJ, Robins, LN (1988). The role of parental disciplinary practices in the development of depression and alcoholism. Psychiatry 51, 2436.Google Scholar
Hussey, JM, Chang, JJ, Kotch, JB (2006). Child maltreatment in the United States: prevalence, risk factors, and adolescent health consequences. Pediatrics 118, 933942.Google Scholar
Hussong, AM, Curran, PJ, Chassin, L (1998). Pathways of risk for accelerated heavy alcohol use among adolescent children of alcoholic parents. Journal of Abnormal Child Psychology 26, 453466.Google Scholar
Ireland, T, Widom, CS (1994). Childhood victimization and risk for alcohol and drug arrests. International Journal of the Addictions 29, 235274.CrossRefGoogle ScholarPubMed
Kendler, KS (1996). Parenting: a genetic–epidemiologic perspective. American Journal of Psychiatry 143, 1120.Google Scholar
Kendler, KS, Bulik, CM, Silberg, J, Hettema, JM, Myers, J, Prescott, CA (2000). Childhood sexual abuse and adult psychiatric and substance use disorders in women. Archives of General Psychiatry 57, 953959.CrossRefGoogle ScholarPubMed
Kendler, KS, Gardner, CO (1998). Twin studies of adult psychiatric and substance dependence disorders: are they biased by differences in the environmental experiences of monozygotic and dizygotic twins in childhood and adolescence? Psychological Medicine 28, 625633.Google Scholar
Kendler, KS, Prescott, CA (2006). Genes, Environment, and Psychopathology. Guilford: New York.Google Scholar
Kilpatrick, DG, Acierno, R, Saunders, B, Resnick, HS, Best, CL, Schnurr, PP (2000). Risk factors for adolescent substance abuse and dependence: data from a national sample. Journal of Consulting and Clinical Psychology 68, 1930.CrossRefGoogle ScholarPubMed
Lovejoy, CM, Graczyk, PA, O'Hare, EO, Neuman, G (2005). Maternal depression and parenting behavior: a meta-analytic review. Clinical Psychology Review 20, 561592.Google Scholar
Luster, T, Small, SA (1997). Sexual abuse history and problems in adolescence: exploring the effects of moderating variable. Journal of Marriage and the Family 50, 131142.Google Scholar
Maes, HH, Neale, MC, Kendler, KS, Hewitt, JK, Silberg, JL, Foley, DL, Meyer, JM, Rutter, M, Simononoff, E, Pickles, A, Eaves, LJ (1998). Assortative mating for major psychiatric diagnoses in two population-based samples. Psychological Medicine 28, 13891401.Google Scholar
McCurdy, K, Daro, D (1994). Current Trends in Child Abuse Reporting and Fatalities: The Results of the 1993 Annual Fifty State Survey. National Committee to Prevent Child Abuse: Chicago, IL.Google Scholar
McLaughlin, TL, Heath, AC, Bucholz, KK, Madden, PAF, Bierut, LJ, Slutske, WS, Dinwiddie, S, Statham, DJ, Dunne, MP, Martin, NG (2000). Childhood sexual abuse and pathogenic parenting in the childhood recollections of adult twin pairs. Psychological Medicine 30, 12931302.Google Scholar
Molnar, BE, Buka, SL, Kessler, RC (2001). Child sexual abuse and subsequent psychopathology: results from the National Comorbidity Survey. American Journal of Public Health 91, 753760.Google ScholarPubMed
Moran, PB, Vuchinich, S, Hall, NK (2004). Associations between types of maltreatment and substance use during adolescence. Child Abuse and Neglect 28, 565574.Google Scholar
Muthén, LK, Muthén, BO (2001). Mplus User's Guide, 2nd edn. Muthén and Muthén: Los Angeles, CA.Google Scholar
National Research Council (1993). Understanding Child Abuse and Neglect. Panel on Research on Child Abuse and Neglect. Commission on Behavioral and Social Sciences and Education, National Research Council: Washington, DC.Google Scholar
Neale, MC, Cardon, LR (1992). Methodology for Genetic Studies of Twins and Families. NATO ASI Series D: Behavioral and Social Sciences, vol. 67. Kluwer Academic: Dordrecht, The Netherlands.Google Scholar
Nelson, EC, Heath, AC, Madden, PA, Cooper, ML, Dinwiddie, SH, Bucholz, KK, Glowinski, A, McLaughlin, T, Dunne, MP, Statham, DJ, Martin, NG (2002). Association between self-reported childhood sexual abuse and adverse psychosocial outcomes: results from a twin study. Archives of General Psychiatry 59, 139145.Google Scholar
Parker, G (1990). The Parental Bonding Instrument: a decade of research. British Journal of Medical Psychology 52, 110.CrossRefGoogle Scholar
Parker, G, Tupling, H, Brown, LB (1979). A Parental Bonding Instrument. British Journal of Medical Psychology 52, 110.Google Scholar
Prescott, CA (2002). Sex differences in the genetic risk for alcoholism. Alcohol Research and Health 26, 264273.Google Scholar
Prescott, CA (2004). Using the Mplus computer program to estimate models for continuous and categorical data from twins. Behavior Genetics 34, 1740.Google Scholar
Prescott, CA, Madden, PA, Stallings, MC (2006). Challenges in genetic studies of the etiology of substance use and substance use disorders. Behavior Genetics 36, 473482.Google Scholar
Rothman, EF, Edwards, EM, Heeren, T, Hingson, RW (2008). Adverse childhood experiences predict earlier age of drinking onset: results from a representative US sample of current or former drinkers. Pediatrics 122, e298e304.Google Scholar
SAS Institute, Inc. (2004). SAS 9.1.3 Language Reference: Dictionary, Volumes 1, 2, and 3. SAS Institute, Inc.: Cary, NC.Google Scholar
Schulz-Heik, RJ, Rhee, SH, Silvern, LE, Haberstick, BC, Hopfer, C, Lessem, JM, Hewitt, JK (2009). The association between conduct problems and maltreatment: testing genetic and environmental mediation. Behavior Genetics. Published online: 19 December 2009. doi:10.1007/s10519-009-9324-6.Google ScholarPubMed
Sher, KJ, Gershuny, BS, Peterson, L, Raskin, G (1997). The role of childhood stressors in the intergenerational transmission of alcohol use disorders. Journal of Studies on Alcohol 58, 414427.Google Scholar
Shin, SH, Edwards, EM, Heeren, T (2009). Child abuse and neglect: relations to adolescent binge drinking in the national longitudinal study of Adolescent Health (AddHealth) Study. Addictive Behaviors 34, 277280.CrossRefGoogle ScholarPubMed
Showers, CJ, Zeigler-Hill, V, Limke, A (2006). Self-structure and childhood maltreatment: successful compartmentalization and the struggle of integration. Journal of Social and Clinical Psychology 25, 473507.Google Scholar
Simantov, E, Schoen, C, Klein, JD (2000). Health-compromising behaviors: why do adolescents smoke or drink?: identifying underlying risk and protective factors. Archives of Pediatrics and Adolescent Medicine 154, 10251033.CrossRefGoogle ScholarPubMed
Simpson, TL, Miller, WR (2002). Concomitance between childhood sexual and physical abuse and substance use problems: a review. Clinical Psychological Review 22, 2777.Google Scholar
Spitzer, RL, Williams, JBW (1985). Structured Clinical Interview for DSM-III-R (SCID). Biometrics Research Department, New York State Psychiatric Institute: New York.Google Scholar
Stein, JA, Golding, JM, Siegel, JM, Burnam, MA, Sorenson, SB (1988). Long-term psychological sequelae of child sexual abuse: The Los Angeles epidemiologic catchment area study. In Lasting Effects of Child Sexual Abuse (ed. Wyatt, G. E. and Powell, G. J.), pp. 135154. Sage Publications, Inc.: Newbury Park, CA.Google Scholar
Topitzes, J, Mersky, JP, Reynolds, AJ (2009). Childhood maltreatment and adult cigarette smoking: a long-term developmental model. Journal of Pediatric Psychology. Published online: 7 December 2009. doi:10.1093/jpepsy/jsp119.Google Scholar
United States Department of Health and Human Services, Administration on Children, Youth and Families (2009). Child Maltreatment 2007. US Government Printing Office: Washington, DC.Google Scholar
Van Oers, JAM, Bongers, IMB, Van de Goor, LAM, Garretsen, HFL (1999). Alcohol consumption, alcohol-related problems, problem drinking, and socio-economic status. Alcohol and Alcoholism 1, 7888.Google Scholar
Walsh, C, MacMillan, HL, Jamieson, E (2003). The relationship between parental substance abuse and child maltreatment: findings from the Ontario Health Supplement. Child Abuse and Neglect 27, 14091425.Google Scholar
Widom, CS, Ireland, T, Glynn, PJ (1995). Alcohol abuse in abused and neglected children followed-up: are they at increased risk? Journal of Studies on Alcohol 56, 207217.Google Scholar
Widom, CS, White, HR, Czaja, SJ, Marmorstein, NR (2007). Long-term effects of child abuse and neglect on use and excessive drinking in middle adulthood. Journal of Studies on Alcohol and Drugs 68, 317326.Google Scholar
Young-Wolff, KC, Kendler, KS, Sintov, ND, Prescott, CA (2009). Mood-related drinking motives mediate the familial association between major depression and alcohol dependence. Alcoholism: Clinical and Experimental Research 33, 14761486.Google Scholar
Zielinski, DS (2009). Childhood maltreatment and adult socioeconomic well-being. Child Abuse and Neglect 33, 666678.CrossRefGoogle ScholarPubMed