Adverse Childhood Experiences are Associated with High-Intensity Binge Drinking Behavior in Adulthood and Mediated by Psychiatric Disorders

• Published in: Alcohol and alcoholism (Oxford) Vol. 55; no. 2; pp. 204 - 214
• Main Authors: Jung, Jeesun, Rosoff, Daniel B, Muench, Christine, Luo, Audrey, Longley, Martha, Lee, Jisoo, Charlet, Katrin, Lohoff, Falk W
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 19-03-2020
• Subjects: Adult; Adult Survivors of Child Abuse - psychology; Binge Drinking - epidemiology; Comorbidity; Female; Humans; Male; Mental Disorders - epidemiology; Middle Aged; United States - epidemiology; United States
• ISSN: 0735-0414; 1464-3502
• DOI: 10.1093/alcalc/agz098

High-intensity binge drinking (HIBD), defined as two or more times the gender-specific binge threshold, is rapidly increasing in the USA; however, the underlying contributing factors are poorly understood. This study investigated the relationship of adverse childhood experiences (ACEs) and HIBD.
Two independent, cross-sectional samples were analysed: (a) past 12-month drinkers in the National Epidemiological Survey on Alcohol and Related Conditions-III (NESARC-III; n = 25,552) and (b) the National Institute on Alcohol Abuse and Alcoholism (NIAAA) clinical sample (n = 1303). Multinomial logistic regressions were utilized to estimate adjusted odds ratios (AORs) of ACEs on HIBD. Mediation analysis was performed to examine the relationship between the past 12-month psychiatric disorders, ACEs, and HIBD.
In the NESARC-III sample, prevalence of ACEs increased across all binge levels with the highest prevalence in extreme HIBD; ACEs were associated with higher odds for HIBD (level II, odds ratio (OR) = 1.2-1.4; P = 0.03-0.001; level III, OR = 1.3-1.9; P < 0.001). Prevalence of DSM-5 diagnoses also increased across all binge levels. Substance use disorders (SUD), mood, personality and post-traumatic stress disorders (PTSD) conferred the highest odds with extreme HIBD (SUD: OR = 21.32; mood: 1.73; personality: 2.84; PTSD: 1.97; all Ps < 0.001). Mediation analyses showed that the association between ACEs and HIBD was fully mediated through SUD (proportion mediated: 70-90%) and partially through other psychiatric disorders (20-80%). In the NIAAA sample, ACEs were 2-5 times more prevalent in extreme HIBD with higher odds (ORs = 3-8, P < 0.001) compared with non-bingers.
ACEs were associated with significantly increased odds of HIBD and the relationship may be mediated by psychiatric disorders.