Aim

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.

Methods

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.

Results

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.

Conclusion

ACEs were associated with significantly increased odds of HIBD and the relationship may be mediated by psychiatric disorders.

中文翻译：

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不良的童年经历与成年后的高强度酗酒行为有关，并由精神疾病介导

 目的

高强度暴饮 (HIBD) 定义为特定性别暴饮阈值的两倍或以上，在美国正在迅速增加；然而，人们对潜在的影响因素知之甚少。本研究调查了不良童年经历 (ACE) 与 HIBD 的关系。

 方法

对两个独立的横断面样本进行了分析：(a) 国家酒精和相关病症流行病学调查 III (NESARC-III；n = 25,552) 中过去 12 个月的饮酒者和 (b) 国家酒精滥用研究所和酒精中毒 (NIAAA) 临床样本 (n = 1303)。利用多项逻辑回归来估计 HIBD ACE 的调整优势比 (AOR)。进行中介分析以检查过去 12 个月的精神疾病、ACE 和 HIBD 之间的关系。

 结果

在 NESARC-III 样本中，所有暴饮水平中 ACE 的患病率均有所增加，其中极端 HIBD 的患病率最高； ACE 与 HIBD 的较高几率相关（II 级，比值比 (OR) = 1.2–1.4；P = 0.03–0.001；III 级，OR = 1.3–1.9；P < 0.001）。所有暴食水平的 DSM-5 诊断患病率也有所增加。药物使用障碍 (SUD)、情绪、人格和创伤后应激障碍 (PTSD) 导致极端 HIBD 的几率最高（SUD：OR = 21.32；情绪：1.73；性格：2.84；PTSD：1.97；所有 Ps < 0.001） 。中介分析表明，ACE 和 HIBD 之间的关联完全通过 SUD 介导（介导比例：70-90%），部分通过其他精神疾病介导（20-80%）。在 NIAAA 样本中，与非酗酒者相比，极端 HIBD 中 ACE 的发生率高出 2-5 倍，且几率更高（OR = 3-8，P < 0.001）。

 结论

ACE 与 HIBD 发病率显着增加相关，这种关系可能是由精神疾病介导的。