Community exposure to armed conflict and subsequent onset of alcohol use disorder

IF 5.2 1区医学 Q1 PSYCHIATRY

Addiction Pub Date : 2023-09-27 DOI:10.1111/add.16343

Ronny Bruffaerts, William G. Axinn, Dirgha J. Ghimire, Corina Benjet, Stephanie Chardoul, Kate M. Scott, Ronald C. Kessler, Paul Schulz, Jordan W. Smoller

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Abstract

Aims

To measure the independent consequences of community-level armed conflict beatings on alcohol use disorders (AUD) among males in Nepal during and after the 2000–2006 conflict.

Design

A population-representative panel study from Nepal, with precise measures of community-level violent events and subsequent individual-level AUD in males. Females were not included because of low AUD prevalence.

Setting

Chitwan, Nepal.

Participants

Four thousand eight hundred seventy-six males from 151 neighborhoods, systematically selected and representative of Western Chitwan. All residents aged 15–59 were eligible (response rate 93%).

Measurements

Measures of beatings in the community during the conflict (2000–2006), including the date and distance away, were gathered through neighborhood reports, geo-location and official resources, then linked to respondents' life histories of AUD (collected in 2016–2018) using the Nepal-specific Composite International Diagnostic Interview with life history calendar. Beatings nearby predict the subsequent onset of AUD during and after the armed conflict. Data were analyzed in 2021–2022.

Findings

Cohort-specific, discrete-time models revealed that within the youngest cohort (born 1992–2001), those living in neighborhoods where armed conflict beatings occurred were more likely to develop AUD compared with those in other neighborhoods (odds ratio = 1.66; 95% confidence interval = 1.02–2.71). In this cohort, a multilevel matching analysis designed to simulate a randomized trial showed the post-conflict incidence of AUD for those living in neighborhoods with any armed conflict beatings was 9.5% compared with 5.3% in the matched sample with no beatings.

Conclusions

Among male children living in Chitwan, Nepal during the 2000–2006 armed conflict, living in a neighborhood where armed conflict beatings occurred is associated with increased odds of developing subsequent alcohol use disorder. This association was independent of personal exposure to beatings and other mental disorders.

Abstract Image

查看原文本刊更多论文

社区暴露在武装冲突中，随后出现酗酒障碍。

目的：衡量2000-2006年冲突期间和之后，尼泊尔男性因酒精使用障碍而遭受社区一级武装冲突殴打的独立后果。设计：一项来自尼泊尔的人口代表性小组研究，对社区层面的暴力事件和随后男性的个人层面AUD进行了精确测量。由于AUD患病率较低，女性未被纳入。背景：尼泊尔奇特旺。参与者：来自151个社区的四千八百七十六名男性，系统选择并代表西奇特旺地区。所有15-59岁的居民都符合条件（回复率93%）。测量：通过社区报告、地理位置和官方资源收集冲突期间（2000-2006年）社区中的殴打情况，包括日期和距离，然后使用尼泊尔特有的生活史日历综合国际诊断访谈，将受访者的AUD生活史（收集于2016-2018年）联系起来。附近的殴打事件预测了随后在武装冲突期间和之后澳元的爆发。2021-2022年的数据进行了分析。结果：特定于队列的离散时间模型显示，在最年轻的队列（1992-2001年出生）中，与其他社区的人相比，生活在发生武装冲突殴打的社区的人更有可能患上AUD（比值比 = 1.66；95%置信区间 = 1.02-2.71）。在该队列中，一项旨在模拟随机试验的多水平匹配分析显示，生活在有任何武装冲突殴打的社区的人，冲突后AUD的发生率为9.5%，而在没有殴打的匹配样本中，这一比例为5.3%。结论：在2000-2006年武装冲突期间居住在尼泊尔奇特万的男性儿童中，生活在发生武装冲突殴打的社区与随后患上酒精使用障碍的几率增加有关。这种联系与个人遭受殴打和其他精神障碍无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addiction 医学-精神病学

CiteScore

10.80

自引率

6.70%

发文量

319

审稿时长

3 months

期刊介绍： Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.