Browsing by Author "Hakonen, Emma"

Objective: Traumatic life events such as sexual violence predispose victims to wide-ranging mental health and substance use disorders. The evidence indicates a strong association between experiences of childhood and adulthood sexual violence and alcohol-related problems, but the reasons behind the association are still debated. Studies show that sexual violence and alcohol use disorders share some risk factors. Only a few studies have taken shared vulnerability into consideration with a co-twin control design, and they have only focused on childhood sexual abuse. Furthermore, results concerning the extent of the shared vulnerability vary. Studies are largely based on samples of young adults, and there is insufficient evidence on whether sexual violence affects alcohol use later in life. The first aim of this study is to explore whether childhood sexual abuse and adulthood sexual violence are associated with lifetime alcohol-related problems and alcohol use in late adulthood. The second aim is to examine whether the found associations are explained by shared vulnerability. Methods: The data were collected as a part of The older Finnish Twin Cohort study. The participants were Finnish twins first studied in 1975. The survey data used in this study were collected in 2011 when the twins (n=8410) were on average 60 years old (ranging from 53 to 68). Experiences of sexual violence and abuse were assessed as a part of the short version of the Trauma History Screen and alcohol-related problems were assessed with the Malmö-Modified Michigan Alcoholism Screening Test. In addition, recent alcohol use was estimated. Associations between sexual violence and alcohol use were examined with linear mixed models. Association between sexual violence and alcohol-related problems was examined with Poisson link function models (1) treating twins as uncorrelated individuals in mixed models and (2) comparing discordant twins with each other in fixed-effects models. Age, sex, and age at first drink were controlled for in all models. In addition, depressive symptoms measured with the CES-D were controlled for when predicting alcohol use. Results and conclusions: Childhood sexual abuse and adulthood sexual violence were associated with a higher risk for increased lifetime alcohol-related problems, but they did not affect alcohol use in late adulthood. Twins exposed to sexual violence in childhood or adulthood had a significantly higher risk for increased lifetime alcohol-related problems compared to their non-exposed co-twins. Common risk factors partly explained the association between sexual violence and alcohol-related problems in adult victims of sexual violence but not in victims of childhood sexual abuse. However, both childhood and adulthood sexual violence seemed to predispose victims to an increased risk of alcohol-related problems independently from shared vulnerability. These findings add to existing literature, providing new insights into the shared vulnerability hypothesis and the potential long-term effects of sexual violence.