Advances in Clinical and Experimental Medicine

Adv Clin Exp Med
Impact Factor (IF) – 1.514
Index Copernicus (ICV 2018) – 157.72
MNiSW – 40
Average rejection rate – 84.38%
ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download PDF

Advances in Clinical and Experimental Medicine

2018, vol. 27, nr 9, September, p. 1271–1277

doi: 10.17219/acem/70792

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Creative Commons BY-NC-ND 3.0 Open Access

A need for intervention: Childhood adversities are a significant determinant of health-harming behavior and poor self-efficacy in patients with alcohol dependence. An observational, cross-sectional study on the population of Central Poland

Dominika Berent1,A,B,C,D,F, Michał Podgórski2,C,F, Andrzej Kokoszka1,E,F

1 Department of Psychiatry II, Medical University of Warsaw, Poland

2 Department of Diagnostic Imaging, Polish Mother’s Memorial Hospital Research Institute, Łódź, Poland


Background. Adverse childhood experiences (ACEs) are known to be associated with a lasting effect on physical and psychological well-being in adulthood. Patients with alcohol dependence (AD) are a particular clinical subgroup who report a higher number of ACE categories than the general population and who develop several health-harming behaviors and poor social skills.
Objectives. To our knowledge, this is the first study on patients with AD that aimed to assess whether ACEs correlate with health habits and general self-efficacy in adulthood.
Material and Methods. The study comprised 196 patients with AD (F = 50) with a mean age of 43.8 years. The following research tools were used: the Health Behavior Inventory (HBI), the Generalized Self-Efficacy Scale (GSES) and the ACE Study score, expanded with 3 more questions about exposure to sudden stress and violence outside the family. Additionally, the patients’ sociodemographic and clinical characteristics were assessed and included in the multiple stepwise regression analysis for variation in health habits and general self-efficacy.
Results. The mean scores of the patients were 64.4 ±16.6 points on the HBI and 28.4 ±6.2 points on the GSES. The study revealed a mean number of 3.3 ±2.7 ACEs. The multiple regression analysis showed that the ACEs were significantly and inversely associated with self-efficacy assessed by the GSES and with health habits evaluated by the HBI (β = –0.377; p = 0.026 and β = –1.210; p = 0.007, respectively). The ACEs accounted for 3.2% of the GSES model variability and 3.9% of the HBI variability.
Conclusion. Adverse childhood experiences might promote the development of health-harming behaviors and inferior general self-efficacy in adult patients with AD. The study suggests the need for primary and secondary preventive strategies targeted at ACEs and at general self-efficacy impaired by childhood adversities for further better well-being. However, although the influence of the ACEs was significant, there are many other factors that were not included in the analysis, which explain the remaining variability of health behaviors and general self-efficacy.

Key words

health, alcoholism, child abuse, adult survivors, self-efficacy

References (37)

  1. Crews FT, Vetreno RP, Broadwater MA, et al. Adolescent alcohol exposure persistently impacts adult neurobiology and behavior. Pharmacol Rev. 2016;68(4):1074–1109.
  2. Bora E, Zorlu N. Social cognition in alcohol use disorder: A meta-analysis. Addiction. 2017;112(1):40–48. doi:10.1111/add.13486
  3. Thorberg FA, Young RM, Lyvers M, et al. Alexithymia in relation to alcohol expectancies in alcohol-dependent outpatients. Psychiatry Res. 2016;236:186–188. doi:10.1016/j.psychres.2016.01.016
  4. Schwarzer R, Mueller I, Greenglass E. Assessment of perceived general self-efficacy on the internet: Data collection in cyberspace. Anxiety Stress Coping. 1999;12:145–161.
  5. Bandura A. Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NY: Prentice-Hall; 1986.
  6. Greenfield SF, Hufford MR, Vagge LM, et al. The relationship of self-efficacy expectancies to relapse among alcohol dependent men and women: A prospective study. J Stud Alcohol. 2000;61(2):345–351.
  7. Trucco EM, Connery HS, Griffin ML, et al. The relationship of self-esteem and self-efficacy to treatment outcomes of alcohol-dependent men and women. Am J Addict. 2007;16(2):85–92.
  8. Bandura A, Reese L, Adams NE. Microanalysis of action and fear arousal as a function of differential levels of perceived self-efficacy. J Pers Soc Psychol. 1982;43:5–21.
  9. Benight C, Bandura A. Social cognitive theory of posttraumatic recovery: The role of perceived self-efficacy. Behav Res Ther. 2004;42(10): 1129–1148. doi:10.1016/j.brat.2003.08.008
  10. Hinnen C, Sanderman R, Sprangers MAG. Adult attachment as mediator between recollections of childhood and satisfaction with life. Clin Psychol Psychother. 2009;16:10–21. doi:10.1002/cpp.600
  11. Suzuki H, Tomoda A. Roles of attachment and self-esteem: Impact of early life stress on depressive symptoms among Japanese institutionalized children. BMC Psychiatry. 2015;15:8. doi:10.1186/s12888-015-0385-1
  12. Felitti VJ. The relationship of adverse childhood experiences to adult health: Turning gold into lead [in German]. Z Psychosom Med Psychother. 2002;48(4):359–369.
  13. Anda RF, Whitfield CL, Felitti VJ, et al. Adverse childhood experiences, alcoholic parents, and later risk of alcoholism and depression. Psychiatr Serv. 2002;53:1001–1009.
  14. Shin SH, Pelucchi C, Bagnardi V, et al. Child abuse and neglect: Relations to adolescent binge drinking in the national longitudinal study of adolescent health (AddHealth) study. Addict Behav. 2009;34:277–280.
  15. Latendresse SJ, Rose RJ, Viken RJ, et al. Parenting mechanisms in links between parents’ and adolescents’ alcohol use behaviors. Alcoholism Clin Exp Res. 2008;32:322−330. doi:10.1111/j.1530-0277.2007.00583.x
  16. Bellis MA, Hughes K, Leckenby N, et al. Measuring mortality and the burden of adult disease associated with adverse childhood experiences in England: A national survey. J Public Health (Oxf). 2015;37(3): 445–454.
  17. Bellis MA, Hughes K, Nicholls J, et al. The alcohol harm paradox: Using a national survey to explore how alcohol may disproportionately impact health in deprived individuals. BMC Public Health. 2016;16:111. doi:10.1186/s12889-016-2766-x
  18. Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998;14:245–258.
  19. Anda RF, Dong M, Brown DW, et al. The relationship of adverse childhood experiences to a history of premature death of family members. BMC Public Health. 2009;9:106. doi:10.1186/1471-2458-9-106
  20. Finkelhor D, Shattuck A, Turner H, et al. Improving the adverse childhood experiences study scale. JAMA Pediatr. 2013;167(1):70–75. doi:10. 1001/jamapediatrics.2013.420
  21. Stathopoulou G, Powers M, Berry A, et al. Exercise interventions for mental health: A quantitative and qualitative review. Clin Psychol Sci Pract. 2006;13:180–193.
  22. World Health Organization. The ICD-10 Classification of Mental and Behavioral Disorders: Clinical Description and Diagnostic Guidelines. Geneva, Switzerland: WHO; 1992.
  23. Daeppen JB, Yersin B, Landry U, et al. Reliability and validity of the Alcohol Use Disorders Identification Test (AUDIT) imbedded within a general health risk screening questionnaire: Results of a survey in 332 primary care patients. Alcohol Clin Exp Res. 2000;24(5):659–665.
  24. Juczyński Z. Instruments for Measurement in Health Promotion and Health Psychology [in Polish]. 2nd ed. Warsaw, Poland: Pracownia Testów Psychologicznych; 2012.
  25. Schieman S, Taylor J. Statuses, roles, and the sense of mattering. Sociol Perspect. 2001;44(4):469–484. doi:10.1525/sop.2001.44.4.469
  26. McCormack L, Haun J, Sørensen K, Valerio M. Recommendations for advancing health literacy measurement. J Health Commun. 2013;18(1): 9–14.
  27. Weaver NL, Wray RJ, Zellin S, et al. Advancing organizational health literacy in health care organizations serving high-needs populations: A case study. J Health Commun. 2012;17(3):55–66.
  28. Dawson DA, Li TK, Grant BF. A prospective study of risk drinking: At risk for what? Drug Alcohol Depend. 2008;95:62–72.
  29. Roerecke M, Rehm J. Irregular heavy drinking occasions and risk of ischemic heart disease: A systematic review and meta-analysis. Am J Epidemiol. 2010;171:633–644.
  30. Rehm J, Patra J, Popova S. Alcohol drinking cessation and its effect on esophageal and head and neck cancers: A pooled analysis. Int J Cancer. 2007;121:1132–1137.
  31. Probst C, Roerecke M, Behrendt S, et al. Socioeconomic differences in alcohol-attributable mortality compared with all-cause mortality: A systematic review and meta-analysis. Int J Epidemiol. 2014;43(4): 1314–1327. doi:10.1093/ije/dyu043
  32. Marmot M, Allen J, Bell R, et al.; Consortium for the European Review of Social Determinants of Health and the Health Divide. WHO European review of social determinants of health and the health divide. Lancet. 2012;380(9846):1011–1029.
  33. Czyz EK, Bohnert ASB, King CA, et al. Self-efficacy to avoid suicidal action: Factor structure and concurrent validity among adults in substance use disorder treatment. Suicide Life Threat Behav. 2014;44(6): 698–709. doi:10.1111/sltb.12101
  34. Kobayashi Y, Fujita K, KanekoY, et al. Self-efficacy as a suicidal ideation predictor: A population cohort study in rural Japan. Open Journal Prev Med. 2015;5:61–71.
  35. World Health Organization. Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020. http:/ Published 2013. Accessed December 16, 2015.
  36. Hardt J, Rutter M. Validity of adult retrospective reports of adverse childhood experiences: Review of the evidence. J Child Psychol Psychiatry. 2004;45(2):260–273.
  37. Layne CM, Warren JS, Hilton S, et al. Measuring Adolescent Perceived Support Amidst War and Disaster: The Multi-Sector Social Support Inventory. In: Baker BK, ed. Adolescents and War: How Youth Deal With Political Violence. New York, NY: Oxford University Press; 2009:145–176.