毒品依赖者童年期虐待及相关因素分析
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摘要
毒品问题是我国面临的重要公共卫生与社会问题。截至2008年12月底,我国上网入库的吸毒人员有112.67万人,且呈现年轻化和低龄化趋势,35岁以下的青少年占69.3%。毒品滥用者最终会出现对毒品的依赖。
目前,毒品依赖的具体原因还不清楚。近年来,心理因素对毒品依赖及复吸的影响受到了广泛关注。本研究从四个心理层面探讨毒品依赖的成因：童年期受虐待是一种早期不良应激,它可导致个体HPA轴功能持续亢进,而体内高的糖皮质激素水平又可以增加个体对成瘾的敏感性,因此儿童期受虐待可能是毒品依赖的一个危险因素；应对与应激紧密相连,应对方式在心理应激与身心健康间的中介作用已被众多研究所证实,不良的应对方式与多种心理行为问题相关,因此也可能与毒品依赖有关；感觉寻求是一种人格特质,高感觉寻求者更可能成为高速驾车者、嗜酒者、毒品使用者和追求高刺激活动者,国内关于感觉寻求与毒品依赖的研究较少；幸福感是个体对自己生活状态的综合评价与感受,毒品依赖者作为一个特殊群体,其幸福感也是本课题的重点研究内容。本研究通过以上四个心理层面探讨毒品依赖的成因,以期为毒品依赖的干预与治疗提供新思路,为以后更深一步的生物学机制方面的研究奠定理论和数据基础。
目的
1了解郑州市强制戒毒学员分布概况；
2了解不同父母养育方式对毒品依赖的影响；
3探讨毒品依赖与儿童期受虐待、应对方式及感觉寻求的关系；
4了解戒毒学员的总体幸福感状况。
对象与方法
戒毒组：郑州市强制戒毒所戒毒学员,共184人,男110人,女74人。
正常对照组：新乡某工厂健康职工,男142人,女58人。
采用现场自评式问卷调查的方法,调查内容包括基本情况、吸毒史／饮酒史、家庭情况、童年期受虐待情况、应付方式特征、感觉寻求人格特质及幸福感状况。采用EpiData和SPSS12.0录入数据,用SPSS12.0对数据进行处理和分析,分类变量的比较采用χ2检验,定量变量的均数比较用单因素方差分析和独立样本t检验。
结果
1郑州市强制戒毒所在所学员男性占59.8%,女性占40.2%,年龄范围：16～53岁；小学及以下者占22.3%,初中占50.3%,高中及以上者占27.4%；吸毒前无业者有36.2%,吸毒后无业者占62.4%,吸毒前后职业变化差异有统计学意义(P<0.05)；婚姻状况中离婚或分居者占32.0%；86.4%来自城市,13.6%来自农村。
2戒毒学员第一次吸毒年龄最小11岁,最大53岁,平均(28.01±7.67)岁；第一次吸毒使用的毒品以海洛因为最多,占81.1%；第一次吸毒方式以烫吸居多,占87.0%；76.1%的人第一次吸毒原因为“好奇”；第一次吸毒,毒品来自亲戚朋友的最多,占67.4%；戒毒2次及以上者占63.4%；使用毒品时,4.2%的人曾与别人共用过注射器；戒毒学员家庭成员中有吸毒者的占14.3%。
3戒毒男性童年期虐待总分(45.62±12.37)大于女性(38.75±12.61),戒毒女性总体幸福感总分(85.11±15.54)高于男性(76.89±19.02),差异均有统计学意义(P<0.05)；不同父母养育方式的戒毒学员在总体幸福感总分、对健康的担心、忧郁或愉快的心境、松弛与紧张分量表上得分差异总的来说有统计学意义(P<0.05),养育方式为不管不问的戒毒学员幸福感总分及各分量表得分都较低。
4戒毒学员与正常对照在婚姻状况上的总体分布不同(χ2=145.48,P<0.05),25岁以上的戒毒学员未婚者占30.2%；两组父母的养育方式总体不同(χ2=43.02,P<0.05),戒毒学员父母养育方式为溺爱者较多,而民主者较少；戒毒学员在情感虐待、躯体虐待、性虐待、情感忽视分量表得分及儿童期虐待总分上均高于对照,差异有统计学意义(P<0.05)；无论男女,戒毒学员的消极应对方式得分均高于对照,差异有统计学意义(P<0.05)；戒毒学员感觉寻求总分与年龄的相关性不明显,且感觉寻求总分始终处于较高水平,不同年龄段戒毒学员和对照的感觉寻求差异不同；戒毒学员在总体幸福感总分及各分量表上的得分均高于正常对照,差异有统计学意义(P<0.05)。
结论
1海洛因是郑州市强制戒毒学员首次吸毒所采用的主流毒品；低文化程度、无
业是吸毒的危险因素；青少年是吸毒的潜在和高危人群。
2家庭环境：毒品依赖者的婚姻状况较差；童年期受虐待和不良的父母养育方
式,特别是不管不问的养育方式是吸毒的危险因素。
3毒品依赖者倾向于使用消极的应对方式,且相对于正常人群,毒品依赖者总体幸福感较弱。
4感觉寻求中的去抑制及兴奋与冒险寻求与毒品尝试及毒品依赖有关。
The use of illegal drug is an important public health and social problem in China. By the time of December 2009, there had been more than 1.12 million drug users in our country, and 69.3% was young people under 35 years old. The ultimate outcome of drug abuse is drug dependence.
The exact reason for drug dependence is not clear now. In recent years, researchers have paid more and more attention on the psychosocial factors of drug dependence and relapse. Child abuse is a kind of early life stress, which can result in the accentuation of hypothalamic-pituitary-adrenal (HPA) axis. While the elevated glucocorticoid level can increase individual's sensitivity to dependence/addiction, child abuse may be a risk factor of drug dependence. Coping is closely linked with stress, and the intermediary role of coping style between stress and physical and mental health has been confirmed by many researches. It has been considered that negative coping styles are associated with varieties of psychological and behavioral problems, and may be also associated with drug dependence. Sensation seeking has been defined as a personality pattern characterized by the need to have a variety of new, complicated sensations and experiences as well as a predisposition to physical and social risk for the pure pleasure of feeling it. Higher sensation seeking has been associated with vulnerability to over-speed driving, alcohol abuse, drug use and high stimulation activities. There are limited reports about the relationship between sensation seeking and drug dependence in our country. Subject well-being refers to the global assessment of all aspects of a person's life, including affective and cognitive components. As a special group, the drug addicts'subject well-being is the key issue of this study. This research plans to explore the cause of drug dependence from the above four respects, in order to provide new ideas for the intervention and therapy of drug dependence and establish basis for the future research of relative blood index.
Objectives
1 To understand the distribution of drug dependents in Zhengzhou city.
2 To understand the influence of parenting pattern on drug dependence.
3 To explore the relationships of child abuse, coping style, sensation seeking and drug dependence.
4 To find out the subject well-being of drug dependents
Subjects and Methods
Total of 184 drug dependents (110 males,74 females) and 200 normal controls (142 males,58 females) were involved in the research. They were assessed with Childhood Trauma Questionnaire-28 item Short Form (CTQ-SF), Simplified Coping Style Questionnaire, Sensation Seeking Scale (SSS), General Well-Being Schedule (GWB) and Michigan Alcoholism Screening Test (MAST) on the spot, and all the questionnaires are self-assessment. The data was entry by using the computer software program of EpiData3.0 and SPSS12.0. Classification variables were tested by chi-square (χ2) analysis. Numerical variables were compared by Independent-Samples T test and one-way ANOVA.
Results
1 There were 59.8% males and 40.2% females in the compulsory detoxification department in Zhengzhou city, and the ages of them were from 16 to 53 years old. The distribution of their education level was that 22.3% primary school and below, 50.2% junior high school, and 27.4% high school and above. There was significant difference on occupation before and after illegal drug use (P<0.05). Their marriage was poor in general,32.0% of them had divorced or separated with spouse.86.4% of them came from city and 13.6% came from countryside.
2 The age of dependents first taking drug was from 11 to 53 years old (the average age 28.01±7.67). Most drug addicts (accounting for 81.1%)use heroin for first taking drug. Chasing dragon was the main method (87.0%) of first taking drug. The main reason of first taking drug was curiosity (76.1%). The main sources of drug for first taking drug were their relatives or friends (67.4%).
3 There were significant differences in the scores of child abuse and general well-being between males and females respectively (P<0.05).The total score of child abuse in males (45.62±12.37) was higher than that of females (38.75±12.61), and the total score of general well-being in females (85.11±15.54) was higher than that of the males (76.89±19.02). There were significant differences in some subscale scores and total score of general well-being among different parenting styles (P<0.05), and the dependents who had neglect parenting style had lower scores in all the subscales.
4 The distribution of marriage status and parenting styles between the dependent group and the normal group were different respectively(χ2=145.48, P<0.05;χ2=43.02, P<0.05). There were significant differences in the total score of child abuse and subscale scores of emotional abuse, physical abuse, sexual abuse, emotional neglect between the two groups, and the scores of dependent group were all higher than that of the normal group (P<0.05). Significant difference also existed in negative coping styles between the two groups (P<0.05). The total score of sensation seeking in the dependent group didn't decrease with the increasing of age, and it was in a relative high level in lifetime. There were differences in sensation seeking in different age stages. The total score and every subscale score of general well-being in dependent group were higher than that in the normal group, the differences between them were significant (P<0.05).
Conclusions
1 Heroin is the main illegal drug epidemics in Zhengzhou city, low educational level and unemployed are the rick factors for drug dependence. Adolescents are the potential high risk groups of drug dependent.
2 The marriage status of dependents is poor. Child abuse and neglect parenting style has infaust influence on drug dependence.
3 Drug dependents inclined to use negative coping styles, and compared with normal people, their general well-being are poorer
4 The disinhibition, thrill and adventure seeking is correlated with the initiation and dependence of illegal drug.
目前,毒品依赖的具体原因还不清楚。近年来,心理因素对毒品依赖及复吸的影响受到了广泛关注。本研究从四个心理层面探讨毒品依赖的成因：童年期受虐待是一种早期不良应激,它可导致个体HPA轴功能持续亢进,而体内高的糖皮质激素水平又可以增加个体对成瘾的敏感性,因此儿童期受虐待可能是毒品依赖的一个危险因素；应对与应激紧密相连,应对方式在心理应激与身心健康间的中介作用已被众多研究所证实,不良的应对方式与多种心理行为问题相关,因此也可能与毒品依赖有关；感觉寻求是一种人格特质,高感觉寻求者更可能成为高速驾车者、嗜酒者、毒品使用者和追求高刺激活动者,国内关于感觉寻求与毒品依赖的研究较少；幸福感是个体对自己生活状态的综合评价与感受,毒品依赖者作为一个特殊群体,其幸福感也是本课题的重点研究内容。本研究通过以上四个心理层面探讨毒品依赖的成因,以期为毒品依赖的干预与治疗提供新思路,为以后更深一步的生物学机制方面的研究奠定理论和数据基础。
目的
1了解郑州市强制戒毒学员分布概况；
2了解不同父母养育方式对毒品依赖的影响；
3探讨毒品依赖与儿童期受虐待、应对方式及感觉寻求的关系；
4了解戒毒学员的总体幸福感状况。
对象与方法
戒毒组：郑州市强制戒毒所戒毒学员,共184人,男110人,女74人。
正常对照组：新乡某工厂健康职工,男142人,女58人。
采用现场自评式问卷调查的方法,调查内容包括基本情况、吸毒史／饮酒史、家庭情况、童年期受虐待情况、应付方式特征、感觉寻求人格特质及幸福感状况。采用EpiData和SPSS12.0录入数据,用SPSS12.0对数据进行处理和分析,分类变量的比较采用χ2检验,定量变量的均数比较用单因素方差分析和独立样本t检验。
结果
1郑州市强制戒毒所在所学员男性占59.8%,女性占40.2%,年龄范围：16～53岁；小学及以下者占22.3%,初中占50.3%,高中及以上者占27.4%；吸毒前无业者有36.2%,吸毒后无业者占62.4%,吸毒前后职业变化差异有统计学意义(P<0.05)；婚姻状况中离婚或分居者占32.0%；86.4%来自城市,13.6%来自农村。
2戒毒学员第一次吸毒年龄最小11岁,最大53岁,平均(28.01±7.67)岁；第一次吸毒使用的毒品以海洛因为最多,占81.1%；第一次吸毒方式以烫吸居多,占87.0%；76.1%的人第一次吸毒原因为“好奇”；第一次吸毒,毒品来自亲戚朋友的最多,占67.4%；戒毒2次及以上者占63.4%；使用毒品时,4.2%的人曾与别人共用过注射器；戒毒学员家庭成员中有吸毒者的占14.3%。
3戒毒男性童年期虐待总分(45.62±12.37)大于女性(38.75±12.61),戒毒女性总体幸福感总分(85.11±15.54)高于男性(76.89±19.02),差异均有统计学意义(P<0.05)；不同父母养育方式的戒毒学员在总体幸福感总分、对健康的担心、忧郁或愉快的心境、松弛与紧张分量表上得分差异总的来说有统计学意义(P<0.05),养育方式为不管不问的戒毒学员幸福感总分及各分量表得分都较低。
4戒毒学员与正常对照在婚姻状况上的总体分布不同(χ2=145.48,P<0.05),25岁以上的戒毒学员未婚者占30.2%；两组父母的养育方式总体不同(χ2=43.02,P<0.05),戒毒学员父母养育方式为溺爱者较多,而民主者较少；戒毒学员在情感虐待、躯体虐待、性虐待、情感忽视分量表得分及儿童期虐待总分上均高于对照,差异有统计学意义(P<0.05)；无论男女,戒毒学员的消极应对方式得分均高于对照,差异有统计学意义(P<0.05)；戒毒学员感觉寻求总分与年龄的相关性不明显,且感觉寻求总分始终处于较高水平,不同年龄段戒毒学员和对照的感觉寻求差异不同；戒毒学员在总体幸福感总分及各分量表上的得分均高于正常对照,差异有统计学意义(P<0.05)。
结论
1海洛因是郑州市强制戒毒学员首次吸毒所采用的主流毒品；低文化程度、无
业是吸毒的危险因素；青少年是吸毒的潜在和高危人群。
2家庭环境：毒品依赖者的婚姻状况较差；童年期受虐待和不良的父母养育方
式,特别是不管不问的养育方式是吸毒的危险因素。
3毒品依赖者倾向于使用消极的应对方式,且相对于正常人群,毒品依赖者总体幸福感较弱。
4感觉寻求中的去抑制及兴奋与冒险寻求与毒品尝试及毒品依赖有关。
The use of illegal drug is an important public health and social problem in China. By the time of December 2009, there had been more than 1.12 million drug users in our country, and 69.3% was young people under 35 years old. The ultimate outcome of drug abuse is drug dependence.
The exact reason for drug dependence is not clear now. In recent years, researchers have paid more and more attention on the psychosocial factors of drug dependence and relapse. Child abuse is a kind of early life stress, which can result in the accentuation of hypothalamic-pituitary-adrenal (HPA) axis. While the elevated glucocorticoid level can increase individual's sensitivity to dependence/addiction, child abuse may be a risk factor of drug dependence. Coping is closely linked with stress, and the intermediary role of coping style between stress and physical and mental health has been confirmed by many researches. It has been considered that negative coping styles are associated with varieties of psychological and behavioral problems, and may be also associated with drug dependence. Sensation seeking has been defined as a personality pattern characterized by the need to have a variety of new, complicated sensations and experiences as well as a predisposition to physical and social risk for the pure pleasure of feeling it. Higher sensation seeking has been associated with vulnerability to over-speed driving, alcohol abuse, drug use and high stimulation activities. There are limited reports about the relationship between sensation seeking and drug dependence in our country. Subject well-being refers to the global assessment of all aspects of a person's life, including affective and cognitive components. As a special group, the drug addicts'subject well-being is the key issue of this study. This research plans to explore the cause of drug dependence from the above four respects, in order to provide new ideas for the intervention and therapy of drug dependence and establish basis for the future research of relative blood index.
Objectives
1 To understand the distribution of drug dependents in Zhengzhou city.
2 To understand the influence of parenting pattern on drug dependence.
3 To explore the relationships of child abuse, coping style, sensation seeking and drug dependence.
4 To find out the subject well-being of drug dependents
Subjects and Methods
Total of 184 drug dependents (110 males,74 females) and 200 normal controls (142 males,58 females) were involved in the research. They were assessed with Childhood Trauma Questionnaire-28 item Short Form (CTQ-SF), Simplified Coping Style Questionnaire, Sensation Seeking Scale (SSS), General Well-Being Schedule (GWB) and Michigan Alcoholism Screening Test (MAST) on the spot, and all the questionnaires are self-assessment. The data was entry by using the computer software program of EpiData3.0 and SPSS12.0. Classification variables were tested by chi-square (χ2) analysis. Numerical variables were compared by Independent-Samples T test and one-way ANOVA.
Results
1 There were 59.8% males and 40.2% females in the compulsory detoxification department in Zhengzhou city, and the ages of them were from 16 to 53 years old. The distribution of their education level was that 22.3% primary school and below, 50.2% junior high school, and 27.4% high school and above. There was significant difference on occupation before and after illegal drug use (P<0.05). Their marriage was poor in general,32.0% of them had divorced or separated with spouse.86.4% of them came from city and 13.6% came from countryside.
2 The age of dependents first taking drug was from 11 to 53 years old (the average age 28.01±7.67). Most drug addicts (accounting for 81.1%)use heroin for first taking drug. Chasing dragon was the main method (87.0%) of first taking drug. The main reason of first taking drug was curiosity (76.1%). The main sources of drug for first taking drug were their relatives or friends (67.4%).
3 There were significant differences in the scores of child abuse and general well-being between males and females respectively (P<0.05).The total score of child abuse in males (45.62±12.37) was higher than that of females (38.75±12.61), and the total score of general well-being in females (85.11±15.54) was higher than that of the males (76.89±19.02). There were significant differences in some subscale scores and total score of general well-being among different parenting styles (P<0.05), and the dependents who had neglect parenting style had lower scores in all the subscales.
4 The distribution of marriage status and parenting styles between the dependent group and the normal group were different respectively(χ2=145.48, P<0.05;χ2=43.02, P<0.05). There were significant differences in the total score of child abuse and subscale scores of emotional abuse, physical abuse, sexual abuse, emotional neglect between the two groups, and the scores of dependent group were all higher than that of the normal group (P<0.05). Significant difference also existed in negative coping styles between the two groups (P<0.05). The total score of sensation seeking in the dependent group didn't decrease with the increasing of age, and it was in a relative high level in lifetime. There were differences in sensation seeking in different age stages. The total score and every subscale score of general well-being in dependent group were higher than that in the normal group, the differences between them were significant (P<0.05).
Conclusions
1 Heroin is the main illegal drug epidemics in Zhengzhou city, low educational level and unemployed are the rick factors for drug dependence. Adolescents are the potential high risk groups of drug dependent.
2 The marriage status of dependents is poor. Child abuse and neglect parenting style has infaust influence on drug dependence.
3 Drug dependents inclined to use negative coping styles, and compared with normal people, their general well-being are poorer
4 The disinhibition, thrill and adventure seeking is correlated with the initiation and dependence of illegal drug.
引文
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