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

Adv Clin Exp Med. 2018 Sep;27(9):1271-1277. doi: 10.17219/acem/70792.


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.

Conclusions: 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.

Keywords: adult survivors; alcoholism; child abuse; health; self-efficacy.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Adult Survivors of Child Abuse / psychology*
  • Adult Survivors of Child Adverse Events / psychology*
  • Adverse Childhood Experiences*
  • Alcohol Drinking / psychology*
  • Alcoholism / epidemiology
  • Alcoholism / psychology*
  • Child
  • Cross-Sectional Studies
  • Health Behavior
  • Humans
  • Middle Aged
  • Poland / epidemiology
  • Self Efficacy