Criminal victimization and comorbid substance use and psychiatric disorders in the United States: results from the NESARC.

PURPOSE Criminal victimization produces enormous personal and societal costs, yet few investigations have systematically examined substance use and psychiatric disorders of crime victims. Our objectives were to (i) examine the prevalence and patterns of criminal victimization in the United States and (ii) their associations with specific substance use disorders, prevalent psychiatric conditions, and violent and nonviolent antisocial behaviors in controlled multivariate analyses. METHODS Data were derived from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative sample of US residents 18 years of age and older (N=43,093). Interviews conducted between 2001 and 2002 included measures of past-year criminal victimization and Diagnostic and Statistical Manual of Mental Disorders, IV mood, anxiety, substance use, and personality disorders. RESULTS More than 1-in-25 adults in the United States (4.1%) reported past-year criminal victimization. Respondents who reported lower levels of income, lived in urban areas, and were separated or divorced were at significantly heightened risk for criminal victimization. Persons reporting various forms of violent and nonviolent antisocial behavior also were more likely to be victims of crime. In controlled multivariate analyses, crime victims evidenced significantly increased rates of alcohol, cocaine, and opioid use disorders. Paranoid personality disorder, major depressive disorder, and a family history of antisocial behavior were also significantly associated with past-year criminal victimization. CONCLUSIONS Criminal victimization is prevalent in the United States and associated with significant psychiatric comorbidities and behavioral dysfunction. Poor, unmarried persons living in urban areas who have family histories of antisocial conduct and personal histories of specific substance use and psychiatric disorders are at substantially elevated risk for criminal victimization.