The use of the term binge drinking and the 5/4 measure have helped to advance the understanding of college alcohol use over the past 10 years. The present article discusses the importance, relevance, and utility of this measure.

Binge drinking and the American college student: what's five drinks?

Characteristics of binge drinkers in Europe

The Addiction Severity Index (ASI) is a multi-dimensional interview used to measure the substance use, health, and social problems of those with alcohol and other drug problems, both at admission to treatment and subsequently at follow-up contacts. This article first discusses the conceptual and practical importance of the ASI's multi-dimensional approach to measuring addiction severity, as illustrated by two case presentations. The second section of the paper reviews how this measurement approach has led to some important findings regarding the prediction and measurement of addiction treatment effectiveness. The third section describes the historical and practical considerations that have changed the instrument over time, details the problems with the instrument, and describes our efforts to correct those problems with the ASI-6. Finally, some recent ASI data collected from over 8,400 patients admitted to a nationally representative sample of U.S. addiction treatment programs are presented.

The Addiction Severity Index at 25: origins, contributions and transitions.

Aims The paper discusses the kinds of reasoning that have been presented as possible mechanisms and reasons for gender differences in alcohol consumption.

Design and methods  An overview of the existing literature from different countries is presented.

Findings  The existing studies provide a picture of great cultural variance in patterns of alcohol use among men and women. The gender differences in drinking behaviour have been shown to be linked with many aspects of biological differences between men and women leading to women's greater vulnerability to alcohol, of women's and men's differing needs, reasons and motivations in relation to drinking, of gender-specific roles in other areas of life and of ways in which societies regulate peoples’ behaviour, often giving women the role of warden or moderator of others’ drinking.

Conclusions  The gender differences in drinking behaviour continue to be considerable and are found in all cultures studied so far. Several studies have argued for reasons underlying these differences, but they still remain largely unexplained.

Gender differences in drinking: why do they still exist?

Acknowledgements 1 Definitions, scope, and origin of the health-related self-help group movement 2 An international tour of addiction-related mutual help organizations 3 Does self-help group participation produce positive substance abuse, psychiatric, and medical outcomes? 4 A different perspective on change in self-help organizations: spirituality, identity, life stories, friendship networks, and politicization 5 Government, health care organization, and clinical interactions with self-help organizations Epilogue: summing up, moving forward References Index

/pdf/circles-of-recovery-self-help-organizations-for-addictions-2figs88ia1.pdf

Circles of recovery : self-help organizations for addictions

Aims To examine the reliability and validity of the widely used Addiction Severity Index (ASI)



Material  Thirty-seven studies of the psychometric performance of the ASI



Findings  The inter-rater and test–retest reliabilities of the severity ratings and composites scores vary from excellent to unsatisfactory High internal consistencies have been reported regularly for only three of the seven composite scores (medical status, alcohol use, psychiatric status) The remaining four composite scores (employment status, drug use, legal status, family/social relations) have low consistencies in at least four different studies Coefficients of criterion validity are often low



Conclusions  There is a discrepancy between the psychometric performance of the ASI and its purported clinical, administrative and research uses

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1360-0443.2003.00665.x

Studies of the reliability and validity of the Addiction Severity Index.

AIMS: To assess associations between drinking behaviour, gender and age with reported experiences related to drinking. DESIGN: Cross-sectional survey. SETTING AND PARTICIPANTS: Interviews were performed in 1992 with a representative sample of the Finnish population between 15 and 69 years of age (N = 3446). MEASUREMENTS: Annual intake of alcohol, frequency of drunkenness, and 14 negative and eight positive reported experiences related to drinking. FINDINGS: Logistic regression models showed that overall intake and frequency of drunkenness were independently associated with almost all reported positive and negative consequences of drinking. Women more commonly reported that drinking had helped them to sort out interpersonal problems at home or in the work-place, to feel more optimistic about life, and to express their feelings. Men more commonly reported that drinking had helped them to be funnier and wittier and to get closer to the opposite sex. Drunken driving was markedly male behaviour, but women more commonly reported other types of reckless behaviour and adverse consequences of drinking. However, men more commonly said they were criticized by family for their drinking. With the exception of health problems, both positive and negative consequences of alcohol were more common among younger drinkers. CONCLUSIONS: Once overall intake and frequency of drunkenness were controlled for, significant differences between men's and women's perceptions of the costs and benefits of alcohol consumption emerged. Men tended to perceive more hedonic benefits while women perceived more functional benefits. Women reported behaving more recklessly in drinking situations. In light of the results, women were not under selective social control. Language: en

Relationships of drinking behaviour, gender and age with reported negative and positive experiences related to drinking

In 1986, AA activities (a minimum of five groups) typically occurred in non-socialist, non-Islamic countries with a GNP per capita above US$ 1000. From 1965 to 1986, the share of English speaking and Scandinavian countries of all AA groups diminished, and the share of Central and Southern European, and particularly of Latin America, increased. Correlation analysis of countries fulfilling the typical preconditions of AA indicates changes in the relationships of AA to social background factors. In 1965, AA was strongest in the wealthiest countries, but no such correlation was observed in 1986. The rate of growth of AA has been higher in Roman Catholic countries. Wine consumption is negatively and beer consumption positively correlated to the strength of AA. Cross-sectional strength of AA is not related to spirits consumption, but its rate of growth has been higher in countries where spirits are consumed. The first wave of diffusion brought AA to the Anglo-Saxon and Protestant world. The second wave covered American and European Catholic countries, and bridgeheads have been established in newly industrialized nations. Still, AA remains a phenomenon of developed and wealthy societies.

Social and cultural preconditions of Alcoholics Anonymous (AA) and factors associated with the strength of AA.

Summary

Interview data on drinking and its consequences, representative of the population between IS and 69 years of age in Finland in 1984, were analysed by loglinear modelling. Most experiences related to drinking were predicted simply as functions of a suitable transformation of logarithmically classified annual alcohol intake (C). The transformation of C varied according to how common each experience was as well as to the nature of the experience. The logarithm of C provided the best prediction of the positive consequences of drinking. Reactions against drinking from institutional agents were most satisfactorily predicted by the square of C. With increasing consumption, problematic behaviour, negative consequences and social reactions against drinking increased more steeply than positive effects, but perceived benefits of drinking continued to increase also among those with the highest consumption levels.

Positive and negative experiences related to drinking as a function of annual alcohol intake.

In drinking and drug surveys, peers are perceived as drinking more and using more drugs than the respondent Particularly in youth studies, this majority fallacy is often interpreted as an indication of peer pressure toward drinking and drug use However, exaggerating the alcohol and drug behaviours of significant others may be a way of reducing cognitive dissonance The behaviour of most people deviates from their ideal norms The ensuing dissonance can be alleviated by introducing the behaviour of others as a third element in the cognitive field Data from three Scandinavian surveys support the following two predictions based on the theory of cognitive dissonance: (1) The tendency to report that other people drink more than oneself is more marked in restrictive than in permissive communities (2) On each level of alcohol intake, the tendency to report that other people drink more than oneself is stronger among respondents having negative alcohol attitudes than among respondents with positive attitudes to alcohol The need to alleviate the cognitive dissonance caused by a discrepancy between actual behaviour and normative standards is thus one of the mechanisms generating the majority fallacy: "I may not be perfect, but other people are still worse" Feeling better than others does not necessarily amount to a pressure to turn bad

Klaus Mäkelä

Papers

Studies of the reliability and validity of the Addiction Severity Index.

Relationships of drinking behaviour, gender and age with reported negative and positive experiences related to drinking

Social and cultural preconditions of Alcoholics Anonymous (AA) and factors associated with the strength of AA.

Positive and negative experiences related to drinking as a function of annual alcohol intake.

Drinking, the majority fallacy, cognitive dissonance and social pressure.