Showing papers in "Journal of Studies on Alcohol and Drugs in 1987"

The Alcohol Expectancy Questionnaire: an instrument for the assessment of adolescent and adult alcohol expectancies.

Abstract: Alcohol-related expectancies can influence the behavioral effects of alcohol and decisions regarding alcohol use. A standard measure of expectancies is needed for research and clinical work in the alcohol arena; the development and current status of the Alcohol Expectancy Questionnaire (AEQ) is summarized. The adolescent and adult forms of this instrument are designed to measure the degree to which individuals expect alcohol to produce a variety of general and specific effects. Research with the AEQ indicates a consistent relationship between alcohol expectancies and alcohol consumption, alcohol abuse and behavior while drinking. Data bearing on the psychometric properties and clinical and research utility of the AEQ are discussed.

Verbal report methods in clinical research on alcoholism: response bias and its minimization.

Abstract: Verbal report procedures, such as interviews, tests and questionnaires, have become the dominant method to obtain clinical data on alcohol abuse and its modification through treatment. The extent to which this method provides reliable and valid information for research purposes, and how its accuracy and usefulness can be enhanced, is examined. A review of methodological studies in the alcohol literature shows that although the information obtained from alcoholics and heavy drinkers tends to be reliable and valid, there can be considerable variability in accuracy, depending on the sensitivity of the information sought, the specificity of the validation criteria, the personal characteristics of the respondents and the demand characteristics of the task. It is suggested that the question of whether verbal report procedures are valid or invalid is less important than the issue of how they can be improved to the point that confidence can be placed in their findings. To facilitate this process, methodological t...

Beliefs about the effects of alcohol on self and others.

Abstract: A questionnaire on beliefs about the effects of alcohol on the behavior of self and others was administered to a sample of college students and a sample from the general population. Respondents reported that alcohol effects are more likely to happen to others than to themselves, particularly for socially undesirable behaviors. Women reported a greater likelihood of behavioral impairment; men reported more aggressive behavior. Nondrinkers reported a greater likelihood of both positive and negative effects; heavier drinkers reported more pleasurable effects.

Genetic and environmental factors in alcohol abuse and antisocial personality.

Abstract: Previous analyses of adoptees from Lutheran Social Services of Iowa developed a multifactorial model of adoptee alcohol abuse that related abuse to three factors: biologic background of alcohol-related problems, biologic background of antisocial problems and exposure to an adoptive family where family members had alcohol-related problems. The present study examines an independently collected sample of adoptees from a different agency--the Iowa Children's and Family Services, and confirms the multifactorial model previously found in the Lutheran Social Service data. The model shows a specificity of type of inheritance and type of environmental influence: biologic family alcohol-related problems predict increased alcohol abuse in adoptee, biologic family antisocial behaviors predict increased antisocial personality diagnoses in adoptee, and environmental factors of alcohol-related problems in the adoptive family predict increased adoptee alcohol abuse.

Variables associated with the adjustment of offspring of alcoholic fathers.

Abstract: A multivariate model of adjustment was used to examine the role of moderator variables hypothesized to provide insight into the adjustment of children of alcoholics. The moderator variables (family environment, social support and coping behaviors) were assessed retrospectively. Present adjustment was also assessed using the Depression-Proneness Rating Scale and the Tennessee Self-Concept Scale. As hypothesized, children of alcoholics, compared with children of nonalcoholics, described their families as more dysfunctional and reported receiving less guidance from others. Children of alcoholics also reported engaging in avoidant coping behaviors (e.g., smoking, drinking, eating) more than did comparison subjects. Despite their disadvantages, many children of alcoholics were functioning at, or well above, the average level of children from nonalcoholic families. Through regression analysis it was found that the moderator variables were extremely useful in accounting for the variability in offsprings' adjustment, providing support for the use of a multivariate approach for understanding offsprings' adjustment.

Personality traits in subtypes of alcoholics

Abstract: Earlier studies have identified at least two distinct subgroups of alcoholics: Type II with early onset and high genetic loading and Type I with late onset in which genetic factors seem to be of minor importance. In the present study, type I and type II alcoholics are compared on stable personality traits determined by the Karolinska Scales of Personality. Both groups were found to have high scores on scales that measured somatic anxiety, psychic anxiety, muscular tension, impulsiveness, detachment, psychastenia, suspicion, guilt and inhibition of aggression. Both groups had low scores on the scale that measured socialization. Type II alcoholics had significantly higher scores than type I alcoholics on Somatic Anxiety and Verbal Aggression scales and significantly lower scores on Socialization and Inhibition of Aggression scales. On the Impulsive Sensation-Seeking Psychopathy factor (Impulsiveness + Monotony Avoidance - Socialization), type II alcoholics were significantly differentiated from both type I alcoholics and healthy volunteers. Results of this study were consistent with those of other studies indicating that alcoholism accompanied by antisocial behavior should be kept separate from alcoholism that is unrelated to antisocial behavior.

Alcohol use among adolescent minority groups.

Abstract: Drinking and drug use in a sample of minority students in the state of New York were studied. Minority groups were compared with White groups and with each other on the prevalence of drinking and heavy drinking, distribution of quantity of consumption, relationship between drinking and social problems, and relationship between drinking and drug use. There are high proportions of heavy drinkers and drug users among American Indian adolescents. Black students are relatively low in alcohol and drug use in comparison to Hispanics and Whites who have intermediate levels of heavy drinking and drug use. The drinking by Oriental youths is unique in that males drink heavily and females are light drinkers. Those groups with the highest proportion of drinkers also have the highest proportion of heavy drinkers. The groups with the most drinking also have the highest prevalence of drug use.

Alcohol as a risk factor for injury or death resulting from accidental falls: a review of the literature.

Abstract: An examination of the English language literature published from 1950 to 1985 on the subject of alcohol consumption and falls yielded 21 studies. Those identified represented four types. Type I studies examined alcohol exposure among fall cases. The percentage of fatal falls related to alcohol exposure ranged from 21 to 77%; for nonfatal falls the range was 17-53%. Among Type II studies comparing fatal falls among alcoholics to the standard population, ratios of observed to expected deaths ranged from 2.9 to 16. Type III studies compared blood alcohol levels (BALs) of fall patients and disease patients treated medically. Those studies yielded odds ratios from 2.5 to 10. In the single Type IV study comparing BALs of fall subjects with nonfall controls relative risks were 1 (BALs, 50-100 mg/dl), 3 (BALs, 100-150 mg/dl) and 60 (BALs, greater than 160 mg/dl). We conclude that there is substantial evidence that alcohol increases risks for falls, but that more case-control studies (Type IV) are required to evaluate the exact magnitude of this risk and intervention studies are needed to assess methods to reduce the risk.

Pharmacological treatment of alcohol intoxication, withdrawal and dependence: a critical review

Abstract: This review critically examines the literature of the past 10 years relating to the use of drugs in treating alcohol intoxication, withdrawal and dependence. Emphasis is given to those studies that have current and potential future clinical relevance. Although research regarding the pharmacological treatment of alcohol disorders still suffers from methodological flaws and lukewarm acceptance, the recognition of this area as a legitimate and fruitful field of study is increasingly apparent.

Treatment compliance of older alcoholics: an elder-specific approach is superior to "mainstreaming"

Abstract: A sample of 24 alcoholics (mean age, 58.8 years) treated in typical mixed-age outpatient groups, is compared to a sample of 25 alcoholics (mean age, 60.2 years) treated in special elderly peer groups. Patients treated in the special peer group program remained in treatment significantly longer and were more likely to complete treatment than those treated in mixed-age groups. These findings support the continued development and evaluation of elder-specific treatment approaches for older alcoholics.

Changes in American drinking patterns and problems, 1967-1984.

Abstract: Data from a 1984 general population survey of drinking practices and problems in the United States are compared with those from identically worded items in a 1967 survey. Results indicate that beverage preference changed between 1967 and 1984. Americans consumed more wine and beer but fewer distilled spirits in 1984. However, the volume of drinks consumed did not change significantly. There were few significant differences in drinking patterns with the exception of a small increase in the percentage of men who were abstainers in 1984. Mixed findings were obtained with regard to drinking problems. Little difference was found over time in the proportion of respondents experiencing any of nine possible problem consequences, but there was an increase in the proportion who reported experiencing one of four possible dependence problems. Implications of this survey for the single distribution theory of consumption are discussed.

Agreement between two measures of alcohol consumption.

Abstract: Responses on the Quantity-Frequency Questionnaire (QF) were compared with those on the self-report diary. The QF was administered to 778 general practice patients prior to their consultation and the same patients completed the diary at home within 24 hours. The diary overestimated the number of nondrinkers in the population relative to the QF and classified a higher proportion of patients as heavy drinkers. The QF failed to detect 78% of heavy drinkers identified by the diary. Significantly (p less than .001) more alcohol was reported to be consumed overall on the diary (mean, 10.51 drinks/week) than on the QF (mean, 6.87 drinks/week). The relationship between responses on the two measures was nonlinear. At low consumption levels patients indicated drinking twice as much on the diary as on the QF, but the magnitude of the reported consumption difference decreased with increasing consumption levels. The results are discussed in terms of their implications for self-report measures of alcohol consumption.

A comparative study of familial alcoholism.

Abstract: In a large multicenter study of 568 male alcoholics, structured interviews were used to compare the clinical characteristics of patients with a positive (65%) or negative (35%) family history of abusive drinking among first degree relatives. Alcoholics with a positive family history were found to have: an earlier onset of alcoholism, greater alcoholic severity, more medical and legal problems, a broader range of treatments, an increased lifetime prevalence of additional psychiatric disorders and a greater diversity of psychiatric disturbance among biological relatives. The degree of psychiatric heterogeneity in the patients roughly corresponded to the degree of psychiatric heterogeneity in their families. Assortative mating was proposed as a possible mechanism to account for clinical differences between the familial and nonfamilial alcoholic.

Reliability and validity of the MAST, Mortimer-Filkins Questionnaire and CAGE in DWI assessment.

Abstract: The internal consistency reliability and criterion-related validity of the Michigan Alcoholism Screening Test (MAST) (N = 90), Mortimer-Filkins Questionnaire (MFQ) (N = 253) and CAGE (N = 375) were examined. Respondents were convicted of driving while intoxicated (DWI) and were assessed for the significance of their drinking problem at 34 DWI assessing agencies. Counselor decisions served as the criterion measure and were considered to be independent of the test scores. The finding revealed that counselors identified lower rates of problem drinking than are generally found to exist in this population. The MAST performance, although statistically impressive, was believed to be mediated by the low rate of counselor-identified problem drinkers. The MFQ, more moderate in its performance, shows promise for improvement based on recommended modifications. CAGE findings suggest little support for its use as a single index of problem drinking with this population. However, it would appear to be a statistical asset to the item pool of a more comprehensive screening inventory. The criterion used in the study did not provide a satisfactory range of problem drinking with which to evaluate the adequacy of these instruments as wide-range assessment inventories. The social-legal mandate to reduce the incidence of DWI will require not only more comprehensive definitions of problem drinking but more extensive study of repeat offenders for the identification of other subgroups as well.

Ethanol metabolism in men and women.

Abstract: Data from the Colorado Alcohol Research on Twins and Adoptees project were analyzed to determine whether 63 women and 75 men differ on three measures of ethanol pharmacokinetics: absorption rate, peak blood alcohol level and elimination rate. The data on women were analyzed separately to investigate whether female hormones influenced the measures of ethanol metabolism by comparing groups tested at different phases of the menstrual cycle and a group who were taking oral contraceptives. Subjects were given 0.80 g of alcohol per kg of body weight diluted by 7 parts of carbonated water or a sugar- and caffeine-free soft drink. This dose was calculated to bring their blood alcohol level (BAL) to near 100 mg/dl. Additional doses were given at the end of each of the next 2 hr in an attempt to maintain BAL near peak for approximately 3 hr. An analysis of beta 60 values showed that women metabolized ethanol faster than men, regardless of phase of menstrual cycle or whether they were taking birth control pills. There was a small gender difference in peak BAL and no gender difference in time to peak BAL. It was also found that the peak BAL attained by subjects had a substantial effect on the beta 60. The effects of smoking, age, ponderal index and reported drinking habits on ethanol metabolism were also analyzed.

Psychosocial factors in adolescent drinking contexts.

Abstract: A number of environmental and personality characteristics of adolescent students and their relationship to types of drinking contexts were examined using a series of canonical correlation analyses. The strongest relationship was defined by the perceived normative support for drinking, which accounted for 55% of the variance in the drinking context items for males (58% among females). Positive functions of drinking, personal attitudes and values, and environmental contexts were also associated with drinking context items but accounted for smaller proportions of the variance. The contribution of important environmental, personality and drinking context variables to each canonical relationship is discussed. Consistency of studies relevant to the major finding is reviewed and possible bases for discrepancies are explored. Further studies relating to antecedent networks of access to various drinking contexts are identified as areas deserving more intensive and extensive research efforts.

Liquor-by-the drink and alcohol-related traffic crashes: A natural experiment using time-series analysis.

Abstract: A quasi-experimental study was conducted to estimate the impact of liquor-by-the-drink (LBD) on alcohol-related traffic accidents in North Carolina counties. Time-series analysis for the period from January 1973 through December 1982 found LBD was associated with statistically significant increases of 16 to 24% in both the number of police-reported alcohol-related accidents and in single vehicle nighttime accidents among male drivers 21 years of age and older in counties implementing LBD. No change in alcohol-related accidents was found for non-LBD counties. Single vehicle nighttime accidents involving male drivers under 21 did not change for either the experimental or comparison groups.

A panel study of normative structure, adolescent alcohol use and peer alcohol use

Abstract: Panel data and multiple regression of follow-up data on baseline data are used to explore direction of relationship among normative structure, adolescent alcohol use and peer alcohol use. Baseline and follow-up data were collected on a random sample of 100 adolescents (54 males). Two separate measures of each of the six variables--Adolescent Alcohol Involvement Scale (AAIS), Quantity-Frequency Index (QF), close friend drinking level, other friend drinking level, perceived harm due to alcohol use and attitudes toward alcohol--were used. The relationship between adolescent self-drinking and peer alcohol use was found to be reciprocal, complex and limited to close friends. Baseline AAIS predicted follow-up close friend drinking level, but baseline QF Index did not. Baseline close friend drinking level predicted follow-up QF Index but not follow-up AAIS. Normative structure toward alcohol was found to be stable over time and unrelated to baseline self or peer alcohol use. Baseline perceived harm due to alcohol use predicted follow-up QF Index, indicating that adolescents adjust behavior to prior attitudes.

Identifying high-risk pregnant drinkers: biological and behavioral correlates of continuous heavy drinking during pregnancy

Abstract: To determine whether women who continued to drink during pregnancy could be differentiated from women who discontinued alcohol use during their second trimester of pregnancy based on biological, social and behavioral data collected during a prenatal interview, 267 women receiving prenatal care at Grady Memorial Hospital, a large metropolitan hospital in Atlanta, were interviewed antepartum, assessing current drug and alcohol use as well as other demographic information. Postpartum interviews were conducted during the first 3 days following delivery to determine any changes in drug use or alcohol consumption that occurred after the first interview. Women who continued to drink throughout pregnancy and women who stopped drinking were similar on most demographic variables examined, including age, marital status, ethnic group, income, obstetrical complications risk score, amount of alcohol consumed per week and use of other drugs. Discriminant analysis was used to determine whether drinking-group membership c...

Longitudinal stability and dimensional structure of problem drinking in adolescence.

Abstract: A multivariate analysis of dimensions of problem drinking and their stability across time is conducted through a series of confirmatory factor analyses (as opposed to exploratory factor analyses used in previous studies), using self-report data from a longitudinal sample of adolescents and youth. Analyses are performed separately by age and gender. Results indicate that traditional measures of problem drinking represent at least two distinct dimensions--intensity of use and use-related problems--rather than a unitary construct for adolescent males and females. The results also suggest that dimensions of problem drinking remain relatively stable from 15 to 21 years of age, except that alcohol-related problems are unstable for males from 15 to 18 years of age.

Public opinions about alcoholism and its treatment.

Abstract: Survey respondents' views about alcoholism as an illness, support for treatment, treatment recommendation and stigma surrounding alcoholics are examined. Subjects (N = 482) comprise a random sample of the population of Contra Costa County, California. About 91% of the respondents agree with the notion that alcoholism is an illness, but 40% also agree that alcoholics drink because they want to. More women than men support the idea that to recover alcoholics will have to quit drinking forever. The contrary is true of the idea of controlled drinking. Education and income are negatively associated with items on loss of control and controlled drinking. Respondents who have had their lives deeply affected by an alcoholic and those who report a drinking problem of their own do not differ in their opinions about alcoholism from those who do not have these characteristics. Alcoholics Anonymous is the most common form of treatment recommended by the respondents. In general, results show considerable support for treatment as well as ambivalence regarding the disease concept.

Relationship between sex-role behaviors and alcohol consumption in undergraduate men and women.

Abstract: The relationship between sex-typed behaviors and alcohol consumption is examined in a questionnaire study involving male and female undergraduates. A multiple regression analysis indicated that for women, feminine behavior was significantly negatively correlated with total alcohol, beer and distilled spirits consumption. Weight was positively correlated with total alcohol and wine consumption. For men, feminine behavior was negatively correlated with total alcohol, wine and beer consumption. Masculine behavior was positively correlated with total alcohol, wine and beer consumption; weight was negatively correlated with wine consumption. Except in the case of wine, sex-role variables were found to account for more of the variance in alcohol consumption than did biological gender. Feminine behavior was negatively associated with alcohol consumption for both men and women. Masculine behavior was positively associated with alcohol consumption for men.

A Prospective Study of Successful Long-Term Adjustment in Alcohol Dependence: Social Drinking versus Abstinence*

Abstract: A series of 1312 alcoholics admitted to the Department of Psychiatry, University Hospital, Lund, Sweden, from 1949 through 1969 was followed up by record data up to 31 December 1980. The conditions of the patients were evaluated with a multidimensional diagnostic rating schedule when first admitted. Two decades after their first admission, 70 male alcoholics with a good social adjustment were chosen for personal examination and of these 60 (86%) were interviewed. Social drinking was twice as common as abstinence among the former alcohol-dependent subjects. Abstainers had a higher frequency of initial ratings indicating lack of internal control of behavior and were less often socially stable when first admitted as compared with the social drinkers. Early improvement was related to initial abstinence; the subjects who improved later in life more often reported a gradual change from alcohol abuse to social drinking.

Extroversion, anxiety and the perceived effects of alcohol.

Abstract: To test the hypothesis that personality characteristics are related to alcohol-effect expectancies, 256 (115 men) college students were divided into groups on the basis of self-reported alcohol consumption and anxiety and introversion scores on the Sixteen Personality Factor Questionnaire. Three-way multivariate analyses of variance were conducted to determine expectancy differences by drinking behavior, personality characteristics and sex. Alcohol expectancy scores were found to vary with drinking behavior and personality measures. Elevated expectancy scores were associated with higher quantity-frequency measures of drinking; however, no significant sex differences were obtained. Extroverted students expected more social and physical pleasure, more relaxation and less arousal with drinking. Students with higher levels of trait anxiety expected more global positive changes, sexual enhancement, social assertion and arousal. The association of drinking behavior and personality with expectancies appears to be independent and additive.

Experience and change in Al-Anon family groups: adult children of alcoholics.

Abstract: Adult children of alcoholics exhibit low self-esteem, excessive feelings of responsibility, difficulties reaching out, depression and the increased likelihood of alcoholism. This study examines how adult children of alcoholics discuss their experiences in an Al-Anon group and describes their perceptions of change in self, personal problems, relationships, spirituality, childhood and the Al-Anon program. Twelve sessions of one Al-Anon chapter were observed, Al-Anon members were interviewed and a coding system to assess the content of the meetings was developed. Improvements constituted 25% of reports, of which improvement in problems constituted 20%. Members reported positive changes in self. Changes in relationships with alcoholics were few, as were changes in perceptions of the program (members felt positively about the program from the start). Although spirituality constituted less than 4% of the reports, many interviewees found spirituality the last and, ultimately, one of the most valued components of...

Self-report validity issues.

Abstract: Two possible sources of the substantial gap usually found between survey self-reported alcohol consumption estimates for a population and estimates based on official alcohol sales records are investigated. A measure of atypical heavy drinking is added to ordinary consumption commonly measured in surveys, and consumption by an adolescent (age 14-17) sample is added to that of the adult sample. The relationship between respondents' purchases and consumption during a 30-day period is also investigated. Personal interviews were completed with a random sample of 997 adults and 182 adolescents in Iowa during February-April 1985. Adding atypical drinking to ordinary drinking narrowed the sales-self-report gap more than did adding adolescent drinking, but a considerable gap remained. Self-reported purchases were closer to sales than was self-reported consumption. However, not all purchasers were drinkers and not all drinkers were purchasers, and the two were not highly correlated. The self-report validity issue, which remains unresolved, is apparently affected by many factors. Self-reports appear to be accurate enough for some purposes but not for others. Official alcohol sales (or purchase) records are not necessarily valid measures of alcohol consumption.

Family history of problem drinking among young male social drinkers: behavioral effects of alcohol.

Abstract: Two experiments examined the behavioral effect of alcohol on male social drinkers aged 19-25, who differed in their family histories of problem drinking--21 reported a problem drinker in their immediate family (FH+) and 22 had no such family history (FH-). These groups did not differ in age, weight or absolute alcohol per kg of body weight typically consumed on social occasions. After drinking absolute alcohol (0.83 ml/kg), subjects performed bead stringing and hand steadiness tasks when their blood alcohol levels (BALs) averaged 63 mg/dl on the rising and the declining limb of the BAL curve. The experiments consistently demonstrated that FH+ individuals displayed a greater degree of impairment on the tasks. One of the experiments also explored subjective ratings of the effects of alcohol at matching BALs and found no significant group differences. The greater behavioral sensitivity to alcohol of FH+ subjects and their apparent absence of a concomitant enhanced perception of its effects were discussed as ...

Alcoholic beverage preference as a public statement: self-concept and social image of college drinkers.

Abstract: Several studies have indicated that drinking-driving violation rates differ significantly across beverage preference groups. In an effort to assess beverage-specific alcohol expectancies, surveys of 120 college students probed self-concept, drinker stereotypes, beverage preference and quantity-frequency of alcohol consumption. The results revealed sharply differentiated social stereotypes for hypothetical drinkers of various alcoholic and nonalcoholic beverages. Beverage preference groups differed little in self-concept except that men who preferred beer or mixed drinks rated themselves as more drunk than did men who preferred wine or nonalcoholic beverages. Combining all beverage preference groups, heavier drinkers rated themselves more positively and they rated male nondrinkers more negatively on most dimensions than did lighter drinkers. Support was found for some, but not all, extrapolations from consistency theory and enhancement theory in predicting beverage choice.

Predictors of attrition from an outpatient alcoholism treatment program for couples.

Abstract: Applicants (N = 105, 22 women) to an outpatient alcoholism treatment research program for married couples were categorized into three classifications: (1) treatment refusers (N = 37), (2) treatment dropouts (N = 23) and (3) treated subjects (N = 45). Discriminant analyses were performed to determine the best predictors of eventual category from baseline data. Compared with those who consented to treatment, refusers were found to be younger, have shorter drinking histories and were less likely to have personally initiated contact with the treatment program. Dropouts were less likely than treated subjects to have made their own initial contact with the program, more likely to have depressive symptoms not associated with alcohol use and were not employed full time. Remaining in treatment was most strongly associated with marital factors--assignment of the couple to a marital therapy condition versus a treatment in which the spouse was not fully involved and the spouse's initial satisfaction with the marriage...