Showing papers in "Journal of Studies on Alcohol and Drugs in 1988"

The co-occurrence of alcoholism with other psychiatric disorders in the general population and its impact on treatment.

Abstract: It is apparent from previous studies in clinical populations that there is a high comorbidity rate between alcoholism and other psychiatric diagnoses. However, this may simply be an expression of Berkson's bias (i.e., an increased tendency for persons with multiple diagnoses to seek and receive treatment and thus fall into study populations drawn from treatment sources). In this article, we use data from the Epidemiologic Catchment Area survey to examine the comorbidity between alcohol abuse and dependence, other substances of abuse and nonsubstance psychiatric disorders in a sample of approximately 20,000 persons drawn from the general population. We also examine the effect of comorbidity on psychiatric treatment. Every one of the psychiatric diagnoses we examined was more likely to occur in alcoholics than in nonalcoholics. Associations were particularly strong with antisocial personality disorder, other substance use and mania. The association between alcoholism and depressive disorders was positive but not very strong. The presence of other illnesses increased the likelihood of utilization of treatment services by alcoholics but did not increase the likelihood that drinking problems would be communicated to a doctor. The findings confirm prior studies of comorbidity in clinical samples and suggest the need for increased vigilance toward alcoholism by physicians.

Changes in depression among abstinent alcoholics.

Abstract: The rate and pattern of change in depressive symptoms among male primary alcoholics (no preexisting major psychiatric disorder) were studied throughout inpatient treatment for alcoholism. A sample of 191 alcoholics was interviewed with the Hamilton Depression Rating Scale within 48 hours of admission and again at each of the 4 weeks of treatment. Results indicate that 42% of alcoholics have clinically significant levels of depression (Hamilton greater than or equal to 20) at intake but only 6% remain clinically depressed at Week 4. Depressive symptoms of alcoholics abate quickly with the largest reduction in scores at Week 2. Mood related symptoms constitute the largest portion of presenting depression and abate most rapidly. Vegetative symptoms remain the most prevalent type of depressive symptom at discharge. Results suggest that antidepressant medication should not be considered prior to 4 weeks of abstinence.

The reliability of alcohol abusers' self-reports of drinking and life events that occurred in the distant past.

Abstract: This study investigated the test-retest reliability of 69 alcohol abusers' current reports about their past (approximately 8 years prior to interview) drinking behavior and life events. Drinking behavior was assessed by the Lifetime Drinking History (LDH) questionnaire and life events were assessed using the Recent Life Changes Questionnaire (RLCQ). Reliability coefficients for LDH variables were generally moderate to high (r = .52 to .81). Using empirical criteria, the diagnostic power of the two LDH interviews to classify correctly subjects as either having had or not having had a drinking problem was quite high. The reliability coefficient for the RLCQ was r = .85 and 91.7% of the identified events were reported in both interviews. Similarly high test-retest reliabilities and individual event agreement rates were obtained for the six homogeneous subscales of the RLCQ. Subjects were also asked why they had given inconsistent answers to life events questions in the two interviews. Inconsistencies often r...

Acculturation and drinking among people of Mexican descent in Mexico and the United States.

Abstract: This article studies the relationships between acculturation and drinking and alcohol-related problems among people of Mexican descent in Mexico and the United States. Subjects in the United States were part of a national probability sample of the Hispanic household population 18 years of age and older. Subjects in Mexico were randomly selected from among adult residents of the city of Morelia and an adjoining rural county, Tarimbaro, both in the State of Michoacan. Both samples were interviewed using the same questionnaire. Response rates were 72% in the United States and 92% in Mexico. Results show that Mexican-American men drink more frequently than men in Michoacan, who, as a group, drink infrequently but consume more often five or more drinks at a sitting as compared with Mexican Americans. Mexican-American women have a lower rate of abstention and a higher rate of women who drink at least once a week and who consume five drinks at a sitting at least once a year than do women in Michoacan. Among men,...

An atypical neurocognitive profile in alcoholic fathers and their sons.

Abstract: Prepubescent boys and their recovering alcoholic fathers exhibited an Atypical Neurocognitive Profile consisting of (1) a reduction in amplitude of the late positive complex (LPC) of the event-related potential (ERP) during a complex visual discrimination task, and (2) reduced visuoperceptual performance evidenced by significantly lower scores on the Object Assembly, Block Design and Picture Completion subtests of the WISC-R and the Embedded Figures Test Low LPC amplitudes were significantly correlated with poorer visuoperceptual performance This Atypical Neurocognitive Profile may represent a marker for alcoholism

Acute and chronic effects of alcohol use on violence.

Abstract: While the empirical association of drinking and problem drinking to violence is well established, the etiological nature of the relationship is poorly understood. Using data collected from 1,149 convicted male felons, the acute (drinking just before the violent event) and chronic (a psychiatric diagnosis of alcohol abuse or dependence) effects of alcohol use on violence were analyzed. Logistic regression models were used to examine the relationship of acute and chronic alcohol effects to incarceration for a violent offense and arrest for a violent offense, with demographic and criminal history factors controlled. The acute effects of alcohol were found to be significantly associated with incarceration for a violent offense, but the net explanatory capacity of acute alcohol effects was not large. Chronic alcohol effects were not significantly associated with incarceration for a violent offense or arrest for a violent offense in the previous year. The findings were interpreted as being consistent with the hypothesis that alcohol effects violence directly, acting through the acute effects of use, rather than indirectly through the effects of underlying or mediating factors.

Weekly recall and dairy estimates of alcohol consumption in a general population survey.

Abstract: Diary and weekly recall measures of alcohol consumption in a representative sample (N = 399) of the Dutch population are compared. The weekly recall method consisted of a personal interview with questions about actual alcohol consumption on the previous 7 days. The diary consisted of 14 daily self-reports of consumption and followed the interview. The diary method yields estimates of consumption that are on average 22% higher than those based on weekly recall measures, reducing total undercoverage by about 11%. The difference between the two methods cannot be attributed to a variation of consumption over weeks but seems to stem from a difference in accuracy of recall. There was an increase in glasses underreported at the upper levels of consumption, but underreporting did not seem to be of a nonlinear nature. Considering the large individual variation in consumption over weeks, the ranking of individuals according to their self-reports is relatively stable across method.

Does alcohol advertising affect overall consumption? A review of empirical studies.

Abstract: This article reviews the empirical warrant for the assertion that alcohol advertising affects overall alcohol consumption. Econometric, exposure, experimental studies and advertising bans are examined. The evidence indicates that advertising bans do not reduce alcohol sales, total advertising expenditures have no reliable correlation with sales of alcoholic beverages, and that experimental studies typically show no effect of advertising on actual consumption. However, one set of studies does show that drinkers are exposed to more television alcohol advertisements, without making the causal connection clear. In general, the evidence indicates little impact of alcohol advertising on alcohol sales or drinking. However, some results are suggestive and there is a need for more sophisticated econometric, exposure and experimental studies that take into account a wider range of variables.

Alcoholics, aggression and antisocial personality.

Abstract: This study investigated relationships among antisocial personality (ASP) disorder, a childhood history of aggressive behavior and violent behavior in a sample of 77 hospitalized alcoholics. Patients classified according to childhood aggression (high, low) and ASP (present, absent) were compared using self-report measures of anger, aggression, depression, well-being and sociability. Items measuring these variables were rated in terms of the patients' typical behavior while drinking and while sober. Alcoholics reported more anger and aggression when drinking than when sober and this effect was greatest among individuals with a history of childhood aggression. ASP accounted for negligible amounts of the variance when the effects of childhood aggression were considered independently. Results indicate that both alcohol consumption and childhood antecedents contribute to the manifestation of violent behavior by alcoholics.

Suicide attempts and alcoholism.

Abstract: This study examined the association among suicide attempts, parental alcoholism, psychopathology and drinking history in a sample of hospitalized alcoholics. Suicide attempters were found to have multiple psychiatric diagnoses (e.g., depression, antisocial personality disorder and substance abuse) and more severe psychiatric symptoms than nonattempters. Alcoholic suicide attempters also tended to have a parental history of alcoholism and began abusing alcohol at an early age. Alcohol abuse symptoms during the month before, and 6 months before, the current hospitalization were generally similar for suicide attempters and nonattempters. Clinical implications of the findings are discussed.

The children of alcoholics life-events schedule: a stress scale for children of alcohol-abusing parents

Abstract: Children of alcoholic parents have been shown to be at risk for the development of mental health problems However, there is little empirical research that would allow one to determine which of these children are most at risk Hypothesizing that the amount of parental drinking-related stress a child experiences may be a factor that discriminates those children of alcoholics who are most at risk from others, the Children of Alcoholics Life-Events Schedule (COALES) was developed Using samples of high-school students, the COALES was found to have satisfactory test-retest reliability, internal-consistency reliability and construct and concurrent validity Children who self-identified as having an alcoholic parent reported higher levels of negative events and lower levels of positive events than did their peers from nonalcoholic homes Scores on the positive- and negative-event subscales were significantly correlated with the children's scores on measures of anxiety and depression

The relationship between relapse and involvement in alcoholics anonymous.

Abstract: Recovering alcoholic members (N = 59) of Alcoholics Anonymous (A.A.) were asked to complete a questionnaire to assess the occurrence of relapse and its correlation to their level of involvement in the A.A. program. The questionnaire was distributed to five different A.A. groups. Subjects were asked to rate themselves, using a Likert scale, on their level of involvement in the A.A. program and were also asked to state if they had relapsed during the course of their involvement with A.A. and if so, to indicate their most recent relapse. Depending on their answers to the relapse question, subjects were placed in either a relapse or a no relapse group. The level of involvement in A.A. was found to be related to whether relapse occurred. Those in the relapse group rated themselves lower in every area of involvement listed on the questionnaire than those in the no relapse group. The most significant area of involvement, where the greatest differences between subjects in each group were found, was in reaching out to other members of A.A. for help and in the use of a sponsor.

A structured diagnostic interview for identification of primary alcoholism: a preliminary evaluation.

Abstract: Forty alcoholic inpatient men were used to evaluate the test-retest reliability and the validity of a new structured diagnostic interview. The Alcohol Research Center (ARC) Intake Interview was constructed from the Schedule of Affective Disorders and Schizophrenia (SADS) parts I and II and from the Diagnostic Interview Schedule family history section by extracting information on diagnoses most likely to be seen in alcoholic patients and by expanding the data set with questions relevant to alcohol and drug use. The test-retest reliability for patients' primary and secondary diagnoses included a kappa of 1.00 for the comparison of interviewers A and B (100% agreement) and of .76 for interviewers A and C. The validity of ARC Intake Interview patient diagnoses as compared to the SADS demonstrated an overall agreement between 91 and 100%. Reliabilities for labeling of families as positive or negative for specific illness in any first-degree relatives revealed a kappa of 1.00; validities on family diagnoses ran...

Unitary versus multidimensional models of alcoholism treatment outcome: an empirical study.

Abstract: This study examined two issues related to the distinction between unitary and multidimensional models of alcoholism treatment outcome. First, does treatment outcome vary along a variety of relatively independent dimensions? Second, how important is abstinence to improved health and psychosocial adjustment? A sample of 266 alcoholics were evaluated at intake and 1 year following inpatient treatment using an extensive battery of assessments. Correlational analysis and factor analysis provided limited support for both the unidimensional and multidimensional approaches. A synthetic measure of posttreatment drinking showed a clear linear relationship between level of consumption and lack of improvement in medical status, biological function, life stress and psychopathology. The findings are discussed in terms of the methodological difficulties in treatment evaluation and the need for more systematic research on the effect of posttreatment drinking on multiple dimensions of outcome status.

Stability of alcohol consumption among youth: a National Longitudinal Survey.

Abstract: The present study draws upon the National Longitudinal Survey (NLS) of Labor Market Experience in Youth (ages 17-24) to describe alcohol use patterns over a 2-year period during the transition years between adolescence and young adulthood. Specifically, turnover in current (using any amount of alcohol in any frequency during the past month) and heavier (drinking six or more drinks on at least 2-3 occasions during the past month) drinking levels among panel members was examined by charting incidence, remission, chronicity, and abstinence between 1982 and 1983. The prevalence of each consumption level increased between the ages of 17 and 22 but declined thereafter for each sex until the age of 24. Changes in prevalence from 1982 to 1983 were shown to be a function of changes in drinking level status. The analysis of turnover in current and heavier drinking levels indicated that there was continuity in drinking behavior over time. Sex differences observed in these trends were examined and their implications ...

Alcohol-related problems, marital disruption and depressive symptoms among adult children of alcohol abusers in the United States.

Abstract: Dependent problem drinking, marital disruption and depressive symptoms of sons and daughters of alcohol abusers are examined in a representative sample of 1,772 adults in the United States. Controlling for the sociodemographic characteristics of the adult sons and daughters in logistic regression analyses and for the alcohol-related problems (e.g., alcohol dependence) of the sons and daughters in the analyses of marital disruption and depressive symptoms, the results suggest that having parents who have been alcohol abusers places sons at risk for dependent problem drinking, both sons and daughters at risk for divorce or separation and daughters at risk for depressive symptomatology.

Identifying developmental paradigms leading to alcoholism

Abstract: The lives of men who had been part of a delinquency prevention program between 1939 and 1945 provide information to identify developmental paths that seem to have led to alcoholism by the time of follow-up three decades later. Alcoholic fathers and their families differed from nonalcoholic fathers and their families in many ways. The analyses suggested that different paradigms describe the pathways to alcoholism for those whose fathers were and those whose fathers were not alcoholics. A mother's high esteem for her alcoholic husband increased risk for alcoholism of the son; among sons whose fathers were not alcoholic, increased risk for alcoholism of the son seemed to be a function of little control during early adolescence.

Alcohol-induced changes in body sway in women at risk for alcoholism: a pilot study.

Abstract: Family history of alcoholism appears to influence acute alcohol responses in young men. We report pilot data from a study designed to expand these observations by measuring blood alcohol levels (BALs), subjective intoxication effects, body sway and cognitive-motor task performance in women. Six young women with (FHP) and six without (FHN) alcoholic first degree relatives provided informed consent and were given 0.56 g/kg ethanol under double-blind conditions. Groups were matched for age, drinking history and height-weight ratio. Subjects performed tasks in random order at 90, 60 and 30 min before drinking alcohol, and 15, 30, 45, 60, 90, 120, 150 and 180 min after drinking alcohol. BALs peaked at 80 mg/dl 30 to 60 min after drinking alcohol. BALs were comparable and disappearance rates were similar for both groups. BALs and intoxication ratings for both FHP and FHN women had highly significant correlations. Alcohol decreased accuracy on an automated version of the Digit Symbol Substitution Test (DSST) for both groups, but FHN women made significantly more errors 30 min after alcohol. Significantly greater alcohol effects on body sway were apparent in FHN women 15, 30, 60, 90 and 120 min after alcohol. Compared with previous findings for men, both FHP and FHN women reported less intoxication at similar BALs, but body sway in FHN women was more affected by alcohol. Small sample size limits generalization of these findings but suggests that some effects of familial alcoholism in women are similar to those observed in men.

The stability of coexisting psychiatric syndromes in alcoholic men after one year

Abstract: Alcoholic men (N = 241) were administered a criterion-referenced, structured, DSM-III compatible, diagnostic interview while hospitalized and again 1 year later as outpatients. This interview independently evaluates the lifetime prevalence of 15 major psychiatric disorders. In addition to alcoholism, the most frequently occurring coexisting disorders were depression, antisocial personality and drug abuse. After 1 year, the number of positive syndromes declined slightly (chi = 2.0 to 1.8). However, the absolute and relative number of additional psychiatric syndromes remained stable over 1 year for the entire sample. Across individuals, the overall rates of agreement for the 15 syndromes ranged from a high of 100% to a low of 85%. Similarly, the agreement for the current and lifetime diagnoses ranged from 86 to 99%. These data indicate that a substantial portion of male alcoholics experience symptoms that are common to other psychiatric disorders. They also suggest that the endorsement of multiple psychiatr...

Adult inpatient alcoholics: physical exercise as a treatment intervention

Abstract: This study examined the usefulness of physical exercise as a treatment intervention to decrease depression and anxiety in adult inpatient alcoholics while increasing aerobic capacity and self-concept. The State-Trait Anxiety Inventory, the Tennessee Self-Concept Scale, the Self-Rating Depression Scale and the Astrand-Rhyming bicycle-ergometer were administered to a treatment and a control group on admission to and again at discharge from a 28-day inpatient treatment program. Control group data were gathered prior to initiating the exercise program. The exercise program consisted of walking or jogging 3 days a week and was designed to meet the American College of Sports Medicine's minimum requirements for a graded exercise program. Results indicated that there were significant differences on posttest scores between the control and exercise groups on state anxiety, trait anxiety and depression, but not on self-concept or aerobic capacity. The usefulness of physical exercise as a treatment intervention as well as the implication for research are discussed.

The effect of type of aftercare follow-up on treatment outcome among alcoholics

Abstract: Past research on methods for actively engaging alcoholics in aftercare has been mixed with respect to the effects of such efforts on treatment outcome. The present study examined whether active follow-up methods do aid in engaging the alcoholic in treatment, whether such procedures improve treatment outcome and how much responsibility the therapist must be willing to assume in order to maintain the patient in treatment. Appointment keeping was significantly improved by a home-visit follow-up method in the first 6 months postdischarge (p less than .01). However, there was no one-to-one correspondence between improved therapy attendance and improved treatment outcome. When subjects were classified into treatment dropout and treatment completion groups, however, a treatment effect was achieved. The most intensive follow-up condition increased the probability of treatment completion, supporting to some degree the utility of aggressive follow-up. However, it was concluded that the cost of such procedures proba...

Some Navajo Indian Opinions About Alcohol Abuse and Prohibition: A Survey and Recommendations for Policy*

Abstract: In this study a questionnaire was administered to a sample of Navajo Indians in the southwestern region of the reservation to examine (1) their knowledge about the consequences of alcohol abuse and (2) their opinions about alcohol abuse, the etiology of abuse and alcohol legalization. Survey responses indicate that the Navajo surveyed are quite knowledgeable about the various adverse consequences of alcohol abuse. The survey found that 52% of these Navajo adults currently drink at all, and the opinion responses generally characterize alcohol consumption, even in small amounts, as a negative behavior. Sixty-three percent of all Navajos agreed with the popular, but scientifically unsubstantiated, belief that Indians have a physical weakness to alcohol that non-Indians do not have. Alcohol legalization on the reservation is opposed by 81% of the Navajos surveyed. Opinions about alcohol use and policy do not vary greatly even when knowledge of alcohol consequences and current drinking status is considered. Th...

The problematic prospects for prevention in the classroom: should alcohol education programs be expected to reduce drinking by youth?

Abstract: Junior and senior high-school students completed a questionnaire, either once or twice (in successive years), providing measures of variables in three principal sets: (1) curricular variables, those typically addressed in contemporary alcohol education programs (knowledge about alcohol, attitudes toward alcohol, decision-making skills and self-esteem); (2) drinking behavior; and (3) noncurricular variables (demographic and social-psychological traits that typically characterize students before they are exposed to alcohol education programs). Bivariate analyses suggested that the curricular variables are related to drinking behavior, whereas multivariate analyses indicated that these same variables contribute little to the explanation of adolescent drinking when adjusted for the noncurricular variables, most of which are logically and/or chronologically prior to curriculum exposure. It is concluded that contemporary alcohol education programs do address variables that, when considered alone, appear to be r...

Comprehensive evaluation of a model alcohol education curriculum.

Abstract: A comprehensive evaluation was conducted of a representative alcohol education program designed to enhance knowledge and self-esteem, instill appropriate attitudes and teach the decision-making skills necessary for youth to make responsible decisions about the use of alcohol. The curriculum was implemented approximately as intended. The immediate, cumulative and longer-term effects of curriculum exposure on the variables thought to mediate alcohol use were modest or unsystematic. There was no consistent evidence of carryover effects from curriculum exposure on subsequent use of alcohol, cigarettes or other drugs. The curriculum was ineffective in attaining its goals.

Predictors of recidivism in duiis

Abstract: The prior driving records of 397 drivers arrested for drinking and driving in the year 1983 were examined with the purpose of comparing biographical factors and variables relating to driving history and arrest circumstance between recidivist and nonrecidivist drinking drivers Of these drivers, 174 (44%) had more than one arrest within a 12-year study period, while 223 (56%) had only one Significant differences were found among drivers with different numbers of drinking and driving offenses Drivers with one or two DUII arrests had more non-moving traffic violations than drivers with three or more DUII arrests Drinking and driving offenders with higher levels of arrests were more likely to be unemployed, to have a past criminal record, to be arrested for drinking and driving on a weekday during afternoon and early evening hours, to drive with a suspended or revoked license and to refuse a blood alcohol level determination test In this study DUII offenders with four or more arrests fit the descriptive m

Drinking habits and alcohol abuse among young men: a prospective longitudinal study

Abstract: The relationship between self-reported frequency of drunkenness at 14-16 years of age and registered alcohol abuse at age 15-25 was studied in a large and representative group of Swedish men. The results showed that the proportion of boys who had experienced drunkenness more than 10 times increased rapidly between ages 14-16. Before the age of 25, 17% of the boys were registered in governmental records (police, social authorities or psychiatric services) because of alcohol abuse. A high frequency of self-reported drunkenness at age 14-16 was found to be significantly related to registered alcohol abuse at age 18-24. At the same time, however, it was found that 70-80% of the adolescent boys with the greatest frequency of drunkenness were not registered for alcohol abuse in early adult years. Using self-reported frequency of drunkenness at age 14-16 as a basis for predicting registered alcohol abuse at age 18-24 allowed correct classification of only 6% more boys than would have been expected by using a ran...

Acute alcohol intoxication in socially drinking female and male offspring of alcoholic fathers.

Abstract: Alcohol pharmacokinetics, mood-state alterations and psychomotor performance were investigated in women and men at risk for developing alcoholism. Estimated body water was used to calculate the alcohol dose in an effort to eliminate differences in alcohol pharmacokinetics between women and men due to differences in body composition. Differences were not detected between women and men or family history groups (family history positive, FH +, and family history negative, FH-) on absorption time, peak blood alcohol level (BAL), elimination time, or area under the blood alcohol curve (AUC). FH + men reported no central stimulant effects at peak BAL on the Sensation Scale, whereas FH- men and women all reported central stimulant effects. Further, FH + men reported a decrease in anxiety after the ingestion of alcohol. Acute intoxication did not affect performance in the FH + group on a finger-tapping task. In the FH - group, the dominant hand was significantly impaired during the ascending limb of the blood alcohol curve and recovered during the descending limb. Differences between family history groups or sex were not detected on a grooved-pegboard task. Results indicated that FH + men may experience alcohol differently from the FH - group and FH + women. FH + women also showed different reactions to acute alcohol than the FH - group. However, these differences were not as consistent across tasks.

Definition of onset in the development of onset-based alcoholism typologies.

Abstract: Age of onset of alcoholism is gaining prominence as an explanatory construct in the development of models of alcoholism. Recently, at least one investigator has cited its potential as a simple means for deriving a typological classification scheme that could have great impact, both in terms of future research and in devising treatment strategies. Various investigators, however, operationalize alcoholism onset in different ways. By comparing five definitions of the concept, we show that the proportion of individuals classified as early or late onset can vary dramatically, depending on the interpretation given to phrases such as "subjective problems." Gender differences in early-late proportions are demonstrated, and the statistical relationship of the five items used as onset indicators is described. We suggest that collecting multiple convergent definitions of onset constitutes a structured recall aid that may ameliorate some of the problems to which self-report data are subject, while additionally providing the data necessary to create an aggregate measure that will increase reliability in comparison with the items individually. Finally, we encourage description of alcoholism onset as a developmental process rather than a single event, and urge investigators to increased precision in the operationalization of this construct as research in this area progresses.