Showing papers in "Journal of Studies on Alcohol and Drugs in 1996"
TL;DR: Results from logistic regression analyses predicting diverging and converging trajectories provided some support for the general hypothesis that trajectories of Chronic and Increased frequent binge drinking over time are associated with difficulties in negotiating the transition to young adulthood.
Abstract: Objective: The purpose of this study was: (1) to identify different trajectories of frequent binge drinking during the transition to young adulthood; (2) to validate the trajectories by relating them to behaviors and attitudes concerning alcohol and other drug use; and (3) to distinguish among the trajectories according to demographic characteristics and lifestyle experiences typical of the transition to young adulthood. Method: Four waves of national panel data were obtained from the Monitoring the Future project; 9,945 weighted cases from the 1976-85 high school senior year cohorts were surveyed at biennial intervals between ages 18 and 24. Frequent binge drinking was defined as having five or more drinks in a row at least twice in the past two weeks. Results: Six distinct frequent binge drinking trajectory groups were specified a priori and confirmed with cluster analysis: Never, Rare, Chronic, Decreased, Increased and "Fling." Repeated measures ANOVAS revealed that the trajectories corresponded to pat...
571 citations
TL;DR: AA experiences and outcomes are heterogeneous, and it makes little sense to seek omnibus profiles of AA affiliates or outcomes, and well-designed studies with large outpatient samples may afford the best opportunity to detect predictors and effects of AA involvement.
Abstract: Objective: Reviews of research on Alcoholics Anonymous (AA) have speculated how findings may differ when grouped by client and study characteristics. A meta-analytic review by Emrick et al. in 1993 provided empirical support for this concern but did not explore its implications. This review divided results of AA affiliation and outcome research by sample origin and global rating of study quality. The review also examined the statistical power of studies on AA. Method: Meta-analytic procedures were used to summarize the findings of 74 studies that examined AA affiliation and outcome. Results were divided by whether samples were drawn from outpatient or inpatient settings and a global rating of study quality that jointly considered use of subject selection and assignment, reliability of measurement and corroboration of self-report. Efficacy of dividing study results was examined by changes in magnitude of correlations and unexplained variance. Results: AA participation and drinking outcomes were more strong...
334 citations
TL;DR: The central finding of this investigation indicates that ECF and its interaction with a FH of substance dependence are associated with aggressive behavior and suggests that violence prevention and treatment efforts in high risk groups should incorporate cognitive habilitation focusing on training in ECFs.
Abstract: OBJECTIVE: This study had three purposes; (1) to assess the underlying factor structure of a battery of neuropsychological tests putatively measuring executive cognitive functioning (ECF) in a sample of boys at high and low risk for substance abuse/dependence; (2) to assess the relationship between ECF and aggressive behavior; and (3) to determine the interactive effects of ECF and a family history (FH) of substance dependence on aggressive behavior. METHOD: Multiple measures of ECF and aggressive behavior were used to test these relationships in a sample of 291 10-12 year old boys with and without a FH of substance dependence. RESULTS: Analyses indicated that the measures of ECF loaded on one factor. ECF was related to aggressive behavior even when accounting for IQ and SES. The interaction between ECF and a FH of substance dependence was also associated with aggressive behavior. CONCLUSIONS: The central finding of this investigation indicates that ECF and its interaction with a FH of substance dependence are associated with aggressive behavior. These results suggest that violence prevention and treatment efforts in high risk groups should incorporate cognitive habilitation focusing on training in ECFs. Language: en
215 citations
TL;DR: It is shown that a significant portion of the delinquent behaviors found in adolescents treated for alcohol and drug abuse is secondary to involvement with alcohol and other drugs.
Abstract: Objective: Delinquent behavior is prevalent among adolescents who abuse alcohol and other drugs. The present study examined the extent to which conduct disorder type behavior predates substance use involvement among 166 adolescents in treatment for alcohol and other drug abuse, and the prognostic significance of conduct disorder behaviors for the clinical course of teens during the first 2 years following treatment. Method: This was prospective longitudinal study of 166 alcohol and other drug abusing adolescents, 67 girls and 99 boys, averaging 15.9 years of age. Consecutive admissions were recruited from two adolescent inpatient alcohol and drug treatment facilities. Subjects were interviewed during treatment and again at 6 months and 1 and 2 years posttreatment. Results: Whereas the vast majority (95%) of teens entering alcohol and drug abuse treatment programs displayed a history of conduct disorder type behavior, only 47% met DSM-III-R criteria when behaviors directly or indirectly related to alcohol ...
209 citations
TL;DR: This review builds on the innovative research synthesis of Holder and his colleagues, addresses some of the limitations of the box-score approach to assessing treatment effectiveness and provides a second approximation of the cost-effectiveness of treatment for alcoholism.
Abstract: Objective: This review builds on the innovative research synthesis of Holder and his colleagues, addresses some of the limitations of the box-score approach to assessing treatment effectiveness that they used and provides a second approximation of the cost-effectiveness of treatment for alcoholism. Method: For each of 141 comparative treatment studies, we determined whether or not it found at least one statistically significant positive effect on a drinking-related outcome variable for each of the modalities examined in a paired contrast with one other condition. We next calculated the predicted probability of each study yielding at least one statistically significant treatment effect, based on the number of tests for treatment effects conducted. Following that, for each study of a particular treatment modality, the strength of the "weakest competitor" against which the modality had been compared was determined. For each modality, we used the average predicted probability of the relevant studies finding a...
191 citations
TL;DR: Outcomes 3 years after alcoholism treatment are related to the presence of specific lifetime comorbid psychiatric diagnoses, which may positively influence the course of alcoholism, trials of clinical interventions that target these disorders are warranted.
Abstract: Objective: To examine the impact of three common comorbid disorders on a variety of outcomes 3 years after inpatient alcoholism treatment. Method: Using a prospective cohort design, we examined the frequency and intensity of drinking, the severity of alcohol-related symptoms, global alcohol-related outcome and severity of psychiatric symptoms in a group of 225 (74% male) alcoholics. At the index admission, patients were categorized as to the lifetime presence of major depression, antisocial personality disorder (ASP) and drug abuse/dependence. Multiple linear regression was used hierarchically to step in blocks of predictors in a logical sequence: (1) gender and age; (2) number of comorbid psychiatric diagnoses and the presence or absence of the three individual comorbid psychiatric disorders; and (3) the interaction between gender and each of the three diagnostic groups. Results: Men showed greater intensity of drinking, more alcohol-related symptoms and poorer global alcohol-related outcome. Younger pat...
186 citations
TL;DR: It is concluded that increased attention to sources of alcohol used by youths would facilitate efforts to reduce underage drinking.
Abstract: Objective: We assessed the extent to which various sources of alcoholic beverages are used by early, middle and older teenagers, the extent to which teenagers perceive alcohol to be available from different sources and factors related to use of alternative sources. Method: Ninth graders (n = 2,269), twelfth graders (n = 2,377) and youth aged 18-20 (n = 1,738) were surveyed in 15 upper-midwestern communities using a nested cross-sectional design. Analyses were based on mixed-model regressions, with both the individual and community treated as random effects, taking into account the intraclass correlation for each dependent variable. Analyses focused on current (last 30 day) drinkers to avoid recall bias for drinking events in the distant past. Results: A person aged 21 or over was the most common source of alcohol for current drinkers in all three age groups; 46% of 9th graders, 60% of 12th graders and 68% of those aged 18-20 obtained alcohol from a person age 21 or older for their last drinking occasion. ...
168 citations
TL;DR: In this paper, the extent to which these associations owe to genetic or shared environmental influences has not been previously investigated using an adoption study design, and they sought to determine whether the familial correlates of adolescent alcohol involvement were due to common genetic or common environmental effects.
Abstract: Objective: Although adolescent alcohol use has been consistently associated with parental drinking behavior, sibling drinking behavior and family functioning, the extent to which these associations owe to genetic or shared environmental influences has not been previously investigated. Using an adoption study design, we sought to determine whether the familial correlates of adolescent alcohol involvement were due to common genetic or common environmental effects. Method: The sample consisted of 653 adopted families ascertained through adoption agencies in four U.S. states. Each family consisted of a target adopted adolescent, an adoptive mother and an adoptive father. In addition, 68 birth adolescents (i.e., biological offspring of the adoptive parents) and 187 second adopted adolescents from these families participated in the study. All participants completed a mail survey that included assessment of drinking behavior and family functioning. Results: The relationship between parental problem drinking and ...
163 citations
TL;DR: The data corroborate a lower level of intensity of response to alcohol in the sons of alcoholics especially as measured by changes in cortisol, with similar but less robust changes in subjective feelings and other measures.
Abstract: Objective: Alcoholism is a complex disorder that demonstrates genetic heterogeneity. Genetic linkage studies of alcohol dependence also suffer from the probability that many individuals who inherit an enhanced risk never develop the clinical syndrome. Thus, studies of genetic influences in alcohol abuse or dependence would benefit from the identification of characteristics of an individual that are associated with the probability of developing the disorder. A reduced responsivity to alcohol has been reported to characterize almost 40% of sons of alcoholics and to predict future alcohol abuse or dependence a decade later. This study explores the existence of this characteristic in a more heterogeneous sample that is part of a genetic pedigree study of families of alcoholics. Method: Eighteen to 30 year old subjects who were sons of alcohol dependent fathers and who were drinkers but not alcohol dependent were selected from pedigrees of alcoholics at all six sites of the Collaborative Study on the Genetics ...
133 citations
TL;DR: For adolescents aged 17 years and older parental alcohol use did not create an environment that stimulated alcohol use in children, and the resemblance for alcohol use between parents and their children aged 17 Years and older could be explained by their genetic relatedness.
Abstract: Objective: Resemblances between parents and children for alcohol use can be due both to cultural transmission and genetic inheritance. We examined the genetic and environmental determinants of the familial resemblances in alcohol use. Method: With a parent-twin design a distinction was made between the contribution of genetic effects, the environmental influences shared by siblings and the effects of cultural transmission from parents to offspring. By questionnaire data on whether subjects had ever used alcohol were obtained from 403 Dutch families with a twin aged 15-16 years old and from 805 families with a twin aged 17 years and older. Results: For 15-16 year olds, the resemblance between parents and offspring could be explained either by genetic inheritance or cultural transmission. Shared environment explained between 58% and 88% of the individual differences in adolescent alcohol use. For twins aged 17 years and older, 43% of the individual differences in alcohol use could be attributed to genetic f...
129 citations
TL;DR: Deficits in spatial cognition exhibited by alcoholics do not seem to arise from dysfunction in any localized brain region and small but potentially important impairments in fundamental aspects of spatial information processing such as scanning and use of visual imagery were found.
Abstract: Objective: To analyze visuospatial cognition in recently detoxified alcoholics from the perspectives of three ways of conceptualizing spatial information processing: egocentric versus allocentric orientation, featural versus configural analysis, and categorical versus coordinate spatial judgements. Method: Twenty-eight chronic alcoholics (19 men, 9 women) were compared to 20 (10 men, 10 women) controls of comparable age and education on a battery of tests of visuospatial scanning, construction, mental imagery, and anterograde and remote spatial memory. Tests were administered 21-40 days after alcoholics entered treatment. Results: Alcoholics displayed impairment in visuospatial scanning, construction, utilizing and manipulating information from visual images and on three tests of anterograde spatial memory, but remote spatial memory was not significantly affected. Their deficits were evident on some measures of allocentric orientation, featural and configural analysis, but consistent deficits on egocentri...
TL;DR: The findings indicate the importance of separating alcohol-specific social influences on help-seeking from more general social contextual variables and provide a social basis for distinguishing the appeal of AA from that of formal treatment.
Abstract: Objective: The role of problem drinkers' social contexts in help-seeking patterns was investigated using recent entrants into outpatient alcoholism treatment or Alcoholics Anonymous (AA). Untreated, active problem drinkers served as controls. Method: Subjects (N = 45, with 15 per group: 62% male) were recruited from the community. Habitual drinking practices, social network characteristics, social support, help-seeking barriers and incentives, and event occurrences during the 2 years prior to help-seeking were assessed during structured interviews. Collaterals verified subject reports. Results: Alcohol-related psychosocial problems and social network characteristics specific to drinking and help-seeking differentiated the groups, whereas drinking practices, general measures of social support and event occurrences did not. Both groups who sought help reported less network encouragement to drink, more network encouragement to seek help and greater alcohol-related psychosocial problems compared to untreated ...
TL;DR: This study characterizes normative developmental patterning in the frequency of alcohol consumption and demonstrates the varying effects of demographic factors across the life-course, and indicates the key influence of cultural and historical context on the establishment of drinking patterns.
Abstract: Objective: This report evaluates the relative contribution of predictors of change in the frequency of alcohol consumption among drinkers, based on the quantitative synthesis of data from 27 longitudinal studies of the general population. The analysis has two objectives: (1) to evaluate the impact of selected demographic characteristics on the magnitude and trajectory of change in drinking across multiple samples, and (2) to assess the influence of methodological characteristics on the consistency of results across studies. Method: Raw data from studies including two serial measures of the frequency of alcohol consumption are analyzed. Fixed, random and mixed effects models for meta-analysis are used to pool measures across observations and model the influence of predictors on variability between results. Results: Gender-based variation in the patterning of change is present across all observations, but concentrated in early periods of the life course. Age displays significant predictive effects across al...
TL;DR: A detailed pattern of alcoholic beverage use was characterized and indicated that at risk drinking is an important public health problem in a developing country.
Abstract: Objective: To describe the pattern of alcoholic beverage consumption and the prevalence of at risk drinking behaviors, as well as their association with demographic and socioeconomic factors in the adult population of Porto Alegre, a southern Brazilian city. Method: In a cross-sectional, population-based, multistage random sampling study, 1,091 (600 female) individuals (92% of those eligible) were selected and interviewed at home. Exposure to alcohol was measured by the CAGE questionnaire and by inquiring about the type, quantity and frequency of alcoholic beverage consumption. An average consumption of 30 g per day or more, a level of exposure associated with health risks, was considered as heavy drinking. Two positive answers to the GAGE questionnaire represented the cutoff for indicating dependence. Results: The prevalences were: 9.3% (95% CI: 7.6 to 11.0) for dependence, 15.5% (13.4 to 17.7) for heavy drinking and 12.3% (10.4 to 14.2) for daily drinking; 24.1% (21.7 to 26.6) were abstinent. Women cons...
TL;DR: The heterogeneity of alcohol-related behaviors among adolescents may be usefully represented via a drinker status typology that incorporates data on alcohol consumption, heavy-drinking episodes and adverse consequences.
Abstract: Objective: This study used data from over 1,000 adolescents to evaluate the convergent validity and longitudinal stability of a five-group drinker typology (abstainers, light, moderate, heavy and problem drinkers). Drinker types were compared on a range of variables from the domains of childhood behavior problems, drinking motives, early substance use onset, family and peer relations. Method: Prospective, longitudinal survey data were collected from 10th and 11th graders and from their primary caregivers (principally mothers) to evaluate hypotheses about correlates of adolescent substance use. Results: General support was indicated for the distinctiveness of the adolescent drinker types. Moderate drinkers differed systematically from light drinkers and abstainers on several variables (e.g., disinhibitory behavior while drinking, percentage of friends who drink); heavy drinkers differed from moderate drinkers (e.g., percentage of friends who use drugs, illicit drug use); and problem drinkers differed from ...
TL;DR: Alcohol consumption prior to the suicide attempt is a more important risk factor than the habitual alcohol consumption pattern.
Abstract: OBJECTIVE: The aim of this study was to obtain an epidemiologic measure of association between suicide attempts and alcohol consumption in eight emergency room (ER) hospitals. METHOD: All patients were interviewed and breath tested for alcohol consumption. The data were analyzed using the case-control methodology. Cases were patients (N = 40; 21 male) admitted to ER because of a suicide attempt. The control group comprised patients (N = 372) admitted to ER because of accidents that are less frequently reported as alcohol related (i.e., workplace accidents, animal bites, and recreational accidents, except drowning). RESULTS: The proportion of suicide attempts under the effects of alcohol was significantly higher than that of the control group. The bivariate odds ratios (and 95% confidence intervals) for self-report of alcohol consumption in the 6 hours prior to the suicide attempt were: abstainers (baseline); 0.001-100 g of alcohol = 2.01 (0.44, 7.85); > 100 g = 31.11 (10.13, 98.61). For habitual alcohol consumption; abstainers (baseline); 0.001-100 g of alcohol = 0.67 (0.25, 1.77); > 100 g = 1.10 (0.44, 2.75). For Alco-Sensor: or = 100 mg/100 ml = 2.97 (0.42, 15.95). Multiple logistic models did not change these findings. CONCLUSIONS: Alcohol consumption prior to the suicide attempt is a more important risk factor than the habitual alcohol consumption pattern. New research should emphasize life events and psychiatric variables and find explanations for differences between the self-reported and the Alco-Sensor estimates. Language: en
TL;DR: The authors used Random Effect Latent Growth (LG) models to study the relation between changes in heavy alcohol use and changes in the frequency of bar patronage over a 3-year period.
Abstract: Objective: Random effects latent growth (LG) models were used to study the relation between changes in heavy alcohol use and changes in the frequency of bar patronage over a 3-year period. Previous research has identified a close link between alcohol use and bar patronage, but these cross-sectional findings limit inferences about possible temporal ordering. LG models are highlighted and compared with the more traditional but restricted cross-lagged models. Method: Three annual measures of heavy alcohol use and frequency of bar patronage were administered to a sample of 3071 adults (62% male) who participated in the National Longitudinal Study of Youch from 1982 to 1984. Background variables included age, gender, ethnicity and marital status. Results: Heavy alcohol use and bar patronage were characterized by negative longitudinal growth trajectories and there was significant individual variability in these changes over time. Changes in heavy alcohol use closely paralleled corresponding changes in bar patro...
TL;DR: It appears that beer and spirits lead to greater problems than does wine consumption, and there is a need for more studies of women and confirmed drinkers of various beverages.
Abstract: Objective: The purpose of this article is to review the literature on the effects of beer, wine and spirits on the behavioral consequences of alcohol consumption. Method: The methods involve library research and analysis of the various published articles relating to experimental and survey studies of different effects Results: The major results indicate that (1) after spirits consumption blood alcohol concentrations rise more quickly than after beer; (2) for most behavioral tasks beer creates less impairment than brandy at the same dose levels; (3) brandy also leads to more emotional and aggressive responses; (4) those who drink beer or beer and spirits have more alcohol-related problems than others; and (5) beer drinkers are more likely than others to drink and drive, to be arrested for drinking-driving and to be in alcohol-related accidents. Conclusions: It appears that beer and spirits lead to greater problems than does wine consumption. However, there is a need for more studies of women and confirmed ...
TL;DR: The symptom onset model suggested a first stage of adolescent alcohol symptoms characterized by heavy and heedless drinking with associated interpersonal and role obligation problems, which did not support the construct validity of DSM-IV alcohol abuse when applied to adolescents, and suggested staging among DSM- IV alcohol dependence symptoms.
Abstract: Objective: This research examined staging in the time to onset of DSM-IV alcohol symptoms in adolescents. Consistent staging in the onset of symptoms provides important tests of the construct validity of diagnostic systems, and aids the development of early case identification strategies. Method: The Structured Clinical Interview for the DSM (SCID), adapted to assess DSM-IV alcohol abuse and dependence symptoms, was used to determine time to symptom onset in 102 male and 97 female adolescent drinkers with and without alcohol use disorders. The sample provided a broad range of drinking practices and alcohol-related problems. Symptom onset patterns were examined using survival-hazard analyses. Results: Survival and hazard data suggested three stages of alcohol problems distinguished by time to onset: heavy and heedless drinking with associated social and role obligation problems, psychological dependence, and withdrawal. This three-stage model fit both the male and female data, and described staging pattern...
TL;DR: The data support previous advice that health promotion and health policy activities in relation to alcohol use should take place during the December festive period and, if one aims at heavy drinking, the summer.
Abstract: Objective: The objective of this article is to describe and quantify seasonality in a number of indicators on alcohol use Method: The data analyzed cover a period between 1988 and 1994, and are collected by a telephone survey of persons living in Glasgow and Edinburgh, Scotland The analysis is on data from 29,256 respondents Cosinor analysis is the analytical instrument applied; a dummy variable is incorporated in the analysis to model the December peak in alcohol use Results: Annual seasonality in alcohol use excluding drinking behavior in December, is highest in the summer Seasonality with regard to changes in the proportion of respondents who report drinking alcohol in the previous month, or in the proportion of less regular heavy drinkers, is, although statistically significant, not very pronounced With regard to drinking five or more drinks on 11 or more occasions in the past month the level of seasonality is very pronounced The December peak in alcohol use powerfully influences the proportion
TL;DR: Investigating the relationships among drinking locations, sociodemographic characteristics and drinking-environment-related factors of convicted DWI offenders found strong family ties among Hispancies and Mexican Nationals may be a factor in remedial treatment.
Abstract: Objective: This study was designed to identify issues for public health/traffic safety in prevention of DWI and alcohol-related traffic injuries/deaths by investigating the relationships among drinking locations, sociodemographic characteristics and drinking-environment-related factors of convicted DWI offenders. Method: Subjects were clients (N = 5,154, 79% male) referred to the Lovelace Comprehensive Screening Program for alcohol-related assessment and were interviewed by counselors using a structured, computer-based questionnaire. Differences among ethnic/racial and gender categories were analyzed by logistic regression. Results: (1) Some groups showed a higher rate of DWI convictions, compared to the adult county population: young, single male: Hispanic and Mexican National; divorced/ separated/widowed (increasing with age): (2) older, educated or employed offenders reported drinking more in bars/lounges, while younger offenders were more likely drinking in private parties; (3) Hispanic and Mexican Na...
TL;DR: The most important finding was that the 1.00 g/kg alcohol dose produced statistically significant increases in aggressive responding relative to placebo, and these observed inconsistencies between this study and previous studies may be attributed to procedural differences, which have varied considerably across studies.
Abstract: Objective: The purpose of this study was to determine the effects of a range of alcohol doses on the aggressive responding of women. Method: The Point Subtraction Aggression Paradigm was used. It has two response options available to the subject: (1) point-maintained responding, emitting 100 responses on one button earned the subject 10 cents; and (2) aggressive responding, emitting 10 responses on an alternative button ostensibly subtracted 10 cents from another person also working to earn money. Aggressive responses were engendered by a random-time schedule of point loss (every 6 sec. to 120 sec.), and instructions attributed these point losses to button presses made by another fictitious subject. Ten female subjects participated, and each experienced placebos and three alcohol doses, 0.25, 0.50, and 1.00 g of 95% alcohol per kg of body weight. Results: The most important finding was that the 1.00 g/kg alcohol dose produced statistically significant increases in aggressive responding relative to placebo...
TL;DR: Findings do not support prevailing practitioner views regarding how traditional treatment works and suggest that interventions in these treatments may be mismatched to patient needs.
Abstract: Objective: Few studies have examined processes that mediate positive outcomes in the treatment of substance use disorders. The present study used a theory-driven approach to assess mechanisms hypothesized as curative by the traditional chemical dependency treatment approach. Several specific disease model processes such as accepting powerlessness over alcohol and two processes common to both the disease model and other treatment approaches (commitment to abstinence and intention to avoid high-risk situations) were studied. It was hypothesized that patients entering treatment would manifest high levels of denial, that there would be significant reduction of denial and increased endorsement of disease model and common processes as a result of treatment and that processes would mediate outcome. Method: Patients (N = 79; 54 men) in intensive traditional alcohol/drug treatment were assessed at entry into treatment, at the end of treatment and 1 month following treatment. Both self-report and clinician ratings ...
TL;DR: Findings suggest that both parents influence child development outcomes, but that the influence of one parent does not depend upon the Influence of the other parent.
Abstract: Objective: This study examined whether maternal parenting behaviors might serve to protect, or buffer, a child from the potentially negative effects associated with an alcoholic father. Method: This hypothesis was tested with a community sample of adolescent children of alcoholics and a demographically matched comparison group of children with nonalcoholic parents (total N = 278, 55% male). Three dimensions of parenting were considered: monitoring of child behavior, consistency of discipline, and social support. These dimensions were used in both cross-sectional and longitudinal regression analyses to predict child externalizing symptomatology, alcohol use and drug use. Results: Cross-sectional results supported independent effects of parenting on child outcomes, but produced limited support for the buffering hypothesis. Longitudinal analyses revealed no prospective effects of parenting and no support for the buffering hypothesis. Conclusions: Findings suggest that both parents influence child development...
TL;DR: Patients with lower educational attainment were more likely to have been warned about alcohol, while the likelihood of ever being told to stop or modify consumption increased with age, and associations were significant after controlling for patient race/ethnicity, cigarette use and CAGE scores.
Abstract: Objective: To identify patient factors associated with primary care physicians asking about alcohol consumption, warning of harmful ethanol effects, and advising modification of alcohol use in their patients. Method: A cross-sectional design was used, with a probability sample of 1,333 adult family medicine patients, stratified by sex and racial/ethnic background, drawn from a university-based, family medicine clinic. Patients completed self-report screens for alcohol-related problems (including the CAGE) and questionnaires on their experiences with the primary care provider. Results: Over 64% of male and female patients indicated their physician had asked them at some time about their alcohol consumption. Logistic regression models indicated that male patients were 1.5 times as likely to have been warned about alcohol and three times as likely to have been told to stop or modify their consumption compared to female patients. Patients with lower educational attainment were more likely to have been warned,...
TL;DR: Use of multiple measures of treatment compliance and examination of patterns of AA utilization use over time provide more complex views of the patterns of involvement with AA than do simple descriptive reports of attendance.
Abstract: Objective: The purpose of this study is to examine implementation of a randomized clinical trial and within treatment behavior when AA is included as an element of treatment. Special attention is given to the measurement of compliance, use of treatment skills, and the nature and extent of involvement with AA during the active phase of treatment. Method: Subjects, 90 male alcoholics and their female partners seeking conjoint, outpatient behavioral alcoholism treatment, were randomly assigned to one of three treatments: alcohol-focused behavioral marital therapy (ABMT), ABMT plus AA/Alanon (AA/ABMT), or ABMT plus relapse prevention (RP/ABMT). Within treatment data are reported for the 68 couples who completed at least five treatment sessions. Measures included: treatment attrition, number of treatment sessions, attendance at AA and Alanon, use of AA and Alanon skills, compliance with homework assignments and drinking during treatment. Results: Several aspects of within treatment behavior were examined: (1) ...
TL;DR: The findings provide evidence for the psychometric validity of the ARCQ, provide convergent validation for the utility of the temptation-coping construct and further highlight differences between adult and teen addictive relapse.
Abstract: Objective: The present study was undertaken to assess the factor structure and psychometric validity of the Adolescent Relapse Coping Questionnaire (ARCQ). The ARCQ is designed to assess alcohol and other drug abusing adolescents coping with situations providing temptations for alcohol and other drug use. Method: This was a prospective longitudinal study of 136 (79 male) alcohol and other drug abusing adolescents who were an average of 16.9 years old. Consecutive admissions were recruited from two adolescent, inpatient alcohol and drug abuse treatment facilities. Subjects completed the ARCQ as part of a 1-year-posttreatment interview and were subsequently interviewed 2 years posttreatment. Results: Analyses yielded three coping factors which were evaluated for construct and criterion validity. Factor 1 contained generic cognitive and behavioral problem-solving strategies, Factor 2 represented self-critical cognitions and Factor 3 included abstinence-focused coping strategies. The factors had good internal...
TL;DR: The results underscore the importance of research and intervention focusing on alcohol outlet policies and practices that affect the propensity to sell alcohol to persons under the legal drinking age.
Abstract: Objective: A recent study found that many alcohol outlets sold alcohol to youthful-appearing study confederates. This article expands upon that work by exploring the linkages between the policies, practices and characteristics of outlets and their propensity to sell alcohol to persons under the legal drinking age. Methods: Data on alcohol outlets are from a telephone survey of 100 establishments located in 28 communities in northeastern Minnesota that hold off-sale licenses for the sale of distilled spirits and/or full strength beer and wine. Alcohol purchase attempts were conducted in each outlet to provide a measure of propensity to sell alcohol to underage persons. Youthful-appearing study confederates conducted three separate purchase attempts in each outlet. Multiple linear regression was used to estimate the effects of outlet characteristics and policies on the purchase success rate. Results: Bars were less likely than liquor stores or bar/liquor stores to sell to study confederates. Having a manage...
TL;DR: The results indicate that the sheer number of alcohol expectancies accessible to an individual may be an important correlate of alcohol dependence, independent of subjective evaluations.
Abstract: Objective: Numerous studies have demonstrated that alcohol outcome expectancies are strong correlates of various aspects of alcohol use. However, it has been suggested that forced-choice alcohol expectancy items may not measure the most salient anticipated effects of alcohol for an individual, and thus may create superficial responses. Additionally, research on attitude-behavior consistency has demonstrated that the nature of how an attitude is elicited can lead to attitudes that are more or less cognitive. The present study examined the applicability of this aspect of attitude theory to the study of alcohol outcome expectancies and the utility of self-generated outcome expectancies and subjective evaluations in predicting alcohol use and problems. Method: In an extension of methodology previously used in attitude research, alcohol-using college students (N = 165, 87 female) generated alcohol expectancies in response to two sentence stems designed to elicit "affectively" and "cognitively" based alcohol ex...