Showing papers in "Journal of Studies on Alcohol and Drugs in 1998"
TL;DR: The CDDR was found to be internally consistent and reliable over time and across interviewers for each major domain assessed, and the validity of the four domains of alcohol and other drug involvement assessed on the CDDR supported.
Abstract: Objective: The present study was undertaken to assess the psychometric characteristics of the Customary Drinking and Drug Use Record (CDDR), an interviewer-administered questionnaire. The CDDR provides current (past 3 months) and lifetime measures of four alcohol- and other drug-related domains: level of involvement, withdrawal characteristics, psychological/behavioral dependence symptoms, and negative consequences. The present report describes the evaluation of the psychometric properties of the instrument with youth between the ages of 13 and 22 years who had markedly variable histories of involvement with alcohol and other psychoactive substances. Method: The sample assessed was composed of 166 adolescents recruited from two inpatient substance abuse treatment programs and 115 adolescents recruited from the community. Of the 281 subjects, 150 were male. Follow-up interviews with each adolescent and a resource person were conducted 6, 12, 24 and 48 months after the initial assessment. Results: Reliabili...
421 citations
TL;DR: This study indicates that the leadership of Greek organizations are participating in setting heavy-drinking norms and suggestions are made concerning targeting prevention programming efforts toward this group.
Abstract: Objective: This study was designed to identify drinking patterns, consequences of use, and belief systems about alcohol among college students according to their level of involvement in campus fraternity and sorority life. Method: This study of 25,411 (15,100 female) students who completed the Core Alcohol and Drug Survey, from 61 institutions, compared alcohol consumption, binge drinking, consequences of use and beliefs about drinking according to students' level of involvement in fraternities and sororities, ranging from no involvement to that of attending functions only, to active involvement, to leadership positions within Greek organizations. Results: Analyses indicated that students in the Greek system averaged significantly more drinks per week, engaged in heavy drinking more often and, with minor exceptions, suffered more negative consequences than non-Greeks. The leaders of fraternities and sororities consumed alcohol, engaged in heavy drinking and experienced negative consequences at levels at l...
296 citations
TL;DR: A multidimensional approach to prevention that addresses different processes of influence (e.g., modeling and social control) involving both parental and peer domains is likely to be most successful in deterring the onset of heavier drinking in adolescents.
Abstract: Objective: Less is known about heavier drinking in adolescents than about alcohol initiation The present study examined the emergence of regular (weekly) and heavy episodic (five or more drinks at a time) adolescent drinking as a function of social influence (modeling and social control) from parents and peers Method: A three-wave study was conducted using a representative household sample of families in metropolitan Buffalo, New York (N = 612) Over half (54%) of the adolescent respondents were female Black families made up 30% of the sample Interviews were conducted at 1-year intervals Adolescent drinking was dichotomized at each wave into abstinence/light drinking versus regular drinking Logistic regression including only adolescents who were abstainers/light drinkers at Wave 1 was performed to assess which Wave- variables could predict regular-drinking onset by Wave 2; a similar analysis examined the onset of heavy episodic drinking by Wave 2 Parallel analyses using Wave-2 variables to predict
251 citations
TL;DR: Encouraging substance abuse patients to regularly attend both outpatient aftercare and self-help groups may improve long-term outcomes.
Abstract: Objective: This study examined whether substance abuse patients self-selecting into one of three aftercare groups (outpatient treatment only, 12-step groups only, and outpatient treatment and 12-step groups) and patients who did not participate in aftercare differed on 1-year substance use and psychosocial outcomes. Method: A total of 3,018 male patients filled out a questionnaire at intake and 1 year following discharge from treatment. Patients were classified into aftercare groups at follow-up using information from VA databases and self-reports. Results: Patients who participated in both outpatient treatment and 12-step groups fared the best on 1-year outcomes. Patients who did not obtain aftercare had the poorest outcomes. In terms of the amount of intervention received, patients who had more outpatient mental health treatment, who more frequently attended 12-step groups or were more involved in 12-step activities had better 1-year outcomes. In addition, patients who kept regular outpatient appointmen...
243 citations
216 citations
TL;DR: The prospective evaluation of subjects at higher risk for alcoholism is a potentially powerful tool in identifying the relationships among a broad range of moderators and mediators of the alcoholism risk.
Abstract: Objective: This article reviews results from an ongoing prospective study of 453 sons of alcoholics and controls, and presents new data from the 15-year follow-up. Method: Drinking, but not alcohol dependent, 20-year-old sons of alcoholics and controls were evaluated for their level of response (LR) to alcohol and were subsequently followed, through personal interviews, 10 years and 15 years later. Results: The 10-year follow-up of 450 (99.3%) men and provisional analyses from the first 127 subjects at 15 years revealed that a low LR at about age 20 predicted subsequent alcoholism, even after considering the original quantity and frequency of drinking and six additional domains of influence. Regarding the latter, behavioral undercontrol and work stress appear to interact with LR, with alcohol expectancies, coping mechanisms and aspects of the drinking in the environment also appearing to add to the model, while other aspects of life stress and the social support network do not. Conclusions: The prospectiv...
213 citations
TL;DR: The stability of rates of frequent heavy drinking places blacks and Hispanics at a higher risk for problem development than whites, and is a concern to public health professionals and others interested in the prevention of alcohol-related problems among ethnic groups in the United States.
Abstract: Objective: To report national trends in alcohol consumption patterns among whites, blacks and Hispanics between 1984 and 1995, in relation to the recent decline in per capita consumption in the United States. Method: Data were obtained from two nationwide probability samples of U.S. households, the first conducted in 1984 and the second in 1995. The 1984 sample consisted of 1,777 whites, 1,947 blacks and 1,453 Hispanics; the 1995 sample consisted of 1,636 whites, 1,582 blacks and 1,585 Hispanics. On both occasions, interviews averaging 1 hour in length were conducted in respondents' homes by trained interviewers. Results: Between 1984 and 1995, the rate of abstention remained stable among whites but increased among blacks and Hispanics. Frequent heavy drinking decreased among white men (from 20% to 12%), but remained stable among black (15% in both surveys) and Hispanic men (17% and 18%). Frequent heavy drinking decreased among white women (from 5% to 2%), but remained stable among black (5% in both surve...
197 citations
TL;DR: Vast individual differences in day-to-day correspondence suggest that the Timeline Follow-Back may be less useful for detecting patterns of consumption, compared to a 28-day daily diary and a 30-day electronic interview.
Abstract: Objective: This study was designed to compare the Timeline Follow-Back (TLFB) to daily and real-time assessments of drinking. Our purpose was to evaluate overall correspondence and day-to-day agreement between these two methods among both problem and moderate drinkers. Method: In Study 1, problem drinkers (n = 20) reported their alcohol consumption daily during 28 days of brief treatment. In Study 2, moderate drinkers (n = 48), recruited from the community, used a palm-top computer to record their drinking for 30 days. In both studies participants completed the TLFB covering the recording period. Results: Participants in Study 1 reported fewer drinking days, fewer drinks per drinking day and fewer total drinks per day on the TLFB, and those in Study 2 reported fewer drinks per drinking day, fewer ounces per drinking day, fewer total drinks per day and fewer total ounces per day. The magnitude of the difference, however, was modest. There was considerable between-person variation in day-to-day corresponden...
188 citations
TL;DR: Alcohol debut was an excellent predictor of subsequent alcohol consumption and alcohol problems, and the strong preventive implication is that interventions should be implemented in order to postpone alcohol debut age.
Abstract: Objective: The aim of this study was to investigate the predictors of the timing of alcohol consumption debut and to analyze possible associations between the timing of debut and later alcohol consumption and possible alcohol-related problems. Method: A population sample of 465 adolescents (249 girls) from the greater Oslo area was followed up through five data collections over a 6-year span. By means of generalized structural equation modeling--accommodating survival variables--parental and friends' influences on debut age were estimated. Further, the consequences of the age of debut on subsequent alcohol consumption and alcohol problems were studied, taking other influences into consideration. In particular, possible gender differences were investigated. Results: The mean age for alcohol consumption debut was 14.8 years. The age of alcohol debut had an independent effect on both future alcohol consumption and the development of alcohol-related problems, and the effects were invariant across sex. Accordi...
181 citations
TL;DR: The results lend support to expectancy theories of alcohol's effects on sexual risk taking and raise the possibility that providing overly simplistic warnings that "alcohol leads to risky sex" may paradoxically increase the likelihood that individuals will fail to act prudently when intoxicated.
Abstract: Objective: Alcohol is frequently identified as a potential contributor to HIV-related sexual risk taking. Drawing on alcohol expectancy explanations for postdrinking behavior, the present study tested the hypothesis that adolescents who drink alcohol on a given occasion will be more likely to engage in sexual risk-taking behavior to the extent that they believe that alcohol disinhibits sexual behavior or promotes sexual risk taking. Method: The combined effects of sex-related alcohol expectancies and alcohol use in sexual situations were investigated using interview data from a representative sample of 907 (476 male) sexually experienced adolescents (13 to 19 years) who had ever consumed alcohol. Results: Regression analyses on a composite measure of risk taking revealed that for two of three intercourse occasions examined alcohol use was associated with greater risk taking primarily among respondents who expected alcohol to increase risky sexual behavior. Conclusions: The results lend support to expectan...
181 citations
TL;DR: The literature since 1986 is evaluated and an alcohol-causal-threshold hypothesis is supported and the following testable hypotheses are suggested: persons drinking five or six U.S. standard drinks per day over extended time periods manifest some cognitive inefficiencies; at seven to nine drink per day, mild cognitive deficits are present; and at 10 or more drinks perday, moderate cognitive deficits equivalent to those found in diagnosed alcoholics are present.
Abstract: Several studies published in the late 1970s and early 1980s reported that quantity of beverage alcohol typically ingested was inversely related to cognitive performance in sober social drinkers. After reviewing the widespread attempts to confirm these findings, Parsons concluded in 1986 that (1) there was no consistent evidence for residual impaired cognitive functions as a result of alcohol ingestion in sober social drinkers and (2) the importance of the problem called for continued research with improved methodology. In this article we evaluate the literature since 1986. Out of 19 pertinent studies, 17 investigated the relationships between cognitive tests and sober social drinking, one investigated event-related potentials (ERPs) and one investigated both cognitive performance and ERPs. Seven studies found that heavy social drinkers had significantly worse performance on one or more cognitive tests than the light drinkers. Ten studies reported negative results. Samples in negative studies had significantly lower averages of weekly drinks (mean = 16.4) than the samples in the positive studies (mean = 41.9). Both ERP studies found differences between heavy and light social drinkers. Our conclusions support an alcohol-causal-threshold hypothesis and suggest the following testable hypotheses: persons drinking five or six U.S. standard drinks per day over extended time periods manifest some cognitive inefficiencies; at seven to nine drinks per day, mild cognitive deficits are present; and at 10 or more drinks per day, moderate cognitive deficits equivalent to those found in diagnosed alcoholics are present.
TL;DR: Fetal alcohol exposure is a risk factor for adolescent alcohol involvement and alcohol-related problems and may account for variance in prediction of problems otherwise attributed to family history of alcoholism.
Abstract: Objective: To examine the relative importance of prenatal alcohol exposure and family history of alcoholism for the prediction of adolescent alcohol problems. Method: In 1974-75, a population-based, longitudinal prospective study of alcohol and pregnancy began with self-report of alcohol use by pregnant women. In a 14-year follow-up, 439 parents provided information on the family history of alcohol problems for these adolescent offspring. The 14-year-old adolescents provided information on the frequency and quantity of their own alcohol consumption within the past month, on the consequences of their drinking over the past 3 years, and on their age at first intoxication. Additional covariates were assessed prenatally and at follow-up. Results: Prenatal alcohol exposure was more predictive of adolescent alcohol use and its negative consequences than was family history of alcohol problems. Prenatal exposure retained a significant predictive effect even after adjustment for family history and other prenatal a...
TL;DR: In this article, the authors examined possible relations between child sexual or physical abuse and adult alcoholism and concluded that current evidence is insufficient to draw conclusions, and several methodological limitations should be taken into consideration when evaluating results of the available studies.
Abstract: Objective: To examine possible relations between child sexual or physical abuse and adult alcoholism. Method: Studies reviewed included prospective studies, retrospective studies on the prevalence of child sexual or physical abuse in alcoholics and nonalcoholics, and retrospective studies in mental health clients and in population samples comparing the prevalence of alcohol use disorders in abused and nonabused subjects. Results: Prospective studies do not indicate a significant association between child sexual or physical abuse and alcoholism. In contrast, studies among alcoholic women do suggest a relationship. Also, a significantly higher prevalence of alcohol problems in abused women than in nonabused women is found in population samples. The results of studies among mental health clients are inconclusive. In addition, several methodological limitations should be taken into consideration when evaluating results of the available studies. Conclusions: Current evidence is insufficient to draw conclusions...
TL;DR: The relatively high frequency of the ADH2*2 allele may contribute to the seemingly lower levels of alcohol consumption and heightened sensitivity to alcohol observed among Jews.
Abstract: Objective: This study provides preliminary evidence on the associations between alcohol consumption patterns and polymorphisms of the alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) enzymes in a Jewish population. Method: Two groups of Jewish men were studied--one group (n = 92) representative of the free-living population of Jerusalem and generally light consumers of ethanol and the other group (n = 53) composed of treatment-enrolled heroin dependent individuals in the same city, most with a history of heavy daily drinking. All participants were interviewed regarding sociodemographic background, present and past alcohol consumption patterns, and familial characteristics including alcohol problems among first-degree relatives. Polymorphisms of the ADH2, ADH3 and ALDH loci were determined for all participants. Results: The less common allele of the ADH2 locus (ADH2*2 allele frequency approximately 20% in Ashkenazic and non-Ashkenazic members of both groups) was related to a reduced mean level...
TL;DR: Overall, the time course of alcohol-related problems for men and women were more similar than different, and there is little evidence that the natural history of alcohol dependence in women is substantially different than in men.
Abstract: Objective: This article examines the differences in the clinical course of alcohol dependence in men and women, interpreting results in light of the gender differences in nonalcoholics and potential findings from the general population. Method: As part of the Collaborative Study on the Genetics of Alcoholism (COGA) protocol, a detailed semistructured interview was administered to 1,085 alcohol dependent women and 2,120 alcohol dependent men, along with 1,936 women and 1,233 men who were drinkers but not alcoholic. Subjects were alcohol dependent probands, controls, and relatives of each. Results: The men's and women's rank orders of alcohol-related life events were similar for alcohol dependent subjects, with a rho (rho) of .95, a figure that remained constant even when only primary alcoholics were considered. In general, those items for which the two genders evidenced differences in either the mean age of occurrence or the proportion of people who experienced an event were similar to gender differences i...
TL;DR: Women's expectancies for sexual functioning and assertiveness improved the prediction of excessive consumption, over and above intentions and perceived behavioral control, and alcohol outcome expectancies, unlike attitudes, are proximal predictors of excessive alcohol consumption among undergraduates.
Abstract: OBJECTIVE: The present study investigated whether alcohol outcome expectancies are empirically distinguishable from attitudes toward drinking. Specifically, the contribution of expectancies and attitudes to the Theory of Planned Behavior was assessed. METHOD: Undergraduates (N = 316; 170 male), of legal drinking age, who drank at least once a month participated. Intentions to drink "too much" and self-report excessive consumption episodes served as criterion measures, and attitudes, subjective norm, perceived behavioral control and alcohol outcome expectancies were employed as predictor variables. Stepwise regression analyses were performed separately for men and women. RESULTS: The Theory of Planned Behavior appeared to be a valid framework for predicting excessive alcohol consumption among undergraduates. The predictive power of the model, however, was enhanced through the inclusion of gender-specific alcohol outcome expectancies. Specifically, in addition to attitudes and perceived behavioral control, women's expectancies for sociability enhanced the prediction of intentions to drink "too much." Expectancies for sexual functioning (male) and assertiveness (female) improved the prediction of excessive consumption, over and above intentions and perceived behavioral control. CONCLUSIONS: Alcohol outcome expectancies, unlike attitudes, are proximal predictors of excessive alcohol consumption among undergraduates. Language: en
TL;DR: It is suggested that the proximal outcomes thought to be specific to cognitive-behavioral treatment are actually general proximal outcome outcomes of both 12-step and cognitive- behavioral treatment.
Abstract: Objective: This article provides data on the early linkages in the treatment process chains that are thought to underlie two prevalent approaches to substance abuse treatment-traditional 12-step treatment and cognitive-behavioral treatment. The focus is on the during-treatment changes on "proximal outcomes" that, according to the treatment theory underlying each modality, patients are supposed to undergo or achieve in order to experience a positive "ultimate outcome." Method: In all, 3,228 men receiving treatment in 15 Department of Veterans Affairs substance abuse treatment programs were assessed at treatment entry and at or near discharge from inpatient programs that had desired lengths of stay of 21-28 days. Results: Between intake and discharge, patients in 12-step programs improved more than did C-B patients on proximal outcome variables assumed to be specific to 12-step treatment (e.g., attending 12-step meetings, taking steps), whereas patients in cognitive-behavioral programs made no greater chang...
TL;DR: BMT-plus-RP produced better marital outcomes throughout the 30 months of follow-up and better drinking outcomes during and for the 6 months following RP sessions, relative to BMT-only outcomes.
Abstract: Objective: This article provides a complete report of outcome data from a study of behavioral marital therapy (BMT) with and without additional couples relapse prevention (RP) sessions (See J Stud Alcohol 54: 652-666, 1993, for an earlier partial report) Method: Fifty-nine couples with an alcoholic husband, after receiving weekly BMT couples sessions for 5-6 months, were assigned randomly to get or not get 15 additional couples relapse prevention (RP) sessions over the next 12 months Outcome measures were collected before and after BMT and at quarterly intervals for the 30 months after BMT Results: BMT-plus-RP produced more days abstinent and greater use of the Antabuse Contract than BMT-only; and these superior drinking outcomes for BMT-plus-RP lasted through 18-month follow-up (ie, 6 months after the end of RP) BMT-plus-RP had better wives' marital adjustment than BMT-only throughout the 30 months of follow-up, with the superiority of BMT-plus-RP over BMT-only being greatest for wives with poor
TL;DR: Becoming married for the first time exerted a unique effect on the overall developmental trajectory of alcohol use over time and this effect held for both ethnic groups but was reliably stronger for white compared to black respondents.
Abstract: Objective: Multiple group latent curve analysis was used to assess the impact of changes in marital status on alcohol use trajectories in young adults and to test if these effects varied across ethnicity and gender. Method: Four years of data were obtained from a sample of young adults (N = 4,052; 54% male) drawn from the National Longitudinal Survey of Youth. Alcohol use and marital status were assessed once per year and covariates included age, gender, education and ethnicity. Results: Latent curve models indicated that there was an overall nonlinear negative alcohol use trajectory across the four time points and that becoming married was reliably associated with an added down-turn to this trajectory. Multiple group models indicated that there was an interaction between ethnicity and marital status in the prediction of alcohol growth trajectories, but there was no interaction with gender. Conclusions: Becoming married for the first time exerted a unique effect on the overall developmental trajectory of ...
TL;DR: The results suggest that educational achievement and some early adaptive behaviors in school are associated with risk for alcohol use disorders.
Abstract: Objective: This prospective study is focused on the characteristics leading to alcohol use disorders in early adulthood among a cohort of black children. The principal aim of this work is to examine the impact of educational attainment, school dropout and early school adaptation on the development of alcohol abuse and dependence in adulthood. Method: From a population that consisted of 1,242 first graders in 1966-67, a total of 953 were interviewed at age 32-33 about their current alcohol and drug use, educational attainment, employment and family situation. Results: Diagnoses of alcohol abuse and dependence were defined according to DSM-III-R criteria resulting in identification of 13.5% as having a lifetime alcohol use disorder. Early predictions of an alcohol use disorder in adulthood included early reports of underachievement in first grade by the child's teacher, dropping out of high school, whether the family set definite rules about school during adolescence, and how often the adolescent worked on ...
TL;DR: Situations and settings of drinking differed according to age and drinking behavior, and persons reporting having five or more drinks on one occasion in the last 2 weeks were more likely to report drinking with peers, in large groups of underage persons and away from home.
Abstract: Objective: Social settings and situations of underage drinking were described for students from 15 communities in Minnesota and Wisconsin. Reports of their last drinking event, including setting, number of persons drinking with them, number of those persons under age 21, and whom they were with, were examined. The role of these variables in the prediction of having five or more drinks on one occasion was assessed. Method: Ninth graders (n = 2,269) and 12th graders (n = 2,377) who reported using alcohol in the last 30 days were included in the sample from a nested cross-sectional survey design. Bivariate analyses were performed between the situational variables and gender, number of older siblings and drinking behavior. Chi-square statistics were divided by an estimate of the design effect and multivariate analyses used mixed-model regression to correct for the nesting of individuals within communities. Results: Situations and settings of drinking differed according to age and drinking behavior. Twelfth gr...
TL;DR: The results confirm previous findings that job loss can increase the risk of alcohol misuse, provide new evidence that two types of underemployment can also increase this risk and suggest that these effects vary over time.
Abstract: Objective: This study measured the impact of unemployment and underemployment on alcohol misuse. Method: A panel of respondents from the National Longitudinal Survey of Youth was studied in 1984-85 and 1988-89. In each pair of years, the effect of employment change (e.g., becoming underemployed) on alcohol misuse was assessed controlling for misuse in the first year. Alcohol misuse was operationalized in two ways: elevated symptoms and heavy drinking. Three samples were analyzed: a core sample of 2,441 who were available in both pairs of years (approximately 65% male) and two extended samples that included everyone available in one pair of years but not the other (n = 4,183 in 1984-85 and n = 3,926 in 1988-89). Results: The 1984-85 analyses revealed a significant association of adverse change in employment with both elevated alcohol symptoms and heavy drinking (the latter moderated by prior heavy drinking). The 1988-89 analyses found no relationship between adverse change in employment and heavy drinking ...
TL;DR: These findings supported prior research showing more familial alcoholism among persons with comorbid dependence and depression than among those with dependence alone, and were supportive of the proposed distinction between pure depression and depressive-spectrum disease.
Abstract: Objective: Data from a representative sample of U.S. adults were used to assess the extent of familial alcoholism, to examine its association with the odds of DSM-IV lifetime alcohol dependence, major depression, and their comorbid occurrence, and to determine whether the magnitude of this association was different for men and women. Method: Self-report data from a sample of 42,862 U.S. adults (25,043 women) 18 years of age and over were analyzed by means of multiple logistic regression models that predicted the odds of various combinations of DSM-IV alcohol dependence and major depression. Results: After adjusting for potential confounders through multiple logistic regression, family history saturation was associated with increased odds of dependence only, depression only, and all primary-secondary-concurrent combinations of these two disorders. The estimated effects were greatest for comorbid dependence and depression, next highest for dependence only and lowest for depression only. Differences in odds ...
TL;DR: Alcohol slowed (i.e., impaired) information processing compared with placebo and no treatment, and those who expected more impairment performed more poorly under alcohol, and under the placebo when alcohol was expected.
Abstract: Objective: This experiment tested the hypothesis that differences in subjects' expectations about the impairing effect of alcohol on cognitive performance predict their responses to alcohol and to a placebo. Method: Twenty-seven male social drinkers were randomly assigned to one of three treatment groups: alcohol (0.62 g/kg), placebo, or no treatment control. All groups practiced a Rapid Information Processing Task that measured cognitive performance by the speed of information processed. After practice, they rated the degree of impairment they expected alcohol to have on their performance, and then performed the task under their different treatments. Results: Alcohol slowed (i.e., impaired) information processing compared with placebo and no treatment. In addition, those who expected more impairment performed more poorly under alcohol, and under the placebo when alcohol was expected. When no beverage was received, no expectancy-performance relationship was obtained. Conclusions: The findings call attenti...
TL;DR: It appears that, whereas mood disturbance predicts short-term outcome, more enduring personality traits predict long-term success in remaining abstinent, even after 5 years of abstinence.
Abstract: Objective: The goals of this study were to examine the hazard of relapse during an average 11 years of follow-up in alcoholics who had achieved long-term abstinence and to determine predictors of later relapse. Method: Male alcoholics (N = 77) with at least 18 months of stable abstinence at time of entry were followed for 2 to 17 years (mean follow-up = 10.9 years). During follow-up, detailed information regarding relapse/abstinence and interim drinking behavior was recorded. Potential predictors of relapse collected at enrollment included past drinking history, severity of alcohol-related life problems, degree of neurocognitive impairment based on neuropsychological (NP) tests, psychological distress (MMPI) and past medical health. Results: Twenty-four of 77 (31%) long-term abstainers relapsed during the follow-up period. The average annual hazard rate of relapse was 3.8% in the first 5 years of follow-up and 2.6% over the next 6-11 years. Based on Cox proportional hazard regression analyses, the only si...
TL;DR: The achievement of remission from substance use dependence during IOP may be an important criterion for moving to the next level of care and the results of the present study point to the need for an increased focus on factors present during the course of aftercare in future studies of retention in aftercare following outpatient rehabilitation.
Abstract: Objective: The goals of this study were to identify predictors of greater participation in aftercare treatment sessions and self-help groups during the first 3 months following completion of a 4-week intensive outpatient rehabilitation (IOP) program. Method: The subjects were 138 male veterans who met DSM-III-R criteria for lifetime diagnoses of both alcohol and cocaine dependence (n = 67), alcohol dependence only (n = 48) or cocaine dependence only (n = 23); completed an IOP program; and expressed a desire to enter a formal aftercare program. Analyses examined relationships between predictor variables from five different domains and number of aftercare sessions and self-help groups attended in the last week of each month of the follow-up period. Results: Of the many potential predictor variables that were examined, only remission from cocaine and alcohol dependence during IOP and higher AIDS risk behavior scores in the prior 6 months contributed independently to the prediction of greater participation in...
TL;DR: The results suggest that interventions focused on managing negative mood may benefit high-risk, comorbid smokers with a history of major depression.
Abstract: Objective: Alcohol dependence and major depression have been associated with heavy cigarette use and poor smoking-treatment outcomes. This preliminary study examined the efficacy of a mood management intervention for smoking cessation in abstinent alcoholics with a history of major depression. Method: Participants were 29 (15 female, 14 male) heavy smokers (mean cigs/day = 30.2), with an average of 6.8 years of continuous abstinence from alcohol and drugs, randomized to behavioral counseling (BC) (n = 16) or behavioral counseling + cognitive-behavioral mood management (CBT) (n = 13). A 2 x 5 repeated measures design was used to evaluate the effectiveness of the interventions on smoking outcome at baseline, posttreatment and at 1-, 3- and 12-month-follow-up. Self-reported smoking status was verified with biochemical (COa) and informant report. Results: Verified self-report indicated that significantly more smokers in CBT quit by posttreatment (69.2%; 9 of 13) than in BC (31.3%; 5 of 16) (chi2 = 4.14, 1 df,...
TL;DR: The RAPS may hold promise for identifying problem drinkers across ethnic and gender subgroups, but it and other screening instruments currently in use require additional evaluation in a variety of settings to determine their usefulness for identifying those who could benefit from a brief intervention or referral for problem drinking.
Abstract: Objective: The purpose of this study was to compare the performance of a number of standard screening instruments for alcohol dependence and harmful drinking/abuse by ethnicity (black, Hispanic and white) and by ethnicity and gender in an emergency room setting. Method: A probability sample of patients (N = 1,429) was breath analyzed and interviewed at the Santa Clara Valley Medical Center in San Jose, California. Sensitivity and specificity were analyzed among current drinkers (n = 857) for the CAGE, Brief MAST, AUDIT, TWEAK, RAPS and other items against combined ICD- 10 or DSM-IV criteria for alcohol dependence and separately for alcohol dependence or harmful drinking or abuse. Results: Screening measures were not found to perform equally well by ethnicity or gender, with lower sensitivity found for women compared to men. Consistency in sensitivity of measures was found to vary considerably across ethnic and gender groups, with some measures (most notably the RAPS and the AUDIT) showing consistently hig...
TL;DR: While drinking within 24 hours is positively associated with sensation seeking, drinking and not sensation seeking is positively predictive of injury.
Abstract: OBJECTIVE: Alcohol consumption is known to be associated with both risk of accidental injury and with sensation seeking, and sensation seeking has been found to be common among those engaging in such high-risk activities as skiing. However, few studies have examined the joint association of alcohol consumption and sensation seeking on injury. METHOD: Alcohol consumption prior to injury and sensation-seeking disposition are analyzed on 389 injured skiers (clinic sample) and 899 randomly selected uninjured skiers (trailside sample) at a Northeastern ski resort. Cases and controls were asked questions pertaining to drinking within 24 hours, amount consumed, time lapsed between the last drink and the event, skiing ability, and sensation seeking. RESULTS: The clinic sample was more likely to be female, to have less skiing experience, to score lower on sensation seeking and to have been drinking within 24 hours compared to the trailside sample. However, they were less likely to have had six or more drinks within 24 hours and were more likely to report a greater time lapse between the last drink and injury or interview. A larger proportion of those who reported drinking in both samples scored high on sensation seeking compared to those who reported not drinking. Logistic regression analysis found the following variables predictive of ski injury: female, low on sensation seeking, amount of alcohol consumed prior to the event, a longer time lapsed between drinking and the event, time of day (later) and day of the week (weekend). CONCLUSIONS: The data suggest that, while drinking within 24 hours is positively associated with sensation seeking, drinking and not sensation seeking is positively predictive of injury. Drinking at least 12 hours prior to skiing, not drinking in close proximity to skiing, may increase risk for accidental injury, possibly due to a hangover or residual alcohol effect in which fatigue may play a part.