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Showing papers in "Journal of Studies on Alcohol and Drugs in 2001"


Journal ArticleDOI
TL;DR: The rate of current pathological gambling in the United States is higher than reported in past surveys and when higher SES persons are classified as current pathological gamblers, they are more likely than lower SES Persons to be dependent on alcohol.
Abstract: Objective: This study was designed to determine the prevalence and demographic distribution of problem gambling, pathological gambling, alcohol abuse and alcohol dependence in the United States, and to examine the co-occurrence of gambling pathology and alcohol pathology in the United States. Method: A representative sample (N = 2,638) of U.S. adults age 18 and older was surveyed in the year 2000 using computer-assisted telephone interviewing. Respondents' gambling pathology and alcohol dependence were assessed by the South Oaks Gambling Screen (SOGS) and the Diagnostic Interview Schedule (DIS). Results: Current pathological gambling had an overall prevalence of 1.3% as measured by the DIS and 1.9% as measured by the SOGS, with a higher prevalence among minorities and lower socioeconomic status (SES) respondents. Current and lifetime alcohol pathology was more common among males and young adults than among females and older adults. Current pathological gambling and alcohol dependence were correlated, and ...

491 citations


Journal ArticleDOI
TL;DR: Results provide support for the efficacy of a brief motivational enhancement intervention in reducing drinking within this high-risk population and the cost-effective use of peer interviewers appears to be a promising strategy for delivering individualized prevention programming in college populations.
Abstract: Objective: The current study tested the efficacy of a brief intervention designed to reduce drinking and drinking-related consequences among first-year fraternity members. Method: Twelve fraternities were randomly assigned to receive either a motivational enhancement intervention with individual and housewide feedback components (n = 6 houses) or a treatment-as-usual control condition (n = 6 houses). Individual feedback was delivered either by peer interviewers or professional research staff. Participants were assessed during their pledge (first) year of house membership and during a follow-up period 1 year later. Results: Of the participants who completed follow-up (N = 120), fraternity members who received the brief intervention reported significant reductions in alcohol use (total average consumption) and typical peak blood alcohol concentrations when compared with fraternity members in the control condition. No differences in drinking-related consequences were observed. Fraternity members who received...

382 citations


Journal ArticleDOI
TL;DR: Estimates of the average effectiveness of alcoholism treatment were derived from seven large multisite studies to provide a meaningful and data-based answer to the common question of how people fare, on average, after being treated for alcoholism.
Abstract: Objective: Following in the footsteps of several prior attempts, this review seeks a meaningful and data-based answer to the common question of how people fare, on average, after being treated for alcoholism (broadly defined as alcohol use disorders). Method: Findings from seven large multisite studies were combined to derive estimates of the average effectiveness of alcoholism treatment. To provide common outcome measures, conversion equations were used to compute variables not reported in the original studies. Results: During the year after treatment, 1 in 4 clients remained continuously abstinent on average, and an additional 1 in 10 used alcohol moderately and without problems. During this period, mortality averaged less than 2%. The remaining clients, as a group, showed substantial improvement, abstaining on 3 days out of 4 and reducing their overall alcohol consumption by 87%, on average. Alcohol-related problems also decreased by 60%. Conclusions: About one third of clients remain asymptomatic duri...

373 citations


Journal ArticleDOI
TL;DR: Results indicate that the effects of a booster session that is added to a brief intervention in the ED can be helpful to injured patients with a history of hazardous or harmful drinking, irrespective of whether they have consumed alcohol prior to their injury.
Abstract: Objective: The study aim was to test whether a brief mo- tivational intervention, with or without a booster session, would improve drinking-related outcomes more than standard Emergency Department (ED) treatment. Method: The study population consisted of 539 (78% male) injured patients treated in the ED and discharged to the commu- nity following their treatment. Injured patients met inclusion criteria if they were assessed as hazardous or harmful drinkers by scoring eight or more on the AUDIT and/or having alcohol in their system at the time of their injury or ED visit. Patients were randomly assigned to either standard care (SC), brief intervention (BI) or brief intervention plus a booster session (BIB). At 1-year follow-up, 447 patients (83% of the sample) were re-interviewed to measure alcohol-related negative con- sequences, injuries and drinking. Results: Patients receiving BIB, but not BI patients, reduced alcohol-related negative consequences and alcohol-related injuries more than did those in the SC group. All three groups reduced their days of heavy drinking. Patients with histories of hazardous drinking responded to BIB, whether or not they had consumed alcohol prior to their injury. Conclusions: Together, these results indi- cate that the effects of a booster session that is added to a brief inter- vention in the ED can be helpful to injured patients with a history of hazardous or harmful drinking, irrespective of whether they have con- sumed alcohol prior to their injury. (J. Stud. Alcohol 62: 806-816, 2001)

365 citations


Journal ArticleDOI
TL;DR: High alcohol outlet density is associated with high rates of violent crime in this urban community, and spatial analysis suggests that alcohol outlets elevate the rate ofviolent crime within the immediate neighborhood context, not in surrounding neighborhoods.
Abstract: Objective: This study examined the relationship between neighborhood social structure, alcohol outlet densities and violent crime in Camden, New Jersey. Method: Data pertaining to neighborhood social structure, violent crime and alcohol density were collected for 98 block groups, and analyzed using bivariate, multivariate and spatial analyses. Results: Each type of analysis showed that those areas with high alcohol outlet densities experienced more violent crime than low-density areas, after controlling for neighborhood social structure. In the multivariate regression analysis, alcohol outlet densities explained close to one fifth of the variability in violent crime rates across block groups--more than any one of the neighborhood structural variables included in the analysis. These findings were replicated in the spatial analysis, which also showed that alcohol outlet densities contributed significantly to violent crime within target block groups but not in adjacent block groups. Conclusions: High alcohol...

306 citations


Journal ArticleDOI
TL;DR: The findings demonstrate the unique and relative contribution of active and passive social influences and provide limited support for a hypothesized process by which social factors influence cognitions and alcohol-related behaviors.
Abstract: Objective: Social influences are among the most robust predictors of adolescent substance use and misuse. Studies with early adolescent samples have supported the need to distinguish among various types of social influences to better delineate relations between social factors and alcohol use and problems. Method: The first major goal of the present study (N = 399, 263 women) was to examine unique relations between particular facets of social influence and alcohol use and problems in a relatively heavy-drinking population (i.e., college students). We hypothesized that active social influences (offers to drink alcohol) and passive social influences (social modeling and perceived norms) would demonstrate positive associations with measures of alcohol use and problems. We also tested the hypothesis that alcohol outcome expectancies would mediate associations between social influences and drinking behaviors. Results: Structural equation modeling analyses provided strong support for the first hypothesis. Social...

288 citations


Journal ArticleDOI
TL;DR: These important malleable predictors, identifiable as early as age 10, provide potential intervention targets for the prevention of alcohol abuse and dependence in early adulthood.
Abstract: Objective: To provide a comprehensive examination of childhood and adolescent predictors of alcohol abuse and dependence at age 21, theoretically guided by the social development model. Method: Data were taken from an ethnically diverse urban sample of 808 stu- dents (51% male), surveyed at age 10 and followed prospectively to age 21 in 1996. Potential predictors of alcohol abuse and dependence at age 21 were measured at ages 10, 14 and 16. Relationships between these predictors and alcohol abuse and dependence were examined at each age, to assess changes in their patterns of prediction over time. Results: Strong bonding to school, close parental monitoring of children and clearly defined family rules for behavior, appropriate parental rewards for good behaviors, high level of refusal skills and strong belief in the moral order predicted a lower risk for alcohol abuse and dependence at age 21. Of these, strong bonding to school consistently predicted lower alcohol abuse and dependence from all three ages (10, 14 and 16). By contrast, youths who had a higher risk of alcohol abuse and dependence at age 21 engaged in more problem behaviors, had more opportunities to be involved with antisocial individuals and spent more time with and were more bonded to those individuals, viewed fewer negative conse- quences from antisocial behaviors and held more favorable views on al- cohol use. Of these, prior problem behaviors and antisocial opportunities and involvements at ages 10, 14 and 16 consistently predicted alcohol abuse and dependence at age 21. Conclusions: These important malleable predictors, identifiable as early as age 10, provide potential interven- tion targets for the prevention of alcohol abuse and dependence in early adulthood. (J. Stud. Alcohol 62: 754-762, 2001)

271 citations


Journal ArticleDOI
TL;DR: Baseline drinking to cope was associated with more alcohol consumption and drinking problems at all four observations across the 10-year interval and individuals who had a stronger propensity to drink to cope showed a stronger link between both anxiety and depressive symptoms and drinking outcomes.
Abstract: Objective: This study examines the ability of baseline drinking to cope to predict drinking behavior across an ensuing 10-year period. In addition, it examines whether a propensity to consume alcohol to cope with stressors strengthens the link between emotional distress and drinking behavior. Method: The study uses survey data from a baseline sample of 421 adults (54% women) assessed four times over a 10-year period (i.e., baseline and 1-, 4- and 10-year follow-ups). Results: Baseline drinking to cope was associated with more alcohol consumption and drinking problems at all four observations across the 10-year interval. Baseline drinking to cope also predicted increases in both alcohol consumption and drinking problems in the following year. Moreover, change in drinking to cope was positively linked to changes in both alcohol consumption and drinking problems over the interval. Individuals who had a stronger propensity to drink to cope at baseline showed a stronger link between both anxiety and depressive...

250 citations


Journal ArticleDOI
TL;DR: It is indicated that religiosity is differentially associated with alcohol use and problem drinking for white and black adolescents, and the "one-size-fits-all" approach to alcohol treatment and prevention is likely inappropriate.
Abstract: Objective: There are racial differences in adolescents' propensity to consume alcohol--with white adolescents tending to consume more alcohol than black adolescents--but there is no clear explanation for why such differences exist. The purpose of this study was to examine the relationship between religiosity, a cultural factor that is not well understood currently, and racial differences in adolescent alcohol use. Method: Participants were white and black ninth-grade adolescents (N = 899; 54% female, 57.5% white) involved in a 3-year longitudinal study of ways to reduce alcohol use and sexual risk-taking behavior among adolescents in Ohio and Kentucky. Results: Findings indicate that religiosity is differentially associated with alcohol use and problem drinking for white and black adolescents. Religious service attendance was the most significant predictor of alcohol use for black adolescents, whereas religious fundamentalism was most important for white adolescents. In contrast, frequency of prayer was t...

203 citations


Journal ArticleDOI
TL;DR: Changes in drinking behavior were related to several life events occurring over a 6-year period for a national cohort of individuals in late middle-age, however, the magnitude of these relationships varied by gender and problem drinking history.
Abstract: Objective: Four waves of the Health and Retirement Study were used to examine changes in alcohol consumption co-occurring and following stress associated with major health, family and employment events. Method: The final sample consisted of 7,731 (3,907 male) individuals between the ages of 51 and 61 at baseline. We used multinomial logit analysis to study associations between important life events and changes in alcohol consumption over a 6-year study period. Interactions between stressful life events, gender and problem drinking were also evaluated. Results: Most persons (68%) did not change their use of alcohol over the entire 6 years. Hospitalization and onset of a chronic condition were associated with decreased drinking levels. Retirement was associated with increased drinking. Widowhood was associated with increased drinking but only for a short time. Getting married or divorced was associated with both increases and decreases in drinking, with a complex lag structure. A history of problem drinking...

190 citations


Journal ArticleDOI
TL;DR: Results showed that receiving good grades in school predicted moderate increases in family social support, and adolescent alcohol use was directly associated with subsequent increases in peer alcohol use and later decreases in school performance.
Abstract: Objective: In this study, the cross-temporal relationship between family social support and adolescent alcohol use was examined. A primary aim was to investigate the mechanisms through which family social support affects drinking among youth. Another aim was to examine reciprocal relationships among the study variables. Method: Four-wave (with 6-month intervals) panel survey data collected from 840 middle adolescent boys (n = 443) and girls (n = 397) attending a suburban school district in western New York were analyzed using structural equation modeling with maximum likelihood estimation. Results: Analyses revealed that family social support was indirectly associated with decreased alcohol consumption among the respondents, primarily through variables measuring religiosity, school grades and peer alcohol use. In addition, adolescent alcohol use was directly associated with subsequent increases in peer alcohol use and later decreases in school performance. Results also showed that receiving good grades in...

Journal ArticleDOI
TL;DR: The findings have implications for theories of stress-related and stress-motivated drinking, particularly the transition to adult drinking status at age 21 and the roles of tension-reduction drinking motives, gender and behavioral undercontrol.
Abstract: Objective: This study investigated the relationship between stress (defined alternatively as negative life events and emotional distress) and heavy drinking across late adolescence and early young adulthood, as well as the roles of tension-reduction drinking motives and gender as moderators of that relationship. The role of personality variables (neuroticism, behavioral undercontrol and extraversion) as moderators also was explored. Method: The data were obtained from 485 individuals (255 women) participating in a five-wave longitudinal study that spanned 7 years. The effects on heavy drinking of stress (either negative life events or emotional distress), tension-reduction drinking motives, gender and personality were analyzed each year with hierarchical multiple regression. Results: Stress (negative life events) was positively related to heavy drinking, but only for men with stronger tension-reduction drinking motives at Year 4 (age 21). The relationship between tension-reduction drinking motives and hea...

Journal ArticleDOI
TL;DR: In this paper, the authors used data gathered in Project MATCH to longitudinally assess intake symptomatology, Alcoholics Anonymous (AA) participation, and outcome, and found that intake symptoms positively predicted AA participation during the first 6 months following treatment.
Abstract: Objective: The present study used data gathered in Project MATCH to longitudinally assess intake symptomatology, Alcoholics Anonymous (AA) participation, and outcome. Three primary constructs were considered: intake symptomatology, engagement in prescribed AA-related activities and functioning after engagement in AA-related behaviors. Method: The participants were 480 outpatient and 434 aftercare clients who participated in Project MATCH. Results: Similar findings were found for each sample. Intake symptomatology positively predicted AA participation during the first 6 months following treatment. Although network support for drinking was negatively related to AA participation, such support did not mediate the relationship between intake symptomatology and subsequent AA participation. AA participation, in turn. positively predicted frequency of abstinent days in Months 7-12 posttreatment. This latter relationship was mediated by perceived self-efficacy to avoid drinking (Month 6). AA participation was posi...

Journal ArticleDOI
TL;DR: Alcohol and drug use patterns during the 4 years following treatment highlight both changes and diversity in substance involvement as youth make the transitions from middle to late adolescence and into young adulthood.
Abstract: Objective: Knowledge of treatment response for alcohol and drug problems among adults is mounting; less is known about long-term outcome for adolescents who receive treatment for alcohol and drug problems. The current study examined youth substance involvement over 4 years (using five waves of data collection) following treatment for alcohol and drug abuse. Method: A cohort of youth (N = 162, 60% male) treated during adolescence (mean age = 16 years) was followed into young adulthood, a period associated with stabilization of alcohol use patterns and elevated risk for life problems secondary to both alcohol and drug use. Participants (14-18 years old) were consecutive admissions to inpatient adolescent alcohol and drug treatment centers in San Diego that were abstinence focused and based on the 12-step approach. Results: Alcohol and other drug use were reduced during the 4 years posttreatment, with the exception of nicotine. The greatest prevalence reduction occurred for stimulants; modest changes were ev...

Journal ArticleDOI
TL;DR: Heterogenous development of alcohol use in the adolescent population is suggested, associated with varying background and covariate influences, linked to alcohol and other substance use in young adulthood.
Abstract: Objective: This study examined issues of heterogeneity in multiple stage development as it corresponds to qualitatively different developmental trajectories in alcohol use during adolescence. Method: Using a piecewise growth mixture modeling methodology, a two-piece growth model capturing growth trajectories in adolescent alcohol use from middle school (Grades 6 through 8) to high school (Grades 9 through 12) was examined (N = 179; 54% male). It was hypothesized that (1) two stages of alcohol use development with varying trajectories would exist in these data (the first corresponding to development during middle school, followed by a second stage of continuing growth during high school) and (2) there would be multiple growth trajectories (subgroups) of alcohol use in the stage-wise development, with varying effects in initial alcohol use and growth rates of alcohol use. Results: Results indicated the tenability of the two-piece growth model of alcohol use with heterogeneity in the population comprising tw...

Journal ArticleDOI
TL;DR: This study adds to the literature on the integrity of executive functions in children with heavy prenatal alcohol exposure, documenting fluency impairment in both verbal and nonverbal domains.
Abstract: Objective: Executive function deficits, including verbal fluency, have been documented in children with histories of prenatal alcohol exposure. Whereas nonverbal fluency impairments have been reported in adults with such exposure, these abilities have not been tested in children. Deficits in both verbal and nonverbal fluency were predicted and assessed in children and adolescents with histories of heavy prenatal alcohol exposure. Method: There was a total of 28 (54% female) subjects; children with heavy prenatal alcohol exposure with (n = 10) and without (n = 8) fetal alcohol syndrome (FAS) were compared to nonexposed controls (n = 10) on the design and verbal fluency measures from the Delis-Kaplan Executive Function System. Both fluency measures consist of three conditions, including a new set-shifting task. All tests require the generation of multiple responses within both rule and time constraints. Results: Data were analyzed using repeated measures analyses of variance and hierarchical regression anal...

Journal ArticleDOI
TL;DR: The social development model partially and significantly mediated the direct effect of age-14 alcohol use on age-16 alcohol misuse and serves as potential targets for the prevention or reduction of adolescent alcohol misuse.
Abstract: Objective: This study was conducted to investigate the ability of the social development model (SDM) to predict alcohol misuse at age 16 and to investigate the ability of the SDM to mediate the effects of alcohol use at age 14 on alcohol misuse at age 16. Method: The sample of 807 (411 males) is from the longitudinal panel of the Seattle Social Development Project which, in 1985, surveyed all consenting fifth-grade students from 18 elementary schools serving high-crime neighborhoods in Seattle, Washington. Alcohol use was measured at age 14, predictors of alcohol misuse were measured at age 15 and alcohol misuse was measured at age 16. Structural equation modeling was used to examine the fit of the model to the data. Results: All factor loadings were highly significant and the measurement model achieved a good fit with the data (Comparative Fit Index [CFI] = 0.93). A second-order structural model fit the data well (CFI = 0.91) and also explained 45% of the variance in alcohol misuse at age 16. The SDM par...

Journal ArticleDOI
TL;DR: The results indicate that predictors of misuse in late adolescence can be identified by Grade 7 and are generally visible and modifiable.
Abstract: Objective: This longitudinal study investigated Grade-7 and Grade-10 risk factors for alcohol misuse at Grade 12. Alcohol misuse was conceptualized as problem-related drinking (e.g., missing school), high-risk drinking (e.g., drunk driving) and high consumption. Method: Prospective analyses using two-part models predicted any alcohol misuse and the amount of misuse (given that some has occurred) for over 4,200 (52% male) participants in the RAND Adolescent Panel Study. Predictor variables were demographics, substance use and exposure, prodrug attitudes, rebelliousness and deviant behavior, self-esteem, family structure and relations, and grades. Results: Grade-7 predictors of alcohol misuse 5 years later included early drinking onset, parental drinking, future intentions to drink, cigarette offers, difficulty resisting pressures to smoke, being white, being male, having an older sibling, deviant behavior and poor grades. By Grade 10, predictors of alcohol misuse 2 years later included drinking and marijua...

Journal ArticleDOI
TL;DR: Investigation of whether EFE decoding skill deficits persist after abstention from alcohol of at least 2 months found deficits in decoding accuracy for anger and disgust, and to a lesser degree sadness, persist with an abstinence of 2 months and beyond.
Abstract: Objective: Emotional facial expression (EFE) decoding skills play a key role in interpersonal relationships. Decoding errors have been described in several pathological conditions, including alcoholism. The aim of this study was to investigate whether EFE decoding skill deficits persist after abstention from alcohol of at least 2 months. Method: Alcoholic patients abstinent for at least 2 months (n = 25) were compared with 25 recently detoxified patients and with 25 normal controls matched for age, gender and educational level. Subjects were presented with 40 photographs of facial expressions portraying happiness, anger, sadness, disgust and fear. Each emotion was displayed with neutral, mild, moderate and strong emotional intensity. Each facial expression was judged successively on eight scales labeled happiness, sadness, fear, anger, disgust, surprise, shame and contempt. For each scale, subjects rated the estimated intensity level. A complementary scale assessed the self-estimated difficulty in perform...

Journal ArticleDOI
Sellman Jd, P. F. Sullivan, G. M. Dore1, Simon J. Adamson1, I. MacEwan1 
TL;DR: In patients with mild to moderate alcohol dependence, MET is more effective for reducing unequivocal heavy drinking than either a feedback/education session alone or four sessions of NDRL.
Abstract: Objective: This study was designed to conduct a randomized controlled trial of motivational enhancement therapy (MET) with two control conditions: nondirective reflective listening (NDRL) and no further counseling (NFC); and to conduct this study in a sample of patients with a primary diagnosis of mild to moderate alcohol dependence, in a "real-life" clinical setting. Method: Patients with mild to moderate alcohol dependence were recruited, assessed and treated at the Community Alcohol and Drug Service of Christchurch, New Zealand. All patients received a feedback/education session before randomization to either four sessions of MET, four sessions of NDRL, or NFC. Outcome data on 122 subjects (57.4% men) were obtained 6 months following the end of treatment, by an interviewer who was blind to the treatment condition. The primary drinking outcome was unequivocal heavy drinking, defined as drinking 10 or more standard drinks six or more times in the follow-up period. Global assessment scale (GAS) measured g...

Journal ArticleDOI
TL;DR: The results confirm that, among primary care patients, substantial changes in alcohol consumption are possible and suggest that matching studies of patient readiness to change their alcohol use, as well as other variables, are warranted.
Abstract: Objective: Brief interventions for hazardous and low-dependent drinkers in the primary care setting have considerable empirical support. The purpose of this study was to (1) evaluate the effects of brief advice (BA) and motivational enhancement (ME) interventions on alcohol consumption. In addition, a hindsight matching design was used to (2) study the moderator effects of patient readiness to change (alcohol use) on alcohol consumption. Method: The subjects (N = 301, 70% men) were patients 21 years of age or older who presented for treatment at one of 12 primary care clinics. After screening for eligibility and providing consent to participate in the study, the patients completed a baseline assessment and were randomly assigned to the BA, ME or standard care (SC) interventions condition. Follow-up assessments were completed at 1-, 3-, 6-, 9- and 12-months postbaseline assessment. Results: Evaluation of the first hypothesis (n = 232 for these analyses) showed that all participants tended to reduce their a...

Journal ArticleDOI
TL;DR: Logistic regression analyses showed that AAS use was associated with such problem behavior as marijuana (cannabis) involvement and overt nondestruction and, to some extent, with involvement in power sports and disordered eating.
Abstract: Objective: To investigate the prevalence of anabolic-androgenic steroid (AAS) use among Norwegian adolescents and to contrast three perspectives on AAS use: performance enhancement in sports competition, body image and eating concerns, and AAS-use as belonging to a cluster of problem behaviors. Method: A nationally representative sample of 8,877 (53.8% female) Norwegian youths (15-22 years of age) were surveyed (response rate 78%). Sports participation included measures of participation in strength sports, participation in competitive sports, strength training and perceived athletic competence. Body image and eating concerns included measures of disordered eating, perceived physical appearance and satisfaction with body parts. Problem behavior was measured by three dimensions of conduct problems (overt destruction, overt nondestruction and covert destruction), illicit drug use and sexual involvement. Results: Information about AAS was obtained from 8,508 subjects. Lifetime AAS use was 0.8% (1.2% male and ...

Journal ArticleDOI
TL;DR: For patients with substance use disorders entering treatment, there was a substantial decline in inappropriate utilization and cost (hospital and ER) in the posttreatment period, suggestive of long-term reductions that warrant a longer follow-up.
Abstract: Objective: This study examines the hypothesis that treatment reduces medical utilization and costs of patients with substance use problems. Method: Adult patients (N = 1.011; 67% men) entering the outpatient chemical dependency recovery program at Sacramento Kaiser Permanente over a 2-year period were recruited into the study. Medical utilization and costs were examined for 18 months prior and 18 months after intake. To account for overall changes in utilization and cost, an age, gender and length-of-enrollment matched nonpatient control group (N = 4,925) was selected from health-plan members living in the same service area. Multivariate analyses controlling for age and gender were conducted using generalized estimating equation methods, allowing for correlation between repeated measures and nonnormal distributions of the outcome variable. Results: The treatment cohort was less likely to be hospitalized (odds ratio [OR] = 0.59; p < .01) and there was a trend for having spent fewer days (rate ratio [RR] = ...

Journal ArticleDOI
TL;DR: Compared with nonalcoholic cocaine-dependent subjects, codependent patients exhibit a wider array of problems, many of which merit professional attention, with alcoholics perhaps requiring extra treatment efforts for successful outcomes.
Abstract: Objective: Concurrent dependence on alcohol is common among those seeking treatment for cocaine dependence. More information is needed about differences between those with and without concurrent alcohol dependence, including possible special treatment needs or outcome differences. Method: Data were obtained from 302 adults (70% men) enrolled in outpatient treatment for cocaine dependence. Individuals who did and those who did not meet criteria for alcohol dependence were compared on demographics, drug use, treatment outcome and other variables. Results: With regard to cocaine use, alcoholics were more likely than nonalcoholics to report an intranasal route of administration, use of cocaine in social settings, more simultaneous use of cocaine and alcohol, and more adverse consequences of their cocaine use. With regard to alcohol use, alcoholics reported consuming alcohol more frequently and in larger amounts, had longer drinking histories and were more likely than nonalcoholics to report increases in alcoh...

Journal ArticleDOI
TL;DR: The factor structure of 22 symptom items used to configure the criteria of DSM-IV alcohol abuse and dependence relates the factor structure to background characteristics and provides further support for the validity of alcohol dependence in general population samples.
Abstract: Objective: This article examines the factor structure of 22 symptom items used to configure the criteria of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) alcohol abuse and dependence and relates the factor structure to background characteristics. Method: Data for this study were drawn from the National Longitudinal Study of Labor Market Experience in Youth (NLSY). The symptom items were related to the covariates using the statistical technique of structural equation modeling generalized to dichotomous outcomes. The present model is a special case of structural equation modeling, a multiple causes and multiple indicators (MIMIC) model, in which one or more latent variables (i.e., alcohol abuse and dependence) intervene between a set of observed background variables predicting a set of observed response variables (i.e., DSM-IV symptom items). Results: The results of the structural equation analysis provide further support for two dimensions underlying the DSM-IV symptom item...

Journal ArticleDOI
TL;DR: Moderation Management appears to attract women and young people, especially those who are nondependent problem drinkers, and it was found that a significant minority of members experienced multiple alcohol dependence symptoms and therefore may have been poorly suited to a moderate drinking program.
Abstract: Objective: Moderation Management (MM) is the only alcohol self-help organization to target nondependent problem drinkers and to allow moderate drinking goals. This study evaluated whether MM drew into assistance an untapped segment of the population with nondependent alcohol problems. It also examined how access to the organization was influenced by the provision of Internet-based resources. Method: A survey was distributed to participants in MM face-to-face and Internet-based self-help groups. MM participants (N = 177, 50.9% male) reported on their demographic characteristics, alcohol consumption, alcohol problems and utilization of professional and peer-run helping resources. Results: MM appears to attract women and young people, especially those who are nondependent problem drinkers. It was also found that a significant minority of members experienced multiple alcohol dependence symptoms and therefore may have been poorly suited to a moderate drinking program. Conclusions: Tailoring services to nondepe...

Journal ArticleDOI
TL;DR: Prevalence rates of self-reported harms due to alcohol were compared for two datasets with equivalent measures to assess the effect of mode of administration in alcohol surveys (telephone vs face-to-face interviews), finding possible explanations for differences between the surveys.
Abstract: Objective: To assess the effect of mode of administration in alcohol surveys (telephone vs face-to-face interviews), prevalence rates of self-reported harms due to alcohol were compared for two datasets with equivalent measures. Method: Two national alcohol surveys were used: the 1990 Warning Labels Survey, in which random digit dialing was used to generate a sample of 2,000 adults interviewed by telephone, and the 1990 National Alcohol Survey (face-to-face interviews), a probability sample of U.S. adults living in households (N = 2,058). Both surveys included identical items on five areas of alcohol-related harm, yielding one composite index of any harm reported in the last 12 months that was compared between the two surveys for current drinkers. Results: After controlling for demographic characteristics and alcohol use, the telephone survey yielded significantly higher rates of alcohol-related health harm, work harm and "any harm" as compared to the in-person survey. The interaction between heavier drin...

Journal ArticleDOI
TL;DR: Residence in substance-free housing was associated with lower likelihood ofheavy episodic drinking in college for students who were not heavy episodic drinkers in high school, whether or not this is a causal relationship or a result of self-selection needs to be examined.
Abstract: Objective: This study examines alcohol use, associated problems and secondhand effects among residents of substance-free and alcohol-free housing on U.S. college campuses. Method: In the spring of 1999, a nationally representative sample of students completed survey questionnaires regarding alcohol use and related behaviors. The responses of 2,555 (61.25% female) students living in different types of residences (substance-free, alcohol-free and unrestricted) at the 52 campuses at which these housing options existed were compared. Results: Substance-free residences were not substance-free; however, residents drank less heavily and experienced fewer alcohol-related problems and secondhand effects than students living in unrestricted housing. They were less likely (three fifths) to engage in heavy episodic drinking. The difference between students in substance-free and unrestricted housing was greatest for students who had not been heavy episodic drinkers in high school and for those on campuses with lower o...

Journal ArticleDOI
TL;DR: These findings support efforts to quantify readiness-to-change substance misuse among persons with an SPMI and provide evidence for the psychometric adequacy of three self-report measures of readiness- to-change.
Abstract: Objective: The high rates of comorbid substance use disorders among persons living with severe and persistent mental illness (SPMI) have increased interest in assessing and enhancing motivation to change substance misuse in this population. This study provides evidence for the psychometric adequacy of three self-report measures of readiness-to-change. Method: The sample consisted of 84 persons (65% men) with co-occurring substance abuse or dependence and an SPMI. After a psychiatric assessment, participants completed three measures of readiness-to-change, which yielded seven subscales: (1) the Stages of Change Readiness and Treatment Eagerness Scale (ambivalence about change, recognition of substance-related problems, taking steps), (2) Decisional Balance Scale (pros of using, cons of using) and (3) the Alcohol and Drug Consequences Questionnaire (costs of quitting, benefits of quitting). Results: All of the subscales were stable over time, and 6 of the 7 subscales demonstrated excellent internal consiste...

Journal ArticleDOI
TL;DR: The results suggest that the influences of marriage on alcohol consumption are complex and cannot be limited to the simple view that marriage causes decreased drinking.
Abstract: Objective: Prior studies have documented an association between marriage and lower alcohol consumption. Data from a longitudinal study of female twins were used to address whether longitudinal drinking trajectories are more closely related to current marital status or to patterns of marital status over time. Method: Past-year alcohol consumption frequency and quantity were obtained on one to three occasions, over 8 years, from 1,986 women aged 17-61. Latent growth models were applied to study whether trajectories of alcohol consumption are altered at first marriage and differ for women with different patterns of marital status changes. Results: There was substantial heterogeneity in consumption trajectories, but marital status was associated with a large proportion of the decline in consumption prior to age 30. Significant group differences in consumption trajectory were associated with marital status patterns; women who later divorced drank more than women who stayed married, and divorced women who remar...