Biomedical subjects

T Harford

Publications and source records attributed to T Harford.

16 recordsLinked to original sources

PubMed2001

The 5-year course of alcohol abuse among young adults.

PURPOSE: This study describes the course of alcohol abuse among a nationally representative sample of young adults over a 5-year time period for the purpose of examining the validity of the DSM-IV alcohol abuse category. METHODS: DSM-IV diagnoses of alcohol abuse at baseline and follow-up were examined using logistic regression analyses. RESULTS: Alcohol abuse and dependence were shown to have different courses. Very few abusers at Time 1 became dependent at Time 2, suggesting that abuse is not merely prodromal to dependence. Females, Blacks, and high school dropouts were less likely to receive an abuse diagnosis at baseline. Marital status, family history, earlier onset of drinking, and heavy drinking were also related to abuse at baseline. Alcohol abuse at baseline, in addition to gender, marital status, family history, early onset drinking, and heavy drinking, predicted abuse at follow-up. Exclusion of the hazardous criterion item "driving after drinking too much" from the abuse diagnosis yielded similar results. DISCUSSION: The DSM-IV alcohol abuse category was shown to have some diagnostic utility.

Adolescent↗

PubMed1998

Prevention and Treatment of Hypertension Study (PATHS): effects of an alcohol treatment program on blood pressure.

OBJECTIVE: To determine whether blood pressure is reduced for at least 6 months with an intervention to lower alcohol intake in moderate to heavy drinkers with above optimal to slightly elevated diastolic blood pressure, and whether reduction of alcohol intake can be maintained for 2 years. DESIGN: A randomized controlled trial. METHODS: Six hundred forty-one outpatient veterans with an average intake of 3 or more alcoholic drinks per day in the 6 months before entry into the study and with diastolic blood pressure 80 to 99 mm Hg were randomly assigned to a cognitive-behavioral alcohol reduction intervention program or a control observation group for 15 to 24 months. The goal of the intervention was the lower of 2 or fewer drinks daily or a 50% reduction in intake. A subgroup with hypertension was defined as having a diastolic blood pressure of 90 to 99 mm Hg, or 80 to 99 mm Hg if recently taking medication for hypertension. RESULTS: Reduction in average weekly self-reported alcohol intake was significantly greater (P<.001) at every assessment from 3 to 24 months in the intervention group vs the control group: levels declined from 432 g/wk at baseline by 202 g/wk in the intervention group and from 445 g/wk by 78 g/wk in the control group in the first 6 months, with similar reductions after 24 months. The intervention group had a 1.2/0.7-mm Hg greater reduction in blood pressure than the control group (for each, P = .17 and P = .18) for the 6-month primary end point; for the hypertensive stratum the difference was 0.9/0.7 mm Hg (for each, P = .58 and P = .44). CONCLUSIONS: The 1.3 drinks per day average difference between changes in self-reported alcohol intake observed in this trial produced only small nonsignificant effects on blood pressure. The results from the Prevention and Treatment of Hypertension Study (PATHS) do not provide strong support for reducing alcohol consumption in nondependent moderate drinkers as a sole method for the prevention or treatment of hypertension.

Adult↗

PubMed1998

Time series analysis of alcohol consumption and suicide mortality in the United States, 1934-1987.

OBJECTIVE: The objective is to analyze time series data on per capita alcohol consumption and suicide mortality between 1934 and 1987. Specifically, the aim is to test the hypothesis that increases in per capita consumption are associated with increases in suicide mortality overall and in gender and age subgroups. This study also examines whether the effect of per capita consumption on subsequent rates of suicide is influenced by other aggregate factors, particularly unemployment rates, per capita income and divorce rates. METHOD: This analysis examines the temporal structure of suicide mortality, alcohol consumption and covariate time series data in the United States, 1934-1987, using the Box-Jenkins method. RESULTS: Bivariate associations between alcohol consumption and suicide rates were not significant. However, when unemployment was included in the model, increases in per capita alcohol consumption were significantly related to increases in suicide overall, for men and women, and for the young (under age 40) and middle-aged (40 to 59 years), but not for those over age 60. CONCLUSIONS: The use in modeling of other known covariates of suicide rates, particularly unemployment, affects the magnitude of the relationship between alcohol consumption and suicide. Consistent with other studies, unemployment was significantly related to suicide and was shown to confound the relationship between alcohol and suicide. The effects of changes in alcohol consumption on changes in suicide rates differ by gender and age group, which demonstrates that focusing on the total population alone can mask divergent effects that can cancel each other out when subgroups are combined.

Adult↗

PubMed1994

Prevention and Treatment of Hypertension Study (PATHS). Rationale and design.

Alcohol consumption has been recognized as an important correlate of blood pressure in many epidemiologic studies, but few interventional studies have been conducted to examine the effect of a reduction in alcohol intake on blood pressure. Because these studies have usually included few subjects and been of short duration, the National Heart, Lung, and Blood Institute (NHLBI), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and the Veterans Affairs (VA) Cooperative Studies Program have initiated a randomized, controlled, multicenter trial to determine whether blood pressure and left ventricular mass are lowered over 6 months of alcohol moderation in non-dependent moderate to heavy drinkers (three or more drinks per day average but not alcohol dependent) with above-average normal (80 to 89 mm Hg) and mildly hypertensive (90 to 99 mm Hg) levels of diastolic blood pressure, and whether a reduction in alcohol intake can be maintained for 2 years. Eligible veterans are randomized to either an alcohol reduction intervention or a control observation group at seven clinical sites. The projected sample size is 580 participants. Alcohol intake is assessed by self-report using a retrospective diary (Chronological Drinking Record) and by various biochemical markers, including apolipoproteins, HDL cholesterol (and subfractions), and carbohydrate deficient transferrin, analyzed at a central laboratory. The alcohol intervention technique is a cognitive-behavioral program, the intensive phase of which consists of six counseling sessions over 3 months. Echocardiograms are obtained at baseline and 6 months after randomization. This trial has important implications for both the prevention and treatment of hypertension.

Adult↗

PubMed1990

Multiple alcohol-related problems in the United States: on the rise?

Are drinking problems on the rise in the U.S. general population? Surveys of drinking practices and problems conducted in the United States in 1967, 1969, 1979 and 1984 included numerous questions on alcohol-related problems that were identical or nearly identical in wording. Using data from these surveys, we tested for ordered increases over time in the prevalence of an indicator of multiple problems, considered on both a current (1-year) and lifetime basis. We studied prevalence in men and women between the ages of 22 and 59 in all four surveys. Prevalence of the multiple problem indicator was rare, especially when considered on a current basis. However, relative increases in prevalence ranging from 53% to over 200% were found from 1967 to 1984 in the multiple problem indicator for men and women, for lifetime as well as current problems. With the exception of current problems in women (a very rare condition even in the 1984 survey), these changes were all statistically significant or showed a trend toward significance. When respondents were subgrouped by age, all subgroups still showed increases since 1967, although sample sizes decreased and significance tests of ordered increases over time were not so consistent.

Adult↗

PubMed1983

Contextual correlates of the duration of drinking: confirmation of ethnographic findings with a self-report instrument.

The present study examined the relationship between the number of drinking companions and duration of drinking events with a representative sample of adult current drinkers. The findings indicated that number of companions is significantly related to duration in both public and private settings. Drinking events are of longer duration when two or more persons are present. Age was found to interact with number of companions. Small group size tends to limit duration with young drinkers while larger groups increase duration among the oldest drinkers. These findings support and extend the results of earlier ethnographic studies.

Adolescent↗

PubMed1972