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PubMed1992

Drinking among homeless and marginally housed adults in New York State.

The drinking patterns of 412 homeless and marginally housed adults in New York State are described, and compared with 5,952 domiciled adults. The homeless and marginally housed persons interviewed were randomly selected from a representative group of public shelters and low-price hotels in New York City and upstate New York. They showed transience in their sleeping arrangements, and in recent months many had slept with friends or in public places. They are disproportionately male (71%), aged 18-34 (61%) and black or Hispanic (74%). Many of the homeless and marginally housed are abstainers (40%, as opposed to 26% in the state as a whole), but a startling 13% drink more than 20 drinks a day, as opposed to less than 1% in the state as a whole. They also reported high rates of dependence signs such as blackouts or loss of control. Among the homeless and marginally housed, heavy drinking is higher among men than women, and higher among blacks than whites or Hispanics. For homeless and marginally housed men, those with the poorest sleeping arrangements (e.g., slept in public places) have higher rates of heavy drinking. A causal model supports the hypothesis that, for a minority of the homeless, drinking is a contributory cause of their homelessness.

Adolescent↗
PubMed1992

Drinkers and their driving: compliance with drinking-driving legislation in four Australian states.

This study replicates work in Norway and the United States in investigating the extent to which Australian drivers attempt to comply with drinking-driving legislation. In a four-state survey of 1,133 drinkers, it was found that people were aware of the need to control their alcohol input before driving, and derived estimates of blood alcohol after a recent away-from-home drinking occasion demonstrated that the amount people drank was influenced by whether or not they were driving. Drivers reported drinking less than nondrivers and were also those who usually consumed less alcohol. These findings were also true of people with different levels of normal consumption. Although these results are encouraging, it is suggested that there is need for further modification of sanctions, and that the community needs more information about the alcohol content of drinks and drink sizes if people are to moderate effectively their drinking before driving.

Accidents, Traffic↗
PubMed1992

Changing the legal minimum drinking age: results of a longitudinal study.

Alcohol consumption patterns of samples of college students were examined before and after legislation to raise the minimum drinking age for "weak" beer (3.2% or less alcohol content by weight). Sampling was completed just before and immediately after inception of the law, and then each semester for a total of 4 years. These samples were compared with baseline data obtained 2 years before the legislative action. Quantity and frequency of consumption showed an increase in the sampling period just before the law change and a decrease immediately following. Overall, the quantity-frequency index remained constant, and reports of problem drinking changed very little. Some adjustments were found in drinking locations with students reporting less drinking in public places, such as bars or restaurants, and more drinking in private places, such as residence halls or homes. Policy implications of legislation designed to control drinking are discussed.

Adult↗
PubMed1995

Drinking-related problems in the United States: description and trends, 1984-1990.

OBJECTIVE: This study uses two national alcohol surveys to assess rates of drinking problems from 1984 to 1990, to examine any changes in reports of drinking problems within demographic subgroups, and to evaluate the role of alcohol use versus demographic variables in predicting drinking problems in the 1990 survey only. METHOD: Data were obtained from two national alcohol surveys that utilized household probability samples within the 48 contiguous states in 1984 and 1990. Weights to adjust for design effects and nonresponse were applied to both samples of current drinkers. RESULTS: No significant changes were found for reports of three or more dependence symptoms (6.7% in 1984, 7.6% in 1990) or two or more social consequences (10.9% in 1984, 12.8% in 1990). Significant increases in reports of two or more social consequences were found for younger people, never married individuals and respondents who were not employed. A significant increase in reports for three or more dependence symptoms was also found for the unemployed group. Based on a cross-sectional analysis of the 1990 survey only, alcohol use variables were significant predictors of drinking problems. With the exception of younger age, demographic characteristics did not significantly predict alcohol problems. CONCLUSIONS: Although drinking problems are pervasive, they may not be sensitive to immediate changes in alcohol consumption. One explanation may be the changing social climate around drinking to which most drinkers have been, and are continuing to be, exposed.

Adolescent↗
PubMed1996

The Driving Expectancy Questionnaire: development, psychometric assessment and predictive utility among young drink-drivers.

OBJECTIVE: The primary objective of this research was to develop a Driving Expectancy Questionnaire (DEQ) that reflects a model in which a distinction is made between driving skill and driving style. The second objective was to study young drivers across the spectrum of drink-driving practices, from non-drivers to convicted drink-drivers, and to examine the relationship between their expectancies about driving and their drink-driving practices. METHOD: The data from two separate samples, recruited through availability sampling, were used for the purpose of exploratory (n = 224; 122 men) and confirmatory factor analyses (n = 191; 101 men), respectively. RESULTS: The results revealed two factors of expectancies, driving skill and driving style, supporting the proposed model. The reliability, internal validity and relative independence of the factors were largely confirmed. Furthermore, criterion-related validity was demonstrated: expectancies about driving varied with drink-driving practices. Expectancies also contributed additional predictive power in relation to drink-driving practices beyond that afforded by several well-validated variables. CONCLUSIONS: The results are encouraging in terms of the ability of the DEQ to identify individual differences in expectancies about driving skill and driving style that are closely related to variations in drink-driving practices. The practical implications of these findings, as well as the potential research possibilities, are discussed.

Adolescent↗
PubMed1997

The structure of problem drinking in adulthood: a confirmatory approach.

OBJECTIVE: The structure of problem drinking in young adults was examined using confirmatory factor analyses to test three models of the relations among measures of drinking behavior, coping functions of drinking and alcohol-related problems. Model 1 was based on the notion that the relations among the variables would be accounted for by two correlated factors, drinking behavior and alcohol problems. Underlying Model 2 was the hypothesis that a more parsimonious, single factor model could be used to represent the data. Model 3 hypothesized two orthogonal factors, a general factor and a residual problems factor, representing a reconceptualization of the structure of problem drinking. METHOD: Data were obtained from surveys of a sample of university graduates (178 women, 84 men) at two points in time and from a community sample of young adults (411 women, 347 men). RESULTS: Results of the analyses indicated that, although the relations among the variables could be adequately accounted for by any of the three models tested, the data were best fit by Model 3. CONCLUSIONS: Model 3 appeared to be most useful to furthering our understanding of the structure of problem drinking, one that, according to the results obtained in this work, is similar for women and men.

Adaptation, Psychological↗
PubMed1997

Association between blood pressure and lifetime drinking patterns in moderate drinkers.

OBJECTIVE: To compare the relationship between blood pressure and recent vs lifetime alcohol intake measures in a nonalcoholic cohort using measures that normalized alcohol intake in terms of the volume of distribution for ethanol (total body water) for each subject. METHOD: Correlations between blood pressure and alcohol intake measures were determined in a cohort of 84 (48 male) normotensive moderate drinkers, using multiple linear regressions to correct for the influence of potentially confounding variables. RESULTS: Significant correlations were observed between systolic pressure and measures of both recent and lifetime alcohol consumption in men. Diastolic pressure was found to be significantly associated only with the duration of lifetime drinking, and only in women. Measures of lifetime total dose were not significantly correlated with either systolic or diastolic pressure. Alcohol intake expressed in terms of the number of "drinks" per drinking day was as highly associated with blood pressure (systolic) in men as were measures that normalized alcohol intake in terms of the body water content of each subject. A measure of the mean number of drinks consumed on drinking occasions over the drinking career produced the highest correlations with systolic pressure. CONCLUSIONS: Measures of both recent and lifetime alcohol intake may be relevant to the understanding of alcohol-blood pressure relationships.

Adult↗
PubMed1997

Sex ratios of drinking patterns and problems among blacks and whites: results from a national survey.

OBJECTIVE: The purpose of this study is to explore whether there are differences in sex ratios of drinking patterns and related problems among blacks and whites, and if so to explain these differences. METHOD: The study is based on a national survey including 1,947 (male, 723; female, 1,224) black and 1,777 (male, 743; female, 1,034) white men and women who were sampled from U.S. adult households using probability methods. Hierarchical regression methods were used to test whether there are significant racial differences in the sex ratio of drinking patterns and problems in the two racial groups. RESULTS: The findings showed that there were no substantive differences in drinking sex ratios along racial lines. However, white women were at the highest risk of experiencing alcohol-related problems as rates of heavier drinking increased, and the effects of heavier drinking differed much more among the sexes for whites than blacks. CONCLUSIONS: The findings for whites are consistent with previous research showing that, due to both biological and psychosocial factors, women when consuming the same amounts of alcohol as men may be at more risk for experiencing intoxication and alcohol-related problems. However, the findings for blacks, which show less problem vulnerability among women than men, have rarely been reported. It was suggested that the comparative risk of alcohol problems may be lower for black women due to possible physiological differences and differences in the normative climate of women's drinking in the two racial groups.

Adolescent↗
PubMed1999

The measurement of problem drinking in young adulthood.

OBJECTIVE: Researchers and clinicians have been struggling for more than 20 years to define problem drinking. This study focuses on young adults and aims to examine the construct validity of three dimensions of problem drinking and to empirically determine appropriate cutpoints for problem drinking along these dimensions. METHOD: A stratified sample of 1,269 young adults who reported drinking alcohol in the year prior to 1995 was used in these analyses. Respondents were originally interviewed in 1985 in middle schools in a southeastern U.S. county. RESULTS: Symptoms of dependency and drunkenness were relatively common in this sample, but adverse consequences were rare. Results of analyses using the Chi-squared Automatic Interaction Detector (CHAID) and the SUrvey DAta ANalysis (SUDAAN) software suggest that drunkenness and adverse consequences are the most significant predictors of problems in other areas of life. Symptoms of dependency were significant only in interaction with drunkenness, although the analyses were limited to only lifetime measures of dependency. Appropriate cutpoints, based on these analyses, appear to be (1) drunk at least six times in the past year, (2) four or more lifetime symptoms of dependency and (3) one or perhaps two or more adverse consequences in the past year. CONCLUSIONS: Results suggest that frequency of drunkenness may be the single best indicator of problem drinking among young adults and that adverse consequences may indicate a more serious form of problem drinking than do symptoms of dependency. In addition, appropriate cutpoints on these dimensions for young adults appear to be similar to those that have been used in studies of adolescents. Further study of both adolescents and young adults is suggested.

Adolescent↗
PubMed1999

Telescoping of landmark events associated with drinking: a gender comparison.

OBJECTIVE: The literature suggests that women exhibit "telescoped" development of (i.e., faster progression to) alcoholism, with fewer years drinking than men. The purpose of this study was to use data gathered in the course of a large clinical trial to further examine this issue. METHOD: Subjects in this retrospective study were from a pool of 1,307 men and 419 women enrolled in Project MATCH, a multisite alcohol treatment matching study. MATCH subjects were recruited from both outpatient and aftercare settings over a 2-year period. Age-of-onset for landmark events in the development of alcoholism were determined from self-report and clinical interviews given at baseline entry into the study. Gender differences in age-of-onset variables were assessed within both outpatient and aftercare settings. Gender differences in progression times between successive landmarks were also examined. Differences were tested with both multivariate and univariate ANOVA techniques. RESULTS: Women generally began getting drunk regularly at a later average age than men (26.6 versus 22.7 years, p< or =.001), began experiencing their first drinking problems at a later average age than men (27.5 versus 25.0 years, p< or =.001) and exhibited loss of control over their drinking at a later average age than men (29.8 versus 27.2 years, p< or =.001). However, these gender differences were most pronounced for older individuals and attenuated for younger subjects. Women also progressed faster than men, on average, between first getting drunk regularly and first encountering drinking problems (0.9 versus 2.3 years, p< or =.001) and between first loss of drinking control and onset of worst drinking problems (5.5 versus 7.8 years, p< or =.001). Women also exhibited shorter average progression times between first getting drunk regularly and first seeking treatment (11.6 versus 15.8 years, p< or =.001), although this effect was negligible for younger subjects. CONCLUSIONS: Telescoping is a relatively robust phenomenon in treatment-seeking alcoholics and indicates that women are more likely to progress faster through the landmark events in the development of alcoholism than are men.

Adult↗
PubMed1999

Beer drinking accounts for most of the hazardous alcohol consumption reported in the United States.

OBJECTIVE: Patterns and correlates of hazardous drinking, defined as occasions in which five or more drinks were consumed in a day, were compared for wine, beer and distilled spirits. METHOD: From a probability sample of the U.S. adult household population, 2,817 respondents who had consumed at least one drink in the previous year were selected for analysis. RESULTS: The results show that, in the U.S., beer accounts for the bulk of alcohol consumed by the heaviest drinkers. Beer also accounts for a disproportionate share of hazardous drinking. Logistic regression analyses revealed that drinkers who consume beer in a hazardous fashion at least monthly are more likely to be young, male and unmarried, and less likely to be black than are other drinkers. Hazardous beer consumption is more predictive of alcohol-related problems than hazardous consumption of wine or spirits. CONCLUSIONS: Three potential explanations for the results are considered: advertising, beer-drinking subcultures and risk compensation. Additional research is urged in order to better specify the causal role of these and other factors in hazardous beer drinking.

Adult↗
PubMed2000

Drinking patterns among individuals with and without DSM-IV alcohol use disorders.

OBJECTIVE: The purpose of this study was to compare alcohol consumption patterns among individuals with and without alcohol use disorders, using a representative sample of the general population that would not exaggerate differences as a result of selection biases associated with treatment for alcohol problems. METHOD: Based on data from 18,352 past-year drinkers selected from a nationally representative sample of U.S. households, 11 measures of past-year alcohol consumption were compared for three diagnostic groups: (1) individuals who did not meet the criteria for either alcohol abuse or dependence, i.e., those without a DSM-IV alcohol use disorder (AUD); (2) those classified with abuse only; and (3) those classified with alcohol dependence, with or without abuse. RESULTS: For all measures reflecting frequency and quantity of drinking, frequency of heavy drinking and intoxication, and frequency of atypical temporal drinking patterns, the values for abusers lay midway between those for individuals without an AUD and those with dependence. Individuals with alcohol use disorders drank a greater proportion of their ethanol intake in the form of beer and a lower proportion in the form of wine than did those without an AUD. Of all the consumption measures considered, frequency of intoxication showed the strongest association with the probability of having an AUD, followed by frequency of drinking 5 + drinks, prevalence of morning drinking and total volume of intake. The ratios of consumption measures for individuals with disorders relative to those without an AUD showed relatively little significant variation across demographic subgroups of the population. CONCLUSIONS: The findings supported the distinction between the disorders of alcohol abuse and dependence, and implicated loss of control as an important element of this distinction. They also indicated that even among individuals with alcohol use disorders, demographic differentials reflecting cultural, physiological and normative forces were maintained and should be considered in approaches to treatment.

Adolescent↗
PubMed2000

Talk is cheap: measuring drinking outcomes in clinical trials.

OBJECTIVE: To evaluate the correspondence among measures of self-reported drinking, standard biological indicators and the reports of collateral informants, and to identify patient characteristics associated with observed discrepancies among these three sources of research data. METHOD: Using data collected from a large-scale clinical trial of treatment matching with alcoholics (N = 1,726), these three alternative outcome measures were compared at the time of admission to treatment and at 12 months after the end of treatment. RESULTS: Patient self-reports and collateral reports agreed most (97.1%) at treatment admission when heavy drinking was unlikely to be denied. In contrast, liver function tests were relatively insensitive, with positive serum gamma-glutamyl transpeptidase (GGTP) values obtained from only 39.7% of those who admitted to heavy drinking. At 15-month follow-up the correspondence between client self-report and collateral report decreased to 84.7%, but agreement with blood chemistry values increased to 51.6%. When discrepancies occurred, they still indicated that the client' s self-report is more sensitive to the amount of drinking than the biochemical measures. Patients who presented discrepant results tended to have more severe drinking problems, more previous treatments, higher levels of pretreatment drinking and significantly greater levels of cognitive impairment, all of which could potentially interfere with accurate recall. CONCLUSIONS: In clinical trials using self-selected research volunteers, biochemical tests and collateral informant reports do not add sufficiently to self-report measurement accuracy to warrant their routine use. Resources devoted to collecting these alternative sources of outcome data might be better invested in interview procedures designed to increase the validity of self-report information.

Adult↗
PubMed2000

Do changes in per capita consumption mirror changes in drinking patterns?

OBJECTIVE: The goal of this study was to examine how well per capita alcohol consumption figures derived from beverage sales data relate to changes over time in survey-based measures of drinking patterns. It was expected that strong associations would be found among these various measures of consumption. METHOD: Data from 12 household surveys conducted in Ontario between 1977 and 1997 provided information on: percentages of drinkers; daily drinkers; those drinking five or more drinks at a sitting weekly; those reporting two or more alcohol-related harms; and average number of drinks per week. These variables were then correlated with per capita consumption. RESULTS: Significant correlations were found only between per capita consumption and percentage of daily drinkers, and between percentage of drinkers and average number of drinks per week. CONCLUSIONS: The relationship of per capita consumption to survey measures of drinking is weak. The absence of consistent associations over time between per capita consumption and survey measures may be attributable to the small number of available data points or to increases in unrecorded consumption. Further research is needed to verify and explain these results.

Adult↗
PubMed2001

Drinking in adulthood: similarities and differences in effects of adult roles for Hispanic ethnic groups and Anglos.

OBJECTIVE: This study examines whether the adult social roles perspective. an approach that explains drinking behaviors for Anglos, similarly affects alcohol use by Cubans, Mexican Americans, Puerto Ricans and Other Hispanics (Central and South Americans). METHOD: The 1993 National Household Survey on Drug Abuse, a national probability sample of the household population in the United States, is used. The sample utilized here (N= 13,822; 56.2% female) consisted of 9,388 Anglos, 611 Cubans, 2,459 Mexican Americans, 611 Puerto Ricans and 753 Central/South Americans age 18 and older. The outcome measures include past-year drinking, and for drinkers, heavy drinking and alcohol-related problems. Logistic regression analyses are conducted using Stata. RESULTS: The results show that there are some ethnic differences in the effects of the adult social roles. Of particular importance is the finding that being married has anomalous effects for Cubans (heavy drinking), Mexican Americans (problems) and Other Hispanics (problems) compared with Anglos and the other Hispanic ethnic groups. CONCLUSIONS: The adult social roles perspective has some utility for explaining Hispanic drinking patterns. Future research should consider not only traditional predictors of drinking but also such socio-cultural factors as acculturation and familism, to better understand adult alcohol use by members of Hispanic ethnic groups.

Adolescent↗
PubMed2003

Changes in drinking status, serious illness and mortality.

OBJECTIVE: We studied the relationship of drinking and abstaining with all-cause mortality in a two-measurement-point prospective study to assess the importance of drinking change versus stability among the healthy and seriously ill. METHOD: The National Health and Nutrition Examination Survey I (NHANES I) and follow-up of men and women (age 22-49 and 50+) at first measurement (1971-74) who survived until second measurement (1982-84) were followed in death records for 10 years (1993). Cox proportional hazards models evaluated those with and without serious illness. RESULTS: We found no elevated mortality risk for consistent never drinkers, but consistent heavier drinkers were at higher all-cause risk among men. Groups of abstainers significantly differed for mortality risk, and illness was implicated in these differences. New drinkers who formerly abstained did not improve their chances for longevity. Heavier drinking men who decreased consumption increased their chances for survival. CONCLUSIONS: Abstinence per se is not a risk factor for all-cause mortality, but heavier drinking is a risk factor among men. Adoption of drinking among former abstainers does not improve chances for survival. Reduction in consumption among heavier drinking men improves chances for survival.

Adult↗
PubMed2003

The role of drinking in suicidal ideation: analyses of Project MATCH data.

OBJECTIVE: The associations of suicidal ideation with both the intensity (drinks per drinking day) and frequency of alcohol consumption were examined in a longitudinal study of treated alcoholics. METHOD: The data are from alcohol dependent subjects (1,187 men and 374 women) enrolled in Project MATCH, a multisite clinical trial of psychosocial treatments of alcoholism. Multivariate analyses for correlated data using generalized estimating equation approaches were performed to examine correlates of suicidal ideation at study entry and at 3-, 9- and 15-month follow-up. Analyses were stratified by gender and controlled statistically for depression and alcoholism severity. RESULTS: Suicidal ideation was common among women (15.5%) and men (9.9%) entering treatment, and at least 3.6% of women and 4.2% of men reported suicidal ideation at each follow-up. There were gender patterns in suicidal ideation. In women, intensity was associated with suicidal ideation, but even nonintense drinking became associated with suicidal ideation with more frequent drinking (intensity-frequency interaction). In men, intensity was also associated with suicidal ideation, whereas frequency was unrelated. Antisocial personality disorder in men but not in women, and depression in both groups, were also linked to suicidal ideation. CONCLUSIONS: Suicidal ideation is prevalent among treated alcoholics. Drinking is strongly associated with suicidal ideation and in women even light drinking, if it occurs regularly, is associated with suicidal ideation, with implications for suicide risk-recognition and intervention.

Adult↗
PubMed2003

Religious influences on heavy episodic drinking in Chinese-American and Korean-American college students.

OBJECTIVE: The purpose of the current study was to examine religious influences that relate to heavy episodic drinking in Chinese-American and Korean-American college students, after controlling for the effects of ALDH2 gene status. METHOD: Participants (159 Chinese-American and 188 Korean-American college students) were assessed for the presence or absence of a heavy drinking episode in the past 2 weeks, using a gender-specific measure. All participants also reported their religious affiliation and the number of religious services attended in the past year, and were genotyped at the ALDH2 locus. RESULTS: Chinese were less likely than Koreans to be affiliated with any religion (55% vs 84%), but were more likely to be affiliated with Eastern religions (12% vs 1%). When controlling for the effects of ALDH2 status, service attendance significantly related to lower rates of heavy episodic drinking in Koreans, but did not reach significance in Chinese. The relationship was significant, however, in Chinese affiliated with Western religions. In addition, religious service attendance only related to heavy drinking in individuals with ALDH2*1/*1 genotype. CONCLUSIONS: These results suggest religious service attendance is inversely related to heavy episodic drinking in Korean Americans and in Chinese Americans with Western religious affiliation. Moreover, service attendance appears to more strongly influence heavy drinking in individuals who are not already protected by an ALDH2*2 allele.

Adult↗