Thomas C. Harford

Using a representative sample of the general population, the test-retest reliability of the alcohol and drug modules of the Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS) was examined. The AUDADIS showed good to excellent reliability for measures of alcohol consumption and use of sedatives, tranquilizers, amphetamines, opioids (other than heroin), cannabis and cocaine. Equally good reliability was demonstrated for diagnoses of alcohol, cannabis, cocaine and heroin abuse or harmful use and dependence defined in terms of the International Classification of Diseases-Tenth Revision (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders-Third Edition-Revised (DSM-III-R) and Fourth Edition (DSM-IV). Results are discussed in terms of the need for future research on the psychometric properties of the AUDADIS in clinical and general population samples.

The purpose of this study was to describe detailed patterns of comorbidity between Diagnostic and Statistical Manual of Mental Disorders--Fourth Edition (DSM-IV) alcohol use disorders and major depression using a representative sample of the United States. Comorbidity rates and associations between DSM-IV alcohol use disorders and major depression were expressed as odds ratios with confidence intervals adjusted for the complex design characteristics of the NLAES. Comorbidity analyses were presented by sex, ethnicity and age for past year, prior to past year and lifetime diagnoses. Virtually all odds ratios were significantly greater than 1.0, demonstrating that comorbidity of alcohol use disorders and major depression is pervasive in the general population. The magnitude of the association remained stable across the three time frames but diagnostic and subgroup variations in comorbidity were noted. The association between alcohol dependence and major depression was greater than the association between abuse and major depression and the association between alcohol abuse and major depression was consistently greater for females and blacks, compared to their male and non-black counterparts. Implications of the results are discussed in terms of professional help seeking, the self-medication hypothesis, and differential social control theory.

Purpose: The purpose of this study was to examine the relationship between age at drinking onset and the development of DSM-IV alcohol abuse and dependence in a 12-year prospective study of youth in the United States. Methods: Logistic regression analyses were used to quantify the relationship between age at drinking onset and the development of alcohol abuse and dependence controlling for sociodemographic factors and problem indicators. Results: The odds of alcohol dependence decreased by 5% in 1989 and 9.0% in 1994 for each year drinking onset was delayed. In 1994, the odds of alcohol abuse increased by 7.0% with each decreasing year of age at drinking onset, while age at drinking onset was not related to alcohol abuse in 1989. Several other risk factors were found to be strong and consistent predictors of abuse and dependence in 1989 and 1994, including being male, divorced, separated or never married, younger, and having an early history antisocial behaviors and marijuana use. Implications: Implications of the results of this study are discussed in terms of other factors that may impact on the onset-abuse and onset-dependence relationship and the need to focus future prevention efforts.

Although there exists a relationship between alcohol consumption and alcoholic liver disease at both the aggregate and individual levels, it is also well established that less than one-third of alcoholics or heavy drinkers develop serious alcohol-related liver damage. A number of factors have been proposed to account for this susceptibility. Evidence supporting the direct dose-response relationship and the role of genetic and environmental factors in influencing vulnerability are reviewed. To date, no consistent evidence attests to the significance of any one factor in the susceptibility to developing alcoholic liver disease.

The purpose of the present study was to determine the prevalence of the concurrent and simultaneous use of alcohol and cocaine in the general population and to examine differences in these rates between important sociodemographic subgroups. The results indicated that a sizable proportion of Americans were engaged in both substance use patterns. The population estimate for simultaneous use of both substances (i.e., simultaneously or on the same occasion) was approximately 4 million for the month preceding the interview, rising to approximately 9 million when the past year timeframe was considered. Corresponding figures for the concurrent use of alcohol and cocaine (i.e., use of both substances during the same time period) were approximately 5 million during the past month and 12 million during the past year. The extent of each substance use practice varied as a function of sociodemographic factors. Implications of these findings are discussed in terms of the need for age-sex-ethnic-specific prevention strategies. The need for future analytic epidemiologic research to determine the precise relationship between dose, frequency and duration of concurrent and simultaneous use and each adverse consequence is emphasized. The need for longitudinal research in the general population is also highlighted.

Background: Studies of the prevalence of DSM-IV alcohol use disorders (AUDs) in general population samples of adolescents and adults are rare. Comparisons of the prevalence of alcohol abuse and dependence in adolescent surveys with the prevalence in adult general population surveys are confounded by differences in survey design and measurement, thereby reducing their validity. The purpose of the present study was to examine the effects of age, sex, race/ethnicity, and drinking status on the prevalence of DSM-IV alcohol abuse and dependence (including diagnostic orphans) and associated diagnostic criteria among adolescents and adults aged 12-65 years in a single representative sample of the US population. Methods: This study was based on data from the 2001 National Household Survey on Drug Abuse public use file. Of the 55,561 subjects in the survey, 33,576 (60.5%) reported alcohol use in the past year and provided information on DSM-IV AUD criteria. DSM-IV AUD criteria were assessed by questions related to specific symptoms occurring during the past 12 months. Results: Overall, the most prevalent criteria of DSM-IV alcohol dependence were “tolerance” and “time spent obtaining alcohol, drinking, or getting over its effects.” The most prevalent criterion of DSM-IV alcohol abuse was “hazardous use.” The prevalence of alcohol abuse only and of dependence with and without abuse was highest among respondents aged 18-23 years, followed by respondents aged 12-17 years, and lowest among respondents aged 50 years and older. Among subgroups of current and heavier drinkers, differences between adolescents and young adults were less pronounced, especially among females. For each age group, the prevalence of alcohol abuse only was greater than the prevalence of dependence (with or without abuse). The abuse-to-dependence ratios also were generally consistent across age groups and slightly higher among males (2.1:1.0) than females (1.6:1.0). Conclusions: The higher prevalence for some dependence criteria among adolescents and young adults as measured in the present study may blur the distinction between symptom reports associated with the normative development of drinking patterns and clinically relevant aspects of DSM-IV alcohol dependence.

For the first time, results are presented on the prevalence of alcohol abuse and dependence in the United States in 1992, according to the most recent psychiatric classification of alcohol-related disorders from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). More than 7 percent of adults surveyed met DSM-IV criteria for 1-year alcohol abuse, alcohol dependence, or both. Males were almost three times more likely than females to meet the criteria for alcohol abuse and/or dependence; however, the male-to-female ratio was lowest in the youngest age group among nonblack respondents, suggesting that the rates of these disorders in nonblack females may be catching up.

The aim of this study is to examine associations among childhood physical, emotional, or sexual abuse and violence toward self (suicide attempts [SA]) and others (interpersonal aggression [IA]). Data were obtained from the National Epidemiologic Survey on Alcohol and Related Conditions Waves 1 and 2 (n = 34,653). Multinomial logistic regression examined associations between type of childhood abuse and violence categories, adjusting for demographic variables, other childhood adversity, and DSM-IV psychiatric disorders. The prevalence of reported childhood abuse was 4.60% for physical abuse, 7.83% for emotional abuse, and 10.20% for sexual abuse. Approximately 18% of adults reported some form of violent behavior, distributed as follows: IA, 13.37%; SA, 2.64%; and SA with IA, 1.85%. After adjusting for demographic variables, other childhood adversity, and psychiatric disorders, each type of childhood abuse was significantly related to increased risk for each violence category as compared with the no violence category. Furthermore, the odds ratio of childhood physical abuse was significantly higher for SA with IA when compared with IA, and the odds ratio of childhood sexual abuse was significantly higher for SA and SA with IA when compared with IA. Childhood physical, emotional, and sexual abuse is directly related to the risk for violent behaviors to self and others. Both internalizing and externalizing psychiatric disorders impact the association between childhood abuse and violence. The inclusion of suicidal behaviors and interpersonal aggression and internalizing/externalizing psychiatric disorders within an integrated conceptual framework will facilitate more effective interventions for long-lasting effects of child abuse.

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.A randomized controlled trial.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.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).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.

The effects of various levels of positive family history of alcoholism on the probability of past year alcohol dependence were investigated using a general population sample of 23,152 drinkers 18 years of age and older. Forty percent reported a positive family history. After adjustment for age, race, gender, and poverty and compared with persons with a negative family history, the odds of alcohol dependence were increased by 45% among persons with alcoholism in second or third degree relatives only, by 86% among those with alcoholism in first degree relatives only, and by 167% among those with alcoholism in first and second or third degree relatives. The effects of family history did not vary among population subgroups as defined by age, race, gender, and poverty.

This study examines attendance and alcohol use at parties and bars among college students by gender, residence, year in school and legal drinking age.The study participants were respondents in the 1997 and 1999 Harvard School of Public Health College Alcohol Study (CAS). The combined sample consisted of 12,830 students (61% women) who reported use of alcohol in the past 30 days prior to interview. Their responses provided information on attendance and alcohol use at parties (dormitory, fraternity, off campus) and off-campus bars. Logistic regression analyses examined the influence of gender, residence, year in school and legal drinking age related to attendance, drinking/non-drinking and heavy drinking (5 or more drinks) at each select setting.Consistent with the literature, fraternity/ sorority parties were occasions of heavy drinking (49%) among drinkers in those settings, yet they drew upon smaller proportions of students (36%) when compared to off-campus parties (75%) and off-campus bars (68%). Off-campus parties (45%) and bars (37%) were also occasions for heavy drinking among drinkers in these settings. College residence was shown to relate to differential exposure to drinking settings, but residence had less impact on the decision to drink and the level of heavy drinking. Attendance at parties decreased with advance in school years, but attendance at off-campus bars increased. Although heavy drinking at off-campus bars decreased with advancing grade year in school, slightly higher proportions of under-age students (41%) compared to students of legal drinking age (35%) exhibited heavy drinking at off-campus bars.The identification of high-risk settings and their correlates serves to better understand the development of heavy drinking on college campuses. Off-campus parties, as compared to campus parties and bars, may pose greater difficulties related to successful intervention.

The relationship between the low Km aldehyde dehydrogenase (ALDH2) phenotype determined by the isoelectric focusing of hair root lysates, facial flushing and alcohol drinking patterns in Japanese (N = 282) was examined. Men who had inactive ALDH2 drank significantly less alcohol than those with active ALDH2. Although the effect was less noticeable, a similar relationship was detected in women. Two types of flushing responses were determined: one due to the inactive ALDH2, the other unrelated to this variant form of the isozyme. A striking difference between these flushing types, in terms of the inhibitory influence over drinking patterns, was noted. Nearly 86% of the subjects who reported always flushing in the face were shown to have inactive ALDH2, whereas infrequent flushing and absence of flushing were associated with active ALDH2. Thus, facial flushing may be used as an indicator of ALDH2 phenotype.

In order to understand the validity of the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) alcohol abuse and dependence diagnoses, studies are needed in both clinical and general population samples. The purpose of this study was to examine the construct and criterion-oriented validity of DSM-IV alcohol dependence and abuse in the general population with respect to factor structure and their relationship to family history of alcoholism, treatment utilization, and psychiatric comorbidity.This analysis is based on data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), in which nationally representative data were collected in personal interviews conducted with one randomly selected adult in each sample household or group quarters. A subset (n=26,946) of the NESARC sample (total n=43,093) who reported drinking one or more drinks during the year preceding the interview formed the basis of analyses. Latent variable modeling was used to assess the concurrent validity of DSM-IV alcohol abuse and dependence symptom items.The latent variable modeling yielded one major factor related to alcohol dependence, a second factor related to alcohol abuse and a third smaller factor defined by tolerance. The validity of alcohol dependence in general population samples was further supported by statistically significant associations with family history of alcoholism, treatment utilization, and psychiatric and medical comorbidities.The factor structure and relationship to external criterion variables observed in the study provide support for the further validity of DSM-IV alcohol dependence in the general population, whereas support for the validity of DSM-IV abuse was equivocal.

Previous studies have identified a violence typology of self- and other-directed violence. This study examines the extent to which substance use disorders (SUDs) as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), independent of serious psychological distress, major depressive episodes, assault arrest, and criminal justice involvement, are associated with these violence categories. Data were obtained from the National Survey on Drug Use and Health (NSDUH) pooled across survey years 2008–2015, with a combined sample of 314,881 adult respondents. According to self-report data on suicide attempt (self-directed) and attacking someone with the intent for serious injury (other-directed), violence was categorized in four categories: none, self-directed only, other-directed only, and combined self-/other-directed. Multinomial logistic regression was used to estimate the adjusted odds ratios associated with the risk factors for different forms of violence. Nicotine dependence and the number of DSM-IV SUDs criteria (except the criterion of legal problems) for alcohol, marijuana, and pain reliever use disorders are significantly associated with the self-/other-directed violence categories. Cross-sectional data do not allow assessment of directionality of important factors. The identification of the combined self- and other-directed violence among adults in the general population extends studies in the adolescent population, and significant correlation between self- and other-directed violence provides additional support for clinical studies that established this association. Findings expand the associated risk factors identified in previous studies for the adult population. Prevention and treatment programs need to address both forms of violence and suicidality.

A combined history of violence toward self and others has been reported in clinical and incarcerated populations. Psychiatric disorders have been implicated as risk factors. This study examines the lifetime prevalence of this combined violence in the general population and its associations with DSM-5 psychiatric disorders in comparison with other- and self-directed violence. Data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) were analyzed, including 36,309 U.S. adults ages 18 and older. Violent behavior was defined by suicide attempts; recurrent suicidal behavior; gestures, threats, or self-mutilating behavior (self-directed); and multiple items of violence toward others (other-directed) in four categories: none, self-directed only, other-directed only, and combined self-/other-directed. Multinomial logistic regression examined these violence categories in association with sociodemographics and lifetime DSM-5 psychiatric disorders. Results show that approximately 18.1% of adults reported violent behavior, including self-directed only (4.4%), other-directed only (10.9%), and combined self- and other-directed violence (2.8%). DSM-5 psychiatric disorders significantly associated with the violence typology include alcohol, tobacco, cannabis, and other drug use disorders; mood disorders; posttraumatic stress disorder; and schizotypal, antisocial, and borderline personality disorders. Findings extend the clinical literature regarding the co-occurrence of self- and other-directed violent behaviors to the general population.

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 items. Although the two-factor dimension bore a strong resemblance to the DSM-IV conceptions of abuse and dependence, there were notable differences in the item content of the symptom items for each dimension. The dependence dimension drew upon items related to the abuse criteria for continued drinking despite social problems and recurrent drinking resulting in failure to fulfill role obligations. The abuse dimension drew upon items related to the abuse criterion for hazardous drinking and the dependence criterion for larger amounts over time. The two factors were shown to have different relationships to the background variables. Alcohol dependence was related to family history of alcoholism and educational status. Age was not related to dependence and inversely related to alcohol abuse. Conclusions: Findings from this study replicate the two-dimensional model for DSM-IV criteria found in other studies and provide further support for the validity of alcohol dependence in general population samples. A major implication of the factor structure in the present study relates to the different classification of cases that would otherwise be obtained with DSM-IV criteria. These departures were shown to affect abuse, which retained only 40% of DSM-IV diagnoses, more strongly than dependence, which retained 91% of DSM-IV diagnoses.

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.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.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.Becoming married for the first time exerted a unique effect on the overall developmental trajectory of alcohol use over time. This effect held for both ethnic groups but was reliably stronger for white compared to black respondents. This interaction may be attributable to lower levels of alcohol use reported by black respondents, or may be related to individual differences in reactivity to social influences by blacks relative to whites.

This study examines relationships between type of (current) residence, heavy episodic drinking in high school and alcohol-related problems among college students.The study participants were respondents in the 1993, 1997 and 1999 Harvard School of Public Health College Alcohol Study (CAS) surveys of students attending 119 4-year U.S. colleges. Based on responses from 6,525 (55.6% female) students in the 1993 CAS, an exploratory factor analysis of the alcohol problem items was specified in a confirmatory factor analysis framework based on a four-factor solution, and related to study variables. The 1993 data were cross-validated with the 1997 and 1999 surveys.When compared with students living in single-gender dormitories, students living off campus with parents reported lower alcohol-related problem consequences and a higher probability of drinking/driving. Students residing off campus without parents, compared with students in single-gender dorms, reported a higher probability of drinking/driving. Associations between off-campus residence and probabilities for drinking/driving were mediated by frequency of driving. Students living in coed dormitories, when compared with students in single-gender dorms, incurred more problem consequences related to drinking but reported significantly lower probabilities associated with designated driving and drinking/driving. Heavy episodic drinking in high school was related to higher probabilities of problems on all outcome measures.The presence of direct and independent effects for both heavy drinking prior to college and high-risk environmental factors in collegiate drinking practices support targeted and diverse strategies for prevention activities.

Objective: Random effects latent growth (LG) models were used to study the relation between changes in heavy alcohol use and changes in the frequency of bar patronage over a 3-year period. Previous research has identified a close link between alcohol use and bar patronage, but these cross-sectional findings limit inferences about possible temporal ordering. LG models are highlighted and compared with the more traditional but restricted cross-lagged models. Method: Three annual measures of heavy alcohol use and frequency of bar patronage were administered to a sample of 3071 adults (62% male) who participated in the National Longitudinal Study of Youch from 1982 to 1984. Background variables included age, gender, ethnicity and marital status. Results: Heavy alcohol use and bar patronage were characterized by negative longitudinal growth trajectories and there was significant individual variability in these changes over time. Changes in heavy alcohol use closely paralleled corresponding changes in bar patronage. Finally, the Time 1 measures of each construct were inversely predictive of subsequent changes over time in the second construct. Conclusions: These findings suggest that heavy alcohol users tended to continue to patronize bars, and bar patronage tended to encourage continued heavy alcohol use. This relation was particularly strong for singles and males. Compared to more traditional cross-lagged models, LG modeling appears to be a much stronger analytic technique for studying growth over time. It is recommended that LG models be used for future studies of change in alcohol use over time.

A representative sample of 1,367 employed men and women in Detroit responded to questions about drinking practices and symptoms of depression. After controlling for age, education, family income, marital status, medication use, fathers' drinking, and other variables, increased quantity of alcohol consumed per drinking occasion was associated with increased depression symptoms in the sober state among men and women. Depression symptoms may be one of a group of not fully identified drug after-effect disorders involving psychological functioning.

There is limited information on the validity of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) alcohol use disorders (AUD) symptom criteria among adolescents in the general population. The purpose of this study is to assess the DSM-IV AUD symptom criteria as reported by adolescent and adult drinkers in a single representative sample of the U.S. population aged 12 years and older. This design avoids potential confounding due to differences in survey methodology when comparing adolescents and adults from different surveys.A total of 133,231 current drinkers (had at least 1 drink in the past year) aged 12 years and older were drawn from respondents to the 2002 to 2005 National Surveys on Drug Use and Health. DSM-IV AUD criteria were assessed by questions related to specific symptoms occurring during the past 12 months. Factor analytic and item response theory models were applied to the 11 AUD symptom criteria to assess the probabilities of symptom item endorsements across different values of the underlying trait.A 1-factor model provided an adequate and parsimonious interpretation for the 11 AUD criteria for the total sample and for each of the gender-age groups. The MIMIC model exhibited significant indication for item bias among some criteria by gender, age, and race/ethnicity. Symptom criteria for "tolerance,""time spent," and "hazardous use" had lower item thresholds (i.e., lower severity) and low item discrimination, and they were well separated from the other symptoms, especially in the 2 younger age groups (12 to 17 and 18 to 25). "Larger amounts,""cut down,""withdrawal," and "legal problems" had higher item thresholds but generally lower item discrimination, and they tend to exhibit greater dispersion at higher AUD severity, particularly in the youngest age group (12 to 17).Findings from the present study do not provide support for the 2 separate DSM-IV diagnoses of alcohol abuse and dependence among either adolescents or adults. Variations in criteria severity for both abuse and dependence offer support for a dimensional approach to diagnosis which should be considered in the ongoing development of DSM-V.

According to a national survey, adolescent drinking patterns appear to have remained relatively stable in the last half decade. Among those aged 16-18, 73% are drinkers; drinking and drunkenness continue to be age- and sex-graded phenomena.

The present study draws upon the National Longitudinal Survey (NLS) of Labor Market Experience in Youth (ages 17-24) to describe alcohol use patterns over a 2-year period during the transition years between adolescence and young adulthood. Specifically, turnover in current (using any amount of alcohol in any frequency during the past month) and heavier (drinking six or more drinks on at least 2-3 occasions during the past month) drinking levels among panel members was examined by charting incidence, remission, chronicity, and abstinence between 1982 and 1983. The prevalence of each consumption level increased between the ages of 17 and 22 but declined thereafter for each sex until the age of 24. Changes in prevalence from 1982 to 1983 were shown to be a function of changes in drinking level status. The analysis of turnover in current and heavier drinking levels indicated that there was continuity in drinking behavior over time. Sex differences observed in these trends were examined and their implications to internal and external age- and sex-appropriate constraints and paradigmatic development were explicated.

Dependent problem drinking, marital disruption and depressive symptoms of sons and daughters of alcohol abusers are examined in a representative sample of 1,772 adults in the United States. Controlling for the sociodemographic characteristics of the adult sons and daughters in logistic regression analyses and for the alcohol-related problems (e.g., alcohol dependence) of the sons and daughters in the analyses of marital disruption and depressive symptoms, the results suggest that having parents who have been alcohol abusers places sons at risk for dependent problem drinking, both sons and daughters at risk for divorce or separation and daughters at risk for depressive symptomatology.

This study examines relationships between alcohol-related aggression and drinking at off-campus parties and bars. Other background variables include gender, year in school, residence and heavy drinking in college.The study participants were respondents in the 1997 and 1999 Harvard School of Public Health College Alcohol Study, national surveys of students attending 119 4-year U.S. colleges. Based on responses from 8,426 students, 18-24 years of age, who were never married and who reported attendance at off-campus parties and bars in the past month, an exploratory factor analysis of the alcohol problem items was specified in a confirmatory factor analysis framework based on a two-factor solution (disruptive behavior and victims of altercations). In addition, the two factors were related to study variables.Among students attending both off-campus parties and bars, level of drinking was related to higher levels of Factor 1 (disruptive behaviors) at off-campus parties and bars. Level of drinking was related to higher levels of Factor 2 (victims of altercations) at off-campus bars but not off-campus parties. Factor 1 was higher among men, freshmen and residents in coed dorms and lower among students living off-campus with parents. Factor 2 was higher among women, freshmen compared with seniors and residents of Greek houses and lower among students living off-campus residence with parents.Findings from this study highlight environmental factors in collegiate drinking practices and support targeted and diverse strategies for prevention activities.

The purpose of this investigation was to quantify the relationship between ethanol consumption and DSM-III-R alcohol dependence using mathematical modeling techniques that allowed for the control of confounding and assessment of interaction. Although sex, education, ethnicity and marital status were not identified as actual confounders in the logistic regression model, the ethanol intake-dependence association was stronger among younger as opposed to older respondents. For 20 year olds, the average log odds for dependence increased .62 for each additional ounce of ethanol consumed daily, while the corresponding increase in risk among 60 year olds was .26. Implications of these results are discussed in terms of age differences in drinking patterns and differential social control of drinking behavior. Separate analyses in which aggregates of the alcohol dependence criteria served as outcome measures helped qualify the interpretation of the overall ethanol intake-dependence relationship. The need to examine components of global classifications of alcohol dependence using better operationalizations is highlighted.

A number of environmental and personality characteristics of adolescent students and their relationship to types of drinking contexts were examined using a series of canonical correlation analyses. The strongest relationship was defined by the perceived normative support for drinking, which accounted for 55% of the variance in the drinking context items for males (58% among females). Positive functions of drinking, personal attitudes and values, and environmental contexts were also associated with drinking context items but accounted for smaller proportions of the variance. The contribution of important environmental, personality and drinking context variables to each canonical relationship is discussed. Consistency of studies relevant to the major finding is reviewed and possible bases for discrepancies are explored. Further studies relating to antecedent networks of access to various drinking contexts are identified as areas deserving more intensive and extensive research efforts.

we sought to provide a profile of U.S. Army soldiers discharged with a permanent disability and to clarify whether underlying demographic changes explain increasing risks.frequency distributions and logistic regression analyses describe active-duty Army soldiers discharged with a disability (January 1981 through December 2005; N = 108,119). Time-series analysis describes temporal changes in demographic factors associated with disability.disability risk has increased 7-fold over the past 25 years. In 2005, there were 1,262 disability discharges per 100,000 active-duty soldiers. Risk factors include female gender, lower rank, married or formerly married, high school education or less, and age 40 or younger. Army population demographics changed during this time; the average age and tenure of soldiers increased, and the proportion of soldiers who were officers, women, and college educated grew. Adjusting for these demographic changes did not explain the rapidly increasing risk of disability. Time-series models revealed that disability among women is increasing independently of the increasing number of women in the Army; disability is also increasing at a faster pace for younger, lower-ranked, enlisted, and shorter-tenured soldiers.disability is costly and growing in the Army. Temporal changes in underlying Army population demographics do not explain overall disability increases. Disability is increasing most rapidly among female, junior enlisted, and younger soldiers.

The drinking settings and companions of college students were studied in relation to the students' gender, year in school, academic standing, work status and residence status. The relationship between year in school and the quantity and frequency of consumption of specific types of alcoholic beverages was also studied.

Rates of on-premise outlets and urbanism were significantly related to rates of alcoholism in 38 states and the District of Columbia.

Inconsistencies in the role sets of women in modern societies are believed by some to account for the difference in rates of mental illness between men and women. In an analysis of rates of neurotic disorders and functional psychoses, Gove (1972) found that the higher rates of mental illness for women, compared to those of men, were due to disproportionately high rates among married women. Gove and Tudor (1973) maintain that the reason for this is that married women are more likely to occupy conflicting role sets. They contend that the role of the housewife involves unskilled labor and low status, both of which are often not consonant with a woman's intellectual attainment. In addition, they argue that the married woman who works outside the home occupies a conflicting role set when her employment involves discrimination in the job market and assignment to positions that are not commensurate with her educational background. Gove and Tudor constructed their roleconflict model to explain mental health differences between women and men, but others have questioned this application. A persistent criticism has been that such between-gender

To examine associations between DSM-IV psychiatric disorders and other- and self-directed violence in the general population. Data were obtained from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Waves 1 & 2 (n = 34,653). Four violence categories were derived from a latent class analysis (LCA) of 5 other-directed and 4 self-directed violent behavior indicators. Multinomial logistic regression examined class associations for gender, race–ethnicity, age and DSM-IV substance use, mood, anxiety, and personality disorders. Approximately 16% of adults reported some form of violent behavior distributed as follows: other-directed only, 4.6%; self-directed only, 9.3%; combined self- and other-directed, 2.0%; and no violence, 84.1%. The majority of the DSM-IV disorders included in this study were significantly and independently related to each form of violence. Generally, other-directed violence was more strongly associated with any substance use disorders (81%) and any personality disorders (42%), while self-directed violence was more strongly associated with mood (41%) and anxiety disorders (57%). Compared with these two forms of violence, the smaller group with combined self- and other-directed violence was more strongly associated with any substance use disorders (88%), mood disorders (63%), and personality disorders (76%). Findings from this study are consistent with recent conceptualizations of disorders as reflecting externalizing disorders and internalizing disorders. The identification of the small category with combined forms of violence further extends numerous clinical studies which established associations between self- and other-directed violent behaviors. The extent to which the combined violence category represents a meaningful and reliable category of violence requires further detailed studies.

The present study examined the relationship between masculinity-femininity and personality. 213 male volunteers were administered a test battery including the Strong Vocational Interest Blank, the Sixteen Factor Personality Questionnaire, the General Aptitude Test Battery, and the Allport-Vernon-Lindzey Study of Values. Measures of masculinity-femininity derived from the Strong differentially related to personality, values, and general aptitudes. While masculinity was associated with aloofness, unpretentiousness and a tough poise, it was also associated with guilt proneness, anxiety, and neurotic tendencies.

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.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.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.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.

Descriptive and multiple regression analyses of data from the National Longitudinal Survey of Youth (NLSY), a longitudinal survey conducted annually since 1979, offer support for the many studies that demonstrate a relationship between marital status and alcohol consumption. Race, gender, history of heavy drinking, and alcoholic relatives were additional key variables utilized in the analysis. Data from this ongoing survey indicate that long-term marriage is associated with decreased drinking, except among women with a history of heavy drinking. Separation and divorce are not associated with long-term effects on current drinking. Divorce is associated with decreased drinking, at least in the short term, for men and women with a family history of alcoholism.

A survey of employed adults in metropolitan Detroit showed that more men than women had alcohol problems but this was largely attributable to the higher percentage of alcohol-dependent drinkers among men. There was little difference between the percentages of men and women who could be identified as nondependent problem drinkers.

Recent studies suggest that alcohol availability as measured by outlet rates is unrelated to per capita consumption or rates of alcoholism in the United States. Drawing from the same data bases, this article assesses the effects of outlet rates while controlling for the effects of per capita income, urbanism, and limitations by population on the number of sales outlets. The analysis discloses strong effects of outlet availability on per capita consumption and alcoholism rates in states that do not have restrictions on the number of outlets per unit of population.

Data from a national survey of junior and senior high-school students and a survey of adults in Boston indicate that the frequency of drinking increases with age and the average quantity consumed on each occasion decreases with age.

This report presents national estimates of The Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R) alcohol abuse and dependence among 24- to 31-year-olds using the 1989 National Longitudinal Survey on Youth (NLS-Y). Population estimates derived from the 1989 NLS-Y are also compared with corresponding estimates from the 1988 National Health Interview Survey (NHIS). The 1-year prevalence of alcohol abuse and dependence was 13.95% in the 1989 NLS-Y. In general, rates of abuse and dependence were greater for men than for women and slightly declined with age. Although the prevalence of abuse was much greater among whites compared to blacks or Hispanics, the rates for dependence among Hispanics and whites exceeded those for their black counterparts. The rates of abuse and dependence were strikingly similar between the 1989 NLS-Y and 1988 NHIS, providing evidence for the population validity or generalizability of the diagnostic measures.

Summary While the dependence syndrome has been extensively studied in alcohol patients, much less information is available about this syndrome in drugs other than alcohol. Since the core symptoms of the dependence syndrome have been defined as comprising a dimension of disability distinct from social, health and other consequences of substance abuse, we examined the relationships of dependence syndrome symptoms and related problems for drugs. We included cannabis, stimulants, barbiturates, tranquilizers, cocaine, opiates and hallucinogens in our analyses. Results showed high clustering of dependence symptoms with each other and with health, social and emotional problems attributed to drug use. This supports the syndrome concept for the core dependence symptoms, but not the concept that the symptoms form distinct dimensions from associated problems.

Attempting to account for greater alcohol consumption among women, social scientists have argued that traditional gender roles and gender‐role attitudes concerning the division of labor in the family have provided women with a moral or cultural protection against heavier drinking but that the “breakdown” of this protection has allowed for greater alcohol use. This paper assesses the breakdown argument using data from two representative samples: a sample of 12,069 young adults in the United States and a sample of 1,367 employed men and women in metropolitan Detroit. Our analysis indicates that among young women the nontraditional role of employment and nontraditional gender‐role attitudes concerning responsibilities for household labor and child care are associated with greater alcohol consumption. However, among the employed, our analysis indicates that it is not nontraditional women and traditional men but rather traditional women and nontraditional men who have greater alcohol use–it is the women and men who believe that they have substantial obligations at home and who have intense competition at the workplace that consume a greater quantity of alcohol.

The purpose of the present study was to compare DSM‐III‐R and the proposed DSM‐IV diagnostic criteria for alcohol abuse and dependence in a representative sample of the United States general population. Alcohol abuse and dependence diagnostic categories were contrasted in terms of prevalence and overlap. The prevalence of DSM‐III‐R diagnoses of alcohol abuse and dependence combined (8.63%) was greater than the corresponding DSM‐IV diagnoses (6.00%). Disaggregation of abuse and dependence diagnoses showed that the major discrepancy between the classification systems resided between the abuse categories. Reasons for the discrepancies are discussed in terms of differences in the content of the DSM‐III‐R and DSM‐IV abuse categories, in the relationship that each abuse category shares with its respective dependence category, and the impact of the DSM‐III‐R duration criterion.

Objective: This prospective study examines the association of educational status in 1984 and the risk for past-year Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), alcohol-use disorders (AUDs) in 1994, 10 years later. Method: A sample of 8,661 respondents was drawn from the National Longitudinal Survey of Labor Market Experience in Youth. Measures included baseline heavy episodic drinking, alcohol-dependence symptoms, early problem behaviors (antisocial behaviors, illicit substance use, family history of alcoholism, and age at onset of alcohol use), demographic characteristics (gender, race/ethnicity, age, marital status), and 1994 assessment for past-year DSM-IV AUDs. Results: Findings from this 10-year prospective study indicate that education beyond high school had a protective effect for alcohol dependence, and dropping out of high school resulted in an elevated long-term risk for alcohol dependence. These associations remained significant when other early behavioral problems were included in the models. Conclusions: The risk of alcohol dependence and, consequently, the need for appropriately tailored prevention efforts is greater among high school dropouts and college nonattenders than among college students, although much of the current literature has focused on the latter. (J. Stud. Alcohol 67: 803-809, 2006)

Previous studies have related the level of alcohol consumption to several context variables. The present study investigates the relationship between context variables and drinking levels. A household survey of 794 adults in metropolitan Boston found that among men, mean alcohol consumption was significantly higher in bars than in other settings and significantly higher with friends than with spouse and relatives. Among women, drinking location interacted significantly with type of companions. Mean consumption with friends was significantly higher in bars than in other settings. Mean consumption with relatives was significantly lower in home contexts than in other settings.

The purpose of this study was to evaluate the psychometric properties of DSM-IV symptom criteria for assessing personality disorders (PDs) in a national population and to compare variations in proposed symptom coding for social and/or occupational dysfunction. Data were obtained from a total sample of 34,653 respondents from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). For each personality disorder, confirmatory factor analysis (CFA) established a 1-factor latent factor structure for the respective symptom criteria. A 2-parameter item response theory (IRT) model was applied to the symptom criteria for each PD to assess the probabilities of symptom item endorsements across different values of the underlying trait (latent factor). Findings were compared with a separate IRT model using an alternative coding of symptom criteria that requires distress/impairment to be related to each criterion. The CFAs yielded a good fit for a single underlying latent dimension for each PD. Findings from the IRT indicated that DSM-IV PD symptom criteria are clustered in the moderate to severe range of the underlying latent dimension for each PD and are peaked, indicating high measurement precision only within a narrow range of the underlying trait and lower measurement precision at lower and higher levels of severity. Compared with the NESARC symptom coding, the IRT results for the alternative symptom coding are shifted toward the more severe range of the latent trait but generally have lower measurement precision for each PD. The IRT findings provide support for a reliable assessment of each PD for both NESARC and alternative coding for distress/impairment. The use of symptom dysfunction for each criterion, however, raises a number of issues and implications for the DSM-5 revision currently proposed for Axis II disorders (American Psychiatric Association, 2010).

Background Adolescent substance users face serious health and social consequences and benefit from early diagnosis and treatment. The objectives of this study were to observe trends in treatment utilization; examine correlates of treatment utilization and treatment types/settings among adolescent substance users with and without substance use disorder ( SUD ); and assess gender differences. Methods National Survey on Drug Use and Health data were pooled across 2002 to 2013, with a combined sample of 79,885 past‐year substance users ages 12 to 17 (17,510 with SUD and 62,375 without SUD ). Treatment was defined as receiving treatment or counseling for use of alcohol or any drug, not counting cigarettes. Trends were assessed by joinpoint linear regression, and multivariable logistic regression assessed odds ratios of treatment utilization. Results Percentages of past‐year treatment use did not change in 2002 to 2013. Treatment utilization was more prevalent among adolescents with SUD than without (11.4% vs. 1.4%) and among males than females. Among adolescents with and without SUD , criminal justice involvement and perceiving a need for treatment increased adolescent treatment utilization, while SUD s other than alcohol abuse, older age, and talking to parents increased treatment use among adolescents with SUD , and polysubstance use and male gender increased treatment among those without SUD . Treatment gaps persisted among non‐Hispanic Blacks for both groups with and without SUD , male Hispanics with SUD , female non‐Hispanic Asians without SUD , and private insurance coverages. Gender differences were observed in SUD , race/ethnicity, and insurance coverage. Most adolescents received treatment for both alcohol and drug use, and self‐help group and outpatient rehabilitation facility were the most used treatment settings. Conclusions Treatment utilization among adolescents with past‐year substance use remained low and unimproved in 2002 to 2013. Treatment gaps among minority populations, insurance coverage, and in educating adolescents on seeking relevant treatment must be addressed. Using screening processes such as Screening, Brief Intervention, and Referral to Treatment, health professionals can help prevent lifelong SUD by recognizing and addressing substance misuse early.

Comparing alcohol consumption patterns by age and gender among Japanese in Japan and Japanese-Americans and Caucasians in the United States, this study examined the associations between age and both heavy drinking and social problems using logistic regression for each ethnic group of male current drinkers. As reported in previous studies of Caucasians, men drink more alcohol than women, older respondents are more likely than younger ones to be abstainers, and the percentages of heavier drinkers and problem drinkers are higher among the young than among older people. Although Japanese-Americans reported consuming less alcohol than Caucasians, their drinking patterns by age were similar: among both United States populations, younger respondents are at higher risk for drinking problems than older respondents, even when alcohol consumption and sociodemographic variables are controlled by logistic regression. However, this association of age and drinking patterns and drinking problems is not universal. Japanese men consumed more alcohol and had a higher proportion of heavier drinkers in the middle age groups; the association between age and drinking problems also varied in this group. In addition to aging, sociocultural factors such as drinking norms probably account for the differences in drinking behavior among different age groups. This study may stimulate further cross-cultural comparison of drinking patterns and problems.

The Data Notes Series is edited by Dr Bridget Grant, Chief of Biometry of the National Institute on Alcohol Abuse and Alcoholism Abstract National estimates of the prevalence of family history for alcoholism in the USA were investigated using a general population sample of 43809 respondents 18 years of age and older. Approximately 38% of the total sample reported a positive history for alcoholism. Positive reports were highest for Native Americans and lowest for Asian Americans.

Previous research has found a relationship between increased quantity of alcohol usually consumed per drinking occasion and decreased sober cognitive performance. It has been suggested that the effects of quantity of alcohol consumed may be conditional upon the frequency of alcohol use and that decreased performance in social drinkers may be a consequence of psychological distress (i.e., anxiety and depression). An analysis of data from a representative sample of employed men and women in metropolitan Detroit indicates that the relation between quantity of alcohol consumed per occasion and abstraction performance is conditional upon the frequency of alcohol use but that the relationship cannot be accounted for by psychological distress.

This paper provides estimates of alcohol consumption and alcohol dependence among employed men and women in the United States. Data from the 1988 National Health Interview Survey indicate that the percentages of drinkers in white‐collar occupations are higher than the percentages of drinkers in blue‐collar occupations among both men and women; however, the men and women in blue‐collar occupations who drink have a higher average daily consumption than drinkers in white‐collar occupations. DSM‐III‐R criteria were used to classify respondents as alcohol‐dependent. Consistent with an earlier survey of employed adults in Detroit, the prevalence of alcohol dependence is highest in certain blue‐collar occupations (craftsmen, laborers, and service workers among men; machine operators, laborers, and service workers among women). Directions for further research on the occupational and drinking experiences of employed men and women are discussed.

This study examines the relationship between typical weekly drinking and perpetration of spouse abuse as well as the relationship between the perpetrator's typical weekly drinking and alcohol use during the abuse event among U.S. Army male soldiers.Cases include all active duty, male, enlisted Army spouse abusers identified in the Army's Central Registry who had also completed an Army Health Risk Appraisal Survey (HRA) between 1991 and 1998 (N = 9534). Cases were matched on sex, rank, and marital status with 21,786 control subjects who had also completed an HRA.In multivariate logistic regression models, heavy drinkers (22 or more drinks per week) were 66% more likely to be spouse abusers than were abstainers (odds ratio 1.66; 95% confidence interval 1.40-1.96). In addition, self-reported moderate and heavy drinkers were three times as likely and light drinkers (1-7 drinks per week) were twice as likely as nondrinkers to be drinking during the time of the abuse event.Self-reported heavy drinking is an independent risk factor for perpetration of spouse abuse among male, enlisted Army soldiers. Even 5 years or more after ascertainment of typical drinking habits, there is a significant association between self-reported heavy drinking and alcohol involvement at the time of the spouse abuse event. Personnel who work with perpetrators and victims of spouse abuse should be trained carefully to query about current and typical drinking patterns.

The purpose of this investigation was to quantify the relationship between ethanol consumption and DSM-III alcohol use disorders using mathematical modeling techniques that allowed for the simultaneous control of several extraneous factors and the assessment of potential interaction. Although gender, education, ethnicity, and marital status were not identified as actual confounders in the logistic regression model, the ethanol intake-dependence association was found to be stronger among younger adults than in the later stages of life. Age was an influential confounder of the ethanol intake-abuse relationship, but the magnitude of the association was generally weaker for abuse than for dependence. Separate analyses in which the abuse and dependence criteria served as outcome measures qualified the interpretation of the overall ethanol intake-disorder associations. Implications of these results are discussed in terms of age differences in exposure and context of consumption, differential interpretation of withdrawal symptoms, and the relationship between abuse and dependence. The need for future research to refine our descriptions of risk of alcohol use disorders in relation to levels of intake is highlighted.

The purpose of the present study was to determine the prevalence of concurrent and simultaneous use of alcohol with sedatives and with tranquilizers in the general population and to examine differences in these rates between important sociodemographic subgroups. The results indicated that a sizable proportion of Americans engaged in both substance use practices in the year preceding the interview. The population estimate for simultaneous use of alcohol in combination with sedatives (i.e., use of both substances simultaneously or on the same occasion) was approximately 3 million while the concurrent use of both substances (i.e., during the same time period) was approximately 4 million. Corresponding figures for the simultaneous and concurrent use of alcohol and tranquilizers were both approximately 6 million. The extent of each substance use practice varied as a function of sociodemographic factors. Implications of these findings are discussed in terms of the need for age-sex-ethnic-specific prevention strategies. The need for future analytic epidemiological research to determine the precise relationship between dose, frequency, and duration of concurrent and simultaneous use and each adverse consequence is emphasized. The need for longitudinal research in the general population is also highlighted.

Background: Prior studies suggest racial/ethnic differences in the associations between alcohol misuse and spouse abuse. Some studies indicate that drinking patterns are a stronger predictor of spouse abuse for African Americans but not whites or Hispanics, while others report that drinking patterns are a stronger predictor for whites than African Americans or Hispanics. This study extends prior work by exploring associations between heavy drinking, alcohol‐related problems, and risk for spouse abuse within racial/ethnic groups as well as variations associated with whether the perpetrator is drinking during the spouse abuse incident. Methods: Cases ( N =7,996) were all active‐duty male, enlisted Army spouse abusers identified in the Army's Central Registry (ACR) who had also completed an Army Health Risk Appraisal (HRA) Survey between 1991 and 1998. Controls ( N =17,821) were matched on gender, rank, and marital and HRA status. Results: We found 3 different patterns of association between alcohol use and domestic violence depending upon both the race/ethnicity of the perpetrator and whether or not alcohol was involved in the spouse abuse event. First, after adjusting for demographic and psychosocial factors, weekly heavy drinking (&gt;14 drinks per week) and alcohol‐related problems (yes to 2 or more of 6 alcohol‐related problem questions, including the CAGE) were significant predictors of domestic violence among whites and Hispanics only. Also for the white soldiers, the presence of family problems mediated the effect of alcohol‐related problems on spouse abuse. Second, alcohol‐related problems predicted drinking during a spouse abuse incident for all 3 race groups, but this relation was moderated by typical alcohol consumption patterns in Hispanics and whites only. Finally, alcohol‐related problems predicted drinking during a spouse abuse incident, but this was a complex association moderated by different psychosocial or behavioral variables within each race/ethnic group. Conclusion: These findings suggest important cultural/social influences that interact with drinking patterns.

This study was conducted to assess the association of "diagnostic orphans" at baseline and subsequent development of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) alcohol use disorders (AUDs) 5 years later.A sample of 8,534 respondents was drawn from the National Longitudinal Survey of Youth for the years 1989 and 1994. Diagnostic orphans were defined as respondents who met one or two alcohol dependence symptom criteria but did not meet the criteria for a diagnosis of alcohol abuse or dependence. Using multinomial logistic regression analysis, 1994 assessments of DSM-IV AUD were regressed on 1989 baseline assessments of diagnostic orphan status and DSM-IV AUD. In addition to demographic characteristics, other background variables included heavy episodic drinking at baseline and early problem behaviors (antisocial behaviors, illicit substance use, and age at onset of alcohol use).Findings from this 5-year prospective study indicate that diagnostic orphan status at baseline was predictive of DSM-IV AUD at follow-up. These associations remained significant when other early behavioral problems were included in the models.The present findings have important diagnostic implications for the proposed DSM-V, particularly for a dimensional diagnosis incorporating less severe forms of alcohol dependence.

The objective of the present study is to analyze time series data on alcohol consumption and divorce rates and assess the directionality of this relationship using alternative aggregate measures of alcohol consumption rates.Granger's causality test and Box-Jenkins time series analysis are used to examine aggregate data on divorce rates and two indicators of alcohol consumption: a per capita consumption measure based on sales and shipments, and an expenditure-based measure for U.S. data from 1934 to 1987.A consumption increase of 1 liter of alcohol per capita brings about an increase in the divorce rate of about 20%. This finding contrasts with results, using expenditures as the aggregate alcohol measure, that show that an increase of 1/1,000 in the divorce rate leads to a 10% increase in alcohol expenditures. (These latter findings confirm earlier published results.)The results from the present study provide support both for the effects of heavy drinking on divorce rates and the effects of divorce rates on expenditures for alcoholic beverages. While both aggregate measures of alcohol consumption are highly correlated, they may tap different aspects of consumption. The relationship between marital instability and alcohol consumption is far from a simple one, and more complete conceptual models need to be developed. Aggregate-level findings indicate that it is reasonable to assume that a bidirectional influence exists between divorce rates and alcohol consumption.

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.DSM-IV diagnoses of alcohol abuse at baseline and follow-up were examined using logistic regression analyses.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.The DSM-IV alcohol abuse category was shown to have some diagnostic utility.

The literature is replete with conflicting articles about the relationship of marital status and drinking in women. This study is an analysis of the drinking practices of women, 24 through 32 years old, who were respondents in the National Longitudinal Survey of Youth (NLSY). Variations in drinking patterns for the years 1982 through 1988 as a function of changes in marital status are detailed. Findings indicated that women who married or remarried decreased drinking, whereas those who became separated or divorced increased drinking. In the present study, women with alcoholic spouses exhibited similar changes in drinking as did other young women. Our conclusion was that the instability created by a change in social position, namely marital status, led to changes in drinking patterns during the study interval in the direction of those associated with the new social position.

Recent studies based on small convenience samples of men and women have found the use of alcohol and other drugs to be associated with unprotected sexual intercourse that places women at elevated risk for sexually transmitted diseases and unintended pregnancy. An analysis of data from a representative sample of 12,069 younger adults indicates that the use of alcohol and other drugs is related to sexual risk-taking among both men and women after controlling for age, education, family income, and other variables.

Suicides among U.S. Army soldiers are increasing and, in January 2009, outpaced deaths due to combat. For this study, 1,873 army suicides identified through death, inpatient, and emergency room records were matched with 5,619 controls. In multivariate models, older, male, White, single, and enlisted soldiers with a prior injury (OR = 2.04, 95% CI = 1.64-2.54), alcohol (OR = 3.41, 95% CI = 2.32-4.99), or mental health hospitalization (OR = 6.62, 95% CI = 4.77-9.20) were at increased risk for suicide. Risk was greatest immediately following diagnoses, but remained elevated even after 5 or more years of follow-up. Most injury hospitalizations were unintentional but, nonetheless, significantly associated with suicide. Interactions indicate soldiers with both mental health and injury history are particularly vulnerable.

Objective: We explored the relationships between two domains of alcohol-related cognitions (expectations and reasons for drinking) and their associations with alcohol consumption and alcohol dependence.It is hypothesized that alcohol-related cognitions will relate directly to drinking behaviors and indirectly to alcohol dependence.Method: Data came from the 1995 National Alcohol Survey, which included black and Hispanic oversamples.The analysis was restricted to 2,817 respondents who reported alcohol consumption at least once in the past year.Path analysis, including key demographic factors, modeled the associations between expectations, reasons for drinking, frequency of heavy drinking, and alcohol dependence.Results: Exploratory and confi rmatory factor analyses yielded separate latent variables for expectations (positive and negative), reasons for drinking (social and escape), frequency of heavy alcohol use, and alcohol-dependence

Abstract Combat exposure is associated with subsequent mental health symptoms, but progression to mental health disability is unclear. Army soldiers discharged with mental health disability ( n = 4,457) were compared to two matched control groups: other disability discharge ( n = 8,974) and routine discharge ( n = 9,128). In multivariate logistic models, odds of mental health disability discharge versus other disability and routine discharge were significantly higher for soldiers deployed to combat zones; odds ratios increased with deployment time. Prior mental health hospitalization decreased these odds, though they remained significantly elevated. Mental health hospitalization with successful treatment may facilitate better coping during deployment. The frequency of disability after mental health hospitalization suggests remaining gaps in deployment‐related mental health assessment and treatment.

This study examines associations between binge drinking and other substance use and perpetration of violence against self and others. Data were pooled from the 2003, 2005, and 2007 Youth Risk Behavior Surveys, yielding a sample of 43,172 U.S. high school students. A typology was constructed to reflect four categories of behaviors: other-directed violence only, self-directed violence only, combined other- and self-directed violence, and no violence. Results from multinomial logistic regressions show that the frequency of binge drinking and other substance use were significant risk factors for each of the violence categories relative to no violence. However, the strengths of these associations varied across the violence categories.

Although associations between personality disorders and psychiatric disorders are well established in general population studies, their association with liability dimensions for externalizing and internalizing disorders has not been fully assessed. The purpose of this study is to examine associations between personality disorders (PDs) and lifetime externalizing and internalizing Axis I disorders.Data were obtained from the total sample of 34,653 respondents from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Drawing on the literature, a 3-factor exploratory structural equation model was selected to simultaneously assess the measurement relations among DSM-IV Axis I substance use and mood and anxiety disorders and the structural relations between the latent internalizing-externalizing dimensions and DSM-IV PDs, adjusting for gender, age, race/ethnicity, and marital status.Antisocial, histrionic, and borderline PDs were strong predictors for the externalizing factor, while schizotypal, borderline, avoidant, and obsessive-compulsive PDs had significantly larger effects on the internalizing fear factor when compared to the internalizing misery factor. Paranoid, schizoid, narcissistic, and dependent PDs provided limited discrimination between and among the three factors. An overarching latent factor representing general personality dysfunction was significantly greater on the internalizing fear factor followed by the externalizing factor, and weakest for the internalizing misery factor.Personality disorders offer important opportunities for studies on the externalizing-internalizing spectrum of common psychiatric disorders. Future studies based on panic, anxiety, and depressive symptoms may elucidate PD associations with the internalizing spectrum of disorders.

Objective:The purpose of this study was to examine the associations between the number of substance use disorder (SUD) criteria as listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and other-and self-directed forms of violence among youth ages 12-17 in the general population.Method: Data were obtained from the National Survey on Drug Use and Health pooled across survey years 2008-2013, with a combined sample of 108,560 respondents ages 12-17.Violence categories defined by suicide attempt (self-directed) and attacking someone with the intent for serious injury (other-directed) were categorized as follows: none, self-directed only, other-directed only, and combined self-/other-directed. Multinomial logistic regression estimated odds ratios of the increased number of criteria for alcohol, marijuana, and other illicit drug use, and nicotine dependence for each violence category, by controlling for sociodemographics and criminal justice involvement.Results: The multivariable model indicates that increased number of SUD criteria confers significantly higher odds for each violence category versus no violence.For combined violence versus self-directed violence, male gender, non-Hispanic Black and mixed race (with non-Hispanic White as referent), nicotine dependence, increased number of alcohol use disorder criteria, and other drug use disorder criteria have significantly higher odds, whereas Native Hawaiian/Pacific Islander and age have significantly lower odds.For combined violence versus other-directed violence, non-Hispanic mixed race and the increased number of other drug use disorder criteria have significantly higher odds, whereas male gender, non-Hispanic Black and Native Hawaiian/Pacific Islander, and Hispanic have significantly lower odds.Conclusions: The identification of the combined self-/otherdirected violence in the general population provides additional support for clinical studies that established associations between self-and otherdirected violent behaviors.Prevention and treatment programs need to address both instances of violence and suicidality.(J.Stud.

This study examines the pattern of marijuana use among respondents who have passed the age of risk of onset, as well as some of the correlates related to the initiation and current use of marijuana. The data for this study included 8885 respondents drawn from the National Longitudinal Survey of Labor Market Experience of Youth (NLSY). Based on cross-tabulations of lifetime marijuana use in 1984 and 1994, the following outcomes were examined: incidence of lifetime marijuana use, inconsistent reports of lifetime marijuana use, and current compared with former use. Controlling for the effects of all variables studied, significant and independent effects were noted for sociodemographic factors, former patterns of use, and the use of other substances.

The relationship of alcohol consumption and cirrhosis mortality was examined by sampling 1% of deaths in the U.S. using the 1986 National Mortality Followback Survey. Quantity and frequency of decedent's alcohol consumption was obtained from next of kin through mailed questionnaire. The percentage of decedents with cirrhosis increased sharply with the increasing number of drinks per day. Three drinks per day was associated with a significantly higher percentage of cirrhosis deaths compared with lifetime abstainers for both whites and blacks. Although blacks had a significantly higher percentage of abstainers than whites, of those persons who were reported to drink every day, blacks were more likely to be heavier drinkers (5 or more drinks per day). Blacks did not have a higher risk of cirrhosis mortality than whites for each drinking category. Although Native Americans were oversampled, the number of deaths was too small for statistical comparisons.

Drawing upon data from the National Longitudinal Survey of young adults, this paper examines the effects of family history of alcoholism and current alcohol use by the young adults. A multivariate analysis of the data from the study indicates that there are both main and interaction effects of family history and current alcohol use on dependence symptoms among the young adults.

Data from a joint Japan-U.S. collaborative study were examined to determine the relationship of acculturation to drinking attitudes among Japanese in Japan and Japanese Americans in Hawaii and California. Drinking attitudes (i.e., self-reported acceptable or appropriate levels of drinking) among ethnic groups differed significantly for the nine situations studied: (1) at a bar with friends, (2) at a party at someone else's house, (3) as a parent, spending time with small children, (4) during working hours, (5) visiting in-laws, (6) with friends at home, (7) with friends after work, (8) with people at sports events and (9) before driving a car. Factor analysis was used to determine the differences in drinking attitudes among these ethnic groups. Japanese and Japanese Americans differentiated drinking situations into different categories. The major difference between the two groups was that the Japanese associated spending time with small children with a situation appropriate for drinking, such as being with friends at home, whereas Japanese Americans associated spending time with small children with a situation inappropriate for drinking, such as before driving.

Annals of the New York Academy of SciencesVolume 472, Issue 1 p. 130-141 Drinking Patterns among Black and Nonblack Adolescents: Results of a National Survey THOMAS C. HARFORD, THOMAS C. HARFORD Laboratory of Epidemiology National Institute on Alcohol Abuse and Alcoholism Rockville, Maryland 20857Search for more papers by this author THOMAS C. HARFORD, THOMAS C. HARFORD Laboratory of Epidemiology National Institute on Alcohol Abuse and Alcoholism Rockville, Maryland 20857Search for more papers by this author First published: July 1986 https://doi.org/10.1111/j.1749-6632.1986.tb29615.xCitations: 20AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL REFERENCES. Bachman, J. G., L. D. Johnston & P. M. O'Malley. 1981. Smoking, drinking and drug use among American high school students: Correlates and trends, 1975-1979. Am. J. Public Health 71: 59– 69. Blane, H. T. & L. E. Hewtt. 1977. Alcohol and Youth: An Analysis of the Literature 1960-75. Report No. PB-268-698. US. National Technical Information Service. Springfield, Va. Bourne, P. & E. Light. 1979. Alcohol problems in blacks and women. In The Diagnosis and Treatment of Alcoholism. J. H. Mendelson & N. K. Mello, Eds.: 83– 124. McGraw-Hill. New York , NY . Cockerham, W. C. 1975. Drinking patterns of institutionalized and noninstitutionalized Wyoming youth. J. Stud. Alcohol 36: 993– 995. Donovan, J. & R. Jessor. 1978. Adolescent problem drinking: Psychosocial correlates in a national sample study. J. Stud. Alcohol 39: 1506– 1524. Fishburne, P. M., H. I. Abelson & I. Cisin. 1979. National Survey on Drug Abuse: Main Findings: 1979 (Contract No. 271-78-3508). National Institute on Drug Abuse. Rockville , MD . Harford, T.C., C. Lowman & C. T. Kaelber. Current prevalence of alcohol use among white and black adolescents. Paper presented at the National Council on Alcoholism Conference, Washington, D.C., April 1982. Harper, F. 1976. Alcohol Abuse and Black America. Douglas Publishers. Alexandria , VA . Herd, D. Migration, cultural transformation and the rise of black cirrhosis. Paper presented at the Alcohol Epidemiology Section, International Council on Alcohol and Addictions, Padova, Italy, June 1983. Jessor, R. & S. L. Jessor. 1977. Problem behavior and psychosocial development: A longitudinal study of youth. Academic Press. New York , NY . Jessor, R., J. A. Chase & J. E. Donovan. 1980. Psychosocial correlates of marijuana use and problem drinking in a national sample of adolescents. Am. J. Public Health 70: 604– 613. Mackay, J. R., D. L. Phillips & F. O. Bryce. 1967. Drinking behavior among teenagers: A comparison of institutionalized and noninstitutionalized youth. J. Health Soc Behav. 8: 46– 54. Rachal, J. V., L. L. Guess, R. L. Hubbard, S. A. Maisto, E. R. Cavanaugh, R. Waddell & C. D. Benrud. 1980. Adolescent Drinking Behavior. Volume 1: The Extent and Nature of Adolescent Alcohol and Drug Use: The 1974 and 1978 National Sample Studies. Research Triangle Institute. Research Triangle Park , NC . Rachal, J. V., J. R. Williams, M. L. Brehm, B. Cavanaugh, R. P. Moore & W. C. Eckerman. 1975. A national study of adolescent drinking behavior, attitudes, and correlates. Report No. PB-246-002; NIAAA/NCALI-75/27. US. National Technical Information Service. Springfield, Va. Rohrbaugh, J. & R. Jessor. 1975. Religiosity in youth: A personal control against deviant behavior. J. Pers. 43: 136– 155. U.S. Bureau OF THE Census. May 1981. School enrollment — Social and Economic Characteristics of Students: October 1980 (Advance Report). Current Population Reports Series P-20, No. 362. US. Department of Commerce. Washington, DC. Citing Literature Volume472, Issue1Alcohol and Culture: Comparative Perspectives from Europe and AmericaJuly 1986Pages 130-141 ReferencesRelatedInformation

Concerns about cocaine dependence are increasing, in some ways replacing heroin as the focus of highest concern. We compared cocaine and heroin dependence by levels of cocaine and heroin use in poly-drug users. While dependence indicators differed markedly between regular and sporadic users of these drugs, cocaine dependence indicators did not differ from heroin dependence indicators. Implications of the findings are discussed.

The present study examined the use of alcohol among student nurses in a senior class of a college of nursing. A majority of the students indicated a stable pattern of alcohol use, and 13% reported alcohol-related problems either at school or at work.

To better understand the underlying concepts of substance dependence and abuse, the present study examines the factor structure of DSM-IV lifetime criteria for cannabis and cocaine use disorders. Data for this study were drawn from the National Longitudinal Alcohol Epidemiologic Survey (NLAES), a large nationally representative U.S. sample aged 18 years and older. Exploratory factor analysis (EFA) examined the factor structure for each substance and the factors were related to background covariates using latent variable modeling techniques. Separate analyses were conducted for lifetime marijuana and cocaine users. A two-factor solution was identified for each substance and was similar to DSM-IV abuse and dependence. The factors were highly correlated for both cannabis (r=0.73) and cocaine (r=0.77). Background variables accounted only for a modest amount of factor variance. In conjunction with the findings in alcohol use disorders, these results support the use of consistent criteria across substances in DSM-IV and ICD-10, and suggest that the consistent finding of two correlated factors across substances needs to be better understood.

We sought to (1) document and describe the relative proportion of disabilities by major type over the study period, (2) describe the population at risk for different types of disability, and (3) document and describe the type of compensation (an indicator of severity) awarded for different types of disability and any temporal changes in these associations. Time-series, logistic regression analyses, and direct standardization of rates were used to study 108,119 active-duty Army soldiers discharged with permanent disability between 1981 and 2005. Of all disability, 91% is captured within the top five most prevalent types of disability: musculoskeletal (72%, n = 77,418), neurological (6%, n = 6,896), mental health (5%, n = 5,075), cardiovascular system (4%, n = 4,429), and respiratory (4%, n = 4,202). Musculoskeletal disability rates are increasing rapidly (+2.5% per year); neurological and cardiovascular disability rates are decreasing (−1.3% and −10.0% annually, respectively), and respiratory and mental health disability rates did not change significantly. Demographic risk factors vary by disability type. At greatest risk for musculoskeletal disability were female soldiers, soldiers who were between the ages of 21 and 35 years, white, in lower- to mid-level enlisted ranks with relatively short service tenure, and soldiers without a college education. Compensation awards also varied by disability type: Overall, 77% (n = 83,320) received separation with severance pay, 15% (n = 16,107) received a permanent disability retirement, and 8% (n = 8,692) received separation without benefits. Separation with severance pay was the largest and fastest growing disability disposition for all disabilities and for musculoskeletal disability specifically. Demographic risk factors vary by type of disability and by compensation award. Musculoskeletal disability rates are rapidly increasing as is separation with severance pay—particularly among white, young, lower ranking female soldiers.

Borderline personality disorder (BPD) is associated with violence toward self and others. This study aims to further identify which DSM-5 BPD criteria are independently related to violence, using data from National Epidemiologic Survey on Alcohol and Related Conditions-III, which included a total of 36,309 U.S. respondents ages 18 and older (n = 4,301 for BPD; n = 19,404 for subthreshold BPD). Multinomial logistic regression examined the associations between BPD criteria and violence categories, including suicide attempt (self-directed), violence toward others (other-directed), combined (self-/other-directed) violence, and no violence. In the total population, identity disturbance, impulsivity, and intense anger significantly characterized violence toward others, while avoidance of abandonment, self-mutilating behavior, feelings of emptiness, and intense anger significantly characterized violence toward self. These criteria (except identity disturbance) also significantly characterized combined self- and other-directed violence. Differential associations of the BPD criteria with violence among BPD and subthreshold BPD populations also are discussed.

This article examines the relationship between prior problem behaviors and change in residence on alcohol use patterns among college students.Measures of alcohol consumption (e.g., drinking frequency, average consumption and frequency of heavy episodic drinking were related to residence patterns and prior problem behaviors (e.g., conduct problems. illicit substance involvement and early age at onset of alcohol consumption). Subjects (N = 2,465; 51% women) were a subsample drawn from the National Longitudinal Study of Labor Market Experience in Youth. The analysis was conducted using a linear growth model for continuous outcomes with time-invariant and time-varying covariates for each of the drinking measures.The results of the structural equation analysis yielded significant and direct effects related to residence patterns and prior problem behaviors. Problem behaviors were related to drinking measures; however, there was no evidence for a mediational hypothesis. Neither was there systematic evidence that the relationship between prior problem behavior and alcohol use was mediated by residence patterns. The analysis of change in residence was related to both time-specific and longer-term influences on alcohol use.The presence of direct and independent effects for both dispositional and high-risk environmental factors in collegiate drinking practices support targeted and diverse strategies for prevention activities.

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 nondependent 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. Am J Hypertens 1994;7:814–823

This research note draws upon the US National Longitudinal Survey (NLS) of Labor Market Experience among youths aged 17-24 to report the effects of variation in the ordering of alcohol questions upon the prevalence of heavier drinking. A secondary analysis of the NLS indicated a substantial decrease in the prevalence of heavier drinking between 1984 and 1985 which is attributed to the order of presentation of two differently styled questions regarding heavier drinking.

Data from the National Longitudinal Survey of Youth (NLSY) are used to examine the association between antisocial behaviors (ASB) reported in youth (15-22 years old) and alcohol use disorders (AUD) 14 years later in a large (N = 7,326) representative national sample.Structural equation modeling generalized to dichotomous outcomes was used to assess the associations between latent variables of ASB with latent variables of AUD and background variables.Exploratory factor analysis of 17 ASB items yielded three factors having clear interpretations with the literature-property offenses, person offenses and illicit substance involvement. When examined in the context of the multivariate structural equation model, several independent associations between ASB and AUD symptoms and covariates were found. Although there were significant and independent effects for each ASB factor on each of the alcohol use disorder factors, the strength of the association was strongest for the effects of early illicit substance involvement on alcohol abuse and dependence.Both illicit substance involvement and delinquency other than illicit substance involvement reported in 1980 were associated with alcohol use disorders 14 years later.

This study examined the relationship between the flushing response and drinking patterns and DSM-III alcohol abuse among Japanese using data collected in the joint U.S.-Japan collaborative study. The flushing response was classified into the following three subtypes: typical flushing (always flushed in the face after drinking), atypical flushing (sometimes) and nonflushing (never). This study of male current drinkers showed that typical flushers drank less alcohol than did atypical and nonflushers, but there was no observed difference between the drinking patterns of atypical flushers and nonflushers. Although the relationship was less pronounced, a similar association was found for female current drinkers. The 12-month prevalence of DSM-III alcohol abuse was estimated to be highest among atypical flushers and lowest among typical flushers, with nonflushers in between for both genders. When daily alcohol consumption and other pertinent sociodemographic variables were controlled, logistic regression analyses revealed that the risk for alcohol abuse by men was approximately 3.0 times higher among atypical flushers and 1.7 times higher among nonflushers than among typical flushers. The corresponding risks for abuse by women were 7.8 (atypical flushers) and 2.8 (nonflushers) times higher. Possible explanations for these differences in drinking patterns and the risk for alcohol abuse among the three flushing subtypes and between genders are discussed.

Alcohol-related problems that are experienced by sons and daughters of heavy-drinking parents (either father or mother) are examined using data from a 1978 household sample of employed adults in metropolitan Detroit. Adult children with heavy-drinking parents were found to have a higher percentage of dependent problem drinking than those without heavy-drinking parents. Also, adult children with low status (blue-collar) occupations were found to have a higher percentage of dependent problem drinking than those with high status (white-collar) occupations. Although it was not possible to disentangle the genetic processes from the social processes in this study, the results support the hypothesis that having both heavy-drinking parents and low occupational status places sons and daughters at elevated risk for alcohol-related problems. Implications for future epidemiological studies are discussed.

Data from 1002 households indicated that contextual factors (group size, subsequent activity) and individual difference factors (sex, extroversion, drinking frequency) differentially influenced consumption and normative ratings. These findings suggest that contextual cues serve as determinants of drinking norms and that drinking behavior reflects individual variation in sensitivity to these cues.

The contextual differentiation of beverage specific consumption is examined in a metropolitan area household survey of current drinkers. The findings indicate that beverage specific consumption is related to such structural proportions as presence/absence of food, drinking location, type of companion, and duration. Wine, for example, is frequently associated with mealtimes, at home, and with relatives.

This study sought to examine the effects of communicating contingent and noncontingent threats and promises upon cooperation in a two-person game (Deutsch and Krauss, 1960). We have adopted Schelling's (1958, 1960) definition of threat and promise as a conditional commitment by the threatening or promising party (sender) contingent upon whether the other party (receiver) acts or fails to act as the sender designates. According to Schelling, a threat is a that punishment is contingent upon the other's behavior; conversely a promise offers a contingent reward. In the context of a bargaining process both warnings and promises are designed to control the behavior of the other party and can be viewed as different forms of social influence. The warning appeals to the other party's fear of punishment and relies upon credible deterrents, whereas promise appeals to his desire to obtain rewards and relies upon incentives. The warning or promise works by influencing the receiver's expectations as to how the sender will react. The social context in which warnings

A recent study of ethnic and sex differences in cooperation in a two-person game indicated that Negro dyads were more cooperative than white dyads (1) . The present study extends the generality of the findings. The two social arrangements were integrated, ethnically mixed dyads and ethnically homogeneous, segregated dyads. Fifry lower class Negro boys and girls and 50 middle class white boys and girls participating in a summer day camp program, were Ss. They ranged in age from 6 to 12 yr. Each S played two games which were conducted in a group setting on the camp playground. In each game S was paired with a different parner of the same sex. Back to back pair members were given a copy of the following payoff matrix representing pieces of candy: blue-blue: 4, 4; blue-red: 1, 6; red-blue: 6, 1; red-red: 2, 2. Ss made a choice by holding up either a red or a blue poker chip on each of 1 0 trials, the payoffs being dispensed after each trial. The amount of cooperation (blue choice) for each S for 10 trials Game 1 with ethnically homogeneous dyads was cast into a 2 x 2 factorial (ethnic groups and sex) and subjected to analysis of variance. Negro boys were significantly Lower in cooperation ( M = 2.75) than Negro girls ( M = 4.60). The white boys ( M = 3.50) did not differ from white girls ( M = 3.70). Both white groups were intermediate between the Negro boys and girls. Comparisons of the ethnically homogeneous and mixed dyads (Games 1 and 2, respectively) were made separately for boys and girls. Analysis of variance (14 white girls and 14 Negro girls) indicated that the level of cooperarion decreased from Game 1 to Game 2. Increased competition in Game 2 may be a function of increased number of trials, ethnic interaction, or order of games. Similar results were obtained for a subsample of 8 Negro boys and 8 white boys. Limitations in time and availability of Ss prevented more complete evaluation of effects of order, race and sex as variables. Another group of 20 white boys, however, permitted examination of the effecn of ethnic interaction on the level of cooperation among white boys. In Game 2 half of this sample participated in an ethnically mixed dyad, while the other half continued playing in a homogeneous dyad. There were significant decreases in cooperation over two games regardless of whether these white boys interacted with other whites or with Negro boys. Further study is required to ascertain whether Negro children would show the same partern of increased competirion. Product-moment correlations between age and amount of cooperarion within the ethnic-sex groups (range: .28 to .07 ) were non-significant. These data are congruent with those of Yarrow, Campbell, and Yarrow ( 2 ) who found that Negro boys were higher in dominance and aggression and Negro girls were higher in affiliation and nurcurance chan white controls. Evidence for the utility of interpersonal games in the analysis of social behavior is clear. REFERENCES 1. SAMPSON, E. E., & KARDUSH, M. Age, sex, class, and race differences in response to a two-person non-zero-sum game. Conflict Resolution, 1965, 9, 212-220. 2. YARROW, M., CAMPBELL, J., & YARROW, L. Interpersonal dynamics in racial inregration. In E. Maccoby, T. Newcomb, & E. Hartley (Eds.), Readings in social psychology. New York: Holt, 1958. Pp. 623-636. Accepted A p ~ i l 8, 1966.

Cirrhosis, the ninth leading cause of death in the United States, has been associated with abusive alcohol consumption patterns. Since the workplace serves as a major exposure variable for alcohol consumption over a significant portion of the lifecourse, and since heavy drinking has been shown to differ by type of occupation, this study examines the relationship between type of occupation and cirrhosis mortality. The California Occupational Mortality Study data set (1979 to 1981) provided the information on primary occupation and liver cirrhosis mortality. Crude and sex-specific mortality rates were calculated based on information from a 20% sample of the 1980 California census (included in the data set). Ninety-five percent confidence intervals were calculated around all rates to determine if any were significantly different from rates for the entire state. The findings uphold the view that an association exists between occupation and cirrhosis mortality. The highest mortality rates were found among persons with blue-collar type jobs (e.g., construction laborers and machinists) or jobs where alcohol was easily available (e.g., bartenders and waitresses). Future research needs to specify the factors associated with occupation that may promote the chronic heavy drinking that leads to cirrhosis.

SvsMaaY. Men drink more than women on each day o) the week, and on Fridays and Saturdays adults aged 18-25 drink more than other adults. Studies of U.S. drinking practices (e.g., 1, 2) indicate more frequent use of alcohol on weekends than on weekdays, a pattern reported in other countries as well (3-6). Argeriou (7) has provided information on daily alcohol consumption by sex and drinker status for a representative sample of respondents in the city of Boston. From the documented cyclical pattern of alcohol-related traffic fatalities and homicides, Argeriou (7) hypothesized a weekly drinking cycle in which would represent a natural trough and Saturday a natural crest. The Tuesday was supported by the findings, but Monday rather than was the day of lowest consumption. Cahalan et al. (1) have noted that the drinking patterns of older adults are characterized by frequent light drinking and by more frequent weekday drinking than are the drinking patterns of younger adults. Age, too, has been shown to be a consistent predictor of traffic accidents, drinkers aged 16 to 25 being involved in a disproportionately large number of them (8). Because more accidents occur on Friday and Saturday and a greater proportion of weekend than weekday crashes involve drinking drivers (8), the hypothesis should find greater support in the behavior of younger rather than older drinkers. Drawing on data obtained in a household survey of metropolitan Boston (9), the present study seeks to replicate the findings of Argeriou (7) and to assess age-related correlates of weekly drinking cycles. Because Argeriou's use of the number of drinks per day as a dependent variable may mask the independent effects of the quantity and frequency of consumption, the present study examines the possibility that weekend consumption levels reflect either an increase in the number of people who drink or an increase in the quantity consumed. METHOD

Two data collection methods, weekly interview and daily record, obtained equally reliable estimates of alcohol consumption per event, but weekly interviews obtained more reliable estimates of the number of drinking events and the amount of alcohol consumed over a 2-week or longer period.

This study compared sociodemographic characteristics, adverse childhood experiences (ACEs), and substance use and psychiatric disorders between adolescent-limited (AL), adult-onset (AO), life-course-persistent (LP) and nonoffender (NO) groups using a large U.S. general population survey. The odds of experiencing several ACEs were greater among each offender group relative to NOs. LP offenders experience more ACEs than AL and AO offenders. Each offender group generally experienced greater substance use and psychopathology than NOs, whereas LP offenders experienced more substance use and psychopathology than AO and AL offenders. The results of this study identified several sociodemographic factors, ACEs, and types of psychopathology that differentiate AL, AO, LP, and NO offenders that can help inform prevention and intervention strategies designed to prevent offending and shorten criminal careers.

Drawing on data from the National Longitudinal Survey of young adults, this study examines the effects of antisocial behavior on alcohol dependence among young men and women in the United States. An analysis of the data from the study indicates that there are effects of antisocial behavior and that these effects cannot be attributed to a lower social class family of origin or to a positive family history of alcoholism. The analysis also indicates that the strongest effects are found among young adults with both antisocial behavior and a positive family history.

The Data Notes Series is edited by Dr Bridget Grant, Chief of Biometry of the National Institute on Alcohol Abuse and Alcoholism. Abstract This data note explores the relationship of gender, alcohol consumption and premature death from cardiovascular disease (MCVD). Data on the 8164 deaths attributed to MCVD from the National Mortality Followback Study (NMFS) were analyzed controlling for gender and consumption. Women who are heavy drinkers die young at a rate equal to that of men who drink heavily. In light of this, we recommend that future research and preventive efforts in this area include females as subjects and alcohol as a major risk factor.

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.

Few epidemiologic studies have examined a full range of adolescent psychiatric disorders in the general population. The association between psychiatric symptom clusters (PSCs) and DSM-IV alcohol use disorders (AUDs) among adolescents is not well understood.This study draws upon the public-use data from the 2000 National Household Survey on Drug Abuse, including a study sample of 19,430 respondents aged 12 to 17. Logistic regression and exploratory structural equation modeling assess the associations between PSCs and DSM-IV AUDs by gender. The PSCs are based on brief screening scales devised from the Diagnostic Interview Schedule for Children Predictive Scales.Several PSCs were found to be significantly associated with DSM-IV AUDs, including separation anxiety, generalized anxiety, depression, oppositional defiant disorder, and conduct disorder among both genders, and panic disorder and obsessive/ compulsive disorder among females. Consistent with the literature, the analysis of PSCs yields 3 factors identical for both genders-2 internalizing factors (fear and anxiety-misery) and 1 externalizing factor. Adolescents who scored higher on the externalizing factor tended to have higher levels of the AUD factor. Female adolescents who scored higher on the internalizing misery factor and lower on the internalizing fear factor also tended to have higher levels of the AUD factor.The associations that we found between PSCs and AUDs among adolescents in this study are consistent with those found among adults in other studies, although gender may moderate associations between internalizing PSCs and AUDs. Our findings lend support to previous findings on the developmentally stable associations between disruptive behaviors and AUDs among adolescents as well as adults in the general population.

Drawing upon data from the Survey of Deviant Behavior Among Youth in the Moscow Region of Russia, this paper examines the effects of early drinking behavior and an antisocial orientation on the use of alcohol by young Russians. Using available data from the U.S. National Household Survey of Drug Abuse, the use of alcohol and the effects of early drinking among youth in the Moscow Region and the United States are compared. The analysis of the data from the two surveys indicates that a greater proportion of Russian youth began drinking by the age of 12 but that early drinking is associated with subsequent alcohol use among both Russian and American youth. Although there are no data on an antisocial orientation from the U.S. survey, there are such data from the Russian survey and an analysis of this data indicates that the greatest alcohol use is found among young Russians who began drinking by the age of 12 and who have an antisocial orientation.

The independence of three descriptive dimensions, commonly used in the design of experimental research on schizophrenia, was investigated. The subjects were 258 male schizophrenic patients from three Boston area hospitals, two private and one public. Only paranoid status was found to be independent of the other two dimensions. Premorbid adjustment and chronicity of symptoms (defined by length of hospitalization) were significantly correlated, rt=.31. Data analysis and discussion focused specifically on the inconsistency between these data and those reported by Goldstein, Held, and Cromwell (1968) on the same problem. Differences in the populations sampled and in patient selection procedures were carefully examined but failed to resolve the inconsistency.