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Alcohol Disorders (alcohol + disorders)
Selected AbstractsMailed treatment to augment primary care for alcohol disorders: A randomised controlled trialDRUG AND ALCOHOL REVIEW, Issue 1 2009DAVID KAVANAGH Abstract Introduction and Aims. Remote delivery of interventions is needed to address large numbers of people with alcohol use disorders who are spread over large areas. Previous correspondence trials typically examined its effects as stand-alone treatment. This study aimed to test whether adding postal treatment to general practitioner (GP) support would lower alcohol use more than GP intervention alone. Design and Methods. A single-blind, randomised controlled trial with a crossover design was conducted over 12 months on 204 people with alcohol use disorders. Participants in an immediate correspondence condition received treatment over the first 3 months; those receiving delayed treatment received it in months 3,6. Results. Few participants were referred from GPs, and little intervention was offered by them. At 3 months, 78% of participants remained in the study. Those in immediate treatment showed greater reductions in alcohol per week, drinking days, anxiety, depression and distress than those in the delayed condition. However, post-treatment and follow-up outcomes still showed elevated alcohol use, depression, anxiety and distress. Greater baseline anxiety predicted better alcohol outcomes, although more mental distress at baseline predicted dropout. Discussion and Conclusions. The study gave consistent results with those from previous research on correspondence treatments, and showed that high levels of participant engagement over 3 months can be obtained. Substantial reductions in alcohol use are seen, with indications that they are well maintained. However, many participants continue to show high-risk alcohol use and psychological distress.[Kavanagh D, Connolly JM. Mailed treatment to augment primary care for alcohol disorders: A randomised controlled trial. Drug Alcohol Rev 2009;28:73,80] [source] The relationship of behavioural undercontrol to alcoholism in higher-functioning adultsDRUG AND ALCOHOL REVIEW, Issue 5 2006MARC A. SCHUCKIT Abstract Externalising behaviours, including the personality characteristics of behavioural undercontrol (BU), represent one of several genetically influenced domains that impact on the alcoholism risk. Because genes explain only about 60% of the vulnerability toward alcohol use disorders (AUDs), an optimal understanding of how such behaviours affect the risk requires evaluation of their impact in the context of additional influences. Few studies have addressed this question regarding BU among relatively well-functioning adults. This paper presents results from testing a BU-based mediational model of risk in men from the San Diego Prospective Study. Structured research instruments were used with 430 adult Caucasian males to evaluate the performance of BU in predicting AUDs at the 15-year follow-up using Pearson product-moment correlations among domains and an AMOS-based structural equation model (SEM). While both the family history of AUDs (FHalc) and BU predicted alcohol-related outcome, BU by itself did not mediate the relationship of the FH to alcohol disorders. The impact of BU on alcohol problems was mediated by alcohol expectancies, peer drinking and by coping. The SEM explained 42% of the variance for AUDs. The current results indicate that BU contributed to the risk for alcohol-related problems, even among more highly functional subjects and after excluding the impact of the antisocial personality disorder, but by itself did not mediate the relationship of FH to outcome in these subjects. [source] Social integration in young adulthood and the subsequent onset of substance use and disorders among a community population of urban African AmericansADDICTION, Issue 3 2010Kerry M. Green ABSTRACT Aims This paper examines the association between social integration in young adulthood and the later onset of substance use and disorders through mid-adulthood. Design Data come from a community cohort of African Americans followed longitudinally from age 6,42 years with four assessment periods. Setting The cohort all lived in the Woodlawn neighborhood of Chicago in 1966, an urban disadvantaged setting. Participants All Woodlawn first graders in 1966 were asked to participate; 13 families declined (n = 1242). Measurement Substance use was measured via interview at age 42 and includes the onset of alcohol and drug use disorders and the onset of cocaine/heroin use between ages 32 and 42 years. Social integration measures were assessed via interview at age 32 and include social roles (employee, spouse, parent), participation in religious and social organizations and a measure of overall social integration. Control variables were measured in childhood and later in the life course. Findings Multivariate regression analyses suggest that unemployment, being unmarried, infrequent religious service attendance and lower overall social integration in young adulthood predict later adult-onset drug use disorders, but not alcohol use disorders once confounders are taken into consideration. Unemployment and lower overall social integration predict onset of cocaine/heroin use later in adulthood. Conclusions Results show meaningful onset of drug use and substance use disorders during mid-adulthood and that social integration in young adulthood seems to play a role in later onset of drug use and drug disorders, but not alcohol disorders. [source] Early weaning and alcohol disorders in offspring: biological effect, mediating factors or residual confounding?ADDICTION, Issue 8 2009Rosa Alati ABSTRACT Aims This study explores associations between early weaning and alcohol use disorders in youth and mechanisms by which these associations may operate. Design We used data from the Mater University Study of Pregnancy and its outcomes, an Australian birth cohort study based in Brisbane. Setting and participants: This study is based on a subsample of 2370 participants for whom complete data were available at age 21 years. Length and method of breastfeeding were assessed at 6 months. Measurements Alcohol use disorders were assessed at age 21 using the life-time version of the Composite International Diagnostic Interview,computerized version (CIDI-Auto). We adjusted for maternal age, marital status, education, alcohol, tobacco use, anxiety, depression and maternal attitudes towards the baby. Attention Deficit and Hyperactivity Disorders (ADHD) and Intellect Quotient (IQ) were measured with the Child Behaviour Checklist (5 years) and the Ravens SM (14 years), respectively. Findings Those who had been weaned within 2 weeks of being born and breastfed at regular intervals were at increased risk of meeting criteria for alcohol use disorders at age 21 [odds ratio (OR) 1.71, 95% confidence interval (CI):1.07, 2.72]. Conclusion This study confirms a small but robust association between early weaning and increased risk of alcohol use disorders. [source] Phosphatidylethanol and Alcohol Consumption in Reproductive Age WomenALCOHOLISM, Issue 3 2010Scott H. Stewart Background:, Fetal alcohol disorders are preventable, but self-reported alcohol consumption can be misleading and impede effective treatment. Biomarkers represent an alternative method for assessing alcohol use, and this study evaluated the relationship between blood phosphatidylethanol (PEth) and alcohol use in a sample of reproductive age women. Methods:, Alcohol use was estimated by validated self-report methods in 80 nonpregnant women ages 18 to 35. PEth was measured by a contracted laboratory using a liquid chromatography-tandem mass spectrometry assay. Regression methods appropriate for the distribution of PEth were used to define its relationship to alcohol consumption during the prior 2 weeks and explore the effects of drinking patterns on this association. Receiver operating characteristic analysis was used to estimate the sensitivity of PEth for various drinking levels at 95% specific cutoffs. Results:, PEth had a positive linear association with grams of alcohol consumed (p < 0.001), and was detectable in 93% of subjects consuming an average of 2 or more drinks per day. The relationship between total alcohol consumption and PEth may be stronger in women with recent heavy drinking days. The relationship between drinking and PEth varied considerably between individuals, and sensitivity for a certain amount of drinking was low at a highly specific cutoff concentration. Conclusions:, PEth is a highly sensitive indicator of moderate and heavy alcohol consumption in reproductive age women and may complement the use of self-report alcohol screens when additional objective markers of alcohol use are desirable. However, choosing a highly valid cutoff concentration for PEth to differentiate various levels of alcohol consumption may not be feasible. [source] Alcohol Abuse or Dependence Among Mexican American Women Who Report ViolenceALCOHOLISM, Issue 10 2001E. Anne Lown Background: Violence against women has been linked to alcohol disorders in various populations. Few studies have assessed alcohol disorders among assaulted women in a general population of Mexican Americans. This study examined alcohol disorders among Mexican American women who reported physical or sexual assault. Methods: Participants were women (n= 1516, ages 18,59) living in Fresno County, California, who were enrolled in a population-based, randomized household survey of Mexican-origin men and women. Crude and adjusted odds ratios (ORs) were calculated for alcohol dependence/abuse (ADA) and physical or sexual assault by a current partner or someone other than a current partner. Results: Women who reported lifetime physical or sexual assault were significantly more likely to meet criteria for ADA (OR = 8.2; 95% confidence interval [CI], 4.4,15.4). After we adjusted for birthplace, age, income, and parental problem drinking, assaulted women were still 4.7 times more likely to meet criteria for ADA (CI, 2.1,10.4). Physical or sexual assault by someone other than a partner was more strongly associated with ADA (OR = 8.7; CI, 4.5,16.9) than assault by a current partner (OR = 3.2; CI, 1.3,7.6). Both physical (OR = 9.0; CI, 4.7,17.0) and sexual assault (OR = 4.7; CI, 2.2,10.0) by either type of perpetrator were associated with ADA. Conclusion: There is a strong association between reporting violence and having a lifetime history of ADA. Although temporal order could not be established, these findings highlight the importance of screening for physical and sexual assault in settings that treat alcohol disorders as well as screening for alcohol disorders among women who seek services related to previous or current violence. [source] | ||||||||||