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Alcohol Severity (alcohol + severity)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Assessing the Severity of Hazardous Drinking and Related Consequences Among Incarcerated Women

ALCOHOLISM, Issue 5 2010
David R. Strong
Background:, Recent epidemiological efforts have demonstrated the utility of measuring individual differences in the severity of alcohol use along a single severity continuum marked by alcohol-related problems, symptoms of alcohol dependence, and the social consequences of drinking. Translation of this utility to specialized clinical populations is not assured. The expected inter-relationships among problems, symptoms and consequences, and enhanced sensitivity of combined assessments require confirmation in applied clinical settings. Method:, Subjects were 245 incarcerated women who met Alcohol Use Disorders Identification Test criteria for hazardous use of alcohol. Participants were recruited from a statewide adult correctional facility for an ongoing clinical trial testing the effectiveness of brief motivational interviewing on alcohol use and HIV risk behaviors. Participants ranged in age from 18 to 56 (M = 34.1, SD = 8.9), 71.4% were Caucasian, and 65.7% reported <12 years of education. Results:, Analyses suggested that the 6 problems of alcohol abuse, 7 symptoms for alcohol dependence, and 14 alcohol-related social consequences loaded to a single factor (0.38 to 0.85) that formed a continuum of alcohol severity. Contrary to epidemiological studies, physical fights and being arrested were the most prevalent consequences and were associated with lower alcohol severity in this population. Three of the five items that discriminated best between higher and lower alcohol severity were related to familial and relationship consequences. Conclusions:, Consistent with epidemiological studies, alcohol severity can be measured among incarcerated hazardously drinking women on a single continuum that includes alcohol problems, symptoms, and social consequences. Replication of the expected alignment of problems and symptoms supports the construct validity of the continuum and further challenges the proposed hierarchical structure of abuse/dependence distinction. Large differences in rates of specific consequences and observed effectiveness of tailored social consequence items suggest the benefits of cross-sample validation to improve evaluation of clinical outcomes. [source]

Factors Affecting %CDT Status at Entry Into a Multisite Clinical Treatment Trial: Experience from the COMBINE Study

ALCOHOLISM, Issue 11 2006
Raymond F. Anton
Background: Carbohydrate-deficient transferrin (CDT) occurs as a higher percentage of normal transferrin (%CDT) in heavy drinkers. %CDT is used as a marker of both alcohol use disorder severity and treatment outcome both clinically and in treatment trials. Nevertheless, little is known about the parameters that predict which patients are %CDT positives at treatment entry. These parameters might include level of drinking, days of abstinence before testing, and severity of alcohol dependence before evaluation. Methods: %CDT levels were collected before randomization from participants of the COMBINE Study, a large federally sponsored multisite clinical trial evaluating medications and behavioral therapies in alcohol-dependent outpatients. %CDT (assayed in a central laboratory) was available in 1,193 individuals for whom drinking history in the 30 days before testing and measures of alcoholism severity were documented. The effects of drinking history and alcohol severity were evaluated for prediction of a %CDT-positive test status. Results: Less percent days abstinent (PDA) and more drinks per drinking day (DDD) were predictive of higher rates of %CDT-positive patients (maximum 67%). Up to 14 days of continuous abstinence before testing did not appear to significantly affect %CDT status. Rates of %CDT positives remained reasonably steady up to about 40% PDA. Years of drinking at dependence levels had an unexpected negative impact on %CDT-positive rates while previous treatment had a small but positive impact of %CDT-positive rates. ADS and DrInC scores had no predictive value over and above recent drinking amounts on %CDT status. Conclusions: %CDT is more likely to be positive in those who have more days of drinking and to a lesser degree in those who drink more per drinking day. It can remain positive even in those alcoholic subjects who stop drinking many days before testing. Alcoholic subjects with more treatment experiences appear to have a marginally higher %CDT-positive rate. [source]

Age of Onset as a Discriminator Between Alcoholic Subtypes in a Treatment-Seeking Outpatient Population

THE AMERICAN JOURNAL ON ADDICTIONS, Issue 1 2000
Bankole A. Johnson M.D., Ph.D.
Subtyping alcoholics may provide a more accurate guide as to the course and character of the disease. Classifications of different ages of onset of problem drinking have so far resulted in categorical inconsistencies. In the past, hospital-based alcoholics have over-represented those most severely ill, and comprehensive evaluations of psychopathology for discriminating between alcoholic subtypes have been infrequent. In a heterogeneous treatment-seeking, outpatient, alcoholic population, we tested the hypothesis that age of onset represents a continuum of disease, and that greater severity of psychopathology is associated with lower ages of onset. Using a standard questionnaire, 253 male and female treatment-seeking alcoholics were stratified according to specific ages of onset: a) <20 years; b) 20,25 years, and c) >25 years. These age of onset groups were compared on alcohol severity and craving, family history, childhood behavior, personality, hostility, overt aggression, mood, and social functioning. Symptom severity and age of onset were negatively correlated, and the 20,25-year onset group usually had intermediate scores. The <20 year onset group was characterized by greater severity of alcohol-related problems, family history, childhood behavioral problems, craving, hostility, antisocial traits, mood disturbance, and poor social functioning. Alcoholics with an earlier age of onset have relatively greater psychopathology than those of later onset. While the preponderance of psychopathology among those in the <20-year onset group could be conceptualized as a clinical "subtype," such a characterization would not define an entirely homogenous category. Yet, this clinical characterization would be clinically important if specific age of onset levels were found to be differentially sensitive to pharmacological and/or psychological treatments. [source]