Incidence Of Alcohol Use Disorders Research Articles

Social anxiety disorder is a risk factor for alcohol use problems in the National Comorbidity Surveys

BackgroundAccording to the self-medication and biopsychosocial models, individuals with social anxiety disorder (SAD) are at increased risk of developing an alcohol use disorder (AUD) as alcohol represents a maladaptive coping mechanism for some sufferers of SAD. The SAD-to-AUD causation was earlier supported in Norwegian longitudinal twin data and later questioned using longitudinal data from the USA. MethodsWe re-analyzed partly the same USA-based data (National Comorbidity Surveys, n = 5001), conducting theoretical and simulation analyses on different formulations of temporality and using real-data Logistic regression analysis to investigate whether baseline SAD was associated with AUD at the follow-up. ResultsUpon proper analysis of temporality, SAD preceded AUD. Specifically, SAD was the only one of the seven anxiety disorders that predicted 10-year later AUD after adjusting for all other anxiety disorders and AUD at the baseline (odds ratio was 1.70% and 95% confidence interval 1.12–2.57). SAD was also associated with incident AUD (OR = 1.64, 95% CI = 1.14–2.37). We provide formal, simulation-based, and data-based arguments on how certain flawed models of incidence attenuate the temporal association. ConclusionsWe demonstrated temporality and specificity in SAD-to-AUD association, which are considered signs of causation. We further identified and discussed problems in previous statistical analyses with different conclusions. Our findings add support for models positing causal effects of SAD on AUD, such as the self-medication and biopsychosocial models. The available evidence suggests that treating SAD should incur better chances of preventing AUD compared to treating other anxiety disorders, which lack comparable evidence on causation.

Alcohol Use Disorder Incidence, Mortality, and Disability-Adjusted Life Years in Estonia, 1990 to 2019: A Joinpoint Regression Analysis Using Global Burden of Disease Study

Background: Alcohol consumption is widely recognized as a leading cause of premature mortality and a significant global health concern. This study aimed to investigate the trends in alcohol use disorders, including incidence, mortality, and disability-adjusted life years (DALYs), in Estonia from 1990 to 2019 using data from the Global Burden of Disease (GBD) dataset. Methods: The GBD study is a comprehensive epidemiological research effort that analyzes various causes of death, diseases, injuries, and risk factors across multiple countries and territories. In this study, we utilized the GBD dataset to estimate annual incidence, prevalence, mortality, years of life lost, years living with disabilities, and DALY rates by gender and age from 1990 to 2019. To assess the trends in these indices, including DALY, incidence, mortality, and 1-mortality-to-incidence ratio (1-MIR), joinpoint regression analysis was employed. This allowed for the identification of significant changes in trends at specific time points and the calculation of annual percent change between these points. Results: Our findings revealed an overall decreasing trend in the incidence rate of alcohol use disorder over the study period. However, the average DALY, mortality, and 1-MIR trends did not exhibit significant variation during this time. Moreover, we observed a more substantial decline in alcohol use disorders among men compared to women from 1990 to 2019. Specifically, the incidence of alcohol use disorders demonstrated a significant increase from 1990 to 2000, followed by a decline from 2010 to 2018, and continued to decrease from 2017 to 2019. Conclusion: This study provides important insights into the changing trends of alcohol use disorders, including incidence and mortality, in Estonia from 1990 to 2019. Our findings indicate a decreasing pattern over time, suggesting a positive shift in alcohol consumption behavior. Additionally, we observed that men had higher rates of MIR, DALY, mortality, and incidence of alcohol use disorders compared to women. These results emphasize the need for targeted health prevention programs to sustain and further promote the downward trend in alcohol-related disorders.

Increased incidence of alcohol use disorder and alcohol-related psychiatric disorders in patients with obstructive sleep apnea: A nationwide population-based cohort study

BackgroundObstructive sleep apnea (OSA) and alcohol-related diseases (ARDs), including alcohol use disorder, alcohol-related psychiatric disorders, alcoholic liver disease, alcoholic polyneuropathy alcoholic cardiomyopathy, and alcoholic gastritis, are both highly prevalent conditions. Alcohol consumption is associated with a higher risk of sleep apnea. However, whether OSA increases the risk of ARD has not, as yet, been studied comprehensively. Our study aimed to determine whether OSA increases the subsequent risk of ARD. MethodsThis study utilized the data from Taiwan's National Health Insurance Database between 2000 and 2015. We identified 7722 individuals newly diagnosed with OSA and randomly selected sex-, age-, and index date-matched (1:3) 22,166 controls without OSA, with a total of 29,888 subjects. We used the Fine and Gray's survival analysis to estimate the effects of OSA on ARD. ResultsThe OSA cohort had an adjusted hazard ratio of subsequent ARDs as 1.486 (95% Confidence Interval: 1.301–1.698), when comparing the cohort without OSA. The Kaplan-Meier analysis showed that the cumulative incidence of ARDs was significantly higher in the OSA cohort than in the controls in the first year of follow-up, till the end of the follow-up. A post-hoc analysis showed that OSA was associated with alcohol use disorder, alcohol-related psychiatric disorders, and alcoholic liver disease, but not alcoholic polyneuropathy, alcoholic cardiomyopathy, and alcoholic gastritis. The use of psychoactive medication, including the sedative-hypnotics, antidepressants or antipsychotics were associated with a lower risk of ARDs. ConclusionsOur study demonstrates that the OSA patients are at a higher risk of developing ARDs.

Post-Combat-Injury Opioid Prescription and Alcohol Use Disorder in the Military

Previous studies have identified combat exposure and combat traumatic experience as problematic drinking risk factors. Increasing evidence suggests that opioid use increases the risk of alcohol use disorder. This study investigated the association between opioid prescription use after injury and (1) alcohol use disorder and (2) severity of alcohol use disorder among deployed military servicemembers. Deidentified health records data of 9,029 deployed servicemembers from a retrospective cohort study were analyzed. Data were randomly selected from the Department of Defense Trauma Registry and included servicemembers with combat injuries during deployment in Iraq or Afghanistan (2002-2016). Pharmacy records and International Classification of Diseases, Ninth and Tenth Revision diagnosis codes were used. Three groups were identified (no opioid prescription use, nonpersistent opioid prescription use, and persistent opioid prescription use) and were compared on the basis of alcohol use disorder risk using Cox proportional hazard models. Data analyses were performed in 2021. Of the 9,029 servicemembers with combat injury, 2,262 developed alcohol use disorder (1,322 developed severe alcohol use disorder). Compared with no opioid prescription use, increased alcohol use disorder risk was associated with persistent opioid prescription use, with a hazard ratio of 1.13 (95% CI=1.02, 1.26). After covariate adjustment, increased risk remained statistically significant (hazards ratio=1.24; 95% CI=1.10, 1.39). There was no significant difference in alcohol use disorder risk between no opioid prescription use and nonpersistent opioid prescription use. The risk of severe alcohol use disorder did not vary by opioid use among servicemembers with alcohol use disorder diagnosis. The findings of the study suggest that the incidence of alcohol use disorder was higher among injured servicemembers with persistent opioid prescription use than among those without opioid use. If replicated in prospective studies, the findings highlight the need for clinicians to consider the current and history of alcohol use of patients in initiating treatment involving opioids.

Definition matters: assessment of tolerance to the effects of alcohol in a prospective cohort study of emerging adults.

Tolerance to the effects of alcohol is an important element in the diagnosis of alcohol use disorders (AUD); however, there is ongoing debate about its utility in the diagnosis AUD in adolescents and young adults. This study aimed to refine the assessment of tolerance in young adults by testing different definitions of tolerance and their associations with longitudinal AUD outcomes. Prospective cohort study. Australia. A contemporary cohort of emerging adults across Australia (n= 565, mean age = 18.9, range = 18-21 at baseline). Clinician-administered Structured Clinical Interview for DSM-IV Research Version (SCID-IV-RV) assessed for AUD criteria across five interviews, at 6-month intervals over 2.5years. Tolerance definitions were operationalized using survey-type response (yes/no), clinician judgement (SCID-IV-RV), different initial drinking quantity and percentage increase thresholds and average heavy consumption metrics. AUD persistence was operationalized by the number of times AUD was present across the 2.5-year study period (n = 491), and new-onset AUD was operationalized as any new incidence of AUD during the follow-up period (n = 461). The (i) SCID-IV-RV clinician judgement [odds ratio (OR) = 2.50, P= 0.005], (ii) an initial drinking quantity threshold of four to five drinks and 50% minimum increase (OR = 2.48, P= 0.007) and (iii) 50% increase only (OR = 2.40, P= 0.005) were the tolerance definitions more strongly associated with any new onset of AUD throughout the four follow-up time-points than other definitions. However, these definitions were not associated with persistent AUD (Ps > 0.05). Average heavy consumption definitions of tolerance were most strongly associated with persistent AUD (OR = 6.66, P= 0.001; OR = 4.65, P= 0.004) but not associated with new-onset AUD (Ps > 0.05). Initial drink and percentage change thresholds appear to improve the efficacy of change-based tolerance as an indicator for new-onset alcohol use disorder diagnosis in self-report surveys of young adults. When predicting persistent alcohol use disorder, average heavy consumption-based indicators appear to be a better way to measure tolerance than self-reported change-based definitions.

Socioeconomic status, alcohol use disorders, and depression: A population-based study

BackgroundDepressive disorders (DD) and alcohol use disorders (AUD) frequently co-occur. They are key to understanding the current increases in “deaths of despair” among individuals with lower socioeconomic status (SES). The aim of this study was to assess the prospective bidirectional associations between AUD and DD, as well as the effect of SES on these two conditions. MethodsThe National Epidemiologic Survey on Alcohol and Related Conditions is a cohort study representative of the US adult population, which began in 2001–2002, with follow-up interviews conducted 3 years later. SES was primarily operationalized as educational attainment. AUD, DD, and their levels of severity were defined according to the DSM-5 criteria. ResultsThe risk of developing an incident DD increased gradually with the recency and the severity of AUD at baseline, but the converse was not observed. Lower SES was an independent risk for incident AUD or DD. SES did not modify the prospective association between AUD and DD. LimitationsThe absence of interaction between SES and moderate or severe AUD for the incident DD must be considered with caution due to the limited number of DD cases reported in these AUD categories. ConclusionsThis result is consistent with a causal relationship between AUD and DD, and suggests that therapeutic interventions for AUD may also have beneficial effects to lower DD rates. The independent effects of a lower SES and AUD on DD may result in a vulnerable population cumulating disorders with heavy consequences on health and social well-being.

Onset of alcohol use disorder among alcohol initiates by race/ethnicity.

Prevalence of alcohol use disorders (AUD) varies across racial/ethnic groups. It remains unclear whether rapid transition from first-time alcohol use to developing AUD varies by race and ethnicity. In this study, we investigate racial/ethnic differences in AUD onset among first-time alcohol drinkers and identify specific predictors of AUD onset by racial/ethnic group. The study population was non-institutionalized US residents aged 12 and older. Within four nationally representative probability samples (n ∼70,000/year) drawn from the 2015-2018 National Surveys on Drug Use and Health, we identified 9,381 individuals who initiated alcohol use within 1-12 months prior to the survey. The probability of AUD after initiation was estimated for the entire sample, followed by racial/ethnic group stratification. Bivariate and multivariable logistic regression models were used to identify predictors of AUD onset among alcohol initiates. The overall incidence estimate of AUD among alcohol initiates was 3.7% (95% CI=3.0%, 4.6%). There was no significant variation in the incidence of AUD between racial/ethnic groups. Drug use, drug use disorders, and major depressive episode were significant predictors of AUD onset among all alcohol initiates. However, these predictors were not significant among non-Hispanic/Latinx Black individuals. Drug use and drug use disorders were strong predictors of AUD onset among alcohol initiates, except among non-Hispanic/Latinx Black individuals. These findings strengthen the importance of focusing on the co-use of alcohol and other drugs and the need to further investigate the risk profile differences between racial/ethnic groups.

Rates of prescription orders for United States active duty service members diagnosed with alcohol use disorder

Background: Alcohol-use disorders (AUD) pose a significant challenge for the United States (US) military. The US Department of Defense has strongly recommended several medications for use in the treatment of patients with diagnosed AUD. This study assessed the prescription of medications for active duty service members (ADSMs) diagnosed with AUD in the US Military Health System (MHS). Methods: Rates of prescription orders were retrospectively examined from 2010 to 2017 among ADSMs with an incident diagnosis of moderate-to-severe AUD. The rate of prescription orders was defined as the proportion of ADSMs with an ICD-9 or ICD-10 diagnosis code of alcohol dependence who received an order for acamprosate, disulfiram, naltrexone, and/or topiramate at a military treatment facility in the year following their incident diagnosis. Results: ADSMs receiving an order for at least one medication in the year following their incident AUD diagnosis increased from 8.8% in 2010 to 16.2% in 2017 (RR = 1.84, 95% CI, 1.76, 1.93). Oral naltrexone was ordered most frequently among this patient population, while injectable naltrexone, a medication option meant to ease and improve adherence, was ordered for a smaller proportion of patients. Conclusions: Most ADSMs who might benefit from prescriptions for AUD are not receiving them as part of their treatment despite strong clinical evidence and Department of Defense policy support for their use among this cohort.

Adolescent alcohol exposure alters DNA and RNA modifications in peripheral blood by liquid chromatography-tandem mass spectrometry analysis

Alcohol consumption is a critical risk factor contributing to a verity of human diseases. The incidence of alcohol use disorder increases across adolescence in recent years. Accumulating line of evidence suggests that alcohol-induced changes of DNA cytosine methylation (5-methyl-2′-deoxycytidine, 5mC) in genomes play an important role in the development of diseases. However, systemic investigation of the effects of adolescent alcohol exposure on DNA and RNA modifications is still lacked. Especially, there hasn't been any report to study the effects of alcohol exposure on RNA modifications. Similar to DNA modifications, RNA modifications recently have been identified to function as new regulators in modulating numbers of biological processes. In the current study, we systematically investigated the effects of alcohol exposure on both DNA and RNA modifications in peripheral blood of adolescent rats by liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS) analysis. The developed LC-ESI-MS/MS method enabled the sensitive and accurate determination of 2 DNA modifications and 12 RNA modifications. As for the alcohol exposure experiments, the adolescent rats were intraperitoneally injected with ethanol with an interval of one day for a total 14 days. The quantification results by LC-ESI-MS/MS analysis showed that adolescent alcohol exposure could alter both DNA and RNA modifications in peripheral blood. Specifically, we observed an overall decreased trend of RNA modifications. The discovery of the significant alteration of the levels of DNA and RNA modifications under alcohol exposure indicates that alcohol consumption may increase the risk of the incidence and development of diseases through dysregulating DNA and RNA modifications.

Prevalence, risk and protective factors of alcohol use disorder during the COVID-19 pandemic in U.S. military veterans

BackgroundThere have been reports of increased alcohol consumption during the COVID-19 pandemic in the general population. However, little is known about the impact of the pandemic on the prevalence of alcohol use disorder (AUD), especially in high-risk samples such as U.S. military veterans. MethodsData were analyzed from the 2019–2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative, prospective cohort of 3078 U.S. veterans. Pre-pandemic and 1-year peri-pandemic risk and protective factors associated with incident and chronic probable AUD were examined. ResultsA total of 6.9 % (n = 183) of veterans were classified as chronic probable AUD, 3.2 % (n = 85) as remitted from AUD, and 2.7 % (n = 71) as incident probable AUD during the pandemic; the prevalence of probable AUD in the full sample remained stable —10.1 % pre-pandemic and 9.6 % peri-pandemic. Younger age, greater pre-pandemic alcohol use severity, and COVID-related stressors were associated with incident AUD during the pandemic, whereas higher pre-pandemic household income was associated with lower risk of this outcome. Younger age, combat experience, lifetime substance use disorder, greater drug use severity, lower dispositional optimism, and more COVID-related worries and social restriction stress were associated with higher risk of chronic AUD. ConclusionsNearly 1-in-10 US veterans screened positive for AUD 1-year into the pandemic; however, the pre- and 1-year peri-pandemic prevalence of probable AUD remained stable. Veterans who are younger, have served in combat roles, endorse more COVID-related stressors, and have fewer socioeconomic resources may be at higher risk for AUD during the pandemic.

Alcohol use disorder in active duty service members: Incidence rates over a 19-year period

Background: Alcohol use is a concerning issue for the military given its potential negative impact on human performance. Limited data are available regarding the incidence of alcohol use disorder in the military, which is critical to understand to evaluate force readiness, as well as for preventative initiatives and treatment planning. The aim was to examine the alcohol use disorder incidence rates (overall and across demographics) among active duty service members from 2001 to 2018. Methods: Data on 208,870 active duty service members between 2001 and 2018 from the Defense Medical Epidemiology Database was examined. Incidence rates were analyzed to determine the diagnostic rates of AUD (including both alcohol abuse and dependence), which were then examined by sex, age, service branch, military pay grade, marital status, and race. Results: Incidence rates of AUD in active duty service members (per 1,000 service members) ranged from 6.45 to 10.50 for alcohol abuse and 5.21 to 7.11 for alcohol dependence. Initial diagnoses of new-onset AUD occurred most frequently within 20–24 year-old, white, male, and non-married U.S. Army service members in the enlisted pay grades of E-1 to E-4. Statistically significant differences (p <.001) were found between observed and expected counts across all examined demographic variables. Conclusions: To our knowledge, this is the first study to provide a comprehensive examination of AUD incidence rates in an active-duty military population over an extended 18-year period and during the last decade. Incidence rates were higher than expected for alcohol dependence and lower than expected for alcohol abuse. Given the untoward effects of AUD on overall health and force readiness, active-duty service members may benefit from more advanced preventative interventions to decrease incidence rates of AUD over time. Future research should use these data to develop targeted interventions for the demographics at greatest risk.

СОСТОЯНИЕ ПРОБЛЕМЫ НАРКОЛОГИЧЕСКИХ РАССТРОЙСТВ В КУРСКОЙ ОБЛАСТИ И СОПРЕДЕЛЬНЫХ ТЕРРИТОРИЯХ В 2014-2019 ГОДАХ

Period 2014-2019 characterized by a certain increase in social instability in Russia, which led to an increase of social risk factors for drug addiction. In the Kursk region, at the same time, there have been changes in the regulation of anti-drug prevention, a large number of specialists have been trained, and a movement of competent volunteers has developed. In this regard, the epidemiological data for 2014-2019 are of particular interest. For the period from 2005 to 2019 the primary incidence of alcohol use disorders in Russia decreased from 147.4 to 48.3, in the Kursk region – from 106 to 53.5 cases per 100 000 population per year. Of the adjacent regions in 2019, a lower incidence rate than in the Kursk region was noted only in the Belgorod region – 39.4 cases per 100,000 population. Primary incidence of disorders associated with the use of narcotic active substances, during 2014-2019 in Russia as a whole decreased from 15 to 9.8, in the Kursk region – from 11.3 to 4 new cases per 100 000 inhabitants per year. In 2019, the detection rate of primary incidence of drug addiction and substance abuse was significantly higher than in the Kursk region in Bryansk and Lipetsk. Despite favorable trends, it was noted that the coronavirus pandemic and the restrictions introduced to combat it can have a significant impact on the risk factors for drug addiction, which requires the adaptation of preventive programs to new conditions.

COVID-19 Aftershocks on Alcohol-Associated Liver Disease: An Early Cross-Sectional Report From the U.S. Epicenter.

Experts have forewarned about the coronavirus disease 2019 (COVID‐19) pandemic environment fomenting the rising incidence of alcohol use disorder (AUD) and alcohol‐associated liver disease (ALD). We performed a cross‐sectional study of ALD at our liver transplantation (LT) center, located in the initial U.S. epicenter, New York City. Centered around the “stay at home” order date in New York state, March 22, 2020, we defined three time periods: “pre‐COVID” (January 1, 2020‐March 21, 2020), “COVID‐quarantine” (March 22, 2020‐April 22, 2020), and “declining‐COVID” (April 23, 2020‐August 25, 2020). We found a 62% increase in interhospital patient transfers for ALD from pre‐COVID (20 of 93, 21%) to the declining‐COVID period (43 of 127, 34%). Our inpatient liver census with ALD also increased: 38% pre‐COVID, 45% COVID‐quarantine, and 49% declining‐COVID. Among 30 patients with severe alcoholic hepatitis (AH) not responding to medical therapy since March 22, 2020, 9 underwent early LT for AH (16% of the total number of early LT during our 8‐year program). Three of 9 early‐LT recipients reported specific COVID‐related stressors. All 25 previous LT recipients with established abstinence pre‐COVID maintained abstinence at follow‐up visits during the declining‐COVID period. Of the 6 recipients with sustained alcohol use within 6 months before March 22, 2020, half regained abstinence during the declining‐COVID period. Our findings help confirm the predictions of rising AUD and ALD as an immediate consequence of the COVID‐19 pandemic. This aftershock particularly affected ethnically diverse patients with ALD with high inpatient mortality, reflecting the disproportionate impact of COVID‐19 on underserved and minority populations. Alcohol relapse did not occur in long‐term early LT for AH recipients during the time of COVID‐19. This lends further support to AH being a viable indication for LT, with recipients able to demonstrate ongoing resilience in the face of this unprecedented universal stressor.

COVID-19 pandemic: Regarding alcohol consumption

IntroductionOn March, 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a global pandemic. Social isolation, unemployment and financial difficulties can have an impact on mental health and trigger the use of alcohol as a form of coping. Since the beginning of this pandemic, the WHO had warned the general public of the potential risks of increased alcohol consumption, which might result in a higher incidence of alcohol use disorders (AUD) in future.ObjectivesThe aim is to do a review of the literature of alcohol consumption during the COVID-19 pandemic.MethodsNon-systematic review of the literature with selection of scientific articles published in the last 7 months; by searching the Pubmed databases, the following MeSH terms were used: COVID-19; alcohol consumption.ResultsA recent article in The Lancet suggested that mental health and alcohol use during the pandemic, a major public health concern, are worthy of attention. Market research showed that alcohol sales increased in several countries compared to the same time last year. However, with the closure of several drinking places, sales are not in themselves reliable enough estimates of alcohol consumption. On the other hand, economic crises can lead to a reduction in alcohol consumption, due to financial problems or the risk of unemployment.ConclusionsThe present global circumstance is unique, and there is a need for further research on the relationship between alcohol consumption and COVID-19 to understand its long-term effects and develop specific prevention programs for this population.

A risk algorithm that predicts alcohol use disorders among college students.

The first year of college may carry especially high risk for onset of alcohol use disorders. We assessed the one-year incidence of alcohol use disorders (AUD) among incoming first-year students, predictors of AUD-incidence, prediction accuracy and population impact. A prospective cohort study of first-year college students (baseline: N = 5843; response rate = 51.8%; 1-year follow-up: n = 1959; conditional response rate = 41.6%) at a large university in Belgium was conducted. AUD were evaluated with the AUDIT and baseline predictors with the Composite International Diagnostic Interview Screening Scales (CIDI-SC). The one-year incidence of AUD was 3.9% (SE = 0.4). The most important individual-level baseline predictors of AUD incidence were being male (OR = 1.53; 95% CI = 1.12-2.10), a break-up with a romantic partner (OR = 1.67; 95% CI = 1.08-2.59), hazardous drinking (OR = 3.36; 95% CI = 1.31-8.63), and alcohol use characteristics at baseline (ORs between 1.29 and 1.38). Multivariate cross-validated prediction (cross-validated AUC = 0.887) shows that 55.5% of incident AUD cases occurred among the 10% of students at highest predicted risk (20.1% predicted incidence in this highest-risk subgroup). Four out of five students with incident AUD would hypothetically be preventable if baseline hazardous drinking was to be eliminated along with a reduction of one standard deviation in alcohol use characteristics scores, and another 15.0% would potentially be preventable if all 12-month stressful events were eliminated. Screening at college entrance is a promising strategy to identify students at risk of transitioning to more problematic drinking and AUD, thus improving the development and deployment of targeted preventive interventions.

Parenting and Home Environment in Childhood and Adolescence and Alcohol Use Disorder in Adulthood

PurposeParenting is a modifiable factor affecting the development of alcohol use disorder (AUD); however, the persistence of this effect into adulthood remains poorly understood. This study aimed to explore the longitudinal relationship between positive parenting and AUD in adulthood. MethodsData were gathered from the Christchurch Health and Development Study (CHDS), a birth cohort of 1,265 children born in Christchurch (New Zealand) in mid-1977. Positive parenting was quantified to age 16, and included the extent to which cohort members self-reported: high scores on measures of maternal and paternal care; low scores on a measure of maternal and paternal overprotection; high scores on a measure of parental attachment; low scores on a measure of parental intimate partner violence; and occasional or no use of physical punishment. Outcome measures were AUD incidence and symptoms at ages 15–35, with potential confounding factors and time-dynamic covariates included. ResultsThere was a significant association between positive parenting and AUD outcomes, with higher levels of positive parenting associated with a lower incidence of AUD and AUD symptoms. Controlling for confounding factors reduced the association between positive parenting and AUD outcomes, but they remained statistically significant. Adjustment for mental health, life stress, and employment reduced the magnitude of the association between positive parenting and alcohol outcomes to statistical nonsignificance. ConclusionsParenting factors in childhood and adolescence are linked to AUD outcomes in adulthood, as well as mental health, substance use, and life stress. Investment in positive parenting in adolescence may reduce AUD and associated harms in adulthood.

Risk of alcohol use disorders in patients with insomnia: A population-based retrospective cohort study

The aim of this study was to explore the risk of alcohol use disorders (AUDs) in patients with insomnia. This was a population-based retrospective cohort study based on data from 2000 to 2013. Data from the Taiwan National Health Insurance Research Database were employed for this study. A total of 8076 patients with insomnia were identified as the study group. The control group comprised 16,152 age- and sex-matched patients. We conducted a Cox proportional hazard regression analysis to estimate the effects of insomnia on the risk of AUDs. The overall incidence of AUDs was 753.71 per 100,000 person-years for patients with insomnia, which was significantly higher than the incidence for those in the control group (377.73 per 100,000 person-years). Overall, patients with insomnia had a higher risk of AUDs than did those in the control group (adjusted hazard ratio [HR]=1.75, 95% confidence interval [CI]=1.42-2.10). We also observed a significantly higher risk of AUDs in patients with both insomnia and depression (adjusted HR=5.85; 95% CI=3.13-8.88) than in those without these conditions. The risk of AUDs in patients with insomnia was found to be significantly higher than that in individuals in the control group; the risk was particularly pronounced among those with insomnia and depression. These conditions thus exhibited a joint effect on AUDs risk.

Determinants of new-onset alcohol use disorder in U.S. military veterans: Results from the National Health and Resilience in Veterans Study

BackgroundAlthough veterans are at increased risk of alcohol use disorder (AUD) relative to civilians, few longitudinal studies have examined both risk and protective factors that influence the development of AUD. This study aimed to identify risk and protective factors that contribute to incident AUD. MethodsData were analyzed from the National Health and Resilience in Veterans Study (NHRVS), a nationally representative, prospective cohort study of U.S. veterans. The sample included 1,770 veterans who did not meet criteria for lifetime AUD at Wave 1 and completed at least one follow-up assessment over a 7-year period. Veterans completed self-report measures to assess for risk and protective factors. A multivariable binary logistic regression analysis was conducted to examine baseline factors associated with incident AUD. ResultsA total of 5.9% of veterans without AUD at Wave 1 developed AUD in the 7-year follow-up period. Adult sexual trauma, greater severity of anxious arousal symptoms of PTSD, lifetime history of drug and nicotine use disorders, and higher alcohol consumption at Wave 1 were independently associated with incident AUD. Lifetime drug use disorder (75.9%) and higher alcohol consumption (22.1%) explained the most variance in incident AUD. ConclusionApproximately 6% of veterans without AUD at Wave 1 developed AUD over a 7-year period. Lifetime drug use disorder and greater alcohol consumption at baseline, as well as trauma-related characteristics (i.e., adult sexual trauma, anxious arousal symptoms), were associated with increased risk of developing AUD. Future research should examine whether treatment of drug use disorder and PTSD symptoms in at-risk veterans may help mitigate risk of developing AUD in this population.

Reacting to social discrimination? Men's individual and social risk behaviors in the context of a male marriage squeeze in rural China

RationaleIn China, a large number of men are being squeezed out of the marriage market due to a shortage of marriageable women. Previous research has largely discussed the consequences of gender imbalances and focused on the behavior of marriage-squeezed men that threatens public safety. No empirical studies explored the impact of the social environment on risky behaviors of marriage-squeezed men. ObjectiveThe main objective of this paper is to examine whether social discrimination is associated with marriage-squeezed men's engagement in the behaviors that threaten their own wellbeing and community safety. MethodUsing individual-level data collected in Chaohu City, Anhui, this study employed binary logistic regression and linear regression to examine the impacts of discrimination on alcohol use disorder and suicidal ideation, respectively. Ordinary least squares regression was performed to predict the effects of discrimination on gambling and verbal conflict based on village-level data collected in 380 villages across 18 provinces in China. ResultsThe results showed that self-reported discrimination was positively associated with incidence of alcohol use disorder and suicidal ideation among marriage-squeezed men; villagers' discrimination was also positively associated with the number of marriage-squeezed men in the village who often gambled or were in conflict with others. ConclusionsEvidence suggests that social discrimination is one important mechanism that triggers marriage-squeezed men to engage in risky behaviors that threaten self- and community safety. Commonly held stereotypes about rural bachelors is one of the reasons that causes marriage-squeezed men to pose a threat to public safety. It is necessary to develop and implement policies aimed at creating a friendly and tolerant social environment for marriage-squeezed men.

Epigenomic mechanisms of alcohol-induced impaired differentiation of skeletal muscle stem cells; role of Class IIA histone deacetylases

Loss of functional metabolic muscle mass remains a strong and consistent predictor of mortality among people living with human immunodeficiency virus (PLWH). PLWH have a higher incidence of alcohol use disorder (AUD), and myopathy is a significant clinical comorbidity due to AUD. One mechanism of skeletal muscle (SKM) mass maintenance and repair is by differentiation and fusion of satellite cells (SCs) to existing myofibers. Previous studies demonstrated that chronic binge alcohol (CBA) administration decreases SC differentiation potential, myogenic gene expression, and miR-206 expression in simian immunodeficiency virus (SIV)-infected male rhesus macaques and that miR-206 targets the Class IIA histone deacetylase, HDAC4. The aim of this study was to determine whether alcohol-induced increases in Class IIA HDACs mediate the observed decrease in differentiation potential of SCs. Data show that CBA dysregulated HDAC gene expression in SKM and myoblasts of SIV-infected macaques. CBA and antiretroviral therapy increased HDAC activity in SKM and this was positively correlated with HDAC4 gene expression. In vitro ethanol (ETOH) treatment increased HDAC expression during differentiation and decreased differentiation potential of myoblasts. HDAC expression was negatively correlated with fusion index and myotube formation, indicators of differentiation potential. Treatment with a Class II HDAC inhibitor, TMP195, restored differentiation in ETOH-treated myoblasts. MEF2C expression at day 3 of differentiation was positively correlated with fusion index and myotube formation. These findings suggest that an alcohol-mediated increase in Class IIA HDAC expression contributes to decreased myoblast differentiation by downregulating MEF2C, a transcription factor critical for myogenesis.