Alcoholic Men Research Articles

A Longitudinal Study of Competence in Elderly Veterans: The Role of Alcohol and Education

Follow-up examinations were made of 326 World War II veterans who had served in the Canadian army and for whom enlistment data were available for 1942-45. The veterans were classified into three groups on the basis of their alcohol-related behavior and educational attainments following military service. Eighteen men who had identified themselves as alcoholics were compared to 159 nonalcoholic men who had obtained post-service education and 149 nonalcoholic men who had not obtained post-service education. At time of enlistment the 159 nonalcoholic men who subsequently obtained additional education after their army service had not differed on socioeconomic background but had had significantly more years of education and had scored significantly higher on five of the eight subtests of the Army M test of intelligence than had the other two groups. Examination of current performance revealed that alcoholic and nonalcoholic men with no post-service education continued to function significantly more poorly on the same M Test subtests, and in addition functioned more poorly on socioeconomic criteria, daily functioning, adjustment and personality measures than did the group of veterans with post-service education. Compared to the nonalcoholic veterans who had not gained post-service additional education, the alcoholic group functioned more poorly on measures of health, coping with stress and adjustment. The results are discussed, emphasizing the influence of alcohol and education on psychological functioning in later life.

Gender-specific drinking styles in alcoholics and nonalcoholics.

This study examined sex differences in drinking style when considering both alcoholics and nonalcoholics (controls). The Alcohol Use Inventory was employed as a descriptive instrument. Of the 16 primary scales two results of significant interaction were obtained indicating sex differences in problem drinking practices corrected, as it were, for sex differences in normal drinking practices. Female alcoholics used alcohol to alter their mood more than did the alcoholic men, whereas women in the control group used it less for this purpose than did the male controls. The second interaction effect indicated that female alcoholics drank in response to marital difficulties much more than did male alcoholics. The control women, by contrast, demonstrated less of a likelihood to drink for this reason than did male controls.

Putative type II alcoholism characteristics in female third DUI offenders in Massachusetts: a pilot study

Women who come to the attention of the courts may exhibit heritable Type II alcoholism. Accumulating evidence indicates that more women report having alcoholic parents, that onset of women's alcohol problems before age 25 predicts greater severity of alcohol problems, that women most frequently acknowledge driving while intoxicated (DUI) as an alcohol-related problem, and that the percent of female arrests for DUI has increased. Alcoholic men have been classified as Type I (onset after age 25 and environmentally influenced) or Type II (onset before age 25 with impulsivity and criminal activity) alcoholics. Alcoholism in daughters of Type I fathers is said to occur after age 25 and to be shaped by environmental conditions, but it has been argued that daughters of Type II alcoholic fathers express their family histories in somatization. We report results from a pilot study that found putative Type II alcoholism characteristics, including early age of onset and inability to curtail drinking, in a sample of 12 incarcerated female third DUI offenders.

Sobriety, friends, and gay men

The purpose of this study was to learn how sobriety affected friendship circles of gay men recovering from alcoholism. Twenty gay recovering alcoholic men, each with at least 1 year of sobriety, were interviewed in depth. Before sobriety, the typical picture portrayed by the men was that of losing friends, having many heavily drinking acquaintances, and having difficulty meeting the responsibilities in friendships. In sobriety, the typical gay man realized that most of the gay men that he had thought were his friends were actually only drinking buddies. As sobriety time lengthened, the men reported expanding their friendship circles to include primarily gay men of Alcoholics Anonymous and others who were either normal drinkers or abstainers. Finally, nursing implications of this study are discussed.

Quantitative computed tomography for bone mineral measurement: technical aspects, dosimetry, normal data and clinical applications

A single KVp quantitative CT (QCT) technique was used for measuring the spinal trabecular bone density. The trabecular bone equivalent density (TBED) was expressed as the density of a K2HPO4 solution that exhibits a linear attenuation coefficient identical to that of trabecular bone. A field non-uniformity correcting factor was obtained from experiments on phantoms. The effective equivalent dose of the whole examination (four sections and a scout view) is 370 muSv. The in vivo short-term precision (reproducibility coefficient of variation) ranges from 1.4% to 4.1% depending on the TBED values of the normal subjects. The TBED was measured in 206 normal Greeks aged 30-69 years. Average TBED decreased with increasing age for both sexes. Analysis considering separately each vertebra showed a tendency to a caudal spinal TBED reduction. No correlation was found between the TBED values and the body habitus, milk consumption, smoking habits in men, and number of full-term pregnancies. A significant difference (p less than 0.01) was found between the TBED values of the normals and those of 50 women suffering from post-menopausal osteoporosis, 37 alcoholic men, and 12 gastrectomized men (Billroth II). Quantitative CT has been established as a method of measuring TBED in health and disease, and the results from this study confirm these applications.

Alcohol-Related Expectancies for Self and others Reported by Alcoholic Men and Women

A questionnaire used by Rohsenow in 1983 was administered to 87 alcoholic men and women taking part in rehabilitation programs at local Swedish outpatient rehabilitation clinics. The purpose was to explore their alcohol-related expectancies for themselves and for others and to compare these with the results from other similar studies in other cultures. The answers, scored according to Rohsenow's eight factors, indicated that alcoholics expected larger positive and negative effects for others than for themselves. This discrepancy was slightly modified by such variables as sex, age, and drinking habits. Alcoholics in Sweden seem to have alcohol-related expectancies similar to those of social drinkers both in Sweden and in other Western countries.

Circulating tumor necrosis factor, interleukin-1 and interleukin-6 concentrations in chronic alcoholic patients

Although altered cytokine homeostasis has been implicated in the pathogenesis of alcoholic liver disease, the relationship between cytokines and metabolic consequences of alcoholic liver disease is unknown. We, therefore, sought to correlate circulating concentrations of tumor necrosis factor-alpha, interleukin-1 and interleukin-6 to clinical and biochemical parameters of liver disease in chronic alcoholic patients. We used an enzyme-linked immunosorbent assay to measure plasma tumor necrosis factor and interleukin-1 and a bioassay to measure serum interleukin-6 in three groups of alcoholic men as follows: (a) actively drinking alcoholic men without evidence of chronic liver disease, (b) nondrinking alcoholic men with stable cirrhosis and (c) patients with acute alcoholic hepatitis. Mean cytokine concentrations were elevated in cirrhotic patients and alcoholic hepatitis patients compared with controls and alcoholic patients without liver disease. Tumor necrosis factor-alpha and interleukin-1 alpha concentrations remained elevated for up to 6 mo after diagnosis of alcoholic hepatitis, whereas interleukin-6 normalized in parallel with clinical recovery. Concentrations of all three cytokines were correlated with biochemical parameters of liver injury and hepatic protein synthesis plus serum immunoglobulin concentrations. We could not demonstrate a relationship between cytokine concentrations and peripheral endotoxemia. Percentages of peripheral blood monocytes that reacted with monoclonal antibodies to CD25 (interleukin-2 receptor) and human lymphocyte antigen-DR were similar for alcoholic patients and controls. These data suggest that tumor necrosis factor-alpha and interleukin-1 alpha are related to some of the metabolic consequences of both acute and chronic alcohol-induced liver disease, whereas interleukin-6 is related to abnormalities seen in acute liver injury.

Circulating tumor necrosis factor, interleukin-1 and interleukin-6 concentrations in chronic alcoholic patients

Although altered cytokine homeostasis has been implicated in the pathogenesis of alcoholic liver disease, the relationship between cytokines and metabolic consequences of alcoholic liver disease is unknown. We, therefore, sought to correlate circulating concentrations of tumor necrosis factor-α, interleukin-1 and interleukin-6 to clinical and biochemical parameters of liver disease in chronic alcoholic patients. We used an enzyme-linked immunosorbent assay to measure plasma tumor necrosis factor and interleukin-1 and a bioassay to measure serum interleukin-6 in three groups of alcoholic men as follows: (a) actively drinking alcoholic men without evidence of chronic liver disease, (b) nondrinking alcoholic men with stable cirrhosis and (c) patients with acute alcoholic hepatitis. Mean cytokine concentrations were elevated in cirrhotic patients and alcoholic hepatitis patients compared with controls and alcoholic patients without liver disease. Tumor necrosis factor-α and interleukin-1α concentrations remained elevated for up to 6 mo after diagnosis of alcoholic hepatitis, whereas interleukin-6 normalized in parallel with clinical recovery. Concentrations of all three cytokines were correlated with biochemical parameters of liver injury and hepatic protein synthesis plus serum immunoglobulin concentrations. We could not demonstrate a relationship between cytokine concentrations and peripheral endotoxemia. Percentages of peripheral blood monocytes that reacted with monoclonal antibodies to CD25 (interleukin-2 receptor) and human lymphocyte antigen-DR were similar for alcoholic patients and controls. These data suggest that tumor necrosis factor-α and interleukin-1α are related to some of the metabolic consequences of both acute and chronic alcohol-induced liver disease, whereas interleukin-6 is related to abnormalities seen in acute liver injury. (HEPATOLOGY 1991;13:267—276).

Adrenal function in abstinent alcoholic men

1. The nocturnal secretion of plasma ACTH and serum cortisol and their responses to ovine corticotropin-releasing hormone (oCRH) were studied in acutely abstinent alcoholic and normal men. 2. Nocturnal cortisol secretion was similar in alcoholic and normal men, but nocturnal ACTH secretion tended to be decreased during the early morning hours (0600h–0900h) in alcoholic men. ACTH, but not cortisol, responses after oCRH administration tended to be attenuated in alcoholic men. CLUSTER ANALYSIS showed that the changes were not due to alterations in ACTH pulse frequency, amplitude, or interpulse interval. 3. The data suggest an intrinsic defect in response to CRH by the pituitary corticotroph cell, possibly due to genetic vulnerability or to the toxic effects of prolonged alcohol abuse.

A rapid increase in lipoprotein (a) levels after ethanol withdrawal in alcoholic men

Plasma concentrations of lipoprotein (a) (Lp(a)) were studied in 11 male alcoholics at the end of a drinking period and monitored during subsequent abstinence. Lp(a) levels showed a daily increase for four consecutive days after the beginning of abstinence, the values for the third and the fourth day being significantly higher than those of the first day (p<0.05 and p<0.01, respectively). The changes in Lp(a) showed no association with the changes in low density lipoprotein (LDL) and high density lipoprotein (HDL) cholesterol levels. In one alcoholic subject with a heterozygous form of familial hypercholesterolemia who was monitored for 11 days, the Lp(a) levels rose up to the fourth day and remained at a high level thereafter. These results suggest that ethanol ingestion may be associated with a lowering of Lp(a) levels, which may contribute to the delayed progression of atherosclerosis observed in alcohol drinkers. Ethanol intake may be added to the short list of factors that affect the quite stable, genetically determined Lp(a) concentrations in the plasma.

Multiple Changes in Apoprotein B Containing Lipoproteins after Ethanol Withdrawal in Alcoholic Men

The plasma concentrations and chemical compositions of the apolipoprotein B containing lipoproteins (VLDL, IDL and LDL) were studied in 29 male alcoholic subjects at the end of a drinking period and in 17 healthy controls. No difference was found in the concentrations of plasma total cholesterol and triglyceride between the alcoholics and the controls, whereas plasma HDL cholesterol and VLDL triglycerides were 90% and 73%, respectively, higher in the alcoholics. The VLDL cholesterol:triglyceride ratio was reduced by 32%, whereas VLDL protein:cholesterol and phospholipid:cholesterol ratios were increased by 36% and 46%, respectively. IDL mass and protein concentrations, and particularly the fractional cholesteryl ester content of IDL tended to be low in the alcoholics. The plasma concentrations of all the LDL components except triglycerides were reduced in the alcoholics, resulting in a lower LDL cholesterol:triglyceride ratio. During the four day abstinence, when the lipoprotein values were followed in 15 alcoholic subjects, the abnormalities in VLDL composition and LDL plasma concentrations changed towards the values of the controls. In six alcoholic subjects who volunteered for LDL kinetic studies the fractional catabolic rate for LDL particles isolated immediately after the drinking period and seven days later were the same. These studies suggest that the alterations in all the apoB containing lipoproteins may contribute to the delayed progression of atherosclerosis observed in alcohol users.

Patient-treatment matching for alcoholic men in communication skills versus cognitive-behavioral mood management training

It would be helpful to be able to predict which alcoholics will be more likely to benefit from specific forms of treatment in order to optimize treatment resources. Certain hypothesized patient-treatment matching predictions were investigated with 52 alcoholics who received either communication skills training or cognitive behavioral mood management training in addition to a standard Veterans Administration inpatient alcoholism treatment program. Significant interaction effects showed that alcoholics had worse treatment outcomes in mood management training if they had higher initial anxiety or urge to drink in high-risk role plays or lower had higher initial anxiety or urge to drink in high-risk role plays or lower education. No significant interaction of treatment with irrational beliefs or marital status was found. Communication skills training seemed to be equally effective for alcoholics at any educational level, irrespective of initial coping skill, anxiety, urge to drink, alcohol dependence, or marital status. Thus, although mood management training seems to be as effective as communication skills training for alcoholics with higher education, less anxiety, and less urge to drink, communication skills training benefits a broader spectrum of patients, regardless of initial level of education, alcohol dependence, skill, anxiety, or beliefs.

Long-term predictors of outcome in abstinent alcoholic men

Twenty-nine alcoholic men who had been abstinent for more than 2 years were evaluated behaviorally and neuroendocrinologically and then followed for 2 years. Mean length of abstinence at intake was shorter in the eight patients with histories of depression (3.3 years) than in the patients without such histories (6.8 years). Six patients relapsed during follow-up, all of whom had been sober less than 5 years. None of the neuroendocrine variables studied was predictive of outcome. In summary, abstinence of less than 5 years and comorbidity with depression were most predictive of poor outcome.

Alcohol content of various beverages: All booze is created equal

After consuming comparable amounts of ethanol, women have higher blood ethanol concentrations than men, even with allowance for differences in size, and are more susceptible to alcoholic liver disease. Recently, we documented significant “first pass metabolism” of ethanol due to its oxidation by gastric tissue. We report a study of the possible contribution of this metabolism to the sex-related difference in blood alcohol concentrations in 20 men and 23 women. Six in each group were alcoholics. The first pass metabolism was determined on the basis of the difference in areas under the curves of blood alcohol concentrations after intravenous and oral administration of ethanol (0.3 g per kilogram of body weight). Alcohol dehydrogenase activity was also measured in endoscopic gastric biopsies. In nonalcoholic subjects, the first pass metabolism and gastric alcohol dehydrogenase activity of the women were 23 and 59 percent, respectively, of those in the men, and there was a significant correlation (r8 = 0.659) between first pass metabolism and gastric mucosal alcohol dehydrogenase activity. In the alcoholic men, the first pass metabolism and gastric alcohol dehydrogenase activity were about half those in the nonalcoholic men; in the alcoholic women, the gastric mucosal alcohol dehydrogenase activity was even lower than in the alcoholic men, and first-pass metabolism was virtually abolished. We conclude that the increased bioavailability of ethanol resulting from decreased gastric oxidation of ethanol may contribute to the enhanced vulnerability of women to acute and chronic complications of alcoholism.

Deranged Vitamin D Metabolism but Normal Bone Mineral Density in Finnish Noncirrhotic Male Alcoholics

To study the effect of prolonged ethanol consumption on calcium metabolism and on the prevalence of osteoporosis we examined 38 Finnish noncirrhotic male alcoholics (30-55 years of age) with dietary interviews and biochemical measurements and by measuring the bone mineral content of the forearm using single photon absorptiometry (SPA) and the bone mineral density of the spine, humerus and proximal femur using nonquantified computer tomography (CT) and dual-energy x-ray absorptiometry (DEXA). In comparison two groups of healthy controls were studied. The mean daily dietary intake of calcium was 1.3 g in the patients and 1.2 g in the controls. The dietary intake of vitamin D was equal in the study groups, too. The serum levels of calcium, phosphate and parathyroid hormone did not show any difference between the patients and controls but in the alcoholics the urinary excretion of calcium was reduced by 42% (p less than 0.0001) as compared to the controls. The serum levels of 25-hydroxyvitamin D3, 1,25-dihydroxyvitamin D3, and 24,25-dihydroxyvitamin D3 were reduced in the alcoholics by 40% (p less than 0.0001), 23% (p less than 0.01), and 48% (p less than 0.0001), respectively, as compared to the controls. The alcoholic men had normal levels of serum testosterone and they did not have hypercortisolism. The bone mineral content of the dominant forearm measured by SPA was similar in the study groups as were the bone mineral densities (BMD) of the lumbar and humeral areas measured by CT. The BMD at the lumbar, femoral neck, Ward's triangle and trochanter sites measured by DEXA did not differ, either.(ABSTRACT TRUNCATED AT 250 WORDS)

Higher blood alcohol levels in women than in men: Vive la petite diféfrence

After consuming comparable amounts of ethanol, women have higher blood ethanol concentrations than men, even with allowance for differences in size, and are more susceptible to alcoholic liver disease. Recently, we documented significant “first-pass metabolism” of ethanol due to its oxidation by gastric tissue. We report a study of the possible contribution of this metabolism to the sex-related difference in blood alcohol concentrations in 20 men and 23 women. Six in each group were alcoholics. The first-pass metabolism was determined on the basis of the difference in areas under the curves of blood alcohol concentrations after intravenous and oral administration of ethanol (0.3 g per kilogram of body weight). Alcohol dehydrogenase activity was also measured in endoscopic gastric biopsies. In nonalcoholic subjects, the first-pass metabolism and gastric alcohol dehydrogenase activity of the women were 23 and 59 percent, respectively, of those in the men, and there was a significant correlation (r8 = 0.659) between first-pass metabolism and gastric mucosal alcohol dehydrogenase activity. In the alcoholic men, the first-pass metabolism and gastric alcohol dehydrogenase activity were about half those in the nonalcoholic men; in the alcoholic women, the gastric mucosal alcohol dehydrogenase activity was even lower than in the alcoholic men, and first-pass metabolism was virtually abolished. We conclude that the increased bioavailability of ethanol resulting from decreased gastric oxidation of ethanol may contribute to the enhanced vulnerability of women to acute and chronic complications of alcoholism.

Effect of combined substance use on laboratory markers of alcoholism.

This article examines the commonly used laboratory indicators of heavy alcohol use (elevated MCV, GGTP and AST values) in subgroups of drug-using and non-drug-using alcoholic men admitted to an inpatient alcoholism treatment program. A total of 380 consecutive admissions meeting DSM-III diagnostic criteria for alcohol use or dependence were studied. Of these subjects, 75% used both alcohol and drugs. The most frequently used drugs were marijuana, cocaine, amphetamines and tranquilizers. Overall, subjects who used drugs with alcohol had significantly lower MCV and GGTP values than subjects who used alcohol alone. More specifically, cocaine use was associated with lower MCV values, marijuana use with lower AST values and heroin use with higher AST and GGTP values. These differences between drug-using and non-drug-using alcoholics were significant even after controlling for variables that affect the laboratory values such as age, quantity, frequency and duration of alcohol consumption. These findings indicate that any study of laboratory markers of alcoholism needs to consider concomitant illicit drug use patterns.

SERUM AND URINARY β-HEXOSAMINIDASE AS MARKERS OF HEAVY DRINKING

Serum and urinary beta-hexosaminidase (SHEX and UHEX) were determined in 32 alcoholic men admitted to inpatient detoxification treatment for seven days, and in 27 teetotallers. On the admission SHEX was increased in 68.8% and UHEX in 81.3% and after seven days of abstinence the corresponding percentages were 37.5 (SHEX) and 71.9 (UHEX). During the treatment SHEX decreased significantly while UHEX did not. On the admission to the treatment UHEX correlated positively with SHEX (r = 0.54; P less than 0.01). The results suggest that UHEX may be a more sensitive marker of heavy drinking than SHEX. Furthermore UHEX stays longer elevated than SHEX.

Hypothalamic‐Pituitary and Thyroid Function in Chronic Alcoholics with Neurological Complications

Endocrinological tests were performed in 14 chronic alcoholic men with signs of intellectual impairment and/or peripheral neuropathy. All had been abstinent from alcohol for at least 1 month. Basal serum growth hormone (GH) was consistently increased in only one patient whereas the GH responses to insulin hypoglycemia stimulation was normal in all patients. Thyroid function values (T4, T3, rT3, TSH) were normal in all patients whereas baseline serum prolactin values were significantly increased in alcoholics as compared with a control group. In a combined TRH- and GnRH-stimulation tests, GH-responses were also normal whereas TSH and prolactin responses were blunted or absent in about half of the patients, the responses correlating significantly (p less than 0.01). It is concluded that disturbances in the hypothalamic-pituitary axis may occur in chronic alcoholics with nervous impairment independently of the physical deterioration, which often is associated with chronic alcoholism.

Treatment Response of Severe and Nonsevere Personality Disorders in a Therapeutic Community Day Unit

The purpose of this study was to determine if personality characteristics identified by Millon (1983) as strongly predisposing to enduring depression are useful in discriminating between transient and enduring depression in alcoholic women. A strong association was found between scores on a scale measuring passive-aggressive personality features and enduring depression among women completing treatment for alcohol abuse. Enduring depression among the alcoholic women in this study was also moderately associated with scores on a scale measuring avoidant personality features. Transient depression was positively associated with scores on a scale gauging compulsive—conforming characteristics. Results of this study of alcoholic women are generally consistent with the results of McMahon and Davidson's (1985) investigation of alcoholic men in indicating that personality factors usefully discriminate between transient and enduring depression.