Early Onset Drinkers Research Articles

Latent Class Analysis for Repeatedly Measured Multiple Latent Class Variables

Research on stage-sequential shifts across multiple latent classes can be challenging in part because it may not be possible to observe the particular stage-sequential pattern of a single latent class variable directly. In addition, one latent class variable may affect or be affected by other latent class variables and the associations among multiple latent class variables are not likely to be directly observed either. To address this difficulty, we propose a multivariate latent class analysis for longitudinal data, joint latent class profile analysis (JLCPA), which provides a principle for the systematic identification of not only associations among multiple discrete latent variables but sequential patterns of those associations. We also propose the recursive formula to the EM algorithm to overcome the computational burden in estimating the model parameters, and our simulation study shows that the proposed algorithm is much faster in computing estimates than the standard EM method. In this work, we apply a JLCPA using data from the National Longitudinal Survey of Youth 1997 in order to investigate the multiple drug-taking behavior of early-onset drinkers from their adolescence, via young adulthood, to adulthood.

Pattern and risk of developing alcohol use disorders, illegal substance use and psychiatric disorders after early onset of alcohol use: Results of the Thai National Mental Health Survey 2013

IntroductionAlthough underage drinking is a global concern, little is known about the relationship between age at first drink and development of various psychiatric comorbidities. MethodsA secondary data analysis was done among 2928 lifetime drinkers from the Thai National Mental Health Survey 2013. Age at first drink, and onset of related psychiatric outcomes were inquired. Survival analysis using Cox regression was performed to estimate the risk over time for psychiatric problems across age ranges at first drink. ResultsTwo-thirds of male and one-third of female drinkers were considered underage at drinking onset. Substance use and abuse developed earlier (<5 years) than alcohol use disorders (AUDs) and other outcomes (mostly >10 years). Those who started drinking before age 15 years were more likely to develop use of cannabis (HR=4.75; 95% CI 2.73, 8.24), club drugs (HR=2.88; 95% CI 1.46, 5.71) and inhalants (HR=6.46; 95% CI% 1.64, 25.37), compared to those who were 20 years or older at drinking onset. Using age as an alternative time-scale, those aged <15years at drinking onset were significantly more likely to experience AUDs, psychotic symptoms, intermittent explosive disorder and panic disorder. However, the early onset drinkers were less likely to develop depression compared to those who started at age 20 years and over. ConclusionPremature alcohol consumption tends to be a gateway to various serious consequences. Efforts of such drinking age policy and interventions are needed to address vulnerable young populations.

Early Onset Drinking Predicts Greater Level But Not Growth of Alcohol-Induced Blackouts Beyond the Effect of Binge Drinking During Emerging Adulthood.

Early onset drinking is associated with later heavy drinking and related consequences. Early drinking onset and binge drinking are also independently associated with blackouts, which are periods of amnesia for events during a drinking episode. The objective of this study was to examine how early onset drinking relates to changes in the frequency of experiencing blackouts across 3years controlling for year-specific binge drinking. Participants (N=1,145; 67.9% female) from a 6-year, longitudinal study are included in these analyses. Measures of self-reported age at drinking onset included ages at first drink, first high, and first drunk, which were used to create a latent early onset drinking factor. Frequency of binge drinking and blackouts were assessed annually during Years 4 to 6. Overall, 69.2% of participants reported experiencing blackouts. After controlling for year-specific binge drinking, a growth curve model indicated that early onset drinkers reported more frequent blackouts at Year 4. There were, however, no significant effects of acceleration or deceleration in the frequency of blackouts across the 3years. Early onset drinkers continued to experience more frequent blackouts compared with those who initiated alcohol use later, despite decreases in binge drinking over time. Early onset drinkers reported more frequent blackouts across all 3years, indicating that early alcohol initiation predisposes those individuals to continue to experience more frequent blackouts, despite a decrease in their binge drinking. This may be due to various factors, such as altered hippocampal development and functioning resulting from early alcohol exposure.

Relationship between early symptoms of alcohol craving and binge drinking 2.5 years later

BackgroundThe first self-reported symptoms of nicotine dependence (e.g., as craving) can appear within days to weeks of the onset of occasional use, and the appearance of symptoms predicts future consumption and dependence. We sought to determine whether craving for alcohol occurs in early stages of adolescent alcohol use, and whether it predicts future binge drinking, a prevalent and problematic behavior. MethodsLongitudinal (30-month) four-wave study of 3415 students (M=12.5 years at baseline) from 29 German schools. Students reported five symptoms of alcohol craving on a scale developed based on well-validated measures for tobacco. Multilevel mixed-effects logistic regression was used to predict having five or more binge episodes by last follow-up, based on the number of symptoms reported before the first lifetime binge. Multiple imputation was used to address study drop-out. ResultsAt baseline, 23% reported at least one symptom, increasing to 54% at wave 4. Any report of symptoms at baseline was associated with frequency of alcohol use, being present in 100% of daily, 93% of weekly, 87% of monthly, 48% of infrequent drinkers, and 16% of ever drinkers reporting no current alcohol use. Moreover, symptoms at baseline independently predicted frequent binge drinking 2.5 years later, AOR=2.08 (95% CI 1.39, 3.11; p<0.001) among baseline never-bingers, after adjusting for covariates. ConclusionsSome early-onset drinkers reported symptoms of alcohol craving and loss of control after minimal exposure to alcohol. If replicated, an early screener could be developed to identify those at risk for frequent binge drinking.

Shared genetic contributions to early-onset drinking and drinking to cope motives

IntroductionRecent evidence from empirical studies indicates that individuals who begin drinking at an early age may be more likely to use alcohol to cope with negative mood states and stress; however, the mechanisms underlying this association are unclear. One possibility is that early drinking directly increases risk for drinking to cope (DTC). Alternatively, the association between early drinking and DTC may be indirect, attributable to overlapping genetic or environmental factors. No prior genetically informative study has investigated the sources of covariation underlying the early-onset drinking-DTC association. MethodEarly-onset drinking (before age 15) was assessed using structured clinical interviews in a sample of 7130 male and female participants aged 19–56years from the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders (VATSPSUD, Kendler & Prescott, 2006). DTC was assessed using the mood management scale of the alcohol use inventory (Horn & Wanberg, 1983). The sources of the covariation between early first drink and DTC were estimated using bivariate twin modeling. ResultsEarly drinking onset was reported by 28% of males and 16% of females and was associated with significantly higher DTC scores (phenotypic correlation: males=.19, females=.22). Results from bivariate twin models indicated that the association between early-onset drinking and DTC was completely attributable to shared genetic factors that contribute to both behaviors. ConclusionsGreater DTC among early-onset drinkers may not reflect a direct causal process, as shared biological pathways may explain vulnerability to stress-related drinking seen among early-onset drinkers.

The effects of age at drinking onset and stressful life events on alcohol use in adulthood: a replication and extension using a population-based twin sample.

A study by Dawson and colleagues (Alcohol Clin Exp Res 2007; 31:69) using data from National Epidemiologic Survey on Alcohol and Related Condition found earlier drinking onset age, and higher levels of past-year stressful life events (SLE) were associated with higher past-year alcohol consumption. The aims of our study were as follows: (i) to attempt to replicate this interaction; (ii) to extend it by examining sex and event dependence as potential moderators of the effect; and (iii) to estimate the roles of genetic and environmental factors in mediating the overlap of early drinking onset and SLE in their relations with alcohol consumption. Data were from 1,382 female and 2,218 male drinkers interviewed as part of the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders. Regression models were used to evaluate the main and interactive effects of early drinking onset and moderate or severe past-year SLE on past-year drinking density (PYDD), a weighted quantity-frequency measure of alcohol consumption. Analyses adjusted for demographic covariates and were stratified by sex and whether SLE were independent or dependent on the person's actions, as rated by interviewers. Structural twin models were used to estimate the degree to which early drinking onset, SLE, and their interaction accounted for additive genetic, common environmental and individual-specific variance in PYDD. We replicated the prior finding of a main effect of higher alcohol consumption among individuals reporting earlier drinking onset. Age at drinking onset accounted for about 5% of the variation in PYDD, and this association was mostly attributable to overlapping genetic influences. Evidence for an interaction between onset age and SLE was generally weak, possibly because of lower power and other methodological differences from Dawson and colleagues' study. However, there was some evidence consistent with an interaction of higher PYDD among early drinking men who experienced independent SLE and early drinking women with dependent SLE. We confirmed prior findings of an association between early age at drinking onset with higher past-year drinking among young- and middle-aged adults and found limited evidence supporting a replication for higher stress-related drinking among early-onset drinkers. The association is consistent with early onset and stress-related drinking being attributable to overlapping genetic liability. Among early drinkers, our results suggest sex differences in consumption with regard to event dependence.

Multiple-Group Latent Transition Model for the Analysis of Sequential Patterns of Early-Onset Drinking Behaviors among U.S. Adolescents

We investigate the latent stage-sequential patterns of drinking behaviors of U.S. adolescents who have started to drink by age 14 years (seven years before the legal drinking age). A multiple-group latent transition analysis(LTA) with logistic regression is employed to identify the subsequent patterns of drinking behaviors among early-onset drinkers. A sample of 1407 early-onset adolescents from the National Longitudinal Survey of Youth(NLSY97) is analyzed using maximum-likelihood estimation. The analysis demonstrates that early-onset adolescents' drinking behaviors can be represented by four latent classes and their prevalence and transition are influenced by demographic factors of gender, age, and race.

Correlates of Alcohol Abuse/Dependence in Early-Onset Alcohol-Using Women

Early-onset alcohol use is associated with increased vulnerability to subsequent alcohol abuse and dependence. However, not all early-onset alcohol users develop alcohol use disorders (AUDs). Using a sample of young women from the United States, we identify correlates that contribute to a greater likelihood of AUDs in early-onset alcohol users. Using interview and questionnaire data on participants of the Missouri Adolescent Female Twin Study (MOAFTS), we examine whether measures from domains including sociodemographic, pubertal development, religiosity, educational achievement, adverse life events, internalizing disorders, externalizing disorders, and family history and discipline were associated with development of AUDs in 1,158 women who had their first drink of alcohol prior to age 16. Early-onset drinkers were 3.6 times more likely to meet criteria for AUDs than later onset drinkers. While univariate analyses revealed that a host of correlates were associated with likelihood of AUDs in early-onset drinkers, multivariate analyses suggested that, even after accounting for a particularly early age of onset of drinking, those with a history of physical abuse, cotwin alcohol problems, conduct disorder, regular smoking, older peers, and peer substance use were considerably more likely to meet criteria for AUDs than early-onset drinkers without a lifetime history of these correlates. The progression from first drink to AUDs is complex, and while early age at first drink is a potent risk factor, other aspects of psychopathology, family history, conduct problems, and peer affiliations can exacerbate or alleviate the risk of AUDs in these young female drinkers.

Impact of Motivational Changes on Drinking Outcomes in Pharmacobehavioral Treatment for Alcohol Dependence

Psychological factors such as motivation to change and self-efficacy influence drinking outcomes in alcohol-dependent individuals who are enrolled in pharmacobehavioral studies. Previous results from our research clinic indicated that initial stage of change of heavy drinkers enrolled in a pharmacobehavioral trial was significantly associated with alcohol consumption. However, overall empirical findings regarding the consistency and extent of the connection between motivational factors and behavior are mixed. This may be in part because of the impact of changes in motivation over the course of treatment and/or characteristics of the individuals receiving the intervention. Our goal in the present study was to examine the extent to which levels of motivation and self-efficacy changed during the treatment phase of a pharmacobehavioral treatment trial, and the extent to which these variables affected drinking behavior in subsets of alcohol-dependent individuals. We conducted an exploratory evaluation of changes in motivation, temptation to drink, confidence to abstain, and drinking behavior over time during the treatment phase of a pharmacobehavioral study involving 321 alcohol-dependent individuals. We also examined the extent to which individual variables such as initial drinking severity, onset of alcohol dependence, and medication status influenced changes in motivation, self-efficacy, and drinking behavior. Participants reported improvements in motivation to change, self-efficacy for change, and drinking behaviors over the course of treatment. As hypothesized, motivation to change and self-efficacy for change were related to specific dimensions of posttreatment drinking. Heavy drinkers reported more improvement in drinking behaviors than did nonheavy drinkers. Early-onset drinkers who were on medication reduced their drinking more than those on placebo, and these drinking changes appear to be partially mediated by reductions in temptation. Reductions in drinking occur and are predicted by increased motivation to change, reduced temptation to drink, and increased confidence to abstain in this population of alcoholic-dependent individuals. Early and late onset and heavy drinkers and those taking medications displayed differential changes in drinking behavior, some of which were explained by the mediating effects of self-efficacy. This is a first step in understanding more about which alcoholic individuals respond best to treatment and what mechanisms may be involved in the changes in drinking and drinking-specific changes in frequency and intensity of drinking.

Latent class profile analysis: an application to stage-sequential process in early-onset drinking behaviours.

Earlier age of drinking is a well-known predictor for a variety of adverse public health consequences in the United States and worldwide. In longitudinal research on early-onset drinkers, a great deal of attention has been paid to the identification of subgroups of individuals who follow similar sequential patterns of drinking behaviours. However, research on the sequential development of drinking behaviour can be challenging in part because it may not be possible to directly observe the particular drinking behaviour stage at a given point in time. To address this difficulty, one can use a latent class analysis (LCA) approach, which provides a set of principles for the systematic identification of homogeneous subgroups of individuals. We apply an LCA approach in an investigation of stage-sequential patterns of drinking behaviours among early-onset drinkers from early to late adolescence, using data from the 'National Longitudinal Survey of Youth 1997.' In this work, an identification procedure is used to sort different patterns of drinking behaviours into a small number of classes, based on responses to questions about drinking at each measurement occasion; with class assignment, next the class sequencing of early-onset drinkers over the entire set of time points is evaluated in order to identify two or more homogeneous subgroups. A condition to be satisfied is that all early-onset drinkers in a subgroup should exhibit a similar sequence of class memberships over time. This approach uncovers four common drinking behaviours in early-onset drinkers over three measurements from 1997 through 2003. The sequences of drinking behaviours can be grouped into three groups of sequential patterns representing the most probable progression of early-onset drinking behaviours.

Alcohol: Crossroads Between Nursing Research and Psychiatric Nursing Practice

This special issue of the Journal of the American Psychiatric Nurses Association highlights research related to alcohol use and abuse and the associated adverse social, behavioral, economic, and health outcomes. Alcohol is the most commonly abused substance. The lifetime prevalence rate for alcohol use disorder is considerably higher among persons with psychiatric disorders than among persons in the general U.S. population. As such, alcohol is a topic of great concern to psychiatric nurses. In this issue, Goldstein and colleagues examined rates and types of additional psychiatric disorders among persons who had posttraumatic stress disorder (PTSD) plus antisocial personality disorder (ASPD), adult-onset antisocial behavior syndrome, or no antisocial behavior. The data for this article were drawn from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Goldstein and colleagues note that because persons with antisocial syndromes (ASPD or adult-onset antisocial behavior) had higher odds of alcohol use disorders and other psychiatric disorders compared with those with no antisocial behavior, nurses need to carefully assess persons with PTSD for co-occurring antisocial behavior and other comorbid conditions. In the article titled “Alcohol and Violence-Related Injuries Among Emergency Room Patients in an International Perspective,” Cherpitel and Ye present data substantiating the global and strong relationship between recent alcohol consumption and violence-related injuries among emergency room patients. In this article, data are reported from 15 countries comprising the Emergency Room Collaboration Alcohol Analysis Project and the World Health Organization Collaborative Study on Alcohol and Injury. The magnitude of the relative risk for alcohol drinking associated violence-related injuries varied among countries. However, the relative risk for violencerelated injury because of drinking prior to the emergency room admission was more than five times greater than risk for injuries because of other causes. These data suggest an urgent need for global educational programs to raise awareness about the strong relationship between alcohol and violence-related injuries. In a relatively new APNA initiative, Buccola, Rosedale, and Bryan wrote a “Clinical Translation” of Cherpitel and Ye’s research article. They clearly articulate that nurses bring a specialized skill set of screening, brief interventions, motivational interviewing, and crisis intervention that can help patients recognize the risks associated with alcohol use/abuse. They also highlight the role of nurses in caring for the “whole patient.” In the article titled “Early Drinking and Its Association With Adolescents’ Participation in Risky Behaviors,” Calvert and colleagues conducted a secondary data analysis using data from the first wave of the Missouri Family Study, which is an ongoing prospective community-based family study designed to examine familial influences on health compromising behaviors among adolescent offspring. Cigarette smoking and marijuana use were significantly more common among early onset drinkers (age 12 or younger) compared with later-onset drinkers. Early drinking was also associated with other adverse health behaviors including disordered eating behavior, having sex, having multiple sex partners, and having sex without a condom. These findings continue to support the need for practitioners to screen for alcohol use as well as the use of other drugs such as marijuana and tobacco among adolescents. These data also support routine screening for other adverse health behaviors. Alcohol dependence among women and alcohol use among girls are areas of growing concern. Corte, Rongmuang, and Stein review the nursing empirical literature on alcohol and women’s health published over the past 5 years. They summarize findings related to (a) determinants of alcohol use and alcohol problems; (b) patterns of use, assessment of alcohol use, and comorbidity; (c) consequences of alcohol use; and (d) the effects of treatment or specific interventions. They also propose a research agenda for nursing that addresses the most pressing issues related to alcohol use and alcohol problems in women. As can be seen in the articles in this special issue, psychiatric nurses have a particularly important role in identifying persons at risk across the lifespan, caring for persons who have alcohol use disorders and their families, educating nurses and other health care providers, and collaborating in or conducting alcohol-related nursing research.

Components of Negative Affect As Moderators of the Relationship Between Early Drinking Onset and Binge-Drinking Behavior

This study examines the moderating effects of negative affect on the relationship between early drinking onset and binge-drinking behavior. Six hundred and thirty-five eleventh- and twelfth-grade students completed the American Drug and Alcohol Survey and reported on a variety of measures, including items assessing anxiety, anger, depression, age first drunk, and current level of binge drinking. Results indicate that males that began drinking at age 12 or younger and reported higher levels of anxiety and depression showed higher current levels of binge drinking compared to later onset drinking males. In addition, female early onset drinkers with higher levels of anger showed lower current levels of binge drinking compared to later onset drinking females. Results are discussed in regard to understanding and preventing binge-drinking behavior.

Relationship of Age of First Drink to Alcohol-Related Consequences Among College Students with Unhealthy Alcohol Use

ABSTRACT This study investigated the relationship between age of first drink (AFD) and a broad range of negative alcohol-related outcomes among college students exhibiting unhealthy alcohol use. We conducted an anonymous on-line survey to collect self-report data from first-year college students at a large northeastern university. Among 1,792 respondents who reported ever drinking, 14% reported an AFD before age 14. These early onset drinkers were more likely than later onset drinkers to report frequent drinking, heavy drinking, and other unhealthy alcohol use behaviors. Among the subset of drinkers with unhealthy alcohol use (36%), early drinkers were more likely than later onset drinkers to report experiencing five out of 13 alcohol-related consequences, including driving while intoxicated, missing work or school due to drinking, getting into trouble at work or school due to drinking, receiving lower grades than they should have due to drinking, and developing a tolerance to alcohol.

Evolution of the DRD2 gene haplotype and its association with alcoholism in Mexican Americans

The human D2 dopamine receptor gene ( DRD2) plays a central role in the neuromodulation of appetitive behaviors and is implicated in having a possible role in susceptibility to alcoholism. We genotyped an SNP in DRD2 Exon 8 in 251 nonalcoholic, unrelated, healthy controls and 200 alcoholic Mexican Americans. The DRD2 haplotypes were analyzed using the Exon 8 genotype in combination with five other SNP genotypes, which were obtained from our previous study. The ancestral origins of the DRD2 polymorphisms have been determined by sequencing the homologous region in other higher primates. Twenty DRD2 haplotypes, defined as H1 to H20 based on their frequency from high to low, were obtained in this major minority population. The ancestral haplotype “I-B2-G-C-G-A1” and two one-step mutation haplotypes were absent in our study population. The haplotype H1, “I-B1-T-C-A-A1”, with the highest frequency in the population, is a three-step mutation from the ancestral form. The first five or eight major haplotypes make up 87% or 95% of the entire population, respectively. The prevalence of the haplotype H1+ (H1/H1 and H1/Hn genotypes) is significantly higher in alcoholics and alcoholic subgroups, including early onset drinkers and benders, than in their respective control groups. The Promoter −141C allele is in linkage disequilibrium (LD) with five other loci in the nonalcoholic group, but not in the alcoholic group. All of the other five loci are in LD in both the alcoholic and control groups. The DRD2 TaqI B allele is in complete LD with the allele located in intron 6. Five SNPs, Promoter −141C, TaqI B (or Intron 6), Exon 7, Exon 8, and TaqI A, are sufficient to define the DRD2 haplotypes in Mexican Americans. Our data indicate that the DRD2 haplotypes are associated with alcoholism in Mexican Americans.

Alcohol consumption debut: predictors and consequences.

The aim of this study was to investigate the predictors of the timing of alcohol consumption debut and to analyze possible associations between the timing of debut and later alcohol consumption and possible alcohol-related problems. A population sample of 465 adolescents (249 girls) from the greater Oslo area was followed up through five data collections over a 6-year span. By means of generalized structural equation modeling--accommodating survival variables--parental and friends' influences on debut age were estimated. Further, the consequences of the age of debut on subsequent alcohol consumption and alcohol problems were studied, taking other influences into consideration. In particular, possible gender differences were investigated. The mean age for alcohol consumption debut was 14.8 years. The age of alcohol debut had an independent effect on both future alcohol consumption and the development of alcohol-related problems, and the effects were invariant across sex. According to the estimated model, a 10% delay in debut age will lead to a 35% decrease in subsequent expected alcohol consumption. Alcohol debut was an excellent predictor of subsequent alcohol consumption and alcohol problems. The strong preventive implication is that interventions should be implemented in order to postpone alcohol debut age. A weak implication is that preventive measures should be implemented for the early onset drinkers. Further, it seems to be important to give high priority to more thorough studies on the exact nature of the relationships we have investigated here.

Convergent validity of DSM-III-R and DSM-IV alcohol dependence: results from the National Longitudinal Alcohol Epidemiologic Survey.

The purpose of this study was to separately examine the associations between ethanol intake and alcohol dependence, as defined in the DSM-III-R and DSM-IV, in conjunction with an identical set of external correlates, with a view toward assessing the convergent validity of the two diagnostic definitions of dependence. Although the sociodemographic, alcohol, drug and comorbid profiles of respondents classified as DSM-III-R and DSM-IV dependent were similar, the results of the linear logistic regression analyses differed for each of the diagnostic definitions. The risk of DSM-III-R dependence was reduced among blacks and increased among early onset drinkers. Given equivalent levels of ethanol intake, the risk of DSM-III-R dependence was greater for these respondents who had experienced a recent death of close relative compared to those who had not. In contrast, the risk of DSM-IV dependence was greatest among respondents with a current alcoholic spouse or partner relative to those without an alcoholic spouse or partner. Major differences in the content and structure of the two definitions of dependence were useful in predicting the observed discrepancies between the risk gradients associated with the DSM-III-R and DSM-IV classifications. Implications of these findings were discussed in terms of differential coverage of the DSM-III-R and DSM-IV diagnostic categories and the impact of the absence of complete convergent validity on epidemiologic research.

Remission of Late‐Life Drinking Problems: A 4‐ Year Follow‐up

This 4-year follow-up study compared stably remitted late-life problem drinkers to nonremitted problem drinkers and nonproblem drinkers. At time 1, to-be-remitted drinkers reported less alcohol consumption and fewer drinking problems, more depression and less self-confidence, less spousal support and approval of drinking from friends, and more help-seeking than did to-be-nonremitted drinkers. Remitted drinkers showed improvement in functioning and life context at the 4-year follow-up, but compared with nonproblem drinkers some deficits persisted. Stable remission and abstinence among late-onset drinkers were closely tied to receiving less spousal support and approval from friends for drinking at time 1, whereas help-seeking was a strong predictor of stable remission and abstinence among early-onset problem drinkers. For both late- and early-onset drinkers, abstinence was predicted by initially having more drinking problems, depression, and health stressors.

Personality characteristics of male alcoholics.

48 alcoholics who were administered the California Psychological Inventory were distinguished from 24 normals on the Socialization and Self-control scales. Early- and late-onset drinkers were also differentiated on several measures, suggesting that the late-onset drinkers are acutely disturbed while the early-onset drinkers are less consistent and exhibit disorders relating to personality organization.