Family History Of Problem Drinking Research Articles

Clinical moderators of response to nalmefene in a randomized-controlled trial for alcohol dependence: An exploratory analysis

BackgroundNalmefene is the only medication marketed to reduce the consumption of alcohol in patients with alcohol dependence, but it remains unclear which patients could most benefit from it. This study aimed to identify clinical moderators that affect treatment response to nalmefene in patients with alcohol dependence. MethodsIn a multicenter, randomized, controlled, double-blind, phase 3 study of nalmefene on Japanese patients with alcohol dependence, the relationship between the reduction of heavy drinking days (HDD) and total alcohol consumption (TAC) at 12 and 24 weeks of treatment and baseline variables of the participants were analyzed in a linear regression and multiple adjusted analysis. ResultsAge < 65, no family history of problem drinking, age at onset of problem drinking ≥ 25, and not currently smoking were possible positive moderators. Nalmefene showed a significant HDD reduction in patients with age < 65 or no family history of problem drinking, and a significant TAC reduction in patients with age at onset of problem drinking ≥ 25 or who were not currently smoking. After multiple adjusted analyses, age < 65 (p = .028), no family history of problem drinking (p = .047), and age at onset of problem drinking ≥ 25 (p = .030) were statistically significant. Not currently smoking (p = .071) was marginally significant. In combination, these moderators indicated synergistic effects. ConclusionsAlcohol-dependent patients with favorable prognostic factors such as non-smoking status, no family history of problem drinking, and a late-onset of problem drinking selectively benefit from nalmefene. Further research is needed to validate these exploratory results.

Change in implicit alcohol associations over time: Moderation by drinking history and gender

Implicit measures of alcohol-related associations or implicit alcohol associations are associated with drinking outcomes over time and can be understood as vulnerability markers for problem drinking. Longitudinal research remains rare, leaving open questions about how implicit alcohol associations themselves change over time and what factors moderate that change. We examined these questions with data from a larger study of first and second year U.S. college students. We investigated how these implicit alcohol associations change over time and potential moderators of those changes (gender, lifetime drinking history, family history of problem drinking, and class standing). A sample of 506 students (57% women) completed baseline demographic measures and implicit measures (variants of the Implicit Association Test [IAT]) assessing associations with drinking and the self [drinking identity], alcohol and excite [alcohol-excite], and alcohol and approach [alcohol-approach]). IATs were completed at 3-month intervals for a total of 8 assessments. Results indicated small, but significant, change in alcohol-excite and alcohol-approach IAT scores over time, and mixed findings for hypothesized moderators. Drinking history moderated change in drinking identity IAT scores, with increases over time among individuals with no history of drinking or no history of intoxication and decreases among individuals with a history of intoxication. Gender moderated change in alcohol-excite IAT scores with greater change among women (vs. men). No significant moderators of change in alcohol approach IAT scores were found. Results point to the importance of evaluating implicit associations’ trajectories and identifying additional factors that predict those trajectories and concomitant vulnerability to problem drinking.

Characterizing a Hidden Group of At-Risk Drinkers: Epidemiological Profiles of Alcohol-Use Disorder Diagnostic Orphans

ABSTRACTBackground: Drinkers who report some symptoms of alcohol-use disorder (AUD) but fail to meet full criteria are “diagnostic orphans.” To improve risk-reduction efforts, we sought to develop better epidemiologic profiles of this underrecognized subgroup. Methods: This study estimated the population prevalence and described AUD symptoms of diagnostic orphans using the 2012–2013 National Epidemiological Survey of Alcohol and Related Conditions-III. Multivariate logistic regression was used to model odds of being a diagnostic orphan or meeting mild, moderate, and severe AUD criteria versus no AUD symptoms. Models were adjusted for the complex survey design using sampling weights and survey procedures (e.g., proc surveylogistic). Results: Among drinkers, 14% of men and 11% of women were classified as diagnostic orphans. The most common symptoms were drinking more or for longer periods than intended, wanting or trying unsuccessfully to quit or cut back, and drinking in ways that increased risk of injury. We noted broad similarities between diagnostic orphans and mild/moderate AUD groups. There were no differences in odds of diagnostic orphans status by race/ethnicity; however, female gender was associated with lower odds of diagnostic orphan status and all levels of AUD. Individual history of AUD, family history of problem drinking, concurrent smoking, and concurrent marijuana use were associated with greater odds of problem drinking, with stronger associations as AUD severity increased. Conclusions: Diagnostic orphans remain a sizeable and overlooked population of problem drinkers. Clarifying the array of symptoms and cooccurring disorders can improve screening and facilitate alcohol risk-reduction intervention efforts.

Family history of problem drinking is associated with less sensitivity of alcohol demand to a next-day responsibility.

Behavioral economic demand curves measure alcohol consumption as a function of price and may capture clinically relevant individual differences in alcohol-reinforcing efficacy. This study used a novel, behavioral-economic, hypothetical demand-curve paradigm to examine the association between family history of alcohol misuse and individual differences in both alcohol demand and the relative sensitivity of alcohol demand to next-day responsibilities. Participants were 207 college students (47% male, 68.5% White, 27.4% African American, Mage = 19.5 years) who reported at least one heavy drinking episode (5/4 or more drinks on one occasion for a man/woman) in the past month and completed two versions of an alcohol purchase task (APT) that assessed hypothetical alcohol consumption across 17 drink prices. In one APT (standard), students imagined they had no next-day responsibilities, and in the other, they imagined having a 10:00 a.m. test the next day. A series of analyses of covariance indicated that participants with at least one biological parent or grandparent who had misused alcohol reported similar levels of alcohol demand on the standard APT but significantly less sensitivity to the next-day academic responsibility as measured by the percentage of reduction in demand intensity and breakpoint across the no-responsibility and next-day-test conditions. These findings provide initial evidence that APTs might clarify one potential mechanism of risk conferred by family history. Young adult heavy drinkers with a family history of problematic drinking may be less sensitive to next-day responsibilities that might modulate drinking in drinkers without a family history of alcohol problems.

Non-treatment-seeking heavy drinkers: Effects of chronic cigarette smoking on brain structure

We previously reported [Cardenas, V.A., Studholme, C., Meyerhoff, D.J., Song, E., Weiner, M.W., 2005. Chronic active heavy drinking and family history of problem drinking modulate regional brain tissue volumes. Psychiatry Res. 138, 115–130] that non-treatment-seeking, active heavy drinkers (HD) demonstrated smaller regional neocortical gray matter volumes compared to light drinking controls; however, the potential effects of chronic cigarette smoking on regional brain volumes were not addressed. The goal of this retrospective analysis was to determine if chronic smoking affected brain structure in the non-treatment-seeking heavy drinking sample from our earlier report (i.e., Cardenas et al., 2005). Regional volumetric comparisons were made among age-matched smoking HD ( n = 17), non-smoking HD ( n = 16), and non-smoking light drinkers (nsLD; n = 20) from our original sample. Quantitative volumetric measures of neocortical gray matter (GM), white matter (WM), subcortical structures, and cerebral spinal fluid (CSF) were derived from high-resolution magnetic resonance imaging. Smoking HD demonstrated smaller volumes than nsLD in the frontal, parietal, temporal GM, and for total neocortical GM. Smoking HD also demonstrated smaller temporal and total GM volumes than non-smoking HD. Non-smoking HD and nsLD did not differ significantly on GM volumes. Further, the three groups did not differ on lobar WM, subcortical structures or regional CSF volumes. These retrospective analyses indicate neocortical GM volume reductions in non-treatment-seeking smoking HD, but not in non-smoking HD, which are consistent with our studies in recently detoxified treatment-seeking alcohol-dependent samples.

Cognitive Performance in Long‐Term Abstinent Alcoholic Individuals

There are few investigations of the potential recovery of neurocognitive function in chronic alcoholic samples after very-long-term abstinence. The current study examined cognitive abilities in middle-aged (mean age 46.8 years), long-term abstinent alcoholic individuals (LTAA). Twenty-five LTAA men and 23 LTAA women abstinent for an average of 6.7 years were compared with an equal number of gender and age-comparable normal controls (NC). We examined the association of neurocognitive variables with age, duration of abstinence, alcohol use measures, and the density of a family history of problem drinking. Long-term abstinent alcoholic individuals and NC underwent comprehensive neuropsychological assessment. Performance was measured in the following 9 domains: abstraction/cognitive flexibility, attention, auditory working memory, immediate memory, delayed memory, psychomotor function, reaction time, spatial processing, and verbal skills. Long-term abstinent alcoholic individuals performed similarly to NC, except for deficits in the spatial processing domain. The spatial processing results must be interpreted with caution because of multiple comparison issues; however, spatial processing deficits are among the impairments most often reported in abstinent alcoholic individuals. None of the cognitive measures were associated with length of abstinence, any alcohol use variable, or family history measure. Very-long-term abstinence resolves most neurocognitive deficits associated with alcoholism, except for the suggestion of lingering deficits in spatial processing.

Characteristics of binge drinkers in europe

This review aimed to give an overview of the factors that influence binge drinking in Europe; binge drinking was defined as ‘heavy occasional intake’. The search strategy was restricted to European articles in English, French and German published since 1995; the final paper was based on 358 articles. Heterogeneity of definitions for binge drinking made comparisons problematic. However, a variety of related socio-demographic, social and individual factors were identified. Binge drinking peaked in early adolescence or early adulthood in most countries; was more common in men than women and was influenced by socioeconomic factors. The link between early onset of drinking and problem drinking in adulthood was weak, but a family history of problem drinking increased the likelihood of adolescent binge drinking possibly triggered by genetics, environmental factors or both. Motivations for binge drinking included its social facilitating effects and its use as a coping mechanism. Binge drinkers had little knowledge of its risks or were unaware of them. Important influences on binge drinking included peer pressure – outweighing parental influences from late adolescence onwards – and the country’s drinking culture; hence it occurred more often in north and mid Europe compared with the south. The authors concluded that there is still limited knowledge regarding binge drinking in Europe, and more research needs to focus on this area.

Chronic active heavy drinking and family history of problem drinking modulate regional brain tissue volumes

The goals of this study were to measure if chronic active heavy drinking is associated with brain volume loss in non-treatment seeking men and women, and to assess the effect of positive family history of problem drinking on brain structure in heavy drinkers. Automated image processing was used to analyze high-resolution T1-weighted magnetic resonance images from 49 active heavy drinkers and 49 age- and sex-matched light drinkers, yielding gray matter, white matter and cerebrospinal fluid (CSF) volumes within the frontal, temporal, parietal and occipital lobes. Regional brain volume measures were compared as a function of group, sex and their interaction. Within heavy drinkers, volumes were correlated with measures of alcohol consumption and compared as a function of family history of problem drinking. Deformation morphometry explored localized patterns of atrophy associated with heavy drinking or severity of drinking. We found significant gray matter volume losses, but no white matter losses, in active heavy drinkers compared with light drinkers. Women had greater gray matter and smaller white matter and CSF volumes as a percentage of intracranial vault than men. Within heavy drinkers, smaller gray matter volumes were associated with higher current levels of drinking and older age, while a positive family history of problem drinking was associated with smaller CSF volumes. Community-dwelling heavy drinkers who are not in alcoholism treatment have dose-related gray matter volume losses, and family history of problem drinking ameliorates some structural consequences of heavy drinking.

Mate similarity, heavy substance use and family history of problem drinking among young adult women.

This study used data from a national sample of young adult women to evaluate issues about spousal similarity for problem drinking. Paternal and maternal problem drinking were also evaluated in regard to daughters' marriage to a problem drinking spouse, and daughters' problem drinking and substance use. Data from over 5,000 young adult women (ages 23-30 yrs) from the National Longitudinal Survey of Youth (NLSY) archive were used to evaluate associations between marrying a problem-drinking spouse, family history of problem drinking, and women's problem drinking and lifetime marijuana and cocaine use. Findings indicated that black women were less likely to marry a problem-drinking spouse than were Hispanic, Native American or white women. Problem-drinking women were twice as likely to have married a problem-drinking spouse than were non-drinking women, and heavier lifetime marijuana or cocaine use by women was also associated with an almost twofold increase in marrying a problem-drinking spouse. Random effects ordinal probit regression models indicated that, while controlling for major sociodemographic variables (e.g., race, poverty status), maternal, paternal and spousal problem drinking all significantly predicted problem drinking and heavier levels of substance use among the women. Nonrandom matching of problem drinking among marital partners was indicated in this study and women's problem drinking and substance use practices were predicted by paternal, maternal and spousal problem drinking. The similarity of problem-drinking spouses was not constant across racial/ethnic groups, as black women were less likely to marry a problem-drinking spouse, though racial differences in the age of onset of heavier drinking may have influenced this finding.

Runners’ Alcohol use and Responses to the Brief MAST

We assessed drinking habits and responses to the Brief Michigan Alcoholism Screening Test (BMAST) in runners (student and nonstudent) participating in a 10-mi race. Questionnaires were sent to 1445 race registrants: 483 nonstudent men, 153 student men, 154 nonstudent women, and 105 student women responded (62% total response rate). We compared the student runners’ responses to BMAST questions, as well as binge rates and family history of problem drinking, to those of a reference college-student (slightly younger) population from the same state (n = 3726). The male student-runner binge drinking rate was 50% and the women student-runner rate was 47.6%, similar to those of the comparison group. There was no difference in rates of an “alcoholic score” on the BMAST among student runners (10.4% men, 5.1% women) compared to other runners. Student runners were more likely to have sought help for their drinking compared to nonrunner students. Nearly 20% of subjects in the student groups (runners and nonrunners) reported at least one parent with problem drinking significantly lower than the 28% reported by nonstudent runners. These data suggest that running may be a healthy substitute for drinking and warrant further investigation.

Event‐Related Potentials in Alcoholic Men: P3 Amplitude Reflects Family History But Not Alcohol Consumption

Multilead event-related potentials (ERPs), elicited by auditory and visual stimuli requiring a button press response and by a startling noise requiring no response, were recorded from male alcoholics and age-matched male controls (26-60 years old). Single-trial analyses of blink responses to the startling stimuli indicated that alcoholics startle less frequently but with equivalent amplitude as the controls. In contrast, single-trial analyses of P3 indicated that alcoholics generate a P3 as often as controls, but that their individual P3s are smaller. Alcoholics who reported a positive family history of problem drinking had larger startle blink amplitudes and smaller auditory and visual P3s than did alcoholics who reported a negative family history. Hierarchical regression analysis was used to demonstrate that smaller P3s in family history positive alcoholics were independent of lifetime alcohol consumption.

Alcoholism, antisocial behavior and family history*

Previous investigations in selected and clinical samples have demonstrated a close association between alcoholism and both antisocial behavior and a family history of problem drinking. This study uses the National Institute of Mental Health (NIMH) Epidemiological Catchment Area (ECA) data to assess this relationship in the general population in St. Louis, Missouri (U.S.A.). The results showed that serious antisocial behavior (both conduct disorder and antisocial personality disorder), gender, and a family history of problem drinking were all significantly associated with alcoholism (DSM-III alcohol abuse or dependence). Having either conduct disorder, antisocial personality, or a first-degree relative (parent, sibling, or child) with problem drinking increased the probability of alcoholism; being male also increased its probability. Antisocial behavior and gender interacted in that antisocial behavior was a more potent risk factor for women than for men. However, despite their close association with alcoholism, having either antisocial personality or a positive family history of problem drinking identified only 49% of male alcoholics and 14% of female alcoholics. Thus, these two important predictors of alcoholism would be somewhat inefficient screeners for primary prevention. More investigation is needed to understand the development of alcoholism in those without these major risk factors and the lack of alcoholism in those with them.

Family history of problem drinking among young male social drinkers: Modeling effects on alcohol consumption.

Family history of problem drinking among young male social drinkers: Modeling effects on alcohol consumption.

Family history of problem drinking among young male social drinkers: modeling effects on alcohol consumption.

Family history of problem drinking among young male social drinkers: modeling effects on alcohol consumption.

Use of the Log Odds Ratio to Assess the Reliability of Dichotomous Questionnaire Data

The use of the log odds ratio to measure test-retest reliability of dichotomous questionnaire response data is discussed. Its application is illustrated using ques tionnaire data on family history of problem drinking. The superiority of the log odds ratio as a measure of reliability of such data is discussed. Uninformative datasets are characterized.

Family history of problem drinking among young male social drinkers: reliability of the Family Tree Questionnaire.

The test-retest reliability of the Family Tree Questionnaire to detect drinking problems of family members was examined in a sample of 60 male volunteer university undergraduates. The Questionnaire was completed twice. The first occasion employed a group administration procedure, and an average of 4 months later it was readministered on an individual basis. Thus the length of time and the different administration procedures provided an extreme test of the reliability of the Questionnaire. Test-retest scores of the number of problem drinkers reported by a subject were significantly correlated for first degree and for second degree relatives. The reliability of the classification of an individual family member was also satisfactory. The Family Tree Questionnaire thus appears to be a potentially useful, reliable tool for assessing the incidence of problem drinkers within families of young male social drinkers.

Association of alcoholism with antisocial personality in urban men.

The association of alcoholism with antisocial personality is important from a research and a therapeutic standpoint. In a sample of urban black men, it was found that those with antisocial personality had a higher rate of alcoholism than those without. In addition, a family history of problem drinking, low educational level, and excessive irritability were also closely associated with alcoholism. The clinical, genetic, and neurophysiological implications of these findings are discussed.

Relationship of family history of alcoholism to patterns of drinking and physical dependence in male alcoholics

The occurrence of physical dependence, morning drinking and binge drinking was assessed in alcoholic men in relation to family history of problem drinking. The incidence of physical dependence, binge drinking and morning drinking was higher in men with a family history of problem drinking than in men without such a history. Physical dependence also developed earlier in family history positive subjects than in family history negative ones. The incidence of physical dependence was higher in subjects who reported binge drinking or morning drinking than in others. These results indicate that family history of problem drinking is associated with severe alcohol abuse resulting in early development of physical dependence.

Variation in length of time to development of alcoholism by family history of problem drinking

Patients hospitalized for treatment of alcoholism were asked to provide information on family history of drinking problems, age at onset of drinking, and timing of the occurrence of problems due to use of alcohol in their lives, using a time scale. Analysis of data from 256 male patients indicated a strong association between a family history of problem drinking and development of alcoholism at a young age. Mean age at the time the patients could be defined as alcoholic, based on the chronological history of the time of occurrence of symptoms, ranged from 27.2 years for bilineal family history positive patients to 38.5 years for those with negative family history, and the difference could not be explained by differences in age at onset of drinking. The results indicate that the increased risk of alcoholism among individuals with family history of problem drinking, which has been postulated on the basis of many cross-sectional studies, is likely to be overestimated.

Diagnostic interactions. Alcoholism and antisocial personality.

The association of alcoholism with other psychiatric disorders is important from both a research and a therapeutic point of view. In a medically hospitalized inpatient sample, we found a strong relationship between alcoholism and antisocial personality. Controlling for the overlap of diagnostic symptomatology, antisocial subjects still had a significantly higher prevalence of alcoholism than nonantisocial. The antisocial individual was more likely to be exposed to problem drinking, and once exposed, he tended to be more susceptible to developing the full alcoholism syndrome. Gender and a family history of problem drinking also predicted alcoholism. Characterological and neurophysiological correlates of antisocial personality and their relationship to problem drinking are discussed.