High Levels Of Alcohol-related Problems Research Articles

Externalising pathways to alcohol-related problems in emerging adulthood.

BackgroundBoth ‘early‐onset persistent’ and ‘adolescent‐onset’ conduct problems (CPs) are associated with alcohol‐related problems in emerging adulthood. The escalation of early CPs into criminal behaviour and heavy alcohol consumption prior to emerging adulthood are both likely to be important pathways.MethodsData were analysed from 3,038 young people in a UK birth cohort, the Avon Longitudinal Study of Parents and Children. The exposure was developmental trajectories of CPs (‘low’, ‘childhood‐limited’, ‘adolescent‐onset’ and ‘early‐onset persistent’) between ages 4 and 13 years. The mediator was latent classes representing heavy alcohol consumption and/ or criminal behaviour at age 15 years. For the outcome, a quadratic latent growth curve was estimated to capture nonlinear change in alcohol‐related problems between ages 18 and 23 years.ResultsThose with ‘early‐onset persistent’ [b(95% CI) = 1.16 (0.17, 2.14)] and ‘adolescent‐onset’ CPs [b(95% CI) = 1.31 (0.17, 2.45)] had higher levels of alcohol‐related problems at age 18 years compared to those with ‘low’ CPs’, but there was little evidence of an association with alcohol‐related problems after age 19 years. There was evidence for an indirect effect of ‘early‐onset persistent’ CPs [b(95% CI) = 1.12 (0.52, 1.72)] on alcohol‐related problems at age 18 years via the latent classes of alcohol and criminal behaviour in adolescence. This was not found for ‘adolescent‐onset’ CPs [b(95% CI) = 0.35 (−0.36, 1.07)].ConclusionsStrong associations exist between early CPs, adolescent alcohol consumption and criminal behaviour and alcohol‐related problems at age 18 years. Associations between early CPs and alcohol‐related problems weakened considerably across emerging adulthood.

Content Analysis of Advantages and Disadvantages of Drinking Among Individuals With the Lived Experience of Homelessness and Alcohol Use Disorders

ABSTRACTBackground: Alcohol use disorders (AUDs) are more prevalent among people who are homeless than in the general population. Thus, homeless individuals experience disproportionately high levels of alcohol-related problems and associated publicly funded criminal justice and healthcare system utilization. Available treatment services, however, are not effective at engaging and treating this population. To better tailor treatment services to their needs, it is imperative we understand this population's perceptions of their alcohol use. Objectives: The aim of this study was to provide description and relative rankings of the advantages and disadvantages of alcohol use from this population's perspectives. Methods: Participants were 44 individuals with lived experiences of AUDs and homelessness who received services at community-based agencies in Seattle, Washington. Open-ended prompts were used in interviews conducted in 2013–2014 to assess the perceived role of alcohol in participants’ lives, including participants’ perceptions of the advantages and disadvantages of their current drinking, and a conventional content analysis was conducted. Results: The most frequently mentioned advantages of drinking included positively and negatively reinforcing psychological reasons, perceived control over drinking, and social benefits. Physical effects, concerns about dependence on alcohol, and health problems were the most commonly mentioned disadvantages. Conclusions/importance: By documenting the perceived advantages and disadvantages of drinking among people with the lived experience of homelessness and AUDs, this study supplies information providers may use to better tailor treatment services to this multimorbid, high service-utilizing population's needs and interests.

Predictors of drinking patterns in adolescence: A latent class analysis

BackgroundUni-dimensional measures of alcohol consumption may be unable to fully capture the complexity of adolescent drinking and experience of alcohol-related harms. Latent class analysis provides an empirical method to understand different adolescent drinking patterns. MethodsLatent class analysis was used to create typologies of drinking among the 5018 current drinkers in the national Youth ‘07 survey. Determinants of drinking patterns were identified using multinomial logistic regression. ResultsFour latent classes were identified, demonstrating an overall increase in risk of alcohol-related outcomes from increasing consumption. One class strongly deviated from this pattern, having moderate consumption patterns but disproportionately high levels of alcohol-related problems. Multinomial logistic regression found that the strongest predictors of belonging to high-risk drinking typologies were having a positive attitude to regular alcohol use, buying own alcohol, peers using alcohol, and obtaining alcohol from friends and/or other adults. Other significant predictors included being male, having a strong connection to friends, having parents with a low level of knowledge of their daily activities and poor connection to school. Class membership also varied by ethnicity. ConclusionThe latent class approach demonstrated variability in alcohol-related harms across groups of students with different drinking patterns. Longitudinal studies are necessary to determine the causes of this variability in order to inform the development of targeted policy and preventative interventions. Legislative controls, such as increasing the legal purchase age and reducing the commercial availability of alcohol, will continue to be important strategies for reducing harm in young people.

The role of substance use and emotion dysregulation in predicting risk for incapacitated sexual revictimization in women: Results of a prospective investigation.

Incapacitated sexual assault (ISA) is the most common form of sexual victimization experienced by college women. Although ISA victims are at risk for future assaults, few studies have examined mechanisms responsible for ISA revictimization besides heavy drinking. Using a prospective design, the present study examined whether emotion dysregulation, given its association with interpersonal trauma and substance use, increases risk for revictimization among women with a history of ISA above and beyond the effects of substance use. Female college students (n = 229) completed a baseline assessment followed by assessment of incapacitated sexual assault over a 9-week follow-up period. Approximately 36% of participants reported a history of ISA, and 73% of those victimized during the study had a history of ISA. Revictimized women reported higher levels of alcohol-related problems, greater marijuana use, greater emotion dysregulation, and higher levels of fear and guilt prior to experiencing ISA during the study; however, they did not consume more alcohol than previously victimized women. In a logistic regression analysis, guilt, emotion dysregulation, and marijuana use accurately classified 78.9% of ISA revictimized women. Women with a history of ISA are at substantial risk for ISA revictimization. Findings suggest that even very small increases in emotion dysregulation, particularly in impulsivity, as well as marijuana use, impact revictimization risk substantially. Efficacy of interventions to reduce ISA revictimization may be improved if emotion dysregulation is addressed.

Individual and situational factors that influence the efficacy of personalized feedback substance use interventions for mandated college students.

Little is known about individual and situational factors that moderate the efficacy of personalized feedback interventions (PFIs). Mandated college students (N = 348) were randomly assigned either to a PFI delivered in the context of a brief motivational interview (BMI; n = 180) or to a written PFI only (WF) condition and were followed up at 4 months and 15 months postintervention. The authors empirically identified heterogeneous subgroups utilizing mixture modeling analysis based on heavy episodic drinking and alcohol-related problems. The 4 identified groups were dichotomized into an improved group (53.4%) and a nonimproved group (46.6%). Logistic regression results indicated that the BMI was no more efficacious than the WF across all mandated students. However, mandated students who experienced a serious incident requiring medical or police attention and those with higher levels of alcohol-related problems at baseline benefited more from the BMI than from the WF. It may be an efficacious and cost-effective approach to provide a written PFI for low-risk mandated students and an enhanced PFI with a BMI for those students who experience a serious incident or have higher baseline alcohol-related problems.

Occupational Stress and Alcohol Use: A Study of Two Nationwide Samples of Operational Police and Ambulance, Personnel in Norway

Police and ambulance personnel are widely believed to have a high prevalence of excessive alcohol consumption. However, the empirical basis for this assumption is scant or nonexistent. We assessed the association of alcohol use with burnout and job stressors, with drinking to cope and neuroticism as two possible moderating factors in two occupations, the police and ambulance services. We undertook a comprehensive nationwide questionnaire survey of police (n = 2,372) and ambulance (n = 1,096) personnel in operational duty. The questionnaire encompassed the Alcohol Use Disorders Identification Test (AUDIT), the Maslach Burnout Inventory, the Job Stress Survey, and the Basic Character Inventory. With a modified AUDIT score of 6 or more, the prevalence for men was 17.7% (police personnel) versus 16.6% (ambulance personnel). The prevalence for women was 9.1% versus 7.4%, respectively. Personnel who were male, were younger, and had higher levels of neuroticism reported higher levels of alcohol-related problems. Drinking to cope was most strongly associated with higher levels of alcohol-related problems (standardized beta = .29, p < .001) and was found to moderate the effect of depersonalization (e.g., cynical and distant attitude toward one's work and the people with whom one works) and gender. In general, the present study does not support the notion of a strong relationship between occupational stress and alcohol use in these emergency service occupations. However, drinking to cope may be a risk factor for alcohol-related problems, particularly among male personnel and those experiencing higher levels of depersonalization.

Social‐Emotional Adjustment and Patterns of Alcohol Use among Young Adults

Individual differences in social-emotional adjustment, jointly defined by levels of distress and self-restraint, were used to evaluate (a) patterns of alcohol use, (b) reasons for use, and (c) associated problems in two college samples of young adults (N = 287 and N = 215). As hypothesized, low self-restraint was associated with high levels of alcohol use, drinking to increase positive affect, and high levels of alcohol-related problems. Subjective distress was not related to levels of use; however, it was associated with drinking to escape negative moods and social discomfort and with excessive alcohol-related problems. Both high distress and low self-restraint predicted problem drinking beyond what could be accounted for by quantity or frequency of alcohol use or by peers' use. Within Weinberger and Schwartz's (1990) six-group typology, reactive individuals (high distress-low restraint) were especially likely to be problem drinkers, even when compared to groups with equivalent alcohol use. In a separate study, knowledgeable peers' reports validated the differences between reactive and repressive individuals, the two groups most likely to have inaccurate self-reports.

Patterns of alcohol and drug abuse in drug treatment clients from different ethnic backgrounds.

In this paper we have sought to identify differences in alcohol consumption patterns and problems among young adult males from white, black, and Hispanic ethnic groups entering drug treatment programs. In overall consumption patterns we found results similar to those obtained in general population studies. However, about one-third of the clients in all ethnic groups could be classified as heavier drinkers (drinking at least once a week and 4 or more drinks per drinking occasion) in the period immediately prior to treatment. About one-fourth of the clients in each ethnic group consumed a daily average of 2.5 ounces of absolute alcohol. Compared with the other ethnic groups, blacks were the most likely to be abstainers and reported regular alcohol use and drunkenness at later ages. Regardless of the pattern of development, similar proportions of the clients in all ethnic groups reported heavier drinking levels by age 21-30. Consistent with the current hypotheses in the literature, whites reported much higher levels of alcohol-related problems and prior treatment. Despite having similar levels of drinking, black and Hispanic ethnic groups did not appear to recognize alcohol as a problem or to report alcohol-related problems to the extent that whites did. Examination of drug-use patterns showed great variation in the nature and extent of drug use among the three ethnic groups. Whites were distributed among the seven patterns of use. Heroin use with cocaine, marijuana, and alcohol was the predominant pattern for blacks and Hispanics. Although the patterns of drug use differed greatly, these patterns were not differentially related to alcohol consumption or alcohol-related problems within ethnic groups. On the contrary, the drug-use patterns appeared to be a stronger predictor than ethnicity of use and problems. Multiple-nonnarcotic-users reported the highest levels of alcohol consumption and the greatest numbers of alcohol-related problems. This group typically reported the highest number of alcohol-related problems. Expression of a current need for treatment and a history of prior alcohol treatment were highest for black multiple-nonnarcotic-users. Our examination of the influences of family and friends was based on a limited number of questions available in the data. Heavier drinking was reported by clients who lived with friends, had family or friends who drank regularly, or had extensive involvement in the drug-use network, including drug sales. No ethnic differences were found.(ABSTRACT TRUNCATED AT 400 WORDS)