Patterns Of Alcohol Abuse Research Articles

Large and small fiber neuropathy in chronic alcohol‐dependent subjects

The aim of the present study was to evaluate the occurrence of large and small fiber neuropathy among alcohol-dependent subjects and to correlate neuropathy with the pattern of alcohol abuse, age of the subjects, nutritional status, and biochemical parameters. The study sample comprised 98 consecutive alcohol-dependent subjects without signs of malnutrition treated for detoxification voluntarily in the specialized unit of the Athens University Psychiatric Clinic in an inpatient basis. Polyneuropathy (PN) was graded using the neuropathy symptoms score and neurologic disability score, conduction velocity studies, and quantitative sensory tests. Seventy-seven men and 21 women aged 27-70 years took part in the study. PN was diagnosed in 57 subjects (58.2%). PN of both large and small fibers was found in 25 patients (25.5%); exclusively small fiber neuropathy was observed in 12 (12.2%) and exclusively large fiber neuropathy in 20 patients (20.4%). Neuropathy was significantly correlated with the age of the subjects, duration of alcohol abuse, liver dysfunction, macrocytosis, and blood sugar levels upon admission. PN was significantly more frequent in males than in females. The two groups of exclusively large and exclusively small fiber neuropathy did not differ significantly in any clinical and laboratory parameter. Subclinical neuropathy (stage 1) was observed in 11.2%, which also did not differ significantly in any clinical and laboratory parameter from the stage 2 PN group subjects. Our findings indicate the direct toxic effect of alcohol on peripheral nerve fibers as the main etiologic factor of alcoholic PN. Long-standing hyperglycemia may be another contributing factor. Impaired vitamin B(12) utilization may be also involved.

Table of Contents

The Brown University Digest of Addiction Theory and ApplicationVolume 24, Issue 12 p. 1-8 Table of Contents First published: 01 December 2005 https://doi.org/10.1002/data.20009AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract Housing, Drug use and Risky Behavior all Predictors of Attrition from Treatment in Teens Ondansetron Reduces Drinking in Adolescents with Alcohol Dependence Study Examines Cue Reactivity in Adolescents who Smoke and Drink Study Finds Adolescent Alcoholics Show Cue Reactivity Adolescent use of Hallucinogenic Substance in Religious Settings Patterns of Alcohol Abuse and Dependence Differ Among Teens and Adults Early Alcohol use Tied to Risk-Taking Among Disadvantaged Youth State by Trait Interactions in Adolescent Smoking Onset and Relapse Volume24, Issue12December 2005Pages 1-8 RelatedInformation

Long-Term Effects of Family Functioning and Child Characteristics on Problem Drinking in Young Adulthood

Several studies have shown that disturbances in the parent-child relationship in childhood are related to patterns of alcohol abuse in adolescence and young adulthood. Recently some researchers, however, argue that whether poor parenting is detrimental depends on specific child characteristics. Hence, instead of examining overall effects of parenting, it might be more appropriate to search for specific child-environment effects that lead to problematic drinking patterns. In this paper, we investigate the interplay between child characteristics (lack of self-control and aggression) and parenting on problematic alcohol use in young adulthood. Data were used from a longitudinal study that followed 301 children and their parents for a period of 10 years. Both parents and their children were interviewed on parenting practices and child characteristics when the child was a young adolescent (mean age of 12 years at time 1) and extensive information on problematic alcohol use was gathered when the participants were young adults (mean age was 22 at time 3). Findings showed strong effects of childhood aggression (men only) and poor family functioning on enhanced levels of problem drinking in young adulthood. Further, the combination of high levels of aggression and low levels of family functioning were related to problem drinking in men, whereas the combination of low parental control and low levels of affection expression were related to problem drinking in women.

Japan Grapples With Alcoholism Crisis

Japan Grapples With Alcoholism Crisis

Inmate Perceptions of Residential Substance Abuse Treatment Programming

ABSTRACT Drug and alcohol use and abuse are responsible for many social ills, including an association with criminal involvement and repeat offending. The Residential Substance Abuse Treatment (RSAT) program at the South Idaho Correctional Institution (SICI) is designed to fill a need for treatment of substance-abusing parole violators. RSAT program design includes a 9-12 month treatment regimen for chronic substance abusers that addresses addiction and criminality. The intent is to create a structured therapeutic environment with three treatment modalities, including cognitive self-change, behavioral, and 12-step programming. In this paper we present the findings from a questionnaire in which we queried inmates regarding their perceptions of the RSAT programming. We found that those inmates enrolled in the first and/or the third phase of the treatment tended to be more positive in their perceptions of program content, the therapeutic atmosphere and the quality of services provided than were those in the middle, or second phase of treatment. Paradoxically, we also found that there was a negative relationship between those with most months in the program and their perceptions of it while those with the most serious pattern of alcohol abuse tended to perceive the program more positively.

Long-term potentiation in the rat hippocampus is reversibly depressed by chronic intermittent ethanol exposure.

Alcohol exposure induces multiple neuroadaptive changes in the CNS that can have serious long-term consequences on CNS function including cognitive effects and attenuation of learning and memory. The cellular mechanisms underlying the CNS effects of alcohol have yet to be fully elucidated and are likely to depend on the pattern and dose of alcohol exposure. Using electrophysiological recordings from hippocampal slices obtained from control and chronic alcohol-treated rats, we have investigated the effects of a binge pattern of alcohol abuse on synaptic plasticity in the CNS. The alcohol-treated animals were exposed to ethanol vapor for 12-14 days using an intermittent exposure paradigm (14 h ethanol exposure/10 h ethanol withdrawal daily; blood alcohol levels approximately 180 mg/dl), a paradigm that models human binge alcohol use. Induction of long-term potentiation (LTP) in the CA1 region of the hippocampus by tetanic stimulation of Schaffer collaterals was completely blocked in slices from the chronic alcohol-treated animals. LTP remained blocked 1 day after withdrawal of animals from alcohol, indicating that the neuroadaptive changes produced by alcohol were not readily reversible. Partial recovery was observed after withdrawal from alcohol for 5 days. Other measures of synaptic plasticity including posttetanic potentiation and paired-pulse facilitation were also altered by the intermittent alcohol treatment paradigm. The results suggest that alterations in synaptic plasticity induced by chronic intermittent ethanol consumption play an important role in the effects of binge alcohol use on learning and memory function.

Cognitive preoccupation with alcohol and binge drinking in college students: Alcohol-induced priming of the motivation to drink.

This research examined alcohol-induced motivation to drink as a factor that contributes to preoccupation with drinking. Forty undergraduates rated their degree of preoccupation with drinking. The author determined the relationship between the undergraduates' preoccupation and the degree to which alcohol primed their motivation to drink by having them rate their desire for alcohol after they consumed a dose of alcohol or a placebo. Results showed that individual differences in preoccupation were predicted by the priming effects displayed after alcohol was consumed. More preoccupied individuals reported greater priming effects. Priming effects following placebo were minimal and were not related to preoccupation. The research shows that reinforcing effects of alcohol may contribute to cognitive preoccupation with drinking and promote patterns of alcohol abuse.

Alcohol abuse and crime: a fixed-effects regression analysis.

To examine linkages between patterns of alcohol abuse and crime in a New Zealand birth cohort studied to the age of 21 taking into account confounding factors through the use of fixed-effects regression methods. Over the period from age 15-21 years assessments were made of: (a) involvement in violent and property crime; and (b) extent (if any) of alcohol abuse/dependence symptoms. In addition, information was gathered on a number of social and contextual factors that were likely to be related to alcohol abuse or crime. Increasing alcohol abuse was associated with clear and significant (p < 0.0001) increases in rates of both violent and property crime. Control for observed and non-observed confounding through the use of fixed-effects regression models indicated that much of this association was attributable to the effects of confounding factors that were associated with both alcohol abuse and crime. None the less, even after such control alcohol abuse remained significantly related to both violent and property offending. The findings suggest the presence of a possible causal association between alcohol abuse and juvenile offending that is evident after control for both observed and non observed sources of confounding.

Alcohol and Private Higher Education A Literature Review

The focus of this literature review is alcohol use and abuse in higher education, specifically as it is found in private, church-related colleges and universities. As these institutions have similar alcohol abuse patterns and problems as public institutions, this review first explores studies examining populations found in both public and private institutions. The review then shifts to research conducted in private college and university settings.

An evaluation of Cloninger's typology of alcohol abuse.

To evaluate Cloninger's typology of "alcoholism" using the Alcohol Symptom Scale (Gilligan et al., 1987). A sample of 300 Australian men and women with a life-time diagnosis of DSM-III-R alcohol abuse/dependence. The Alcohol Dependence Scale, the Short Alcoholism Screening Test, the Composite International Diagnostic Interview (CIDI) Substance Abuse Module, the Brief Symptom Inventory, the CIDI core modules, the Family History Questionnaire and the Sensation Seeking Scale. The Alcohol Symptom Scale classified only 18% of the sample into either type 1 or type 2. There was mixed support for the hypothesized differences between type 1 and type 2 problem drinkers in pattern of alcohol abuse, gender, personality characteristics and familial aggregation of alcohol abuse. More women than men were classified as type 1 (19% vs. 6%) but, contrary to expectations, similar numbers were classified as type 2 problem drinkers (7% vs. 4%). As predicted, type 2 problem drinkers had more symptoms of antisocial personality disorder, more social consequences of drinking and higher sensation-seeking scores than type 1 problem drinkers. Cloninger's typology failed to classify two types of problem drinkers and it did not predict gender differences in symptoms of alcohol dependence, family history or personality. Schuckit, Irwin & Mahler's (1990) hypothesis that type 2 problem drinkers are more likely to have primary ASPD was supported.

PTSD as a mediator between childhood rape and alcohol use in adult women

Objective: Though a relationship between childhood sexual abuse and later alcohol use among women has been documented, little is known about the pathways that link these two variables. A tension reduction hypothesis posits that emotional distress precedes substance usage. PTSD symptomatology resulting from childhood sexual abuse is examined as a possible source of emotional distress that may cause subsequent alcohol use. Method: A sample of adult women was selected and interviewed on two occasions 1 year apart and childhood rape history, lifetime PTSD symptoms, and lifetime alcohol use were assessed. Path analytic techniques were used to evaluate the mediating role of PTSD symptoms on the relationship between childhood rape and subsequent alcohol use. Results: A history of childhood rape doubled the number of alcohol abuse symptoms that women experienced in adulthood Path analysis and cross-validation results demonstrated significant pathways connecting childhood rape to PTSD symptoms and PTSD symptoms to alcohol use. Conclusions: The results of the present study suggest that PTSD symptomatology which develops after childhood rape may be one of many variables that affect alcohol abuse patterns in women who were victims of childhood sexual abuse.

Hepatitis C serotypes in nonalcoholic and alcoholic patients.

Genotyping of the hepatitis C virus (HCV) RNA can be performed by a variety of methods following polymerase chain reaction amplification of a stable RNA portion of the genome. The gold standard is amplification of the RNA from the NS5 region, followed by direct sequencing and homology comparison. This method is extremely labor intensive. In this study, we compared an immunoblot serotyping technique (HCV SIA) to a reverse-hybridization line-probe assay (LiPA) for genotype classification among non-alcoholic HCV infected patients. We then compared and contrasted the response in this cohort to a population of alcoholic patients with HCV infection. To validate the serotype assay, sera from 110 patients with chronic HCV infection was utilized. Serotyping (Chiron SIA) and genotyping by the LiPA (Line Probe Assay, Innogenetics) reverse-hybridization technique was performed. Additionally, both methods were compared to sequence-derived genotyping in 26 patients based on PCR amplification of the NS5 region. After the validation phase, sera from 105 alcoholic patients was genotypically classified by the serologic method. The nonalcoholic and alcoholic groups were then compared with regard to serotype, demographics, and frequency of untypable test results. Among typable pairs, the overall concordance rate between serotyping and LiPA-based genotyping was 93.75%. Patients with genotype 1 by reverse hybridization demonstrated a 95.8% concordance with serotype. Untypable samples were present for both techniques, but since they occurred in different patients, the techniques were complementary. Alcoholic patients were significantly more likely to be infected with untypable serotypes than those without a pattern of alcohol abuse. These patients were also more likely to be HCV RNA negative than sera from typable patients. Serotype 1 was associated with high HCV RNA titer and poor interferon treatment response among both nonalcoholic and alcoholic patients. An immunoblot method for the evaluation of genotype classification was rapid and easily performed compared to sequence-based genotyping. There was a high degree of concordance compared to reverse-hybridization and sequence-based genotype characterization methods. Failure to detect HCV RNA in the serum is associated with a higher likelihood of classification failure. This problem was particularly prevalent in the alcoholic population. HCV RNA titers and treatment outcomes were strongly associated with serotype classification results, demonstrating clinical utility of this assay technique.

Genetic and environmental influences on lifetime alcohol-related problems in a volunteer sample of older twins.

Few studies have employed genetically informative designs to study the causes of alcohol-related problems in nonclinical populations. We report patterns of alcohol abuse in a community-based U.S. volunteer sample of 3,049 female and 1,070 male twins aged 50 to 96. Significant gender and age effects were found for self-report measures of current and lifetime alcohol-related problems, with higher prevalence among males and lower frequency among older birth cohorts. Significant associations were found between severity of alcohol abuse (adapted from Feighner criteria) and age of drinking onset, parental history of alcohol problems and, among males, lower educational attainment. Model-fitting analyses based on data from 650 identical and 479 fraternal twin pairs indicate substantial family resemblance for a variety of definitions of lifetime alcohol abuse and alcohol problems. The median estimate of genetic variance across several definitions of alcohol problems was 38.5%, while that for shared environmental influence was 15.5%. Gender heterogeneity was not found for magnitude of genetic and environmental influences, but these comparisons were limited by low statistical power. Findings are discussed with reference to the literature on alcohol abuse among older adults and the genetic epidemiology of alcoholism.

Dysthymia characteristics of heavy alcohol use in depressed adolescents

The increased prevalence of heavy alcohol use and abuse among depressed adolescents has been well documented (as reviewed in Bukstein et al 1989). As an example, Greenbaum et al (1991) studied 547 adolescents having serious emotional disturbances, and found that adolescents with severe depressive disorders were more likely to be diagnosed with a substance-abuse disorder, including alcohol abuse/dependency, than were adolescents without depressive disorders (48.3% versus 17.0%). A high prevalence of-alcohol abuse in depressed adolescents also has been documented in nonclinical samples (Deykin et al 1987). Recognition and appropriate treatment of alcohol abuse in depressed adolescents are critical. Both alcohol abuse and depression tend to be chronic conditions with high rates of secondary problems. The co-occurrence of alcohol abuse and depression is particularly problematic, having been associated with an increased risk for suicidal behavior in adolescents (King et al 1993; Pfeffer et al 1988). Despite the importance of identifying and treating each of these conditions, common clinical features make differentiation difficult. Studies with adults suggest that depression may actually motivate treatment-seeking in alcohol abusers (Regier et al 1990), but that the alcohol abuse often goes unrecognized by treatment providers (Helzer and Pryzbeck 1988). The recognition of alcohol-abuse patterns in depressed adolescents would be assisted by information on the phenomenology of depression in adolescents who abuse alcohol. This study was conducted to determine the nhennmennlcmv of depressive symn. . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . . ~ . . . . . ~ d 1

Trauma in Cirrhosis: An Indicator of the Pattern of Alcohol Abuse in Different Societies

While some morbidities associated with the excessive use of alcohol are related to the total amount of alcohol consumed--cirrhosis being an example--other pathologies, such as trauma and those of psycho-social origin, are mainly related to the frequency of acute alcoholic intoxication rather than to the total amount consumed. The balance between these two types of alcohol-associated morbidities can provide an indication of the relative frequency of intoxication, and thus of the pattern of alcohol abuse in a population. Since trauma is highly associated with acute alcoholic intoxication, the prevalence of bone fractures was determined in cirrhotics in nine countries. The prevalence of rib and vertebral fractures on routine chest x-rays showed a 17-fold variation in the different countries, from 2% and 6% in Spain and Italy to 30% and 34% in Canada and the USA, suggesting marked differences in the pattern of alcohol abuse to intoxication. Conversely, the prevalence of cirrhosis is twice as high in Spain and Italy than in Canada and the USA. A strong positive correlation between per capita consumption and cirrhosis mortality (r = 0.86; p less than 0.01) exists among the nine countries studied, while the correlation between per capita alcohol consumption and the prevalence of trauma is not statistically significant (r = 0.40). Supporting a strong association between trauma and alcoholic intoxication, the prevalence of trauma was found to be highly correlated: r = 0.88, p less than 0.002, with the degree of concern for the psycho-social consequences of alcohol abuse in the different countries. Data indicate that trauma can be used as an objective indicator to assess the pattern of alcohol abuse in a population.

A Survey of Drinking Patterns During Medical School

Several studies have documented the common use of alcohol among medical students and the significant fraction of students (7% to 17%) who show a pattern of alcohol abuse. Many authors have pointed out the implications of physician impairment due to alcoholism, presently estimated at about 10%. We surveyed 263 junior and senior medical students, and our data support earlier surveys of the prevalence of alcohol abuse and indicate that students tend to drink less heavily and less frequently after entering medical school. The clinically proven CAGE questions used in the survey showed statistically significant associations between heavy or frequent drinking before and during medical school, but only 4.2% of respondents indicated that school officials had asked whether they had a drinking or drug abuse problem. Given these findings, we suggest the routine administration of screening instruments to medical students, using education and minimal intervention strategies with individuals at risk.

Alcohol and Trauma

Countermeasures to alcohol-related trauma are essential. The public perception that there is low risk of detection and punishment for alcohol-precipitated violence is being addressed. Current legislation is aimed at decreasing the availability of alcohol (e.g., adjusting legal drinking age, decreasing the serum alcohol intoxication limit, restricting the sale of alcoholic beverages at public events), increasing detection (e.g., greater driver surveillance, increased number of dedicated personnel), strengthening legal penalties for alcohol-related offenses, and mandating rehabilitative therapy. Physicians can intervene in the alcohol-trauma cycle. Unfortunately, they are notably poor in detecting the patient with alcohol-related injury. Moreover, physicians infrequently refer these patients to facilities and personnel that are expert in alcohol detoxification and rehabilitation. Recidivism can be positively impacted by physicians who are sensitive to and versed in the medical and social patterns of alcohol abuse.

Prevalence of childhood physical abuse in adult male veteran alcoholics

Although past research has identified psychological and behavioral consequences for adults who were abused as children, few studies have examined the incidence and consequences of childhood physical abuse among adult alcoholics. The purpose of this study was to assess the prevalence of a childhood history of physical abuse in adult male alcoholics and to determine what differences may exist in the psychological profile and patterns of alcohol abuse in abused and nonabused alcoholics. The study sample was comprised of 100 male alcoholic inpatients from the alcoholism treatment unit at a metropolitan Veterans Administration hospital. Subjects were administered a self-report devised by the authors to assess a history of childhood physical abuse, the Michigan Alcoholism Screening Test (MAST), the Severity of Alcohol Dependence Questionnaire (SADQ), and the Symptom Checklist-90-Revised (SCL-90-R). Findings indicated that approximately one-third of the alcoholics were physically abused as children. Abused alcoholics reported having more severe psychological symptoms and distress than their nonabused counterparts, although they did not differ on the onset, severity, or treatment history for alcohol dependency.

Etiologic heterogeneity in alcoholism.

Etiologic heterogeneity in alcohol abuse was evaluated in 195 extended pedigrees, comprising 288 nuclear families of 140 male and 55 female Caucasian American hospitalized alcoholics. Previous adoption studies in Sweden demonstrated differential heritability of two patterns of alcohol abuse in men: type-2 alcoholism exhibited early onset of abuse associated with criminal behavior, while type-1 abuse began at a later age, uncomplicated by antisocial traits. Alcohol abuse in female Swedish adoptees was relatively homogeneous and similar to the late-onset, type-1 abuse. The notion of etiologic heterogeneity, as suggested by the Stockholm Adoption Studies, was examined in the American pedigrees by contrasting the models of familial transmission of susceptibility to alcoholism obtained via segregation analyses of families of male versus female probands. Families of male probands demonstrated significant familial resemblance, accounted for by a multifactorial-polygenic background in addition to a major (gene) effect. In contrast, familial resemblance in the pedigrees of female probands was attributed solely to a multifactorial-polygenic effect. We considered whether some families of male alcoholics were similar to families of female probands, who expressed type-1 abuse predominantly. Pedigrees of male probands were separated in two groups: (1) "female-like" families had a better likelihood for the model obtained for families of female probands than the one for families of all male probands, (2) "male-like" families had a better likelihood for the model of familial transmission describing families of all male probands. A statistically significant difference in the pattern of familial transmission was observed between the "male-like" and "female-like" groups. Discriminant function analysis of alcohol-related symptoms showed that the familial subtypes differed in clinical features as well. Alcohol abuse by male relatives in "male-like" families was characterized by the early onset of inability to abstain entirely from alcohol or lack of desire to stop drinking; in contrast, abuse in "female-like" families was characterized by late onset of guilt feelings and loss of control over binge drinking.

Alcohol abuse among clinically anxious patients

Of 156 patients meeting DSM-III criteria for either agoraphobia with panic attacks, panic disorder, simple or social phobia, or generalized anxiety disorder, 27 (17.3%) were found to score in the alcoholic range (⩾ 5) on the Michigan Alcoholism Screening Test. This pattern of alcohol abuse was primarily associated with the diagnosis of agoraphobia. Agoraphobic patients with a concurrent affective disorder were especially prone to abuse alcohol.