Positive Family History Of Alcoholism Research Articles

The role of opioidergic system in modulating cost/benefit decision-making in alcohol-preferring AA rats and Wistar rats.

Research has highlighted the association of a positive family history of alcoholism with a positive treatment response to opioid antagonists in those with a gambling disorder. However, the role of the opioidergic system in gambling behavior is not well understood, and preclinical studies are needed to clarify this. In this study, Alko Alcohol (AA) and Wistar rats went through operant lever pressing training where the task was to choose the more profitable of two options. Different sized sucrose rewards guided the lever choices, and the probability of gaining rewards changed slowly to a level where choosing the smaller reward was the most profitable option. After training, rats were administered subcutaneously with opioid agonist morphine or opioid antagonist naltrexone to study the impact of opioidergic mechanisms on cost/benefit decisions. No difference was found in the decision-making between AA rats or Wistar rats after the morphine administration, but control data revealed a minor decision enhancing effect in AA rats. Naltrexone had no impact on the decisions in AA rats but promoted unprofitable decisions in Wistar rats. Supporting behavioral data showed that in both rat strains morphine increased, and naltrexone decreased, sucrose consumption. Naltrexone also increased the time to accomplish the operant task. The results suggest that opioid agonists could improve decision-making in cost-benefit settings in rats that are naturally prone to high alcohol drinking. The naltrexone results are ambiguous but may partly explain why opioid antagonists lack a positive pharmacotherapeutic effect in some subgroups of gamblers.

P3 Component as a Potential Endophenotype for Control Inhibition in Offspring of Alcoholics.

To assess inhibitory processes and the ongoing event-related potential (ERP) activity of offspring of alcoholics (OA) during a Go/No-Go task, with the purpose of characterizing possible psychophysiological endophenotypes for alcohol-dependent vulnerability. EEG recordings and ERP measurements of young adults with positive and negative family history of alcoholism where obtained while they performed a Go/No-Go task to assess inhibitory processes. Offspring of alcoholics showed a different ERP pattern compared to the control group and exerted greater effort than the control group. ERP measurements were obtained by electroencephalogram (EEG) recordings of 65 participants divided into two groups: one group of 30 subjects with positive family history of alcoholism and a control group of 35 subjects with negative family history of alcoholism. They performed a Go/No-Go task, where each individual was required to classify visual stimuli by colour (Go) and inhibit their response to a No-Go signal. OA have higher P3 amplitudes during the Go condition in all of the regions analysed and higher No-Go P3 amplitudes than control subjects in the frontal region. Unlike controls, OA have no differences between the P3 amplitudes across conditions. The absence of differences between the P3 Go and No-Go observed in the OA group can be interpreted as a possible alteration related with inhibition, in a way that they may need to recruit similar resources for inhibitory and classificational processes for both conditions. Therefore, the P3 component may be considered as a useful endophenotype and a vulnerability marker to develop addictive behaviour.

Alcohol use among medical students: a possible risk for future doctors? Uso de Álcool entre Estudantes de Medicina: um possível risco para futuros médicos?

Introduction: The use of psychoactive drugs in the world population increased until 2011 as well the alcohol consumption of university students. Many studies have appointed factors that may aggravate the problem. Objective: To evaluate the alcohol use by medical students in a private medical institution in Fortaleza, Ceará. Methods: A quantitative, cross-sectional study developed from July of 2015 to May 2016. Two instruments for collecting data were used: one related to socioeconomic, demographic, and nosographic data; and the AUDIT, the most used instrument for evaluating alcohol disturbance. There were 502 students enrolled from the first to the eighth semester. The sample was composed by 384 students, representing 76.5% of the eligible population. Results: The prevalence of risk related to use of alcohol was 36%. 62% of the students were female; 61.9% single; the age average was 22 years. The AUDIT’s average score was 6.1 points. The majority of the students (64%) were classified as low risk use or abstinence (Zone I), while others 36% were located in different levels of risk. 37% had a positive family history for alcoholism, and only 28 (7.3%) had mental illness diagnosis. Variables as to being male, non-practicing religious, being sexually active, having a steady partner, concomitant use of tobacco and illicit drugs, living without the parents and hanging out with friends addicted to drinking were found to be risk factors for the abuse of alcohol. Conclusion: Data showed a high prevalence on the studied population in regard to risk related to the use of alcoholic beverages. The gravity of the problem demands health care and educational efforts to face it.

Adolescents Admitted to In-Patient Treatment with Alcohol Intoxication: Risk and Resilience Factors Associated with Problematic Alcohol Use

Background and Objectives: Although the number of adolescents admitted to in-patient treatment with alcohol intoxication (AIA) has strongly risen in many countries, knowledge about this patient population with respect to risk and resilience factors is lacking. The objectives of this study were (1) to explore whether the prevalence of substance use and use-related problems in a sample of AIA is elevated compared to adolescents from the general population and (2) to investigate which biopsychosocial factors are associated with prior problematic alcohol use in AIA. Methods: In a cross-sectional naturalistic study 65 AIA (M and SD age 15.2 ± 1.6 yr) completed questionnaires and were interviewed the morning after admission in two pediatric hospitals in the City of Dresden, Germany. Assessment included substance use, alcohol use disorders, and risk and resilience factors for problematic alcohol use. Results: Elevated prevalence rates were found for alcohol abuse, alcohol dependence, binge drinking, smoking, and illicit substance use. Exploratory analyses revealed that deviant peer affiliations, a positive family history of alcoholism, an elevated alcohol tolerance, and a parenting style characterized by less supervision and strictness were associated with problematic alcohol use. Conclusions: The investigated risk and resilience factors for problematic alcohol use should be included in the clinical decision regarding psychosocial interventions following hospitalization.

Relationships between Reward Sensitivity, Risk-Taking and Family History of Alcoholism during an Interactive Competitive fMRI Task

BackgroundIndividuals with a positive family history for alcoholism (FHP) have shown differences from family-history-negative (FHN) individuals in the neural correlates of reward processing. FHP, compared to FHN individuals, demonstrate relatively diminished ventral striatal activation during anticipation of monetary rewards, and the degree of ventral striatal activation shows an inverse correlation with specific impulsivity measures in alcohol-dependent individuals. Rewards in socially interactive contexts relate importantly to addictive propensities, yet have not been examined with respect to how their neural underpinnings relate to impulsivity-related measures. Here we describe impulsivity measures in FHN and FHP individuals as they relate to a socially interactive functional magnetic resonance imaging (fMRI) task.MethodsForty FHP and 29 FHN subjects without histories of Axis-I disorders completed a socially interactive Domino task during functional magnetic resonance imaging and completed self-report and behavioral impulsivity-related assessments.ResultsFHP compared to FHN individuals showed higher scores (p = .004) on one impulsivity-related factor relating to both compulsivity (Padua Inventory) and reward/punishment sensitivity (Sensitivity to Punishment/Sensitivity to Reward Questionnaire). Multiple regression analysis within a reward-related network revealed a correlation between risk-taking (involving another impulsivity-related factor, the Balloon Analog Risk Task (BART)) and right ventral striatum activation under reward >punishment contrast (p<0.05 FWE corrected) in the social task.ConclusionsBehavioral risk-taking scores may be more closely associated with neural correlates of reward responsiveness in socially interactive contexts than are FH status or impulsivity-related self-report measures. These findings suggest that risk-taking assessments be examined further in socially interactive settings relevant to addictive behaviors.

Effects of Family History of Alcohol Dependence on the Subjective Response to Alcohol Using the Intravenous Alcohol Clamp

Alcohol use disorders are well recognized to be common, debilitating, and the risk of developing them is influenced by family history (FH). The subjective response to alcohol may be determined familialy and related to the risk of developing alcoholism. The aim of this study was to evaluate differences between family history positive (FHP) and family history negative (FHN) individuals in their response to alcohol within the domains of subjective, coordination, and cognitive effects using an intravenous (IV) clamping method of alcohol administration. Two groups of healthy subjects, those with an FHP (n=65) versus those who were FHN (n=115), between the ages of 21 to 30, participated in 3 test days. Subjects were scheduled to receive placebo, low-dose ethanol (EtOH) (target breath alcohol clamping [BrAC]=40mg%), and high-dose EtOH (target BrAC=100mg%) on 3 separate test days at least 3days apart in a randomized order under double-blind conditions. Outcome measures included subjective effects, measures of coordination, and cognitive function. Both low- and high-dose alcohol led to dose-related stimulant and sedative subjective effects as measured the Biphasic Alcohol Effects Scale and subjective measures of "high" and "drowsy" measured on a visual analog scale. However, there were no effects of FH. Similar dose-related effects were observed on cognitive and coordination-related outcomes, but were not moderated FH. Results from this study showed that healthy individuals responded to an IV alcohol challenge in a dose-related manner; however, there were no significant differences on subjective response, or on EtOH-induced impairment of coordination or cognition, between individuals with a positive FH for alcoholism and those with a negative FH. Results suggest that FH may not be a specific enough marker of risk, particularly in individuals who are beyond the age where alcohol use disorders often develop.

Effects of memantine on event-related potential, oscillations, and complexity in individuals with and without family histories of alcoholism.

Enhanced N-methyl-D-aspartate (NMDA) receptor function associated with a positive family history of alcoholism (FHP) has been hypothesized to contribute to the heritable risk for alcoholism. The objective of this study was to evaluate the relationship of alcoholism family history, NMDA receptor function, and cortical information processing by testing acute effects of the NMDA receptor antagonist memantine on event-related potential (ERP). Twenty-two healthy FHP and 20 healthy family history-negative (FHN; no alcoholic relatives) subjects were administered placebo or 40 mg of memantine under double-blind counterbalanced conditions on two separate occasions. Electroencephalogram data were collected from eight channels with eyes open during an auditory oddball discrimination task. We evaluated P3b amplitude, total theta, alpha activity, and fractal dimension from ERP trials. FHP and FHN subjects did not differ in P3b amplitude. A significant Group × Drug interaction was observed in theta, alpha activity, and fractal dimension at the parietal and occipital sites. FHP individuals exhibited significantly higher fractal dimension and lower theta and alpha activity after placebo relative to FHN subjects. Following memantine administration, theta activity decreased in both groups but more markedly for FHN individuals. Alpha activity decreased for FHN subjects and increased for FHP individuals, whereas the fractal dimension decreased for FHP subjects and increased for FHN subjects after memantine. A plausible interpretation of these results is that FHP individuals may have altered NMDA receptor function compared with FHN individuals. These findings provide additional evidence of differences in the regulation of NMDA receptor function between FHP and FHN individuals.

A study on socio-demographic characteristics of alcoholics attending the de-addiction center at Burdwan medical college and hospital in West Bengal

Prevalence of alcohol use in India is reported to be 21.4% and there is increasing alcohol intake among the young people. The present study was undertaken to study the socio-demographic characteristics of patients having alcohol-related disorders attending the de-addiction center at Burdwan Medical College in West Bengal and to find out some factors responsible for that. A clinic-based descriptive cross-sectional study was conducted among 187 patients with the help of pre-tested pre-designed schedule after obtaining informed consent. Data analysis was carried out with the help of Epi info software version 6. Majority of the patients were male, in productive age group and married. Age of initiation and amount of alcohol intake were significantly associated with positive family history of alcoholism. Children having family history of alcoholism should be counseled to prevent development of alcoholism.

Adolescent Brain Development and Underage Drinking in the United States: Identifying Risks of Alcohol Use in College Populations

Alcohol use typically is initiated during adolescence, a period that coincides with critical structural and functional maturation of the brain. Brain maturation and associated improvements in decision making continue into the third decade of life, reaching a plateau within the period referred to as emerging adulthood (18-24years). This particular period covers that of traditionally aged college students, and includes the age (21years) when alcohol consumption becomes legal in the United States. This review highlights neurobiological evidence indicating the vulnerabilities of the emerging-adult brain to the effects of alcohol. Factors increasing the risks associated with underage alcohol use include the age group's reduced sensitivity to alcohol sedation and increased sensitivity to alcohol-related disruptions in memory. On the individual level, factors increasing those risks are a positive family history of alcoholism, which has a demonstrated effect on brain structure and function, and emerging comorbid psychiatric conditions. These vulnerabilities-of the age group, in general, as well as of particular individuals-likely contribute to excessive and unsupervised drinking in college students. Discouraging alcohol consumption until neurobiological adulthood is reached is important for minimizing alcohol-related disruptions in brain development and decision-making capacity, and for reducing the negative behavioral consequences associated with underage alcohol use.

P-16 - Dexamethasone suppression test and depressive symptoms among alcohol dependent subjects are connected with positive family history of alcoholism

Clinicians and researchers have long considered stress to play major role in the development and continuation of alcohol use disorders. There are studies which reveal that alcohol dependent individuals manifest dysfunction in hormonal stress response system - the hypothalamic-pituitary-adrenal (HPA) axis. Some data indicate that there is a connection between the HPA axis dysfunction and a family history of alcohol dependence. Investigation of the relationship between the HPA axis function, depression and family history of alcohol problem. 40 abstinent, alcohol dependent patients (9 females and 31 males) of inpatient treatment program were tested during the hospitalization with questionnaires (including family history of alcohol problem (FHA) and depressive symptoms measured by Beck Depression Inventory (BDI)) and with combined dexamethasone (DEX) suppression test. 22,5% of subjects had abnormal results of DEX test. There was significant (p < 0,05) correlation between DEX test and depressive symptoms among alcohol dependent subjects with positive FHA. There was no such correlation in negative FHA group. Abnormal DEX test was connected with higher scores in BDI. There are correlations between depression, HPA-axis function and family history of alcohol problem.

Subjective Perceptions Associated with the Ascending and Descending Slopes of Breath Alcohol Exposure Vary with Recent Drinking History

The differentiator model predicts that individuals with a positive family history of alcoholism (FHA) or heavy alcohol consumers will feel more sensitive to the effects of alcohol on the ascending phase of the blood alcohol content while feeling less sedated on the descending phase. This study tested whether subjective perceptions are sensitive to the slope of breath alcohol concentration (BrAC) and whether that sensitivity is associated with an FHA and/or recent drinking history (RDH). Family-history-positive (FHP, n = 27) and family-history-negative (FHN, n = 27) young adult nondependent drinkers were infused intravenously with alcohol in 2 sessions separated by 1 week. After 20 minutes, one session had an ascending BrAC (+3.0 mg%/min), while the other session had a descending BrAC (-1 mg%/min). The BrAC for both sessions at this point was approximately 60 mg%, referred to as the crossover point. Subjective perceptions of intoxication, high, stimulated, and sedation were sampled frequently and then interpolated to the crossover point. Within-subject differences between ascending and descending responses were examined for associations with FHA and/or RDH. Recent moderate drinkers reported increased perceptions of feeling intoxicated (p < 0.023) and high (p < 0.023) on the ascending slope compared with the descending slope. In contrast, recent light drinkers felt more intoxicated and high on the descending slope. Subjective perceptions in young adult social drinkers depend on the slope of the BrAC when examined in association with RDH. These results support the differentiator model hypothesis concerning the ascending slope and suggest that moderate alcohol consumers could be at risk for increased alcohol consumption because they feel more intoxicated and high on the ascending slope. Subjects did not feel less sedated on the descending slope, contrary to the differentiator model but replicating several previous studies.

Dextromethorphan as a potential rapid-acting antidepressant

Dextromethorphan shares pharmacological properties in common with antidepressants and, in particular, ketamine, a drug with demonstrated rapid-acting antidepressant activity. Pharmacodynamic similarities include actions on NMDA, μ opiate, sigma-1, calcium channel, serotonin transporter, and muscarinic sites. Additional unique properties potentially contributory to an antidepressant effect include actions at ß, alpha-2, and serotonin1b/d receptors. It is therefore, hypothesized that dextromethorphan may have antidepressant efficacy in bipolar, unipolar, major depression, psychotic, and treatment-resistant depressive disorders, and may display rapid-onset of antidepressant response. An antidepressant response may be associated with a positive family history of alcoholism, prediction of ketamine response, increased AMPA–to–NMDA receptor activity ratio, antidepressant properties in animal models of depression, reward system activation, enhanced erythrocyte magnesium concentration, and correlation with frontal μ receptor binding potential. Clinical trials of dextromethorphan in depressive disorders, especially treatment-resistant depression, now seem warranted.

Alcoholism among male patients attending emergency units, Baghdad, Iraq

Background: The problem of excessive alcohol consumption is a major cause of public health concern in most countries of the world today. Royal Colleges of Physicians and Psychiatrists recommended that every inpatient should be screened with a questionnaire for alcohol related problems. Therefore, this work was carried out to report on alcoholism in the emergency unit in two general hospitals in Baghdad, Iraq.Methods: The study was carried out in Al-Sader general hospital (Al-Sader city, Baghdad) and Baghdad teaching hospital (Baghdad) for the period 1st July 2008 to 1st May 2009. Data collection was two days per week. Version of 25 items Michigan Alcoholism Screening Test (MAST) and semi-structured schedule based on Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for alcohol dependence were used. Males aged 16 – 70 years attended emergency units were included in the study.Results: There were 11% had alcoholism. Alcoholism was significantly associated with age &gt; 40 years, married, low educated and employed (p= 0.02, 0.002, 0.03, respectively). Alcohol dependence was significantly associated with younger age (&lt; 40 years), single, low educated, early onset of drinking (&lt; 30 years) and positive family history of alcoholism (p=0.006, 0.004, 0.004, 0.004, 0.005, respectively). Sensitivity and positivity of MAST were 86.7% and 60.7%, respectively.Conclusion: High prevalence of alcoholism was reported among attendents to emergency units.

Multiple polymorphisms in genes of the adrenergic stress system confer vulnerability to alcohol abuse

Environmental factors such as stress influence both the predisposition to and development of alcoholism, as well as have significant implications for alcoholism relapse. One predominant biological response to acute stress is the release of norepinephrine, which activates the peripheral stress response and also the hypothalamic-pituitary-adrenal axis. We aimed to examine the role of two genes of the adrenergic system (SLC6A2 and ADRA2A) in alcoholism by genotyping 21 SNPs in 785 adult alcohol-dependent patients and 1237 controls. Two single nucleotide polymorphisms (SNP) (rs36020 and rs36029) in SLC6A2 were significantly associated with alcoholism [false discovery rate corrected P-value (FDR) P = 0.007]. Two SNPs in ADRA2A (rs521674 and rs602618) were associated with a positive family history of alcoholism (FDR P ≤ 0.05). A combined SNP-set analysis was also carried out to determine the risk of harbouring multiple alcohol risk alleles across SLC6A2 and ADRA2A. Logistic regression analysis revealed that an increase in the number of alcohol risk alleles increased the risk for alcoholism (P = 0.000567, odds ratio = 1.75, 95% confidence interval 1.26-2.44). A three-SNP haplotype consisting of rs187715, rs36020 and rs40147 alleles, AGC, was also found, which was significantly over-represented in cases compared with controls (61% versus 56%). We therefore demonstrate an association of SLC6A2 and ADRA2A with adult alcoholism. These data confirm the relevance of the adrenergic stress system when considering genetic predisposition to alcohol dependence and suggest that SLC6A2 and ADRA2A should be studied in additional alcohol-dependent cohorts.

Analgesic Effects of Ethanol Are Influenced by Family History of Alcoholism and Neuroticism

Although personality factors and family history of substance abuse influence how individuals experience pain and respond to analgesics, the combined effects of those factors have not been extensively studied. The objective of this study was to consider the possible role of personality trait of neuroticism and family history of alcoholism on the experience of pain and their role in the analgesic response to an ethanol challenge. Forty-eight healthy subjects participated in this study; thirty-one had a positive family history of alcoholism (FHP), seventeen had a negative family history of alcoholism (FHN). They were also categorized based on their neuroticism (N) scores (low N = 28, and high N = 20). This was a double-blind, placebo-controlled, randomized, within-subject design study of intravenous administration of three doses of ethanol. The testing consisted of 3 separate test days scheduled at least 3 days apart. Test days included a placebo day (saline solution), low-exposure ethanol day (targeted breathalyzer = 0.040 g/dl), and high-exposure ethanol day (targeted breathalyzer = 0.100 g/dl). Noxious electrical stimulation and pain assessments were performed prior to start of infusion and at the 60-minute infusion mark. The analgesic effect of ethanol was mediated by an interaction between the personality trait of neuroticism and family history. Individuals with family history of alcoholism and high N scores reported significantly more analgesia on low dose of ethanol than those with low N scores. There was no difference in the analgesic response to ethanol among FHNs with low and high N scores. These findings support the conclusion that neuroticism and family history of alcoholism both influence the analgesic response of alcohol. Individuals with high N scores and FHP have the strongest response to ethanol analgesia particularly on the low exposure to alcohol.

Risk factors for suicide attempts in patients with alcohol dependence or abuse and a history of depressive symptoms: A subgroup analysis from the WHO/ISBRA study

Alcoholism, depression and suicide attempts (SA) are strongly interrelated. The aims were to determine risk factors and develop a prognostic predictor model for SA in a subgroup of patients with a history of alcohol dependence or abuse and depressive symptoms. A subgroup analysis from the data of the World Health Organisation (WHO)/the International Society for Biomedical Research on Alcoholism (ISBRA)-collaborative study on biological state and trait marker of alcohol use and dependence, an international multi-centre study with a cross-sectional design, based on a standardised questionnaire. We analysed from 1314 variables 43 factors-including demographic characteristics, dependence variables, comorbid disorders, personality trait markers and family history-that were supposed to be most predictive for SA according to the literature. Correlation analyses by the chi(2)-test and Mann-Whitney U-test were performed to obtain statistical meaningful parameters for logistic regression analysis. Of the 1863 persons included in the WHO/ISBRA study, 292 had both a history of depressive symptoms and alcohol dependence or abuse and were included in the subgroup analysis. In the logistic regression analysis, drinking status, depressive symptoms, adverse drinking experiences during alcohol consumption, bad experiences from drug abuse and antidepressant therapy were found to be independent risk factors for SA. Positive family history of alcoholism was a model-improving co-factor. This predictive model explains approximately 60% of the variance (Nagelkerkes' square). This prognostic model derived from data of the WHO/ISBRA collaborative study shows important risk factors for SA in patients with history of alcohol abuse or dependence and depressive symptoms.

Association of the dopamine D2 receptor gene with alcohol dependence: haplotypes and subgroups of alcoholics as key factors for understanding receptor function

The dopamine D2 receptor (DRD2) plays an important role in the reinforcing and motivating effects of ethanol. Several polymorphisms have been reported to affect receptor expression. The amount of DRD2, expressed in a given individual, is the result of the expression of both alleles, each representing a distinct haplotype. We examined the hypothesis that haplotypes composed of polymorphisms, associated with reduced receptor expression, are more frequent in alcoholics compared with healthy individuals. The polymorphisms -141ins/del, C957T, A1385G, and TaqlA were genotyped in a case-control sample comprising 360 alcoholics and 368 controls, and in a family-based sample of 65 trios. To investigate more homogenous groups, we constructed two subgroups with respect to age at onset and antisocial personality disorder. In addition, a subgroup with positive family history of alcoholism was investigated. The haplotypes I-C-G-A2 and I-C-A-A1 occurred with a higher frequency in alcoholics [P=0.026, odds ratio (OR): 1.340; P=0.010, OR: 1.521, respectively]. The rare haplotype I-C-A-A2 occurred less often in alcoholics (P=0.010, OR: 0.507), and was also less often transmitted from parents to their affected offspring (1 vs.7). Among the subgroups, I-C-G-A2 and I-C-A-A1 had a higher frequency in Cloninger 1 alcoholics (P=0.083 and 0.001, OR: 1.917, respectively) and in alcoholics with a positive family history (P=0.031, OR: 1.478; P=0.073, respectively). Cloninger 2 alcoholics had a higher frequency of the rare haplotype D-T-A-A2 (P<0.001, OR: 4.614) always compared with controls. In patients with positive family history haplotype I-C-A-A2 (P=0.004, OR: 0.209), and in Cloninger 1 alcoholics haplotype I-T-A-A1 (P=0.045 OR: 0.460) were less often present. We confirmed the hypothesis that haplotypes, which are supposed to induce a low DRD2 expression, are associated with alcohol dependence. Furthermore, supposedly high-expressing haplotypes weakened or neutralized the action of low-expressing haplotypes.

Diagnosing alcohol abuse in alcohol dependent individuals: Diagnostic and clinical implications

In DMS-IV, the diagnosis of alcohol abuse is precluded by the diagnosis of alcohol dependence. The goal of this study was to examine the diagnostic and clinical implications of diagnosing alcohol abuse among alcohol dependent individuals. Treatment-seeking psychiatric outpatients with a lifetime history of alcohol dependence ( n = 544), some of whom ( n = 45) did not meet lifetime criteria for alcohol abuse completed in-depth, face-to-face, semi-structured clinical assessments of DSM-IV axis I and axis II psychopathology. Alcohol dependent patients who did not meet criteria for alcohol abuse were significantly more likely to be female, have a later age of onset for alcohol dependence, have fewer dependence symptoms, and have a lower rate of positive family history for alcoholism, and were less likely to report a lifetime history of DSM-IV drug use disorders and PTSD. These findings suggest that diagnosing alcohol abuse among alcohol dependent patients may be clinically useful as an index of severity and higher likelihood of comorbid drug abuse and dependence. Future studies are needed to establish whether these differences are clinically significant in terms of the course of the disorder and response to treatment.

Predictors of alcohol problems in college women: The role of depressive symptoms, disordered eating, and family history of alcoholism

Disordered eating and depressive symptoms are established correlates of alcohol use in college women. Family history of alcoholism (FHA) is also related to problematic alcohol use, but there have been limited studies of how it relates to other established cofactors in women. Predictive associations between disordered eating (i.e., overall levels as well as binge eating), depressive symptoms, and alcohol problems were examined in a sample of 295 female twins. The direct and moderating effects of FHA on the relationships between alcohol problems, disordered eating, and depressive symptoms were investigated. Using hierarchical linear modeling depressive symptoms, but not disordered eating or FHA, significantly predicted alcohol problems. However, there was a significant interaction between disordered eating and FHA; disordered eating was associated with alcohol problems in those with a positive FHA. The implications for high-risk subgroups of college women are discussed.

Predicting response to opiate antagonists and placebo in the treatment of pathological gambling

Although opiate antagonists have shown promise in the treatment of pathological gambling (PG), individual responses vary. No studies have systematically examined predictors of medication treatment outcome in PG. Understanding clinical variables related to treatment outcome should help generate treatment algorithms for PG. We sought to identify clinical variables associated with treatment outcome in PG subjects receiving opiate antagonists. Two hundred eighty-four subjects [137 (48.2%) women] with DSM-IV PG were treated in one of two double-blind placebo-controlled trials (16 weeks of nalmefene or 18 weeks of naltrexone). Gambling severity was assessed with the Yale Brown Obsessive Compulsive Scale Modified for Pathological Gambling (PG-YBOCS) with positive response defined as > or =35% reduction in PG-YBOCS score for at least 1 month by study endpoint. Depression, anxiety, and psychosocial functioning were included in stepwise logistic regression analyses designed to identify clinical factors independently associated with treatment response. The clinical variable most strongly associated with a positive response to an opiate antagonist was a positive family history of alcoholism (p = 0.006). Among individuals receiving higher doses of opiate antagonists (i.e., nalmefene 50 or 100 mg/day or naltrexone 100 or 150 mg/day), intensity of gambling urges (PG-YBOCS urge subscale) was associated with a positive response on a trend level (p = 0.036). Among individuals receiving placebo, younger age was associated, on a trend level, with positive treatment outcome (p = 0.012). A family history of alcoholism appears to predict response to an opiate antagonist in PG. Future research is needed to identify specific factors (e.g., genetic) mediating favorable responses.