Study Of Alcohol Use Research Articles

Alcohol, Helping Young Adults to Have Unprotected Sex with Casual Partners: Findings from a Daily Diary Study of Alcohol Use and Sexual Behavior

Purpose To examine the event-level association between alcohol consumption and the likelihood of unprotected sex among college-age young adults considering contextual factors of partner type and amount of alcohol consumed. Methods A 30-day, Web-based, structured daily diary was used to collect daily reports of sexual behaviors and alcohol use from 116 sexually active young adults, yielding 2,764 diary records. Each day we assessed the prior evening's behavior regarding alcohol consumption, opportunities for sex, sexual intercourse, condom use, and contextual factors including type of sexual partner. Results Based on multilevel models, drinking proximal to events of sexual intercourse increased the likelihood of unprotected sex with casual but not steady partners. For women there was a positive association between number of drinks and a greater likelihood of unprotected sex with casual partners but a negative association with steady partners. Drinking during situations involving opportunities for sex with casual partners increased the likelihood of sex. For women especially, drinking more increased the likelihood of sex occurring regardless of partner type. Conclusions Failure to assess the contextual determinants of the alcohol—unprotected sex association may result in underestimates of the magnitude of this association. These data highlight an important area for intervention with young adults: reducing alcohol-involved sexual risk behavior with casual partners, especially among women.

A longitudinal study of alcohol use and antisocial behaviour in young people

Aims: To examine the direction of causation between young people's antisocial behaviour and alcohol (mis)use in the longer and shorter term, together with their joint effects on alcohol-related trouble. Methods: A longitudinal study (2586 pupils) supplied data, allowing exploration of the causal effects of alcohol (mis)use and antisocial behaviour between ages 11 and 15, using structural equation models of longer and shorter-term relationships and joint-effects models in respect of alcohol-related trouble at age 15. This method allowed us to evaluate which of three hypotheses, described as ‘disinhibition’ [alcohol (mis)use causes or facilitates antisocial behaviour], ‘susceptibility’ [antisocial behaviour causes alcohol (mis)use] or ‘reciprocal’ [alcohol (mis)use causes antisocial behaviour and the reverse] receives most support, both overall and by gender, social class, and drinking context. Results: Overall, the results support the susceptibility hypothesis, particularly in the longer-term models. There is no support for ‘pure’ disinhibition. However, in the shorter-term and joint-effects models (i.e. as the time lag becomes shorter), there is evidence that in some gender, social class, or drinking contexts, in addition to antisocial behaviour causing alcohol (mis)use, the reverse also applies. Conclusions: Antisocial behaviour is the main predictor of alcohol (mis)use and alcohol-related trouble, with alcohol (mis)use impacting only modestly on antisocial behaviour and alcohol-related trouble in the shorter term.

Effects of home access and availability of alcohol on young adolescents' alcohol use.

The purpose of the present study was to examine the effects of parental provision of alcohol and home alcohol accessibility on the trajectories of young adolescent alcohol use and intentions. Data were part of a longitudinal study of alcohol use among multi-ethnic urban young adolescents who were assigned randomly to the control group of a prevention trial. Data were collected from a cohort of youth, and their parents, who attended public schools in Chicago, Illinois (2002-2005). The sample comprised the 1388 students, and their parents, who had been assigned randomly to the control group and were present and completed surveys at baseline, in the beginning of 6th grade (age 12). The sample was primarily low-income, and African American and Hispanic. Students completed self-report questionnaires when in the 6th, 7th and 8th grades (age 12-14 years; response rates 91-96%). Parents of the 6th grade students also completed questionnaires (70% response rate). Student report, at age 12, of parental provision of alcohol and home alcohol availability, and parental report of providing alcohol to their child and the accessibility of alcohol in the home, were associated with significant increases in the trajectories of young adolescent alcohol use and intentions from ages 12-14 years. Student report of receiving alcohol from their parent or taking it from home during their last drinking occasion were the most robust predictors of increases in alcohol use and intentions over time. Results indicate that it is risky for parents to allow children to drink during early adolescence. When these findings are considered together with the risks associated with early onset of alcohol use, it is clear that parents can play an important role in prevention.

Age-Dependent Variation in Behavior Following Acute Ethanol Administration in Male and Female Adolescent Rhesus Macaques (Macaca mulatta)

There has been considerable focus on the adolescent stage of development in the study of alcohol use and the etiology of alcohol-related problems. Because adolescence is a process of dynamic change rather than a discrete or static stage of development, it is important to consider ontogenetic changes in the response to ethanol within the adolescent time period. In rodents, levels of ethanol-induced motor impairment have been shown to increase from early to late adolescence. This study investigated associations between behavior following acute ethanol administration and age, rearing condition (mother-reared vs nursery-reared), and serotonin transporter (rh5-HTTLPR) genotype in a sample of alcohol-naïve adolescent rhesus macaques. Rhesus macaques (n=97; 41 males, 56 females), ranging in age from 28 to 48 months, were administered intravenous (IV) doses of ethanol (2.2 g/kg for males, 2.0 g/kg for females) twice in 2 separate testing sessions. A saline/ethanol group (n=16; 8 males, 6 females) was administered saline in 1 testing session and ethanol in the second session. Following each IV injection, subjects underwent a 30-minute general motor behavioral assessment. Behavior in the saline/ethanol group was compared between the saline and ethanol-testing sessions using analysis of variance. Behavioral data for the larger study sample were averaged between the 2 testing sessions and summarized using factor analysis. Rotated factor scores were used as dependent variables in multiple regression analyses to test for relationships between behavior and age, rearing condition, and rh5-HTTLPR genotype. During the ethanol-testing session, behaviors indicative of motor impairment (stumbles, falls, sways, bumping the wall, and unsuccessful jumps) were frequently observed in the saline/ethanol group, while they did not occur under the saline-testing session. Factor analysis of behavior following ethanol administration in the larger study sample yielded 3 factors: Ataxia, Impaired Jumping Ability, and Stimulation. Significant negative correlations between age and Ataxia were found for both males and females. Females also exhibited positive correlations between age and Impaired Jumping Ability and age and Stimulation. No significant correlations were found with either rearing condition or rh5-HTTLPR genotype. These findings suggest that ontogenetic changes during adolescence in the behavioral response to ethanol differ between rodents and primates. Furthermore, sex differences in the behavioral response to ethanol appear to develop during adolescence.

ERYTHROCYTE ALDEHYDE DEHYDROGENASE ACTIVITY: LACK OF ASSOCIATION WITH ALCOHOL USE AND DEPENDENCE OR ALCOHOL REACTIONS IN AUSTRALIAN TWINS

Aldehyde dehydrogenase 1 (ALDH1) has been advocated as a marker of alcohol intake. The absence or low levels of ALDH1 may be associated with alcohol-induced flushing or other reactions to alcohol in Europeans and therefore, with reduced alcohol use. This study tested whether variation in erythrocyte ALDH1 activity was associated with alcohol use, alcohol dependence or reactions to alcohol in unselected subjects of European descent, and whether variation in ALDH1 activity was subject to genetic influences. ALDH activity was measured in erythrocytes from 677 men and women who had participated in a twin study of alcohol use and dependence. There were no significant effects of sex, alcohol consumption or alcohol dependence on ALDH activity. Subjects who reported reactions to alcohol did not have low activity. Women aged below 45 years had lower ALDH activity than men or older women. The heritability of ALDH activity was 56% (95% confidence interval = 42-67%). Previous reports that erythrocyte ALDH activity is low in alcoholics were not substantiated in this community-based sample. Associations with alcohol reactions were not found. ALDH activity varies widely between subjects, largely because of genetic factors.

Predicting heavy alcohol use among adolescents.

A prospective, school-based study of alcohol use in a multiethnic sample of 3,675 adolescents found that family factors, other drug use, psychosocial-behavioral factors, and ethnic status are important discriminators of adolescents who are heavy alcohol users when compared with those who are experimental or moderate users. Implications for prevention and intervention are discussed.

Alcohol dehydrogenase 2 genotypes, maternal alcohol use, and infant outcome

Objective: To determine whether different alleles of the ADH2 gene (ADH2-1, ADH2-2 and ADH2-3) with differing levels of enzymatic activity can alter the risk of fetal alcohol effects. Study design: ADH2 genotypes were performed on 404 pregnant high-risk women and 139 infants as part of a larger study of alcohol use in pregnancy. Mothers were interviewed about alcohol use during pregnancy, and their infants were examined for alcohol-related features without knowledge of the exposure status. Results: The ADH2-1/3 genotype was more prevalent among black women (46%) than expected (33%); the rate among white women was low as expected (2%). More black women who reported high alcohol use during the pregnancy had the ADH2-1/3 genotype compared with those who reported no alcohol use (70% vs 44%). Sixty percent of the affected black infants had the ADH2-1/3 genotype compared with 29% of the unaffected infants (P <.045). The maternal genotype correlated with her chance of having an infant with alcohol-related physical features (odds ratio = 2.49). This association remained significant after accounting for confounders, such as smoking and maternal weight gain. Alcohol exposure was not significantly associated with infant outcome in black infants after accounting for genotype, smoking, and maternal weight gain, but this association could only be tested in 10 infants of mothers with high exposure. Conclusion: Women with the ADH2-1/3 genotype may be at greater risk for having an affected infant, which may be the result of greater ingestion of alcohol. (J Pediatr 2002;141:780-5)

Is genotype important in predicting the fetal alcohol syndrome?

Is genotype important in predicting the fetal alcohol syndrome?

Alcohol use in South Africa: findings from the South African Community Epidemiology Network on Drug use (SACENDU) Project.

To provide community-level public health surveillance on alcohol misuse in South Africa and the associated negative consequences. A descriptive, epidemiological study of alcohol use based on data gathered biannually from multiple sources over 4 years, including specialist treatment centers, trauma units, mortuaries, psychiatric facilities, and surveys of school students and arrestees. Networks were set up in five sentinel sites to facilitate the collection, interpretation and dissemination of data. Indicators point to the widespread misuse of alcohol. Alcohol consistently dominates the demand for substance use disorders treatment services. In the second half of 2000, 51.1% (Cape Town) to 77.0% (Mpumalanga) of patients reported alcohol as their primary substance of abuse. A high proportion of patients in trauma units tested positive for alcohol in 2000, ranging from 40.3% (Durban) to 91.8% (Port Elizabeth). Similarly, a high proportion of mortality cases tested positive for alcohol, ranging from 40.3% (Durban) to 67.2% (Port Elizabeth). Although treatment demand is dominated by men and older persons, alcohol misuse occurs among all sectors. School surveys reflect harmful drinking patterns among students, with 53.3% and 36.5% of male students in Durban and Cape Town, respectively, reporting heavy-drinking episodes by Grade 11. Alcohol misuse has a number of implications for public health policy, such as the need to develop protocols for the management of alcohol-positive patients in trauma units and to target prevention programs at heavy drinking by young people. Further monitoring of alcohol misuse and its associated negative consequences is required.

Alcohol Use and High-Risk Sexual Behavior Among Adolescents and Young Adults in Harare, Zimbabwe

We conducted a quantitative and qualitative study of alcohol use and high-risk sexual behavior among adolescents and young adults of age 15–21 years in Harare, Zimbabwe. Methods included a cross-sectional survey of youth sampled at nightclubs and bottle stores informed by participant observation, key informant interviews, and focus group discussions. Findings corroborated a cycle of HIV transmission that involves older men, younger women, and ultimately the steady partners of both. Nightclubs and other drinking establishments catering to youth can provide opportunities for preventing HIV transmission through stuctural interventions or targeted outreach education.

The TWEAK: application in a prenatal setting.

The TWEAK is a screening instrument used to identify women who are risk drinkers. Potential limitations of previous studies of the TWEAK in the prenatal setting include indirect administration of the instrument to minority, indigent pregnant women. The purpose of this study is to assess the efficacy of the TWEAK when it is given directly to a sample of pregnant women of different socioeconomic backgrounds. The original TWEAK, with two different tolerance questions, was administered to a sample of 135 pregnant women enrolled in a study of alcohol use during pregnancy at the obstetrics practices of the Brigham and Women's Hospital in Boston, Massachusetts. The TWEAK, using the first tolerance question (number of drinks before feeling the first effects of alcohol) with the cut point set at more than two drinks, had the best predictive ability for lifetime alcohol diagnoses and risk drinking. The sensitivity of the TWEAK can be increased if the cut point for the first tolerance question is set at two drinks, with some loss of specificity and predictive ability. Medical record assessment was the least sensitive but most specific method of identifying alcohol use by pregnant women. The TWEAK has promise as a screening instrument for identifying risk drinking during pregnancy. Future work should include testing in other clinical populations.

Predicting academic problems in college from freshman alcohol involvement.

The present article examines the relation of problematic alcohol use to collegiate academic problems based on a systematic assessment of problematic alcohol use and college transcript data. The degree to which this prospective association can be explained by reference to third variables is also explored. These third variables include: students' high school academic achievement and aptitude, concurrent drug use, participation in deviant behaviors and students' investment or participation in the college experience. A sample of 444 (240 female) college freshman recruited for a longitudinal study of alcohol use was followed for 6 years. Alcohol and drug involvement, general deviance, academic investment, campus involvement and several background variables were assessed during the freshman year. Additional measures of high school aptitude and achievement as well as collegiate performance were calculated based on college transcript data from all institutions attended. A latent variable structural equation model revealed that problematic alcohol use during the freshman year correlated +.32 with collegiate academic problems. No evidence was found for a unique association between the two constructs when additional constructs were included in the model. Specifically, the association was substantially reduced when preexisting student differences traditionally associated with academic failure in college were taken into account. The inclusion of concurrent drug use and deviance also resulted in a significant reduction in the magnitude of the association. Although a substantial bivariate association exists between problematic alcohol use and academic problems during college, much of this association appears attributable to preexisting student differences on admission to college.

Total versus hazardous per capita alcohol consumption as predictors of acute and chronic alcohol-related harm

This paper is a preliminary attempt to compare the power of different measures of alcohol consumption to predict variations in rates of alcohol-related harm across 130 adjacent geographical areas comprising the state of Western Australia (WA). It has been argued recently that there may be both scientific and political advantages to replacing, where possible, estimates of per capita total consumption of alcohol with estimates of hazardous consumption.' The arguments favoring this view include: (i) evidence that frequency of heavy drinking occasions predicts self-reported alcohol-related harm in population surveys to a greater degree than does average daily intake;2 (ii) evidence that prevention strategies that overtly target total population consumption are less well received by the voting public than those that target high-risk drinking or actual harm.3 To date this evidence has accumulated mainly from survey data. The present study attempts to examine the issue of predictive power in relation to rates of actual harm as indicated by traffic, health and police statistics for WA and of rates of alcohol consumption derived from both wholesale and survey data. Alcohol consumption is reported in a variety of ways to suit different purposes. For example, surveys frequently report the number of people whose average daily consumption exceeds levels considered to be harmful by Australia's peak medical research body' (e.g., 6% men and 3% women-). We are often told about per capita alcohol consumption-e.g., in 1993 the average Australian adult consumed 9.4 liters of absolute alcohol.6 What is not reported, however, is how much of this consumption is low risk or even beneficial (e.g., in terms of protecting the drinker against ischemic heart disease') and how much would be considered medium or high risk. A method for making such estimates from consumption survey data was described recently, which resulted in the calculation that almost one-third of all alcohol consumed in WA was at a harmful level.8 This method is adapted in this paper to calculate the proportion of total alcohol consumption in 130 regions of WA that is, to use a more conservative term, hazardous. Most other studies of drinking patterns have estimated these in terms of the frequency of heavy drinking occasions-e.g., drinking more than five standard drinks.2 The measure used here combines both frequency and the quantity consumed on such occasions and may thus combine the advantages of measures of both pattern and volume of drinking in one variable. This study is an early product of a research program entitled Measurement of Alcohol Problems for Policy (MAPP). This program brings together for the first time a number of statewide data sets that include measures or likely indicators of alcohol consumption and related harm. The relationships between these various measures and other sociodemographic variables have so far been explored for the financial year 1991-1992.9 The eventual aim of the MAPP project is to identify those indicators that are most sensitive to variations in consumption and harm across different geographical regions and over time. It is hoped this will enable prevention strategies to be better targeted, monitored and evaluated. In the road safety research area, a surrogate measure of alcohol-related crashes has been developed to overcome the problem of estimating alcohol-relatedness: single-vehicle nighttime accidents. These have been shown repeatedly to involve mostly drunk drivers and are now used routinely in the evaluation of major statewide prevention initiatives that target drinking and driving.'o It is likely that similar surrogate measures can be developed for other problem domains. For example, in a study of alcohol use and violence, Ireland and Thommeny reported that 91% of street offenses committed between 10 pm and 2 am involve prior consumption of alcohol. The first report of the MAPP project examined a number of potential harm indicators in the domains of road crashes, hospital morbidity data, drink driving, and assault offenses! …

Predictors of alcohol use among rural adolescents.

There is increasing evidence that alcohol use is becoming more common during childhood and early adolescence. However, little is known about alcohol use among rural youths. This article reports a study of alcohol use among 367 fifth-grade students in two rural South Carolina school districts. More than one third (n = 131) of the fifth graders reported having used alcohol. Of these, 34 percent (n = 44) reported drinking during the previous month; 8 percent had been intoxicated during the previous two months; and 54 percent reported drinking in the home with or without parental approval. Logistic regression analysis was used to determine the predictors of alcohol use by fifth graders. The results indicated that gender (OR = 2.82), mother's alcohol use (OR = 1.86), father's alcohol use (OR = 2.13), and smoking (OR = 8.30) were significantly associated with alcohol use. The findings suggest that prevention programs address cigarette smoking and drinking behaviors of parents to reduce alcohol use and the acquisition of other health compromising behavior by youths. Early intervention approaches must go beyond the schools and target families as well as community populations.

The epidemiology of alcohol use in Australian women: findings from a national survey of women's drinking.

This is the first study of alcohol use, alcohol problems and alcohol dependence in a general population sample of Australian women using a standardized screening instrument developed by the World Health Organization, the Alcohol Use Disorders Identification Test (AUDIT). Sixty-six percent of a sample of 6000 women randomly selected from the electoral rolls responded to the questionnaire. The majority of women (87%) had drunk alcohol at some time in their lives, while 82% had consumed alcohol within the past 12 months. Of the women who currently drank alcohol, 34% were classified as hazardous drinkers, 4% as harmful drinkers and 1% as dependent according to AUDIT definitions. Using a cut-off score of 8 for the AUDIT, 8% of women were classified as currently having a drinking pattern of hazardous or harmful alcohol consumption. These women were more likely to be younger (17-44 years), single, or living in a de facto relationship. The results of this survey provide important data which can be used as a bench-mark to measure changes in women's drinking behaviour and drinking related problems.

College alcohol use

A composite screening measure pin-pointed college students9 drinking patterns and predicted risk for future problem drinking, reported the April 1996 Journal of Adolescent Health. A random sample of 452 subjects — about 90 percent white, from a selective Southern university — entered a long-term study of alcohol use at the beginning of their college freshman year. Of the 318 still enrolled at the end of junior year, 184 (58 percent) completed follow-up questionnaires.

Concurrent and prospective screening for problem drinking among college students

Previous studies suggest that combining the CAGE questionnaire with the Perceived Benefit of Drinking Scale (PBDS), information about an adolescent's use of tobacco, and best friend's drinking pattern is a useful composite screening measure for problem drinking. The present study was undertaken to evaluate this composite screening measure prospectively as a predictor of subsequent problem drinking among late adolescents across 3 years of college. A random sample of 452 college freshmen entered a longitudinal study of alcohol use at the beginning of their freshman year. A total of 184 (58%) completed follow-up measures of alcohol use 32 months later. Outcome measures included the quantity and frequency of alcohol use and a composite measure of specific alcohol-related problems. CAGE scores, PBDS scores, tobacco use, and best friend's drinking patterns as reported at college entry together explained 33% of the variance in the quantity/frequency measure and 37% of the variance in the alcohol-related problems measure from the end of the junior year. These same variables as reported at the end of the junior year explained 50% of the variance in the quantity/frequency measure and 61% of the variance in the alcohol-related problems measure. The composite screening measure as reported at college entry had a sensitivity of 73%, specificity of 70%, positive predictive value (PPV) of 63%, and negative predictive value (NPV) of 78% for students at high risk for problem drinking at the end of the junior year. A similar concurrent composite screening measure consisting of the same variables reported at the end of the junior year had a sensitivity of 88%, specificity of 56%, PPV of 60%, and NPV of 83% for high-risk drinkers. A total of 70-73% of students could be correctly categorized by each composite screening measure. These composite screening tests had significantly better test characteristics than the CAGE or PBDS alone. College students' responses to the CAGE, PBDS, tobacco use, and their friends' drinking remain consistent over 3 years and correlate with concurrent and future risk for problem drinking. These variables explain significant variance in drinking and alcohol-related problems and may constitute a useful screening measure for current and future problem drinking.

Relation of alcohol expectancies to changes in problem drinking among college students.

To evaluate the relation between alcohol expectancies and problem drinking during 3 years of college. Cohort with 3-year follow-up. Private university campus. A random sample of 260 students entered a longitudinal study of alcohol use at the beginning of their freshman year. One hundred eighty-four students completed follow-up measures at the end of their junior year. Respondents were 90% white, with a mean (+/-SD) age of 17.9 +/- 0.5 years. None. A standardized measure of expectations and subjective evaluations of outcomes associated with drinking, quantity and frequency of alcohol use, and a composite measure of alcohol-related problems. Students were divided into nondrinking, low-risk, and high-risk groups for problem drinking. A repeated-measures multivariate analysis of variance indicated significant interaction effects for risk group by expectancy scale (P < .009) and for expectancy scale by time (P < .001). The three risk groups differed significantly from each other on positive outcome expectations at entry into college and positive expectations and negative outcome evaluations at the end of the junior year. Students who became problem drinkers during college had significantly higher positive outcome expectation scores at both times and developed less concern for negative outcomes by the end of their junior year. The few initial problem drinkers who moderated their drinking during college demonstrated an increased concern for negative outcomes by their junior year. Alcohol expectancies are associated with differing patterns of alcohol use and are longitudinally related to subsequent changes in alcohol use and problem drinking.

Longitudinal evaluation of a screening measure for problem drinking among female college freshmen.

A previous study suggested that combining the CAGE (cutting down of drinking, feeling annoyed by criticisms of drinking, feeling guilty about something that happened because of drinking, having an eye-opener) questionnaire with the Perceived-Benefit-of-Drinking Scale, an adolescent's use of tobacco, the age at which an adolescent first started drinking, and an adolescent's best friend's drinking pattern is a useful composite screening measure for problem drinking among adolescents. The present study was undertaken to evaluate prospectively this composite screening measure as a predictor of subsequent problem drinking among college women during their freshman year. Cross-sectional. Private university student health service. A random sample of 248 college freshman women entered a longitudinal study of alcohol use at the beginning of their freshman year. One hundred twenty (48%) completed follow-up measures of alcohol use at the end of the year. Respondents were 90% white, with a mean age of 17.9 years (SD = 0.5 years). An index of the quantity and frequency of alcohol use and a composite measure of specific alcohol-related problems. The CAGE questionnaire score, the Perceived-Benefit-of-Drinking Scale score, the student's tobacco use, the student's best friend's drinking pattern, and the age at which the student first started drinking as reported at the beginning of the year together explained 38% of the variance in subsequent drinking habits and 26% of the variance in alcohol-related problems reported during the freshman year. Use of the composite screening measure significantly increased sensitivity and specificity beyond that obtained with the CAGE questionnaire or the Perceived-Benefit-of-Drinking Scale alone for problem drinking. The CAGE questions, the Perceived-Benefit-of-Drinking Scale, the student's tobacco use, the student's best friend's drinking pattern, and the age at which the student first started drinking may together constitute a clinically useful screening measure for subsequent problem drinking among female college freshmen.

Attachment Styles and Marital Adjustment among Newlywed Couples

Recent research has shown a relation between adults' attachment styles and their interpersonal functioning. The present study examined attachment styles and marital adjustment among 322 young, newlywed couples participating in a longitudinal study of alcohol use and marital functioning. Couples completed a three-item measure of adult attachment styles and measures of marital intimacy, partners' marital functioning and partners' conflict resolution behaviors. The data were analyzed within a repeated measure design. Couple attachment type (both partners' attachment styles) was the between subject factor, and husband-wife was the within subject factor. Results showed that husbands and wives tended to pair on the basis of similarity of attachment security. However, it was the nature of the pairings, rather than their similarity, per se, which was associated with the marital adjustment variables. Couples in which both partners were securely attached evidenced better overall marital adjustment than couples in which one or both partners were insecurely attached. Additional findings are discussed.