Journal of Studies on
Alcohol
Volume 66
Number 2
March 2005
Issues Available Online
September 2006
July 2006
May 2006
March 2006
January 2006
November 2005
September 2005
Supplement 15 July 2005
July 2005
May 2005
March 2005
January 2005
November 2004
September 2004
July 2004
May 2004
March 2004
January 2004
November 2003
September 2003
July 2003
May 2003
March 2003
January 2003
November 2002
September 2002
July 2002
May 2002
Selected Abstracts
Dick, D.M., Agrawal, A., Schuckit, M.A., Bierut, L., Hinrichs, A., Fox, L., Mullaney, J., Cloninger, C.R., Hesselbrock, V., Nurnberger, J.I., Jr., Almasy, L., Foroud, T., Porjesz, B., Edenberg, H., and Begleiter, H. Marital Status, Alcohol Dependence, and GABRA2: Evidence for Gene-Environment Correlation and Interaction
ABSTRACT. Objective: The gene GABRA2 has been associated with the risk for alcohol dependence in independent samples. This article explores how this genetic risk factor interacts with marital status, another factor previously shown to be associated with the risk for alcohol dependence. Method: Data from more than 1,900 male and female subjects from the Collaborative Study of the Genetics of Alcoholism (COGA) sample were analyzed. Subjects were recruited based on membership in a family with multiple individuals with alcoholism. A series of analyses was performed to evaluate the relationship between the following: (1) GABRA2 and alcohol dependence, (2) marital status and alcohol dependence, (3) GABRA2 and marital status, and (4) interactions between GABRA2 and marital status on the development of alcohol dependence in the high-risk COGA sample. Additional analyses were carried out in a sample of ~900 individuals from control families to test the generalizability of results. Results: Both GABRA2 and marital status contributed independently to the development of alcohol dependence in the COGA sample. The high-risk genotype at GABRA2 was also related to a decreased likelihood of marrying and an increased likelihood of divorce, which appeared to be mediated in part by personality characteristics. There was also differential risk associated with the GABRA2 genotype according to marital status. Conclusions: These analyses provide evidence of both gene-environment correlation and gene-environment interaction associated with GABRA2, marital status, and alcohol dependence. They illustrate the complex pathways by which genotype and environmental risk factors act and interact to influence alcohol dependence and challenge traditional conceptualizations of “environmental” risk factors. (J. Stud. Alcohol67: 185-194, 2006)
ABSTRACT. Objective: The purpose of this study was to investigate the effects of transitional life events related to education, employment, and family formation on the likelihood of recovery from alcohol dependence as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), distinguishing the short- and long-term effects of these events and potential effect modification by treatment history, gender, and severity of dependence. Method: This analysis is based on data from the Wave 1 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a cross-sectional, retrospective survey of a nationally representative sample of U.S. adults 18 years of age and older. The analytic sample consisted of 4,422 individuals with prior-to-past-year (PPY) onset of DSM-IV alcohol dependence. Time-dependent proportional hazards models were used to estimate the effects of completing school, starting full-time work, getting married, becoming separated/divorced/widowed, and becoming a parent on the outcomes of nonabstinent recovery (NR; e.g., low-risk asymptomatic drinking) and abstinent recovery (AR). Results: Entry into and exit from a first marriage each increased the likelihood of NR during the first 3 years after those events occurred (hazard rate ratio [HRR] = 1.37 and 1.76, respectively). However, individuals who were still dependent 3 or more years after those events occurred had a decreased likelihood of subsequent NR (HRR = 0.70 for both events), as did those who were still dependent 3 or more years after completing schooling (HRR = 0.54). The likelihood of AR was more than doubled in the 3 years after first becoming a parent (HRR = 2.22) but was decreased among individuals still dependent 3 or more years after starting full-time work. For the outcome of NR, all of the negative effects associated with still being dependent 3 or more years after the occurrence of key life events were more strongly negative among individuals with less severe cases of dependence. Conclusions: Transitional life events demonstrate many effects on recovery, including both direct effects consistent with role socialization and associations more reflective of selectivity than causation. Taken as a whole, these events appear to contribute to (but by no means fully explain) the high rates of recovery from alcohol dependence that have been observed even in the absence of treatment. (J. Stud. Alcohol67: 195-203, 2006)
ABSTRACT. Objective: The present study examined the influences of personality dimensions (extraversion, neuroticism) on college alcohol involvement both (1) directly and (2) mediated by positive and negative alcohol expectancies across two imagined (high and low) alcohol doses. Method: Participants (N = 339; 176 women) were regularly drinking college students who completed a questionnaire battery on demographic characteristics, personality, expectancies, and alcohol use and problems. Results: Structural equation modeling analysis of low- and high-dose models revealed partial support for the Social Learning Theory conceptualization of expectancies as mediators of more distal (personality) influences. Interestingly, patterns of association differed by dose. At high-expectancy doses, positive alcohol expectancies fully mediated the extraversion-use association. At low doses, positive expectancies did not play a critical role. Two distinct pathways from neuroticism to alcohol use were observed: a direct pathway, whereby neuroticism is a protective factor for alcohol use, and an indirect pathway, through positive expectancies, whereby neuroticism is a risk factor. The protective pathway was evident regardless of expectancy doses, whereas the risk pathway was evident only at high doses. Negative expectancies partially mediated the association between neuroticism and alcohol problems at both high- and low-expectancy doses. Conclusions: These data underscore the unique role of both positive and negative expectancies in the association between personality and drinking behavior and point to the importance of considering alcohol dose when assessing expectancies. Findings suggest that it may be beliefs about the effects resulting from heavy (rather than moderate) drinking that may be the active mechanism underlying drinking behavior. (J. Stud. Alcohol67: 204-214, 2006)
ABSTRACT. Objective: The development of alcohol-use disorders (AUDs) reflects a complex relationship between genetic influences and environmental/cultural forces. Some genes operate through intermediate phenotypes, including a low level of response (LR) to alcohol, externalizing symptoms (EXT), and internalizing characteristics such as depressive syndromes (DEP). This article evaluates the impact of these three intermediate phenotypes and additional domains in a structural equation model (SEM). Method: Data were available from baseline at approximately age 20 for LR, as well as from additional domains at the 10- and 15-year follow-up periods for 393 men from the San Diego Prospective Study. Correlational analyses and an AMOS-based SEM were used to evaluate the development of alcohol problems, including AUDs, with the hypothetical model based on results from prior studies evaluating each key intermediate phenotype separately. Results: The SEM explained 51% of the variance of the 15-year outcome, and had good fit characteristics. The family history of AUDs (FHalc) was linked, directly or indirectly, to all three key domains. The combination of LR and EXT mediated the relationship between FHalc and 15-year alcohol outcomes, with a trend (p = .07) for LR to mediate between FHalc and the 10-year outcome. DEP, by itself, did not mediate FHalc to alcoholism. The LR predicted the 15-year outcome both through alcohol problems at 10 years and via drinking to cope (COPE), with each of these domains functioning as mediators. The relationship of EXT to outcome was mediated by alcohol expectations (EXPECT) and by COPE. DEP added to the model in the context of an FH of independent depressions, stress, and lower social supports, subsequently affecting COPE. Conclusions: The results indicate that the development of AUDs reflects several genetically influenced endophenotypes in the context of multiple additional domains. Both EXPECT and COPE represented important pathways through which the phenotypes influenced the AUD risk. (J. Stud. Alcohol67: 215-227, 2006)
ABSTRACT. Objective: The purpose of this study was to determine whether opioid-dependent patients with diagnosed posttraumatic stress disorder (PTSD) have poorer long-term outcomes in opioid substitution treatment than do patients without PTSD. Method: This prospective observational study examined outcomes of 255 opioid-dependent patients (men = 248) entering opioid substitution treatment at eight clinics in the Veterans Health Administration (VHA). Subjects were interviewed at treatment entry, 6 months, and 1 year about substance use and related problems, health status, treatment satisfaction, and non-VHA health care utilization. Medical records were reviewed to obtain toxicology results, health care utilization data, and diagnoses. Medical record review identified a diagnosis of PTSD in 71 (28%) patients. Substance-use and mental-health outcomes and health care utilization in the first year following treatment entry were compared between patients with and without a diagnosis of PTSD. Results: Patients with and without PTSD had similar treatment responses. Although patients with PTSD had longer histories of drug use at intake, at 1-year follow-up they showed reductions in heroin, cocaine, and alcohol use, comparable to patients without the disorder. PTSD patients received higher doses of opiate medication, attended more psychosocial treatment sessions for substance-use disorder, and had better treatment retention. Psychiatric symptoms for patients with PTSD were more severe at intake and showed little improvement throughout treatment. Conclusions: Opioid substitution therapy is as effective at reducing substance use in PTSD patients as it is in patients without the disorder, but additional services are needed for treatment of psychological problems that are largely unchanged by treatment for addiction. (J. Stud. Alcohol67: 228-235, 2006)