Alcohol

Volume 65
Number 5
September 2005

Issues Available Online

MANZARDO, A.M., PENICK, E.C., KNOP, J., NICKEL, E.J., HALL, S., JENSEN, P., MILLER, C.C. AND GABRIELLI, W.F. Neonatal Vitamin K Might Reduce Vulnerability to Alcohol Dependence in Danish Men

ABSTRACT. Objective: Levels of oxidative defenses and blood-clotting factors are normally reduced in newborns, increasing the risk of injury to developing brain structures around the time of birth. This early neonatal vulnerability corresponds to a timeframe in which the development of reward-related limbic structures is particularly active. ­Taking advantage of a serendipitous event in the history of treating newborns, we tested the hypothesis that vitamin K supplementation, administered to facilitate the synthesis of blood-clotting proteins within this critical timeframe, might also reduce the development of alcohol dependence later in life. Method: Subjects were approximately full-term male infants, selected from a large Danish birth cohort. Two thirds of the original 330 subjects in this study were high-risk sons of alcoholic fathers; 241 of the total completed the 30-year follow-up. Of subjects reported on for this article (N = 238), 44 received vitamin K supplementation at birth; 161 were considered high risk, and 66 were categorized as having lower birth weight (<6 lbs). A comprehensive series of measures was obtained on each subject before, during and shortly after birth as well as at 1 year of age. The Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, diagnosis of alcohol dependence and a measure of lifetime problem drinking served as the 30-year outcome variables. Results: Vitamin K treatment, inherited risk and low birth weight each independently predicted alcohol dependence and problem drinking at age 30. Vitamin K treatment was associated with significantly lower rates of ­alcohol dependence and fewer symptoms of problem drinking. Conclusions: Vitamin K treatment at birth might protect against the development of alcoholism in adults by reducing early postnatal hemorrhage and oxidative brain damage. (J. Stud. Alcohol66: 586-592, 2005)

VILJOEN, D.L., GOSSAGE, J.P., BROOKE, L., ADNAMS, C.M., JONES, K.L., ROBINSON, L.K., HOYME, H.E., SNELL, C., KHAOLE, N.C.O., KODITUWAKKU, P., ASANTE, K.O., FINDLAY, R., QUINTON, B., MARAIS, A.-S., KALBERG, W.O. AND MAY, P.A. Fetal Alcohol Syndrome Epidemiology in a South African Community: A Second Study of a Very High Prevalence Area

ABSTRACT. Objective: The aim of the study was to determine the prevalence and characteristics of fetal alcohol syndrome (FAS) in a second primary school cohort in a community in South Africa. Method: Active case ascertainment, two-tier screening, and Institute of Medicine assessment methodology were employed among 857 first grade pupils, most born in 1993. Characteristics of children with FAS were contrasted with characteristics of a randomly selected control group from the same classrooms. Physical growth and development, dysmorphology and psychological characteristics of the children and measures of maternal alcohol use and smoking were analyzed. Results: The rate of FAS found in this study is the highest yet reported in any overall community in the world, 65.2-74.2 per 1,000 children in the first grade population. These rates are 33-148 times greater than U.S. estimates and higher than in a previous cohort study in this same community (40.5-46.4 per 1,000). Detailed documentation of physical features indicates that FAS children in South Africa have characteristics similar to those elsewhere: poor growth and development, facial and limb dysmorphology, and lower intellectual functioning. Frequent, severe episodic drinking of beer and wine is common among mothers and fathers of FAS children. Their lives are characterized by serious familial, social and economic challenges, compared with controls. Heavy episodic maternal drinking is significantly associated with negative outcomes of children in the area of nonverbal intelligence but even more so in verbal intelligence, behavior and overall dysmorphology (physical anomalies). Significantly more FAS exists among children of women who were rural residents (odds ratio: 7.36, 95% confidence interval: 3.31-16.52), usually among workers on local farms. Conclusion: A high rate of FAS was documented in this community. Given social and economic similarities and racial admixture, we suspect that other communities in the Western Cape have rates that also are quite high. (J. Stud. Alcohol66: 593-604, 2005)

VERDURMEN, J., MONSHOUWER, K., VAN DORSSELAER, S., TER BOGT, T. AND VOLLEBERGH, W. Alcohol Use and Mental Health in Adolescents: Interactions with Age and Gender—Findings from the Dutch 2001 Health Behaviour in School-Aged Children Survey

ABSTRACT. Objective: This study examines the association between alcohol use and mental health in adolescence, specifically the interaction with age and gender. Method: Data were derived from the 2001 Health Behaviour in School-Aged Children (HBSC) survey—a repeated cross-sectional study with a total of 5,730 students aged 12-16 years, carried out as part of the World Health Organization cross-national HBSC Project. A two-stage random sampling procedure was used. Written questionnaires were administered in classroom settings. These contained questions about alcohol and other drug use as well as sociodemographic and behavioral variables. In addition, the Youth Self-Report was used to assess mental health. Results: Weekly alcohol use among adolescents is related to less withdrawn behavior and more delinquent, aggressive behavior. Significant interactions between weekly alcohol use and age were found on both externalizing and internalizing problems, indicating a stronger association between weekly alcohol use and problems among younger adolescents. No interactions with gender were found. Conclusions: Particularly at a young age, the weekly use of alcohol is associated with mental health problems. Regular alcohol use should alert parents and professionals that these adolescents might experience problems in other areas. (J. Stud. Alcohol66: 605-609, 2005)

ULLMAN, S.E., FILIPAS, H.H., TOWNSEND, S.M. AND STARZYNSKI, L.L. Trauma Exposure, Posttraumatic Stress Disorder and Problem Drinking in Sexual Assault Survivors

Abstract. Objective: Sexual assault history is associated with higher risk of problem drinking in women, yet little is known about mechanisms linking trauma histories to women’s problem drinking. This study examined how trauma histories, alcohol-related cognitive mediators and posttraumatic stress disorder (PTSD) relate to past-year problem drinking in adult female sexual assault survivors. Method: Data from self-report questionnaires completed by a large, diverse sample (N = 865) of community-residing women who had experienced adult sexual assault were analyzed. Structural equation modeling was used to test a theoretical model examining the relationship between trauma exposure, alcohol-related cognitive mediators, PTSD symptoms and past-year problem drinking. Results: These analyses suggested that trauma exposure, drinking to cope with distress and tension-reduction expectancies are the most consistent factors associated with problem drinking, whereas PTSD symptoms are not. Drinking to cope and tension-reduction expectancies were both related to greater PTSD symptoms, consistent with self-medication theory. Conclusions: These results suggest that trauma histories, drinking to cope and tension reduction may be important risk factors distinguishing sexually assaulted women who develop problem drinking from those who do not. Screening women for trauma histories even within samples of victims and assessment of women’s ways of coping and beliefs about alcohol’s effects may help to identify those at greater risk for problem drinking. (J. Stud. Alcohol66: 610-619, 2005)

MCCABE, S.E., HUGHES, T.L., BOSTWICK, W. AND BOYD, C.J. Assessment of Difference in Dimensions of Sexual Orientation: Implications for Substance Use Research in a College-Age Population 

ABSTRACT. Objective: The present research examines the associations between three distinct dimensions of sexual orientation and substance use in a random sample of undergraduate students. Method: A Web-based survey was administered to students attending a large, midwestern research university in the spring of 2003. The sample consisted of 9,161 undergraduate students: 56% female, 68% white, 13% Asian, 6% black, 4% Hispanic and 9% other racial categories. Using multivariate logistic regression analyses, several measures of alcohol and other drug use were compared across three dimensions of sexual orientation: sexual identity, sexual attraction and sexual behavior. Results: All three dimensions of sexual orientation were associated with substance use, including heavy episodic drinking, cigarette smoking and illicit drug use. Consistent with results of several other recent studies, “nonheterosexual” identity, attraction or behavior was associated with a more pronounced and consistent risk of substance use in women than in men. Conclusions: Study findings suggest substantial variability in substance use across the three dimensions of sexual orientation and reinforce the importance of stratifying by gender and using multiple measures to assess sexual orientation. Study results have implications for future research and for interventions aimed at reducing substance use among college students. (J. Stud. Alcohol66: 620-629, 2005)