Alcohol

Volume 67
Number 3
May 2006

Issues Available Online

Duncan, A.E., Scherrer, J., Fu, Q., Bucholz, K.K., Heath, A.C., True, W.R., Haber, J.R. Howell, D., and Jacob, T. Exposure to Paternal Alcoholism Does Not Predict Development of Alcohol-Use Disorders in Offspring:  Evidence From an Offspring-of-Twins Study

ABSTRACT. Objective: Using an offspring-of-twins design, we tested the hypothesis that exposure to paternal alcoholism during the child’s first 12 years will increase offspring risk for subsequent alcohol-use disorders (AUD). Method: Structured psychiatric interviews assessed history of psychiatric and substance-use disorders in Vietnam Era Twin Registry fathers (n = 512), their offspring (n = 877), and mothers of the offspring (n = 507). Exposure was defined as the fathers’ endorsement of any Diagnostic and Statistical Manual of Mental Disorders (DSM), Fourth Edition, AUD symptom, according to the Lifetime Drinking History assessment (administered in 1999), at any time between offspring ages 0-12 years; all fathers had satisfied DSM, Third Edition, Revised (DSM-III-R), criteria for alcohol dependence in a 1992 diagnostic interview. Cox proportional hazards models were fit to predict time to first symptom of abuse/dependence in offspring. Results: Offspring exposed to paternal alcoholism were significantly more likely to develop an AUD when compared with offspring of nonalcoholic fathers (hazard ratio [HR] = 1.51; 95% confidence interval [CI]: 1.10-2.07). Although offspring unexposed to paternal alcoholism did not significantly differ from control offspring (HR = 1.50, 95% CI: 0.93-2.41), the magnitude of association was similar to that in the exposed offspring. There were no significant differences in AUD between offspring of alcoholics who were exposed and those who were not exposed to paternal alcoholism, as long as fathers had satisfied DSM-III-R criteria for alcohol dependence at some point in their lives. Conclusions: There does not appear to be a relationship between exposure to paternal alcoholism during childhood and development of an AUD in offspring. Genetic and high-risk environmental factors that are correlated with lifetime paternal alcoholism may be stronger predictors of offspring AUD than fathers’ problem drinking. Future research should be encouraged, using more comprehensive analyses, to examine the role of family genetic influences and other family environmental influences on offspring alcohol outcomes. (J. Stud. Alcohol67: 649-656, 2006)

Hartman, C.A., Lessem, J.M., Hopfer, C.J., Crowley, T.J., and Stallings, M.C. The Family Transmission of Adolescent Alcohol Abuse and Dependence

ABSTRACT. Objective: This study examines the familial transmission of alcohol abuse and dependence to adolescents. Method: Male adolescents recruited from a treatment program for substance problems, matched controls, and all available biological parents and siblings were assessed with a structured psychiatric interview assessing Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, based diagnoses of alcohol abuse and alcohol dependence. A total of 2,612 individuals from 911 families were interviewed. Structural equation modeling estimated tetrachoric correlations among family members, the proportion of variance in abuse and dependence attributable to parent-offspring transmission, and the effects of assortative mating and horizontal transmission among siblings. Results: Tetrachoric correlations among siblings and parent-offspring ranged from .19 to .34 for abuse and dependence. Mother-father correlations were .14 and .37 for abuse and dependence, respectively. Modeling of familial transmission showed that 33% of the variance in abuse and 56% of the variance in dependence was accounted for by factors transmitted from parents. The effects of assortative mating could not be dropped from the abuse model without significant loss of model fit but could be dropped from the dependence model. Horizontal transmission among siblings could be dropped from both models without significant loss of fit. Conclusions: These results suggest that aggregation of alcohol abuse and alcohol dependence in families of male probands is significantly influenced by parental transmission of risk but is not reliably influenced by horizontal sibling effects such as sibling interactions or cohort effects. Spousal resemblance was found to be an important source of familial aggregation for alcohol abuse but not alcohol dependence. ( J. Stud. Alcohol 67: 657-664, 2006)

Testa, M., VanZile-Tamsen, C., Livingston, J.A., and Buddie, A.M. The Role of Women's Alcohol Consumption in Managing Sexual Intimacy and Sexual Safety Motives

ABSTRACT. Objective: Two studies, based on an alcohol myopia model, were designed to understand the role of women's alcohol consumption on vulnerability to sexual assault. We predicted that, in a high-conflict social situation, alcohol would make it more difficult to recognize sexual assault risk, lowering intentions to resist sexual advances. Method: In Study 1, women ( N = 51) were recruited in bars and classified as having a high (.06 or greater) breath alcohol concentration (BrAC) or low BrAC. They were asked to project themselves into a hypothetical scenario that portrayed interest in establishing an intimate relationship and included mild sexual aggression. In Study 2, women ( N = 101) were randomly assigned to an alcohol (target BrAC: .08%), placebo, or no-alcohol condition. They responded at two time points to a similar hypothetical scenario that described mild sexual aggression (Time 1) and serious sexual aggression (Time 2). Results: In Study 1, women with higher BrAC perceived less risk in the scenario and anticipated less resistance than women with low BrAC. In Study 2, similar results were found but only following serious aggression. There were no placebo effects. Both studies suggest that the effects of alcohol on resistance are partially mediated via risk perceptions. Conclusions: Alcohol appears to reduce intentions to resist sexual advances from an acquaintance while increasing intentions to pursue relationship-enhancing behaviors. Effects are not completely explained by an alcohol myopia perspective. Differences in findings between the two studies may reflect differences in methodology, context, or sample. ( J. Stud. Alcohol 67: 665-674, 2006)

Venner, K.L. and Feldstein, S.W. Natural History of Alcohol Dependence and Remission Events for a Native American Sample

ABSTRACT. Objective: Examining the progression of a disorder cross-culturally may help distinguish elements common to addictions from those that are differentially shaped by culture. This study sought to construct a combined sequence of both problem emergence and recovery efforts with Native Americans. Method: In a cross-sectional sample, 44 adult Native Americans (61% men) who had resolved alcohol dependence completed face-to-face interviews at a research center. The Alcohol Related Behaviors Survey and the Change Effort Card-sorts along with measures of alcohol involvement and current quality of life were administered. Results: This sample's sequence of alcohol-related events was compared to that reported for Jellinek's historical white male sample ( r s = .46, p = .001), a recent Navajo sample ( r s = .33, p = .024), and a recent Mission Indian sample ( r s = .28, p = .24). This sample's sequence of change efforts was compared to that in the Navajo sample ( r s = .33, p = .182). Conclusions: Despite the small sample size precluding generalizability, there was greater concordance between this intertribal sample and Jellinek's white male sample than between this sample and a Mission Indian sample, indicating both cross-cultural and intracultural variation. In addition, change efforts begin during the development of alcohol problems rather than waiting until the person “hits bottom,” as suggested by previous research. Integrating the pathology of substance-use disorders with the process of resolving those disorders extends our understanding of the course of alcohol dependence. ( J. Stud. Alcohol 67: 675-684, 2006)

McKellar, J.D., Harris, A.H., and Moos, R.H. Predictors of Outcome for Patients With Substance-Use Disorders Five Years After Treatment Dropout

ABSTRACT. Objective: Few studies focus on the outcome of patients after they drop out of substance-use disorder (SUD) treatment, and there appear to be no prior studies of the long-term outcomes of these patients. The aim of this study is to determine how well such patients do after dropping out of treatment and to identify predictors of differential outcomes. Method: Patients in 15 residential SUD treatment programs were assessed at treatment entry and at 5-year follow-up on their frequency and severity of substance use, expectancies and beliefs about substance use, and social resources and stressors. Patients who dropped out and stayed out of treatment ( n = 193) were compared with those who completed treatment ( n = 3,204). Predictors of 5-year SUD problems among dropouts were identified. Results: In general, dropouts and treatment completers did not differ significantly on their levels of SUD problems at 5 years. At baseline, patients who dropped out reported more involvement in 12-step organizations and greater cognitive impairment and more closely identified with the label “drug addict” than “alcoholic.” Lower severity of SUD, lower self-efficacy, fewer positive substance-use expectancies, and less stress from social networks predicted fewer SUD problems at 5 years among dropouts. Conclusions: In addition to focusing on substance use, providers should address the adequacy of patients' social support and counter positive substance-use expectancies at the earliest stages of treatment before patients drop out. ( J. Stud. Alcohol 67: 685-693, 2006)