Temporal progression of alcohol dependence symptoms in the U.S. household population: Results from the National Comorbidity Survey.

General population data are presented on patterns and predictors of temporal progression of alcohol dependence symptoms in the general population. The data come from the National Comorbidity Survey, a nationally representative general population survey of respondents ages 15–54. Lifetime symptom classes were estimated with latent class analysis (LCA). A 4-class LCA solution, including a 1st asymptomatic class and 3 progressively more serious symptomatic classes, was found to fit the data. Probability of initial symptom onset among drinkers was found to be highest in the 10–24 age range, to be higher among men than women, and to have increased dramatically in the past 4 decades. Age, gender, and cohort effects were less powerful in predicting symptom progression. A narrowing of the gender difference over time was due largely to a convergence in initial symptom onset among men and women ages 10–24. These results suggest that a rise in initial problems was more important than an increase in the transition from problems to dependence in accounting for the growing prevalence of alcohol dependence during the post-World War II years in the United States. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Visiting the father''s grave

General population data are presented on patterns and predictors of temporal progression of alcohol dependence symptoms in the general population. The data come from the National Comorbidity Survey, a nationally representative general population survey of respondents ages 15-54. Lifetime symptom classes were estimated with latent class analysis (LCA). A 4-class LCA solution, including a 1st asymptomatic class and 3 progressively more serious symptomatic classes, was found to fit the data. Probability of initial symptom onset among drinkers was found to be highest in the 10-24 age range, to be higher among men than women, and to have increased dramatically in the past 4 decades. Age, gender, and cohort effects were less powerful in predicting symptom progression. A narrowing of the gender difference over time was due largely to a convergence in initial symptom onset among men and women ages 10-24. These results suggest that a rise in initial problems was more important than an increase in the transition from problems to dependence in accounting for the growing prevalence of alcohol dependence during the post-World War II years in the United States.     

Stability and change in patterns of concerns related to eating, weight, and shape in young adult women: A latent transition analysis.

Although college women are known to be at high risk for eating-related problems, relatively little is known about how various aspects of concerns related to eating, weight, and shape are patterned syndromally in this population. Moreover, the extent to which various patterns represent stable conditions or transitory states during this dynamic period of development is unclear. The present study used latent class and latent transition analysis (LCA/LTA) to derive syndromes of concerns related to eating, weight, and shape and movement across these syndromes in a sample of 1,498 women ascertained as first-time freshmen and studied over 4 years. LCA identified 5 classes characterized by (a) no obvious pathological eating-related concerns (prevalence: 28%–34%); (b) a high likelihood of limiting attempts (prevalence: 29%–34%); (c) a high likelihood of overeating and binge eating (prevalence: 14%–18%); (d) a high likelihood of limiting attempts and overeating or binge eating (prevalence: 14%–17%); and (e) pervasive bulimiclike concerns (prevalence: 6%–7%). Membership in each latent class tended to be stable over time. When movement occurred, it tended to be to a less severe class. These findings indicate that there are distinct, prevalent, and relatively stable forms of eating-related concerns in college women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Transitioning into and out of large-effect drinking in young adulthood.

As individuals age beyond the college years into young adulthood, many exhibit a tendency to moderate or "mature out of alcohol" involvement. The current study classified effect-drinking statuses in young adults and examined transitions among statuses using latent transition analysis, a latent variable state-sequential model for longitudinal data. At 3 occasions over 7 years (Years 1, 4, and 7), 443 men (47%) and women (mean age of both at baseline?=?18.5 years; 51% with family history of alcoholism) responded to 3 past-30-day items assessing drinking and subjective effects of drinking: whether the respondent drank alcohol, felt high, and felt drunk. Latent statuses included abstainers (14% at Year 1), limited-effect drinkers (8%), moderate-effect drinkers (23%), and large-effect drinkers (54%). Respondents with family history of alcoholism were less likely to transition out of large-effect drinking than those without family history. Men exhibited more severe initial effect-drinking statuses and lower transition probabilities into less severe effect-drinking statuses than women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interaction between the DRD4 VNTR polymorphism and proximal and distal environments in alcohol dependence during emerging and young adulthood.

The manifestation of alcohol dependence at different developmental stages may be associated with different genetic and environmental factors. Taking a developmental approach, we characterized interaction between the dopamine receptor 4 variable number tandem repeat (DRD4 VNTR) polymorphism and developmentally specific environmental factors (childhood adversity, college/Greek organization involvement, and delayed adult role transition) on alcohol dependence during emerging and young adulthood. Prospective data were obtained from a cohort of 234 White individuals (56% women, 44% men) who were followed up at ages 18 through 34. A longitudinal hierarchical factor model was estimated to model a traitlike persistent alcohol dependence factor throughout emerging and young adulthood and 2 residual statelike alcohol dependence factors limited to emerging adulthood and young adulthood, respectively. We accounted for those alcohol dependence factors by modeling 3 two-way interaction effects between the DRD4 VNTR polymorphism and the 3 developmentally specific environment factors. Carriers of the DRD4 long allele showed greater susceptibility to environmental effects; they showed more persistent symptoms of alcohol dependence as childhood adversity increased and more alcohol dependence symptoms limited to emerging adulthood as college/Greek organization involvement increased. Alcohol dependence among noncarriers of the long allele, however, did not differ as a function of those environments. Although replication is necessary, these findings highlight the importance of repeated phenotypic assessments across development and modeling both distal and proximal environments and their interaction with genetic susceptibility at specific developmental stages. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Local interaction fields and adaptive regularizers for surface reconstruction and image relaxation

This study investigates familial alcoholism effects and the comparative probability of risk for alcohol dependence in adult children of alcoholics (ACAs) with a control group of non-ACAs. A cohort of 12,686 young adults from the National Longitudinal Survey of Youth (NLSY) is examined over a five-year period and conventional and lineal intergenerational models of alcoholism transmission are assessed. The results of multivariate logistic regression analyses indicate that the risk is relatively greater for male ACAs; sons of alcoholics drink significantly more heavily, experience problems earlier, and develop alcohol dependence more extensively than female ACAs or non-ACAs of either gender. The extent of dependence found in subjects with a lineal history of alcoholism on the father's side of the family, as well as heavy drinking, cigarette smoking and drinking onset in adolescence should be considered as critical predisposing factors of high risk for dependence at later ages. These observations corroborate clinical studies and support a growing body of biopsychosocial research literature.     

Latent class analysis of lifetime depressive symptoms in the national comorbidity survey

OBJECTIVE: Although clinical trials have documented the importance of identifying individuals with major depression with atypical features, there are fewer epidemiological data. In a prior report, the authors used latent class analysis (LCA) to identify a distinctive atypical depressive subtype; they sought to replicate that finding in the current study. METHOD: Using the National Comorbidity Survey data, the authors applied LCA to 14 DSM-III-R major depressive symptoms in the participants' lifetime worst episodes (N=2,836). Validators of class membership included depressive disorder characteristics, syndrome consequences, demography, comorbidity, personality/attitudes, and parental psychiatric history. RESULTS: The best-fitting LCA solution had six classes. Four were combinations of atypicality and severity: severe atypical, mild atypical, severe typical, and mild typical. Syndrome severity (severe atypical and typical versus mild atypical and typical classes) was associated with a pronounced pattern of more and longer episodes, worse syndrome consequences, increased psychiatric comorbidity, more deviant personality and attitudes, and parental alcohol/drug use disorder. Syndrome atypicality (severe and mild atypical versus severe and mild typical classes) was associated with decreased syndrome consequences, comorbid conduct disorder and social phobia, higher interpersonal dependency and lower self-esteem, and parental alcohol/drug use disorder. CONCLUSIONS: As in prior reports, the atypical subtype of depression can be identified in epidemiological samples and, like typical depression, exists in mild and severe variants. Atypical depressive subtypes were characterized by several distinctive features. However, the correspondence between epidemiologically derived typologies of atypical depression and DSM-IV major depression with atypical features is not yet known.     

Subtypes of alcohol-dependent men: a typology based on relative genetic and environmental loading

Using scales that distinguish between relative genetic and environmental loading, cluster analysis was used to identify three subtypes of alcohol dependence in Caucasian men from the Epidemiologic Catchment Area study (n = 911). Although all subjects met DSM-III criteria for alcohol dependence, only the severe subtype showed evidence of substantial genetic influence. When compared on a range of clinical characteristics, the mild subtype (53% of the sample) was typically least adversely affected and the severe subtype (17%) most affected, with the dyssocial subtype (30%) falling between. Severe subtype subjects had significantly greater comorbid drug dependence and were at least four times more likely than mild subjects to have sought treatment for alcohol problems. Ratio of genetic scale score to total symptom count (genetic ratio) was highest for the severe subtype (mean = 0.37), and negatively correlated with age of first alcohol problem (rs = -0.16) and years between first intoxication and first problem (rs = 0.19). No significant correlations were found between these clinical features and genetic ratio for the mild or dyssocial subtypes. Use of these scales and subtypes may improve our ability to detect specific gene effects in genetic linkage studies and to identify environmental influences in behavioral and epidemiological studies.     

Extension of a typology of alcohol dependence based on relative genetic and environmental loading

Mild, severe, and dyssocial subtypes of alcohol dependence, previously identified among Caucasian men from the Epidemiologic Catchment Area study, were also identified among Caucasian men and women with DSM-IV alcohol dependence from the National Longitudinal Alcohol Epidemiologic Survey (n = 2,703; 1,746 respectively). These subtypes were not identified among African American and Hispanic American men or women with DSM-IV alcohol dependence. Among Caucasians with alcohol dependence, the subtypes were characterized by differential loading on three dimensions: genetic, general environmental, and dyssocial environmental symptom scales developed in a prior twin study. The mild subtype (60% of men and 66% of women) was distinguished by low mean scores on all three scales; the dyssocial subtype (24% of men and 20% of women) by low mean genetic and general environmental scores but high mean dyssocial environmental scores; and the severe subtype (16% of men and 14% of women) by high scores on the genetic and general environmental scales. These subtypes also showed the expected distinctions in clinical characteristics. The severe subtype showed greater comorbid drug dependence and major depression, more treatment seeking, and a higher prevalence of parental alcoholism. The severe subtype also showed significantly greater genetic influence adjusted for overall severity of alcohol dependence (genetic ratio). Only the severe subtype showed a pattern of scale scores and clinical characteristics suggestive of substantial genetic influence. The present study indicates a robustness of the typology originally developed among DSM-III alcohol-dependent Caucasian men by empirical extension of the subtypes to a different sample of Caucasian men and, separately, Caucasian women. The use of this typology may aid in distinguishing between Caucasian alcohol-dependent individuals on the basis of relative genetic influence, enabling genetic, behavioral, and epidemiological investigations to reduce genetic or environmental "noise" and better focus on specific aspects of alcohol dependence.     

Alcohol outcome expectancies as socially shared and socialized beliefs.

Alcohol expectancies are important predictors of alcohol involvement in both adolescents and adults, yet little research has examined the social origins and transmission of these beliefs. This paper examined alcohol outcome expectancies collected in a cohort-sequential longitudinal study of 452 families with children followed over seven waves. Children completed interviews every 6 months, and parents completed interviews annually. Eighteen of 27 alcohol expectancies were highly consensual, being endorsed by significantly more than 67% of the mothers and fathers. These consensual expectancies were also highly stable over a 3-year period. Over the same period, children increased their adoption of both the positive and negative consensual alcohol expectancies. Unconditional latent growth modeling showed that piece-wise growth models with a transition at age 12 fit the data best. Both the positive and negative consensual expectancies were adopted at a faster rate between ages 8.5 and 11.5 than between ages 12 and 13.5. For negative expectancies, there was no further growth between ages 12 and 13.5. Taken together, these findings support the conceptualization of alcohol outcome expectancies as socially shared and transmitted beliefs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality disorder symptoms, drinking motives, and alcohol use and consequences: Cross-sectional and prospective mediation.

Research shows high comorbidity between Cluster B personality disorders (PDs) and alcohol use disorders (AUDs). Studies on personality traits and alcohol use have identified coping and enhancement drinking motives as mediators in the relations among impulsivity, affective instability, and alcohol use. To the extent that PDs reflect extreme expression of these traits, drinking motives should mediate the relation between PD symptoms and alcohol involvement. This was tested using path models estimating the extent to which coping and enhancement drinking motives mediated the relation between Cluster B symptom counts and alcohol use and problems both concurrently and at a 5-year follow-up. Three hundred fifty-two adults participated in a multiwave study of risk for alcoholism (average age = 29 years at Wave 1). Enhancement motives mediated (a) the cross-sectional relation between Cluster B symptoms and drinking quantity/frequency, heavy drinking, total drinking consequences, dependence features, and AUD diagnosis and (b) the prospective relation to AUDs. Although coping motives mediated the relation between Cluster B symptoms and drinking consequences and dependence features cross-sectionally, prospective effects were limited to indirect effects through Time 1. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trajectories of PTSD and substance use disorders in a longitudinal study of personality disorders.

This study investigated the co-occurrence of posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) in a sample (N = 668) recruited for personality disorders and followed longitudinally as part of the Collaborative Longitudinal Personality Disorders Study. The study both examined rates of co-occurring disorders at baseline and temporal relationships between PTSD and substance use disorders over 4 years. Subjects with a lifetime history of PTSD at baseline had significantly higher rates of SUDs (both alcohol and drug) than subjects without PTSD. Latent class growth analysis, a relatively novel approach used to analyze trajectories and identify homogeneous subgroups of participant on the basis of probabilities of PTSD and SUD over time, identified 6 classes, which were compared with respect to a set of functioning and personality variables. The most consistent differences were observed between the group that displayed low probabilities of both SUD and PTSD and the group that displayed high probabilities of both. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Chronic fatigue--'tired with 23 i's'

Two patients, a woman aged 32 years and a man aged 49, presented with severe chronic fatigue. The woman had chronic fatigue syndrome; she recovered slowly. The man suffered from a pituitary adenoma producing follicle stimulating hormone; he recovered after transsphenoidal hypophysectomy. In patients with chronic fatigue, the history and a thorough physical examination to exclude underlying illness are very important; secondary symptom criteria must not be overemphasized (as is the case with the Holmes and Fukuda criteria), chronic fatigue syndrome should not be diagnosed if the condition has a shorter duration than 6 months, but it should be diagnosed if the clinical picture is compatible. The prognosis is not poor: in patients with a median disease duration of 4.5 years, 20% show significant improvement over an 18-month period.     

Alcohol dependence and domestic violence as sequelae of abuse and conduct disorder in childhood

OBJECTIVES: To examine in the Navajo population: (1) the importance of childhood abuse as a risk factor for conduct disorder; (2) the importance of each form of abuse and conduct disorder as risk factors for alcohol dependence; and (3) the relative importance of each form of abuse, conduct disorder, and alcohol dependence as risk factors for being a perpetrator and/or victim of domestic violence. METHOD: The study is based on a case-control design. Cases (204 men and 148 women) between the ages of 21 and 65 were interviewed in alcohol treatment program and matched to community controls. There were two groups of controls: alcohol dependent (374 men, 60 women) and nonalcohol dependent (157 men, 143 women). When adjusted for stratification by age, community of residence, and sex, the combined control groups comprise a representative sample of the Navajo male and female population 21-65 years of age. RESULTS: The prevalence of physical and sexual abuse before age 15 is within limits observed in other populations. Each form of abuse is a risk factor for conduct disorder. Along with conduct disorder, physical abuse is a risk factor for alcohol dependence. Physical abuse and alcohol dependence are independent risk factors for being involved in domestic violence as both perpetrator and victim. There appears to have been no secular trend in the incidence of childhood abuse over the past several generations, but there is suggestive evidence that domestic violence has become more common. CONCLUSIONS: Physical abuse is a significant risk factor for alcohol dependence as well as for domestic violence independent of the effects of alcohol abuse. The effects of sexual abuse with regard to both domestic violence and alcohol dependence do not appear to be significant.     

Gender differences and developmental change in externalizing disorders from late adolescence to early adulthood: A longitudinal twin study.

Using data from over 1,000 male and female twins participating in the Minnesota Twin Family Study, the authors examined developmental change, gender differences, and genetic and environmental contributions to the symptom levels of four externalizing disorders (adult antisocial behavior, alcohol dependence, nicotine dependence, and drug dependence) from ages 17 to 24. Both men and women increased in symptoms for each externalizing disorder, with men increasing at a greater rate than women, such that a modest gender gap at age 17 widened to a large one at age 24. Additionally, a mean-level gender difference on a latent Externalizing factor could account for the mean-level gender differences for the individual disorders. Biometric analyses revealed increasing genetic variation and heritability for men but a trend toward decreasing genetic variation and increasing environmental effects for women. Results illustrate the importance of gender and developmental context for symptom expression and the utility of structural models to integrate general trends and disorder-specific characteristics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of experience in liking "read-to-drink" alcoholic beverages.

Ready-to-drinks (RTDs) are composed of an alcoholic component and a soft-drink base and are primarily consumed by a youth market. The authors explored whether liking and experience with an RTD soft-drink base predicts liking for the RTD. Participants (N=350) from ages 12 to 30 years sampled 3 RTDs and their respective soft-drink and alcoholic components. For milk- and fruit-based RTDs, liking for and familiarity with their soft-drink base was the best predictor of liking for and familiarity with the RTD itself. For the Coke-based RTD, familiarity with and liking for bourbon best predicted familiarity with and liking for the RTD. All of these effects were consistent across blind and nonblind testing. The authors' results suggest that where there is perceptual similarity between the RTD and its soft-drink base, these beverages may provide an easy transition into alcohol consumption for novice drinkers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A latent class analysis of maternal depressive symptoms over 12 years and offspring adjustment in adolescence.

The authors used data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development to model patterns of maternal depressive symptoms, from the period of infants’ age 1 month to adolescence (age 12 years), and then examined adolescent adjustment at age 15 years as a function of the course and severity of maternal symptoms. The authors identified 5 latent classes of symptoms in 1,357 women, while also taking into account sociodemographic measures: never depressed, stable subclinical, early decreasing, moderately elevated, and chronic. Women with few symptoms were more likely to be married, better educated, and in better physical health than were women with more elevated symptoms. At age 15 years, adolescents whose mothers were in the chronic, elevated, and stable subclinical latent classes reported more internalizing and externalizing problems and acknowledged engaging in more risky behavior than did children of never depressed mothers. Latent class differences in self-reported loneliness and dysphoria were also found. Discussion focuses on adolescent adjustment, especially among offspring whose mothers reported stable symptoms of depression across their childhoods. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Age of onset of first alcohol intoxication and subsequent alcohol use among urban American Indian adolescents.

The objective was to assess the effect of early onset intoxication on subsequent alcohol involvement among urban American Indian youth. The data come from the American Indian Research (AIR) project, a panel study of urban Indian youth residing in King County, Washington. Data were collected annually from the adolescent and his/her primary caregiver from the 1988–89 school year to the 1996–97 school year, providing a total of nine waves of data. Early intoxication (by age 14) was related to delinquency, family history of alcohol abuse or dependence, poverty, broken family structure, less family cohesiveness, and more family conflict. The effects of these characteristics were, therefore, partialed out in testing effects of early intoxication on later alcohol involvement. Two-part latent growth models of alcohol use and alcohol problems were specified. Effects of early onset intoxication on these trajectories, as well as lifetime alcohol abuse or dependence by the transition to young adulthood, were examined. Findings indicate that adolescents who experienced their first intoxication early (by age 14), used alcohol more heavily from the ages of 16 to 18, experienced more problems related to the alcohol's use from the ages of 16 to 18, and were more likely to have a diagnosed alcohol disorder by the final wave of data collection. Congruent with similar studies in the general population, early intoxication appears to be associated with a deleterious course of alcohol involvement during adolescence and into the transition to young adulthood among urban American Indian youth. Implications for prevention are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Classification and short-term course of DSM-IV cannabis, hallucinogen, cocaine, and opioid disorders in treated adolescents.

This study examined the latent class structure of Diagnostic and Statistical Manual of Mental Disorders (text rev.; DSM-IV; American Psychiatric Association, 2000) symptoms used to diagnose cannabis, hallucinogen, cocaine, and opiate disorders among 501 adolescents recruited from addictions treatment. Latent class results were compared with the DSM-IV categories of abuse and dependence, and latent transition analysis (LTA) was used to examine changes in symptom severity over a 1-year follow-up. Although 2- and 3-class solutions provided the best fit to the data (2-class: hallucinogens, cocaine, opioids; 3-class: cannabis), 3-class solutions provided more substantive results and were emphasized in analyses. There was good agreement between latent classes and DSM-IV diagnosis. LTA suggested greater likelihood of transitioning to a less severe class at 1 year for all 4 drugs; in- and outpatients differed in pattern of change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Stage-Sequential Model of Reading Transitions: Evidence From the Early Childhood Longitudinal Study.

This study uses latent transition analysis to examine reading development across the kindergarten and 1st-grade year. Data include poverty status and dichotomous measures of reading at 4 time points for a large sample of children within the Early Childhood Longitudinal Study. In each of 4 waves of the study, 5 latent classes were represented in different proportions: low alphabet knowledge, early phonological processing, advanced phonological processing, early word reading, and early reading comprehension. Transition probabilities were calculated for the full sample and for children living above and below poverty. The findings indicate that children living below poverty are less likely to experience successful reading transitions than their above-poverty peers. However, children in the below-poverty group who began kindergarten with at least early phonological processing experienced transition probabilities similar to their above-poverty peers. Researchers should target and test preschool interventions for their potential efficacy to mediate the effects of poverty on early reading. (PsycINFO Database Record (c) 2010 APA, all rights reserved)