Relationship between level of consumption and harms in assessing drink cut-points for alcohol research: Commentary on "Many college freshmen drink at levels far beyond the binge threshold" by white et Al

In this commentary, we describe the use of a 5/4 drink summary measure of heavy episodic alcohol consumption, or "binge" drinking, in survey research and its usefulness for preventing negative alcohol-related consequences. Data from 4 nationally representative surveys of more than 50,000 college students are utilized to examine the utility of this measure in comparison with alternative cut-points. Our analysis demonstrates that while higher drink threshold measures incrementally improve the ability to identify correctly students who experience harms or who meet DSM-IV diagnostic criteria of alcohol abuse and dependence, they capture only a small proportion of those college students experiencing harms. We conclude that the selection of a measurement tool should be consistent with the purpose for which it is to be used. The 5/4 measure of binge drinking provides a valuable means for understanding and preventing alcohol-related harms in a college population and can be utilized as a screen to identify students who may need additional clinical assessment for intervention.     

Heavy drinking among individuals with HIV: who drinks despite knowledge of the risk?

Heavy drinking can cause medical problems for individuals with HIV, and drinking despite medical contraindications indicates problem use. However, little is known about which individuals with HIV drink despite knowledge of health problems. This study utilizes two subsamples of individuals with HIV from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III): those reporting at least one drink (a) in their lifetime (n = 205) or (b) in the past year (n = 166). Participants reported on drinking despite health problems and psychopathology in the past year and in their lifetime, and family history of alcohol problems. Individuals with a drug use disorder (Adjusted Odds Ratios [AORs] = 3.56–12.65), major depressive disorder (AORs = 10.18–10.55), or a family history of alcohol problems (AORs = 33.60–96.01) were more likely to drink despite health problems. Anxiety and personality disorders did not increase risk. Individuals with HIV with drug use disorders or major depressive disorder are more likely to drink despite health problems. Individuals with a family history of alcohol problems were also more likely to do so, although further research is needed given large confidence intervals. Future research should consider how to help these individuals avoid alcohol-related harm.     

Alcohol, nightlife and violence: the relative contributions of drinking before and during nights out to negative health and criminal justice outcomes

AIMS: To explore differences in alcohol consumption and negative nightlife experiences between young people who drink prior to attending city nightlife venues and those who do not drink until reaching bars and nightclubs. DESIGN, SETTING AND PARTICIPANTS: A cross-sectional survey of 380 young people (aged 18-35 years) in bars and nightclubs in a large city centre in the North-west of England. MEASUREMENTS: An anonymous questionnaire explored participants' basic demographics; frequency of utilizing nightlife; quantities of alcohol consumed prior to and during a typical night out in the city; and negative experiences in the city's nightlife in the previous year [fighting, being verbally abused, being sexually molested (e.g. groped) and being too drunk to walk]. FINDINGS: Participants who reported drinking prior to attending nightlife (e.g. at their own or a friend's home) reported significantly higher total alcohol consumption over a night out than those not drinking until reaching bars and nightclubs. Over a quarter (26.5%) of female and 15.4% of male alcohol consumption over a night out occurred prior to attending nightlife. Individuals who drink before going out were over four times more likely to report drinking >20 units on a usual night out and 2.5 times more likely to have been involved in a fight in the city's nightlife during the previous 12 months. CONCLUSIONS: Measures to tackle drunkenness and alcohol-related violence in nightlife should expand beyond those targeted solely at nightlife environments. Continued disparities in pricing and policing of alcohol between on- and off-licensed premises may increase at-home drinking prior to nights out and alcohol-related problems in residential areas.     

The effects of parental diagnosis and changing family norms on alcohol use and related problems among urban American Indian adolescents

This study investigated the role of parental diagnosis of alcohol abuse/dependence and perceived family norms for adolescent drinking on alcohol use and alcohol-related problems among urban American Indian youth. A total of 251 urban, American Indian youth and their parents/caregivers were followed from ages 13 to 18. Perceived family norms against alcohol decreased and alcohol use increased from ages 13 to 18. Relative to no parental diagnosis, youth with one or two parents diagnosed with alcohol abuse/dependence were less likely to perceive family norms against alcohol use. Youth with two parents diagnosed were more likely to report alcohol-related problems at age 18 compared to no parental diagnosis. Faster rates of decrease in perceived family norms against alcohol use were associated with faster increases in alcohol use over time. Higher rates of perceived family norms against alcohol use protected youth from high rates of use at age 13, but higher rates of alcohol use at age 13 predicted more alcohol-related problems at age 18. These results suggest that both family history and family behaviors in the form of communication of norms for adolescent alcohol use are likely to impact both rates of use and eventual alcohol-related problems.     

The short-term effects and unintended long-term consequences of binge drinking in college: a 10-year follow-up study

This study addresses binge drinking in college as a risk factor for heavy drinking and alcohol dependence after college. A national probability sample of 1972 college students from the National Longitudinal Surveys of Youth (NLSY79) was interviewed in 1984 and reinterviewed again as adults in 1994. The short-term effects of binge drinking in college were assessed as well as the extent to which experiences of negative effects in college predicted patterns of alcohol use across the transition from college into postcollege years. As expected, college binge drinkers were comparatively more likely than nonbinge drinkers to experience one or more alcohol-related problems while in college. In addition, weighted estimates of DSM-IV-defined diagnostic criteria in logistic regression models indicated that the binge drinking patterns exhibited during the college years, for some former college students of both genders, posed significant risk factors for alcohol dependence and abuse 10 years after the initial interview, in conjunction with evidence of academic attrition, early departure from college and less favorable labor market outcomes.     

Spouse abuse and alcohol problems among white, African American, and Hispanic U.S. Army soldiers

BACKGROUND: Prior studies suggest racial/ethnic differences in the associations between alcohol misuse and spouse abuse. Some studies indicate that drinking patterns are a stronger predictor of spouse abuse for African Americans but not whites or Hispanics, while others report that drinking patterns are a stronger predictor for whites than African Americans or Hispanics. This study extends prior work by exploring associations between heavy drinking, alcohol-related problems, and risk for spouse abuse within racial/ethnic groups as well as variations associated with whether the perpetrator is drinking during the spouse abuse incident. METHODS: Cases (N=7,996) were all active-duty male, enlisted Army spouse abusers identified in the Army's Central Registry (ACR) who had also completed an Army Health Risk Appraisal (HRA) Survey between 1991 and 1998. Controls (N=17,821) were matched on gender, rank, and marital and HRA status. RESULTS: We found 3 different patterns of association between alcohol use and domestic violence depending upon both the race/ethnicity of the perpetrator and whether or not alcohol was involved in the spouse abuse event. First, after adjusting for demographic and psychosocial factors, weekly heavy drinking (>14 drinks per week) and alcohol-related problems (yes to 2 or more of 6 alcohol-related problem questions, including the CAGE) were significant predictors of domestic violence among whites and Hispanics only. Also for the white soldiers, the presence of family problems mediated the effect of alcohol-related problems on spouse abuse. Second, alcohol-related problems predicted drinking during a spouse abuse incident for all 3 race groups, but this relation was moderated by typical alcohol consumption patterns in Hispanics and whites only. Finally, alcohol-related problems predicted drinking during a spouse abuse incident, but this was a complex association moderated by different psychosocial or behavioral variables within each race/ethnic group. CONCLUSION: These findings suggest important cultural/social influences that interact with drinking patterns.     

Drunkenness, feeling the effects and 5+ measures

Aims. The purpose of this study is to compare changes in the definitions of drunkenness and feeling the effects of drinking between 1979 and 1995 in US surveys, and compare three measures of heavier drinking as predictors of negative consequences of heavier alcohol use. Design. A trend analysis using the 1979 (N = 1772) and 1995 (N = 2178) US National Alcohol Surveys and a cross-sectional analysis using only the 1995 National Alcohol Survey. Participants. The analysis included only those respondents who reported consuming alcohol in the last year. The data were collected by face-to-face interviews. Measurements. Three measures of heavier drinking were obtained in each survey: frequency of drunkenness, frequency of feeling the effects of alcohol and frequency drinking five or more drinks on one day. The three outcome measures were derived as indices of social consequences, alcohol dependence symptoms and alcohol-related harm. Findings. Significantly higher proportions of respondents reported being drunk or feeling the effects of alcohol in 1995, and they also reported a lower number of drinks needed to become drunk (8.2 vs. 6.3 drinks) and to feel the effects (4.7 vs. 4.0 drinks). Frequency of drunkenness was found to be the best predictor of social consequences, alcohol dependence symptoms and alcohol-related harm. Conclusions. These results point to some of the cultural shifts that have occurred in the United States during this "drying" period and the importance of considering more subjective measures of heavier drinking to assess risk.     

Response Inhibition Moderates the Relationship Between Implicit Associations and Drinking Behavior

Background:  Contemporary dual-process models of alcohol abuse propose that alcohol abuse develops because of dysfunctions in the impulsive system, which generates automatic impulses to drink alcohol, and disruptions in the reflective system, which becomes unable to inhibit the influence of these automatic impulses. Based on these insights, this study investigated whether individual differences in the ability of the reflective system to exert response inhibition moderate the relationship between automatic cognitive processes and drinking behavior. Specifically, it was examined whether the interaction between implicit alcohol-related associations and response inhibition predicted drinking behavior.
Methods:  Seventy-one university students completed the study online via the Internet. Implicit alcohol associations with positive affect and with arousal were assessed with variants of the Implicit Association Test. Response inhibition was measured using the original Stroop task. Participants also reported their weekly alcohol use and alcohol-related problems.
Results:  As predicted, implicit associations were unrelated to drinking behavior when response inhibition was high. In contrast, when response inhibition was low, stronger implicit associations between alcohol and positive affect predicted increased alcohol use and alcohol-related problems.
Conclusions:  These findings indicate that the relationship between automatic cognitive processes, originating in the impulsive system, and drinking behavior depends on individual differences in response inhibition exerted by the reflective system. As prolonged alcohol abuse is known to impair response inhibition, alcohol abusers may benefit from interventions that increase response inhibition, thereby restoring inhibitory control over automatic impulses.     

ALDH2*2 and peer drinking in East Asian college students

Background: The ALDH2*2 allele (A-allele) at rs671 is more commonly carried by Asians and is associated with alcohol-related flushing, a strong adverse reaction to alcohol that is protective against drinking. Social factors, such as having friends who binge drink, also contribute to drinking in Asian youth. Objectives: This study examined the interplay between ALDH2*2, peer drinking, and alcohol consumption in college students. We hypothesized that the relationship between ALDH2*2 and standard grams of ethanol per month would vary based on the level of peer drinking. Methods: Subjects (N = 318, 63.25% female) were East Asian college students in the United States who reported drinking alcohol. Data were from the freshman year of a university survey that included a saliva DNA sample. ALDH2*2 status was coded ALDH2*2(+) (A/G and A/A genotypes) and ALDH2*2(?) (G/G genotype). Peer drinking was students’ perception of how many of their friends “got drunk”. Results: Main effects of ALDH2*2(?) and having more friends who got drunk were associated with greater alcohol consumption. The ALDH2*2 × peer drunkenness interaction showed a stronger positive association with alcohol consumption for ALDH2*2(?) versus ALDH2*2(+) at increasing levels of peer drunkenness. Follow-up comparisons within each peer drunkenness level identified significantly higher alcohol consumption for ALDH2*2(?) compared to ALDH2*2(+) at the all friends got drunk level.

Conclusion: There was evidence of a stronger effect for ALDH2*2(?) compared to ALDH2*2(+) with greater alcohol use when students were more exposed to peer drinking. Findings contribute to a growing literature on the interrelationships between genetic influences and more permissive environments for alcohol consumption.     

Association between GABRA1 and drinking behaviors in the collaborative study on the genetics of alcoholism sample

BACKGROUND: A wealth of literature supports the role of gamma-aminobutyric acid (GABA) in neurobiological pathways contributing to alcohol dependence and related phenotypes. Animal studies have consistently tied rodent homologs of the GABAA receptor genes on human chromosome 5q to alcohol-related behaviors; however, human studies have produced mixed results. Family-based association analyses previously conducted in the Collaborative Study on the Genetics of Alcoholism (COGA) sample yielded no evidence of association with Diagnostic and Statistical Manual of Mental Disorder-fourth edition (DSM-IV) alcohol dependence and these genes. As a follow-up to that study, we examined several alcohol-related behaviors in the COGA sample as follows: (1) a broader definition of alcohol dependence, including DSM-III-R symptoms and Feighner criteria (referred to as COGA alcohol dependence); (2) withdrawal; (3) history of alcohol-induced blackouts; (4) level of response to alcohol; (5) age of onset of regular drinking; and (6) age at first drunkenness. METHODS: Family-based association tests were conducted, using multiple single-nucleotide polymorphisms (SNPs) in each of the 4 GABAA receptor genes on chromosome 5q. RESULTS: In GABRA1, we found evidence of association with several of the drinking behavior phenotypes, including COGA alcohol dependence, history of blackouts, age at first drunkenness, and level of response to alcohol. We did not find consistent evidence of association with the remaining genes and any of the phenotypes. CONCLUSIONS: We found evidence for association between GABRA1 and COGA alcohol dependence, history of blackouts, age at first drunkenness, and level of response to alcohol. These analyses suggest that efforts to characterize genetic contributions to alcohol dependence may benefit by examining alcohol-related behaviors in addition to clinical alcohol dependence diagnoses.     

No Association of PROP Taster Status and Paternal History of Alcohol Dependence

Taste sensitivity to bitter substances, including ethanol, may play a moderating role both in the initiation of drinking and in the intensity and frequency of drinking once it is initiated. A study (Pelchat and Danowski, Physiol Behav 51:1261-1266, 1992) showed an association between the capacity to taste PROP (6-n-propylthiouraciI), a bitter tasting compound, and a family history of alcoholism. The implication of that finding is that family-history-negative individuals may be protected from early initiation of drinking or heavy consumption of alcohol once drinking is initiated. The present study sought to replicate those findings by using direct interview methods (versus history methods) to obtain alcohol use and alcohol problem information from the parents of "at risk" individuals and by examining a larger number of subjects. A bimodal distribution of the ability to taste PROP was found, similar to that observed in the general population. No association was found between the ability to taste PROP and a paternal history of alcoholism, regardless of the taste threshold employed or after controlling for several potentially confounding variables. A lack of association with alcoholism risk was also observed for subjects' self-reports of reasons for drinking or not drinking alcohol based upon taste preference: high-risk and low-risk for alcoholism groups were not distinguished by either a stated preference for the taste of alcohol as a reason for drinking or a stated dislike for the taste of alcohol as a reason for limiting drinking. Thus, neither taste sensitivity for PROP nor the palatability of ethanol appear to influence the choice to drink among adolescent and young adult individuals at high risk for developing alcohol-related problems.     

Many college freshmen drink at levels far beyond the binge threshold

BACKGROUND: Binge drinking is a dichotomous variable that allows researchers to sort students into categories based upon a specific threshold of consumption, commonly 4 (females) or 5 (males) drinks. Crossing the binge threshold increases the risk of negative alcohol-related consequences. The use of such thresholds has played a vital role in the study of college drinking. While extremely valuable, the dichotomous nature of binge drinking variables removes information about how heavily students actually drink, leaving the characterization of college drinking incomplete. The present study examined patterns of alcohol use beyond the binge threshold. METHODS: The data set consisted of self-reported 2-week drinking histories from 10,424 first-semester freshmen at 14 schools across the United States during the fall of 2003. The number of students who reached the 4+/5+ binge-drinking threshold was calculated, as was the number who reached 2 times (8+/10+ drinks) or 3 times (12+/15+ drinks) the binge threshold. Logistic regression analyses were used to explore gender differences and to assess whether frequent binge drinkers (3+ binges per 2 weeks) were more likely than infrequent binge drinkers (1-2 binges per 2 weeks) to reach high peak levels of consumption. RESULTS: Roughly 1 of 5 males consumed 10+ drinks and 1 of 10 females consumed 8+ drinks, twice the binge threshold, at least once in the previous 2 weeks. Gender differences were observed at every drinking level and were particularly large at higher peak levels. Frequent binge drinkers were more likely than infrequent binge drinkers to consume 2 or 3 times the binge threshold. DISCUSSION: A surprisingly large percentage of students, particularly males, drink at peak levels well beyond the binge threshold. Such findings suggest that schools might make additional progress in the battle against alcohol misuse by focusing on extreme drinking practices in addition to binge drinking per se.     

Gender convergence in alcohol consumption and related problems: issues and outcomes from comparisons of New Zealand survey data

AIMS: This paper aims to compare women's and men's alcohol consumption patterns and alcohol-related problems in New Zealand in 1995 and 2000, by age groups. Secondary aims are to consider the findings in relation to debates on the gender convergence hypothesis regarding the link between gender convergence in alcohol consumption and possible explanations, such as social role convergence and policy changes. DESIGN: Data were collected in two general population surveys conducted in New Zealand in 1995 (n = 4232) and 2000 (n = 5113) using the same questionnaire. MEASUREMENTS: Quantity consumed on a typical drinking occasion, volume of absolute alcohol consumed per annum, proportions drinking 20+ litres per annum, proportion of total consumption consumed in heavy drinking occasions, frequency of consumption, proportion who drink enough to feel drunk at least once a week, proportions reporting three or more alcohol-related problems and attitudes to intoxication. FINDINGS: Evidence for gender convergence was found across a range of measures of alcohol consumption and alcohol-related problems. In the 20-39-year age group quantities of alcohol consumed on a typical occasion and the related measures of volume, drunkenness and problems all showed convergence. In the groups over 40 years of age convergence occurred in relation to frequency of drinking. In the groups below 20 years, which consumed relatively high quantities and where the differences in consumption between gender groups were relatively small, further convergence did not occur. CONCLUSIONS: Gender convergence took place in New Zealand from 1995 to 2000.     

Differences in the measured alcohol content of drinks between black, white and Hispanic men and women in a US national sample

Aims   To measure and describe drink alcohol content differences between Hispanic, non-Hispanic white and non-Hispanic black men and women in the United States.
Design   A telephone survey re-interview of 397 respondents who participated originally in the 2005 National Alcohol Survey, of whom 306 provided complete information on home drinks.
Setting   United States.
Participants   Adults aged 18 years and older from across the United States.
Measurements   Direct measurement by respondents of simulated drink pours in respondents' own glassware using a provided beaker and reported beverage brands were used to calculate drink alcohol content.
Findings   Black men were found to have the largest overall mean drink alcohol content at 0.79 oz (23 ml) of alcohol. This was significantly larger than the mean for white men or for black women and added 30% to black men's monthly alcohol intake when applied to their reported number of drinks. Spirits drinks were found to be particularly large for men. Multivariate models indicated that drink alcohol content differences are attributable more to income and family structure differences than to unmeasured cultural factors tied to race or ethnicity per se . Models predicting alcohol-related consequences and dependence indicate that adjusting drink alcohol content improves model fit and reduces differences between race/ethnicity defined groups.
Conclusions   Differences in drink alcohol content by gender, race/ethnicity and beverage type choice should be considered in comparisons of drinking patterns and alcohol-related outcomes. Observed differences can be explained partially by measured characteristics regarding family structure and income.     

Prevalence and Determinants of Alcohol-Related Problems

In this study, we sought to determine what factors, in addition to alcohol consumption, were the best predictors of social and physical alcohol-related problems. Variables examined as possible predictors of problems included circumstances under which people drink, feelings of alienation, and religious affiliation. Data for this study were collected continually from 1984 to 1989 using a random telephone survey of 2094 New York State residents aged 18 or older; the study sample was comprised of the 1076 who had consumed alcohol in the previous 30 days. Stepwise regression analyses examined the main effects of all possible predictors of problems while controlling for alcohol consumption. Forced-entry regressions examined interaction effects of problem predictors while controlling for basic demographics. Drinking with breakfast, smoking marijuana, and drinking in bars alone were all significant predictors of more problems. This suggests that problems are associated with an aberrant lifestyle (i.e., different from a typical lifestyle), although it makes no assumption about motivations. Further investigation of this subject area is warranted to ascertain which population subgroups are the most vulnerable to alcohol-related problems and to guide the design of prevention programs.

The fact that alcohol consumption is the primary contributor to social and physical alcohol-related problems has prompted researchers to study both alcohol consumption and the problems emanating from it; therefore, demographic distributions of each are fairly well understood. This body of research has revealed that distributions of drinking problems match distributions of heavy drinking in the United States . For example, lower socioeconomic status members, males, urbanites, and those who are young and/or single tend to drink more than their counterparts and to experience more problems from their drinking as a result .

In contrast to this wealth of research is the relatively small number of studies focused on whether the traditional problem-experiencing groups continue to have the highest problem rates when alcohol consumption is held constant. Identification of those most at risk of experiencing negative consequences from their drinking requires more than knowing who drinks more and assuming that they will experience more problems as a result; an adequate understanding of alcohol’s untoward effects requires specification of the contexts in which the effects of alcohol are the greatest.

Despite Babor, Kranzler, and Lauerman’s findings that social, moderate, and heavy drinkers are all at risk of experiencing serious health hazards and psychosocial consequences, it is generally reasonable to assume that studies focusing mainly on severe alcohol-related consequences are likely to miss lighter drinkers who experience less severe, yet potentially dangerous, repercussions from their drinking. Since, at most, about 10% of the drinking population in the United States can be classified as chronic, heavy drinkers , studying only people with severe alcohol-related problems would result in missing what is occurring across a broad cross section of the population . Conversely, studying only those with less serious alcohol-related problems (e.g., keeping one’s drinking secret versus developing cirrhosis) would still include heavy drinkers, who are more likely than moderate and social drinkers to experience all problems. In the present study, alcohol-related problems of a less serious nature were analyzed.

Babor et al. found that risk of experiencing social and physical alcohol-related problems is not always a direct function of amount consumed, but may instead reflect complex interactions among many variables. They asserted that occurrence of such problems can be predicted better when those interactions are taken into account. Hilton found that, holding alcohol consumption constant, occurrence of alcohol-related problems had no strong association with frequent binges, gender, age, marital status, income, education, region, or urbanicity. Makela and Simpura found in Finland that physical alcohol-related problems are less responsive than social problems to increased alcohol consumption. They also found that differences in problem rates between the sexes vanished when alcohol consumption was held constant. Knupfer found that, among those who drink enough to get high or drunk, women seem to experience slightly more alcohol-related problems than men, and young men and married men had slightly more problems than older men and single men. Wilsnack, Wilsnack, and Klassen found that, in their category of highest consumption (2 ounces per day or more), women exceeded men in rates of problem consequences, but not in rates of dependence symptoms. Grant and Harford found that the relationship between absolute alcohol intake and alcohol dependence was stronger among younger than among older adults. Herd’s review points out that national survey data suggest black men are more likely to experience alcohol-related problems than white men, even though they have similar alcohol consumption rates. Park’s review suggests that rates of drunkenness among the social classes are more a reflection of police attitudes toward those social classes than of actual differential alcoholism rates among them.

While these past studies are not completely comparable (because definitions of alcohol-related problems vary from study to study) or consistent, it is clear that very different results were obtained from investigations in which alcohol consumption was held constant when compared with those in which it was not. Thus, one of the purposes of this study was to investigate whether chosen groups experience more problems than their counterparts with alcohol consumption held constant. We also sought to identify factors that, in addition to amount of alcohol consumed, were the best predictors of alcohol-related problems. A better understanding of these predictive factors may enhance our capability to identify correctly those individuals most at risk of experiencing alcohol-related problems and to help them through improved design and application of screening, prevention, intervention, and treatment programs.     

Prenatal Alcohol Exposure and Interhemispheric Transfer of Tactile Information: Detroit and Cape Town Findings

Background:  Previous research has demonstrated that heavy prenatal alcohol exposure affects the size and shape of the corpus callosum (CC) and compromises interhemispheric transfer of information. The aim of this study was to confirm the previous reports of poorer performance on a finger localization test (FLT) of interhemispheric transfer in a cohort of heavily exposed children and to extend these findings to a cohort of moderately exposed young adults.
Methods:  In Study 1, the FLT was administered to 40 heavily exposed and 23 nonexposed children from the Cape Coloured community of Cape Town, South Africa, who were evaluated for fetal alcohol syndrome (FAS) dysmorphology and growth. Anatomical images of the CC were obtained using structural MRI on a subset of these children. In Study 2, the FLT was administered to a cohort of 85 moderate-to-heavily exposed young adults participating in a 19-year follow-up assessment of the Detroit Prenatal Alcohol Exposure cohort, whose alcohol exposure had been ascertained prospectively during gestation.
Results:  In Study 1, children with FAS showed more transfer-related errors than controls after adjustment for confounding, and increased transfer-related errors were associated with volume reductions in the isthmus and splenium of the CC. In Study 2, transfer-related errors were associated with quantity of alcohol consumed per occasion during pregnancy. More errors were made if the mother reported binge drinking (≥5 standard drinks) during pregnancy than if she drank regularly (M ≥ 1 drink/day) without binge drinking.
Conclusions:  These findings confirm a previous report of impaired interhemispheric transfer of tactile information in children heavily exposed to alcohol in utero and extend these findings to show that these deficits are also seen in more moderately exposed individuals, particularly those exposed to binge-like pregnancy drinking.     

Binge drinking in Jewish and non-Jewish white college students

BACKGROUND: In the United States, religious commitment, as measured by service attendance, has an inverse relationship with alcohol consumption, heavy use, and problem use. This association, however, has not been found consistently in Jewish Americans. The present study examined the relationship between religious variables and binge drinking in Jewish and non-Jewish white college students. In addition, the association among genetic, cultural, and religious variables and binge drinking was examined in the Jewish sample alone. METHODS: Participants were 132 Jewish and 147 non-Jewish white college students. All participants completed the Time-Line Follow-Back, had blood drawn for genotyping at the alcohol dehydrogenase locus ADH2, and reported their religious affiliation and the number of religious services attended in the past year. Jewish subjects also completed the Jewish Identity Scale. RESULTS: As hypothesized, more frequent religious service attendance related to lower rates of binge drinking in non-Jews but was not related to binge drinking in Jews. Within the Jewish sample, individuals who were religiously affiliated had approximately one third the risk of binge drinking as those who were secularly affiliated, but identification with Jewish culture was not related to binge drinking. In the total sample, individuals who possessed a variant alcohol dehydrogenase allele ADH2*2 were approximately half as likely to binge drink as those who did not possess this allele. CONCLUSIONS: These results are consistent with previous studies that find an inverse relationship between religious service attendance and heavy alcohol use in Christian but not Jewish college students. Findings within the Jewish sample support theories that suggest religious, not just cultural, Jewish affiliation relates to lower levels of alcohol behavior. More research is needed to identify additional factors, including other religious, cultural, genetic, and biological influences, that protect Jewish Americans from heavy drinking.     

Gender differences in alcohol consumption in Mexico City]

OBJECTIVE: The objectives of the present study were: 1) To corroborate the increase in alcohol consumption in the female population registered by results from the National Surveys on Addictions (ENA), 1988 and 1993; and 2) to determine affected age groups, and obtain basic information on age of onset, amount consumed per event and drunkenness frequency in the adult population of Mexico City, as indicators to orient preventive measures. MATERIAL AND METHODS: A multi-stage, stratified household survey was applied. A total of 1,932 interviews was completed, subjects were between 18 and 65 years of age, with a response rate of 60.4%. The instrument was a modified version of the Composite International Psychiatric Interview (CIDI), which is a highly structured instrument, applicable by non-specialized personnel, although limited training is necessary. The alcohol section included questions on the age of the first drink, the frequency and amount consumed during each event and the drunkenness frequency during the last 12 months, among other variables. Median and percentage were obtained by sex and among age-cohorts. RESULTS: Of the total, 96.5% of men and 18.1% of women have consumed at least one drink in their lives. In average, age of onset is 16 years for men, and 18 years for women. Age group comparisons show a clear tendency to begin drinking at an earlier age, particularly in women. The growing trend indicated by ENA with respect to alcohol consumption in the feminine population and at a younger age was corroborated. Results indicated that, in average, 5 years after the age of onset, both men and women reach their highest quantities of alcohol consumption, which tend to be excessive. Additionally, high-risk drinking among women (five or more drinks per event) increased to be four times higher in a period of seven years, and with an apparent tendency to rise. Sixty percent of the drinking population reduced alcohol consumption before the age of 30, however, the remaining 40% continued to drink at the same rate, or even increased consumption, particularly among women. CONCLUSIONS: The age of onset of alcohol consumption has diminished, especially in women, showing tendencies towards abuse. Preventive programs should predominantly focus on young age groups with emphasis on the feminine population.     

Alcohol: Lipid metabolism and cardioprotection

The decision to consume alcohol is associated with risks and benefits that vary according to family history (genes) and environment. The risk for coronary heart disease (CHD) is reduced in populations that regularly consume moderate amounts of alcohol. The risk reduction is associated with increased plasma high-density lipoprotein (HDL) cholesterol. Predisposing factors may make some individuals more vulnerable to alcohol-related risks than others. For example, individuals with hypertriglyceridemia and a personal or family history of pancreatitis might consider the benefits of alcohol consumption not worth the health risks. The risks might be more acceptable to someone with a family history of CHD, normal plasma triglyceride levels, low HDL cholesterol, and no personal or family history of addictive behavior or pancreatitis. An understanding of the metabolic effects of alcohol and a careful study of personal and family histories should permit physicians and their patients to make informed decisions about the risks and benefits of alcohol consumption.     

Correlates of alcohol abuse/dependence in early-onset alcohol-using women

Early-onset alcohol use is associated with increased vulnerability to subsequent alcohol abuse and dependence. However, not all early-onset alcohol users develop alcohol use disorders (AUDs). Using a sample of young women from the United States, we identify correlates that contribute to a greater likelihood of AUDs in early-onset alcohol users. Using interview and questionnaire data on participants of the Missouri Adolescent Female Twin Study (MOAFTS), we examine whether measures from domains including sociodemographic, pubertal development, religiosity, educational achievement, adverse life events, internalizing disorders, externalizing disorders, and family history and discipline were associated with development of AUDs in 1,158 women who had their first drink of alcohol prior to age 16. Early-onset drinkers were 3.6 times more likely to meet criteria for AUDs than later onset drinkers. While univariate analyses revealed that a host of correlates were associated with likelihood of AUDs in early-onset drinkers, multivariate analyses suggested that, even after accounting for a particularly early age of onset of drinking, those with a history of physical abuse, cotwin alcohol problems, conduct disorder, regular smoking, older peers, and peer substance use were considerably more likely to meet criteria for AUDs than early-onset drinkers without a lifetime history of these correlates. The progression from first drink to AUDs is complex, and while early age at first drink is a potent risk factor, other aspects of psychopathology, family history, conduct problems, and peer affiliations can exacerbate or alleviate the risk of AUDs in these young female drinkers.