Carolyn E Sartor

Publications (51) View all

• Article: Religion/Spirituality, Risk, and the Development of Alcohol Dependence in Female Twins.

  Jon Randolph Haber, Julia D Grant, Carolyn E Sartor, Laura B Koenig, Andrew Heath, Theodore Jacob
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  ABSTRACT: The contention that Religion/Spirituality (R/S) influences the development of alcohol dependence (AD) is increasingly supported, but risk factors have not been adequately examined together with protective R/S factors so as to determine the nature and relative strength of these domains at different stages in the development of alcoholism. Secondary data analysis of a sample of 4,002 young adult female twins used conditional Cox proportional hazards survival models to examine three distinct stages in the development of alcoholism: years to initiation of drinking, years from first drink to at-risk drinking, and years from at-risk drinking to AD. Risk and protective factors from models of alcoholism etiology and studies of R/S dimensionality were modeled simultaneously as predictors of each discrete stage and compared. Findings demonstrated that both risk factors and R/S variables influenced initiation of alcohol use; only R/S variables influenced subsequent progression to at-risk drinking; and risk factors primarily influenced further progression to AD. Protective factors (R/S variables being an exemplar) appeared to be critical determinants of intermediate-stage progression, thus suggesting that R/S factors and other psychosocial interventions might be particularly effective in delaying progression toward AD at this stage. In contrast, after the onset of at-risk drinking, the influence of (genetically based) risk factors appeared to accelerate AD regardless of most other influences. Thus, the timing of psychosocial interventions appears critical to their potency and impact. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
  Psychology of Addictive Behaviors 03/2013; · 2.09 Impact Factor
• Article: Childhood Sexual Abuse and Early Substance Use in Adolescent Girls: The Role of Familial Influences.

  Carolyn E Sartor, Mary Waldron, Alexis E Duncan, Julia D Grant, Vivia V McCutcheon, Elliot C Nelson, Pamela A F Madden, Kathleen K Bucholz, Andrew C Heath
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  ABSTRACT: AIM: To assess the extent to which the association between childhood sexual abuse (CSA) and early use of alcohol, cigarettes, and cannabis in adolescent girls is mediated by risk factors that tend to cluster in families where CSA occurs. DESIGN: An abridged version of the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA) was administered by telephone. Participants: 3,761 female twins aged 18-29 (14.6% African American, 85.4% European American). MEASUREMENTS: CSA experiences and history of substance use were queried in the SSAGA-based interviews. FINDINGS: After controlling for familial influences on early substance use by including co-twin early use status in models, separate Cox proportional hazards regression analyses predicting onset of alcohol, cigarette, and cannabis use revealed a significant association with CSA. The effect was observed through age 19 for cigarettes and through age 21 for cannabis, but was limited to age 14 or younger for alcohol, with the most pronounced risk before age 10 (HR=4.59; CI: 1.96-10.74). CSA-associated risk for initiation of cigarette and cannabis use was also highest in the youngest age range, but the decline with age was much more gradual and the hazard ratios significantly lower (1.70; CI:1.13-2.56 for cigarettes and 2.34, CI:1.58-3.46 for cannabis). CONCLUSIONS: Childhood sexual abuse history is a distinct risk factor for use of cigarettes and cannabis, and a very strong predictor of early age at first drink.
  Addiction 01/2013; · 4.31 Impact Factor
• Article: Investigating the association between childhood sexual abuse and alcohol use disorders in women: does it matter how we ask about sexual abuse?

  Carolyn E Sartor, Vivia V McCutcheon, Elliot C Nelson, Alexis E Duncan, Kathleen K Bucholz, Andrew C Heath
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  ABSTRACT: The purpose of this study was to determine whether the type of questions used to assess childhood sexual abuse (CSA) introduces systematic bias into estimations of the magnitude of the association between CSA and alcohol use disorders (AUDs). The Semi-Structured Assessment for the Genetics of Alcoholism was administered by telephone to 3,787 female twins ages 18-29 years (14.6% African American, 85.4% White). Interviews included questions regarding sexual abuse experiences described in behavioral terms and a standard trauma checklist (in a separate section) with the items "rape" and "sexual molestation," with definitions provided in respondent booklets. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnoses of alcohol abuse and dependence, parental history of alcohol-related problems, and psychiatric conditions associated with AUDs were also assessed. The majority of women who endorsed one question type also endorsed the other type. Rates of psychiatric risk factors for AUDs did not vary by pattern of CSA question endorsement. Separate Cox proportional hazards regression analyses using CSA variables derived from behavioral questions (hazard ratio [HR] = 1.67, 95% CI [1.27, 2.19]) and checklist items (HR = 1.41,95% CI [1.08, 1.84]) each revealed elevated risk for AUDs associated with CSA, and HRs did not differ significantly across models. However, a Cox proportional hazards regression analysis predicting AUD from the pattern of CSA question endorsements revealed a significantly higher risk for AUDs among women who endorsed only behavioral questions (HR = 3.26, 95% CI [1.72, 6.21]) than for all other groups. Findings underscore the importance of querying CSA in studies of alcohol-related problems and highlight some of the limitations of assessment methods that can be integrated into studies covering a wide range of psychosocial domains.
  Journal of studies on alcohol and drugs 09/2012; 73(5):740-8. · 2.25 Impact Factor
• Article: Lifetime trauma exposure and posttraumatic stress disorder in women sentenced to drug court.

  Carolyn E Sartor, Vivia V McCutcheon, Catina Callahan O'Leary, Dorothy J Van Buren, Jenifer E Allsworth, Donna B Jeffe, Linda B Cottler
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  ABSTRACT: The aims of this study were to characterize trauma exposure and posttraumatic stress disorder (PTSD) in female drug court participants and test for differences in socioeconomic status and familial status between women with: (i) no trauma exposure, (ii) trauma exposure without PTSD, and (iii) trauma exposure resulting in PTSD. Three hundred and nineteen women were recruited from drug courts. Rates of exposure and likelihood of traumatic events leading to PTSD were examined, sociodemographic characteristics were compared across groups, and a logistic regression analysis was conducted to test for differences in PTSD risk for assaultive vs. non-assaultive events. Twenty percent of participants met PTSD criteria, 71% had trauma exposure without PTSD, and 9% did not endorse any traumatic events. Prostitution and homelessness were more prevalent in women with vs. without a history of trauma, but among trauma-exposed women prevalences did not vary by PTSD status. No differences in risk for PTSD were found between assaultive and non-assaultive events (OR=0.91; 95%CI: 0.48-1.75). Women sentenced to drug court represent a heavily trauma-exposed population, for whom risk for PTSD is not limited to assaultive events. Within this high-risk population, trauma is associated with elevated rates of homelessness and prostitution, even in the absence of PTSD.
  Psychiatry Research 07/2012; · 2.52 Impact Factor
• Article: Differences in time to onset of smoking and nicotine dependence by race/ethnicity in a Midwestern sample of adolescents and young adults from a high risk family study.

  Alexis E Duncan, Christina N Lessov-Schlaggar, Carolyn E Sartor, Kathleen K Bucholz
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  ABSTRACT: The objective of this study was to determine whether race/ethnicity was associated with time to smoking initiation and time from first cigarette to onset of DSM-IV nicotine dependence (ND) after adjusting for familial and individual psychosocial risk factors. Cox proportional hazards models with time-dependent covariates were used to analyze data from 1376 offspring aged 12-33 years from 532 families at high risk for substance use problems due to paternal alcohol problems and 235 low risk families. Fifty-six percent of the sample self-identified as African-American (AA) and 44% were mainly of European descent. Controlling for covariates, AAs began smoking at older ages (HR=0.58; 95% CI: 0.48-0.70) and had longer times between smoking initiation and onset of ND compared to non-AAs (HR=0.25, 95% CI: 0.16-0.39 for ND onset occurring <18 years and HR=0.49, 95% CI: 0.30-0.80 for ND onsets ≥ age 18). After additionally controlling for number of cigarettes smoked daily, the racial/ethnic effects for onset of ND were attenuated, but remained statistically significant for ND onset <18 (HR=0.34, 95% CI: 0.19-0.61); however, the estimate was no longer significant for later ND onset (HR=0.84, 95% CI: 0.50-1.41). AA adolescents and young adults initiate smoking at older ages and have longer transition periods between initiation and onset of ND compared to non-AAs, even after controlling for many relevant psychiatric and psychosocial covariates; however, racial/ethnic differences in time to onset of nicotine dependence in late adolescence and young adulthood may be explained by differences in daily quantity smoked.
  Drug and alcohol dependence 05/2012; 125(1-2):140-5. · 3.60 Impact Factor