Alcohol consumption, alcohol-related problems, problem drinking, and socioeconomic status

Addiction Research Institute (IVO), Erasmus University Rotterdam, The Netherlands.
Alcohol and Alcoholism (Impact Factor: 2.09). 03/1999; 34(1):78-88. DOI: 10.1093/alcalc/34.1.78
Source: PubMed

ABSTRACT In general, a lower socioeconomic status (SES) is related to a lower health status, more health problems, and a shorter life expectancy. Although causal relations between SES and health are unclear, lifestyle factors play an intermediate role. The purpose of the present study was to obtain more insight into the relation between SES, alcohol consumption, alcohol-related problems, and problem drinking, through a general population survey among 8000 people in Rotterdam. Odds ratios were calculated using educational level as independent, and alcohol consumption, alcohol-related problems, and problem drinking as dependent variables. Abstinence decreased significantly by increasing educational level for both sexes. For men, excessive drinking, and notably very excessive drinking, was more prevalent in the lowest educational group. For women, no significant relation between educational level and prevalence of excessive drinking was found. After controlling for differences in drinking behaviour, among men the prevalence of 'psychological dependence' and 'social problems' was higher in intermediate educational groups, whereas prevalence of 'drunkenness' was lower in intermediate educational groups. For women, a negative relation was found between educational level and 'psychological dependence'; prevalence of 'symptomatic drinking' was higher in the lowest educational group. Prevalence of problem drinking was not related to educational level in either sex. It is concluded that differences exist between educational levels with respect to abstinence, but only limited differences were found with respect to excessive drinking. Furthermore, there is evidence for higher prevalences of alcohol-related problems in lower educational levels, after controlling for differences in drinking behaviour, in both sexes.

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Available from: Henk Garretsen, Aug 03, 2015
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    • "Another important factor which has been emphasised by Ahmed (2005) is that in contrast to human drug users who generally have concurrent access to a wide variety of alternative reinforcers in addition to drugs, experimental animals usually have no options in their environment other than drug reinforcement. Findings in humans with low socio-economic status, in which there are fewer opportunities for alternative forms of reinforcement, show that these individuals have higher rates of smoking (for review, see Hiscock et al. 2012) and alcoholism (Grant 1997; van Oers et al. 1999). In laboratory settings, the presence of alternative reinforcers has been shown to alter drug use in humans (for review, see Higgins 1997), in monkeys (for review, see Campbell and Carroll 2000), and in rats in both discrete choice procedures (Ahmed 2005; Lenoir et al. 2007) and under concurrent reinforcement schedules (Cosgrove et al. 2002; Kanarek et al. 1995; Klebaur et al. 2001; Mattson et al. 2001), indicating their efficacy at competing for behavioural output. "
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    ABSTRACT: Background The availability of alternative reinforcement has been shown to reduce drug use, but it remains unclear whether it facilitates a reduction or cessation of drug seeking or taking. Objectives We compared the effects of punishment of cocaine seeking or taking behaviour after brief or extended cocaine-taking histories when behavioural reallocation was facilitated or not by making available an alternative ingestive reinforcer (sucrose). Methods In the first experiment, punishment of either seeking or taking responses was introduced immediately after training on the seeking-taking chained schedule. In the second experiment, punishment of cocaine seeking was introduced after 12 additional days of either 1 or 6 h daily access to cocaine self-administration. In both experiments, beginning 1 week before the introduction of punishment, a subset of rats had concurrent nose poke access to sucrose while seeking or taking cocaine. Results The presence of an alternative source of reinforcement markedly facilitated behavioural reallocation from punished cocaine taking after acquisition. It also facilitated punishment-induced suppression of cocaine seeking after an extensive cocaine self-administration history likely by prompting goal-directed motivational control over drug use. However, a significant proportion of rats were deemed compulsive—maintaining drug use after an extensive cocaine history despite the presence of abstinence-promoting positive and negative incentives. Conclusion Making available an alternative reinforcer facilitates disengagement from punished cocaine use through at least two different processes but remains ineffective in a subpopulation of vulnerable animals, which continued to seek cocaine despite the aversive consequence of punishment and the presence of the alternative positive reinforcer.
    Psychopharmacology 06/2014; 232(1). DOI:10.1007/s00213-014-3648-5 · 3.99 Impact Factor
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    • "Those of higher SES are more likely to consume alcohol and tend to drink more frequently than those of lower status, but those of lower status who do drink consume more alcohol in total (e.g. Marmot, 1997; Van Oers et al., 1999; Bloomfield et al., 2000). Moreover, there is recent evidence from the USA that those with higher incomes are more likely to engage in hazardous drinking according to DSM-IV criteria (Keyes and Hasin, 2008). "
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    ABSTRACT: To examine the influence of country-level characteristics and individual socio-economic status (SES) on individual alcohol-related consequences. Data from 42,655 men and women collected by cross-sectional surveys in 25 countries of the Gender, Alcohol and Culture: An International Study study were used. The individual SES was measured by the highest attained educational level. Alcohol-related consequences were defined as the self-report of at least one internal or one external consequence in the last year. The relationship between individuals' education and alcohol-related consequences was examined by meta-analysis. In a second step, the individual level data and country data were combined in multilevel models. As country-level indicators, we used the purchasing power parity of the gross national income (GNI), the Gini coefficient and the Gender Gap Index. Lower educated men and women were more likely to report consequences than higher educated men and women even after controlling for drinking patterns. For men, this relation was significant for both internal and external problems. For women, it was only significant for external problems. The GNI was significantly associated with reporting external consequences for men such that in lower income countries men were more likely to report social problems. The fact that problems accrue more quickly for lower educated persons even if they drink in the same manner can be linked to the social or environmental dimension surrounding problems. That is, those of fewer resources are less protected from the experience of a problem or the impact of a stressful life event.
    Alcohol and Alcoholism 04/2012; 47(5):597-605. DOI:10.1093/alcalc/ags040 · 2.09 Impact Factor
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    • "Parental psychopathology and parental alcohol problems are also associated with poor parenting (Chassin et al. 1996; Berg-Nielsen et al. 2002; Lovejoy et al. 2005), potentially putting children at an increased risk for both maltreatment exposure (through direct parent to child maltreatment and/or increased exposure to other forms of maltreatment) and later development of alcoholism. Furthermore, contextual family risk factors, such as poverty, are also associated with risk for both childhood maltreatment (for a review, see Freisthler et al. 2006) and problematic drinking (Van Oers et al. 1999; Hasin et al. 2007). Taken together, these overlapping risk factors make it difficult to determine the specific effects of childhood maltreatment on alcoholism risk, and suggest that the association may reflect a shared familial vulnerability to both. "
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    ABSTRACT: An association between childhood maltreatment and subsequent alcohol abuse and/or dependence (AAD) has been found in multiple studies of females. Less is known about the association between childhood maltreatment and AAD among males, and the mechanisms that underlie this association in either gender. One explanation is that childhood maltreatment increases risk for AAD. An alternative explanation is that the same genetic or environmental factors that increase a child's risk for being maltreated also contribute to risk for AAD in adulthood. Lifetime diagnosis of AAD was assessed using structured clinical interviews in a sample of 3527 male participants aged 19-56 years from the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders. The sources of childhood maltreatment-AAD association were estimated using both a matched case-control analysis of twin pairs discordant for childhood maltreatment and bivariate twin modeling. Approximately 9% of participants reported childhood maltreatment, defined as serious neglect, molestation, or physical abuse occurring before the age of 15 years. Those who experienced childhood maltreatment were 1.74 times as likely to meet AAD criteria compared with males who did not experience childhood maltreatment. The childhood maltreatment-AAD association largely reflected environmental factors in common to members of twin pairs. Additional exploratory analyses provided evidence that AAD risk associated with childhood maltreatment was significantly attenuated after adjusting for measured family-level risk factors. Males who experienced childhood maltreatment had an increased risk for AAD. Our results suggest that the childhood maltreatment-AAD association is attributable to broader environmental adversity shared between twins.
    Psychological Medicine 03/2010; 41(1):59-70. DOI:10.1017/S0033291710000425 · 5.43 Impact Factor
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