[Show abstract][Hide abstract] ABSTRACT: Two different measures have been used to establish a person's level of response (LR) to alcohol as a risk factor for alcohol use disorders. LR values established by the alcohol challenge protocol and the Self-Report of the Effects of Ethanol (SRE) questionnaire usually correlate at 0.3 to 0.4, up to 0.6. However, it is not clear how this correlation relates to the ability of each measure to predict alcohol outcomes. This paper evaluates that overlap.
Sixty-six Caucasian males (mean age = 22 years) from 2 protocols participated in alcohol challenges with 0.75 ml/kg of ethanol, filled out the SRE, and were followed with a structured interview approximately 5 years later. The relationship between the subjective feelings of intoxication at the time of peak breath alcohol levels from the alcohol challenge and the SRE score for a time early in the drinking career were evaluated regarding predicting the drinks per occasion in the 6 months prior to follow-up.
Cross-sectional correlations between alcohol challenge and SRE LR's ranged from -0.25 (p < 0.05) to -0.32 (p = 0.02) for the full sample, and the 2 LR measures correlated with drinking at follow-up (-0.26 and 0.41, respectively). The SRE measure was more robust than the challenge in a regression analysis predicting the outcome in the context of other baseline predictors (e.g., drinking at baseline). As much as 60% of the ability of the more well established (gold standard) alcohol challenge LR to predict outcome was shared with the SRE. The alcohol challenge accounted for as much as 44% of the ability of the SRE to predict outcome.
The SRE-generated LR overlapped considerably with the alcohol challenge LR in the ability to predict future heavier drinking.
Alcoholism Clinical and Experimental Research 12/2008; 33(3):563-9. · 3.42 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The validity of the DSM-IV diagnostic criteria for alcohol abuse has been questioned, and additional issues have been raised regarding the performance of this label in adolescents. While future diagnostic manuals might alter the approach to abuse, it is worthwhile to evaluate the implications of the current definition that has been in place since 1994.
Six hundred and sixteen 12-19-year-old subjects (mean 16.5 years) were offspring identified in the Collaborative Study on the Genetics of Alcoholism (COGA) protocol who had ever consumed a full drink and who were followed up 5 years later using age-appropriate semi-structured interviews. Following the guidelines for evaluating the utility of the diagnostic labels of Robins and Guze [Robins, E., Guze, S.B., 1970. Establishment of diagnostic validity in psychiatric illness: its application to schizophrenia. Am. J. Psychiat. 126, 983-987], the subjects with alcohol abuse were compared with other groups regarding clinical validators and clinical course.
At initial interview, the pattern of most alcohol use and problem variables were least severe for teenagers with no diagnosis, intermediate for those with abuse, and the highest for individuals with alcohol dependence. At follow-up, 50% of those with initial abuse maintained that diagnosis, 19% developed dependence, and 31% had no DSM-IV diagnosis. Baseline alcohol abuse predicted follow-up diagnosis even when evaluated along with initial demographic and substance use characteristics.
These results support some assets for the DSM-IV alcohol abuse criteria in these adolescents, including indications of both cross-sectional and predictive validities. Additional studies will need to compare the current abuse label with other possible approaches.
Drug and Alcohol Dependence 10/2008; 97(1-2):94-104. · 3.14 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The low level of response (LR) to alcohol, an endophenotype related to heavy drinking and alcohol problems, influences the risk for alcoholism in the context of additional life domains. This article evaluates an LR-based model of drinking patterns in 113 drinking offspring, ages 12 to 24 years, from the San Diego Prospective Study.
Correlations and structural equation models (SEMs) were evaluated using LR as measured from the Self-Report of the Effects of Alcohol questionnaire in the offspring. The expectations of the effects of alcohol (EXPECT), the perception of drinking in peers (PEER), the use of alcohol to cope with stress (COPE), and the drinking quantities and alcohol-related problems (ALCOUT) were evaluated in the SEM.
The LR-based model worked well, with good fit characteristics and 78% of the variance of outcome explained. LR related directly to ALCOUT, with additional mediation of that relationship through EXPECT and COPE.
The LR-based model performed well in adolescents from the San Diego Prospective Study. Knowledge of which domains mediate how LR impacts alcohol-related outcomes may be useful in developing more focused and potentially more effective prevention approaches.
Journal of studies on alcohol and drugs 08/2008; 69(4):571-9. · 1.68 Impact Factor