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

Addiction Research Institute (IVO), Erasmus University Rotterdam, The Netherlands.
Alcohol and Alcoholism (Impact Factor: 2.89). 03/1999; 34(1):78-88. DOI: 10.1093/alcalc/34.1.78
Source: PubMed


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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    • "Temporal discounting has received considerable attention in human behavioral neuroscience, not least because many forms of maladaptive behavior are readily characterized as pursuit of immediate gratification at the expense of reaping greater rewards in the future (Critchfield and Kollins, 2001; Bickel et al., 2007, 2014a; Koffarnus et al., 2013; Story et al., 2014). Indeed, lending validity to the discounting construct, steeper discounting is positively associated with behaviors with potentially harmful long-term consequences such as tobacco smoking (Odum et al., 2002; Epstein et al., 2003; Reynolds et al., 2004; Bickel et al., 2008; MacKillop and Kahler, 2009; Fields et al., 2009a,b; Reynolds and Fields, 2012), alcohol use (Van Oers et al., 1999; Mazas et al., 2000; Petry, 2001; Field et al., 2007; Reynolds et al., 2007; Rossow, 2008; MacKillop and Kahler, 2009; Moore and Cusens, 2010), illicit drug misuse (Kirby et al., 1999; Petry and Casarella, 1999; Kollins, 2003; Petry, 2003; Kirby and Petry, 2004; Washio et al., 2011; Stanger et al., 2012), credit card debt (Meier and Sprenger, 2012) and risky sexual or drug-taking practices (Odum et al., 2000; Dierst-Davies et al., 2011). Also, many authors have explored how discounting relates to demographic variables, finding that measured discounting decreases across the lifespan (Green et al., 1996, 1999; Chao et al., 2009; Steinberg et al., 2009), is negatively correlated with income (Green et al., 1996; Eckel et al., 2005; Reimers et al., 2009), and tends to be lower in individuals living in the developed world than in the developing world (Wang et al., 2010). "
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    ABSTRACT: Impatience for reward is a facet of many psychiatric disorders. We draw attention to a growing literature finding greater discounting of delayed reward, an important aspect of impatience, across a range of psychiatric disorders. We propose these findings are best understood by considering the goals and motivation for discounting future reward. We characterise these as arising from either the opportunity costs of waiting or the uncertainty associated with delayed reward. We link specific instances of higher discounting in psychiatric disorder to heightened subjective estimates of either of these factors. We propose these costs are learned and represented based either on a flexible cognitive model of the world, or an accumulation of previous experience, or through evolutionary specification. Any of these can be considered suboptimal for the individual if the resulting behaviour results in impairments in personal and social functioning and/or in distress. By considering the neurochemical and neuroanatomical implementation of these processes, we illustrate how this approach can in principle unite social, psychological and biological conceptions of impulsive choice.
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    • "For weekly+ HDOs, the use of MHI instead of AUDIT-C data resulted in SES associations of greater magnitude, and these associations were only significant for men when MHI data were used. Associations of various indicators of low SES with heavy drinking have been previously reported (van Oers et al., 1999; Casswell et al., 2003; Kuntsche et al., 2004; Jefferis et al., 2007; Huckle et al., 2010; Paljärvi et al., 2013), but the potential for differential misclassification of alcohol exposure to affect these associations in a sex-specific manner has not been previously noted. A limitation of our consistency analysis is the focus on dichotomized alcohol consumption variables (Heavner et al., 2010). "
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    ABSTRACT: To describe inconsistencies in reporting past-year drinking status and heavy drinking occasions (HDOs) on single questions from two different instruments, and to identify associated characteristics and impacts. We compared computer-presented Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) with categorical response options, and mental health interview (MHI) with open-ended consumption questions, completed on the same day. Participants were 464 men and 459 women aged 38 (91.7% of surviving birth cohort members). Differences in dichotomous single-item measures of abstention and HDO frequency, associations of inconsistent reporting with sex, socioeconomic status (SES) and survey order, and impacts of instrument choice on associations of alcohol with sex and SES were examined. The AUDIT-C drinking frequency question estimated higher past-year abstention prevalence (AUDIT = 7.6%, MHI = 5.4%), with one-third of AUDIT-C abstainers being MHI drinkers. Only AUDIT-C produced significant sex differences in abstainer prevalence. Inconsistencies in HDO classifications were bidirectional, but with fewer HDOs reported on the MHI than AUDIT-C question. Lower SES was associated with inconsistency in abstention and weekly+ HDOs. Abstention and higher HDO frequency were associated with lower SES overall, but sex-specific associations differed by instrument. In this context, data collection method affected findings, with inconsistencies in abstention reports having most impact. Future studies should: (a) confirm self-reported abstention; (b) consider piloting data collection methods in target populations; (c) expect impacts of sex and SES on measurements and analyses. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.
    No preview · Article · Feb 2015 · Alcohol and alcoholism (Oxford, Oxfordshire). Supplement
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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.
    Full-text · Article · Jun 2014 · Psychopharmacology
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