Biomedical subjects

B F Grant

Publications and source records attributed to B F Grant.

At least 19 recordsLinked to original sources

PubMed2001

The 5-year course of alcohol abuse among young adults.

PURPOSE: This study describes the course of alcohol abuse among a nationally representative sample of young adults over a 5-year time period for the purpose of examining the validity of the DSM-IV alcohol abuse category. METHODS: DSM-IV diagnoses of alcohol abuse at baseline and follow-up were examined using logistic regression analyses. RESULTS: Alcohol abuse and dependence were shown to have different courses. Very few abusers at Time 1 became dependent at Time 2, suggesting that abuse is not merely prodromal to dependence. Females, Blacks, and high school dropouts were less likely to receive an abuse diagnosis at baseline. Marital status, family history, earlier onset of drinking, and heavy drinking were also related to abuse at baseline. Alcohol abuse at baseline, in addition to gender, marital status, family history, early onset drinking, and heavy drinking, predicted abuse at follow-up. Exclusion of the hazardous criterion item "driving after drinking too much" from the abuse diagnosis yielded similar results. DISCUSSION: The DSM-IV alcohol abuse category was shown to have some diagnostic utility.

Adolescent↗

PubMed2001

Age at onset of alcohol use and DSM-IV alcohol abuse and dependence: a 12-year follow-up.

PURPOSE: The purpose of this study was to examine the relationship between age at drinking onset and the development of DSM-IV alcohol abuse and dependence in a 12-year prospective study of youth in the United States. METHODS: Logistic regression analyses were used to quantify the relationship between age at drinking onset and the development of alcohol abuse and dependence controlling for sociodemographic factors and problem indicators. RESULTS: The odds of alcohol dependence decreased by 5% in 1989 and 9.0% in 1994 for each year drinking onset was delayed. In 1994, the odds of alcohol abuse increased by 7.0% with each decreasing year of age at drinking onset, while age at drinking onset was not related to alcohol abuse in 1989. Several other risk factors were found to be strong and consistent predictors of abuse and dependence in 1989 and 1994, including being male, divorced, separated or never married, younger, and having an early history antisocial behaviors and marijuana use. IMPLICATIONS: Implications of the results of this study are discussed in terms of other factors that may impact on the onset-abuse and onset-dependence relationship and the need to focus future prevention efforts.

Adolescent↗

PubMed2001

The critical dimension of ethnicity in liver cirrhosis mortality statistics.

BACKGROUND: In 1997, liver cirrhosis was the 10th leading cause of death in the United States. Beginning in the 1950s, liver cirrhosis mortality rates have been consistently higher for black than for white men and women. There has been a gradual adoption of the recommendation that all death certificates include information on the Hispanic origin of decedents, with universal adoption in the 1997 data year. It is the purpose of this study to examine the extent to which relative risks for cirrhosis mortality might shift for different demographic groups when Hispanic origin is considered along with the race and sex of the decedent. METHODS: Age-adjusted death rates were calculated for liver cirrhosis by using public-use data files produced by the National Center for Health Statistics. Trends in cirrhosis mortality rates from 1991 through 1997 are shown for white Hispanic, white non-Hispanic, black Hispanic, and black non-Hispanic men and women. RESULTS: In 1997, white Hispanic men show the highest cirrhosis mortality rates over the period examined, followed by black non-Hispanic and white non-Hispanic men, white Hispanic women, and black non-Hispanic and white non-Hispanic women. Among Hispanic decedents, the largest group was of Mexican ancestry, with large numbers being born outside the United States and having low education levels. CONCLUSIONS: The findings of higher risk for cirrhosis mortality among white men and women of Hispanic origin serve to focus new attention on these demographic groups. Collateral analyses of other causes of death do not support alternate explanations of these findings as artifacts of demographic misclassification. Future studies of amounts and patterns of alcohol consumption should include Hispanic origin among demographic factors examined.

Black or African American↗

PubMed2000

Theoretical and observed subtypes of DSM-IV alcohol abuse and dependence in a general population sample.

The purpose of this study was to quantify the degree of heterogeneity of the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) alcohol abuse and dependence categories by comparing the number of theoretically predicted subtypes of each category with those observed in a nationally representative sample of the US general population. Among respondents classified with a past year diagnosis of abuse, only 11 (47.8%) of the 23 theoretically predicted subtypes of abuse were observed, while 53 (53.5%) of the 99 theoretically predicted subtypes of dependence were observed in this general population sample. Approximately 90% of the respondents classified with abuse could be represented by three subtypes of abuse and 70% of the respondents with current diagnoses of dependence could be characterized by six subtypes of dependence, indicating the relative homogeneity of both diagnostic categories. Sociodemographic differentials were also observed including the reduction in the number of observed subtypes of abuse and dependence with age as well as the larger numbers of subtypes associated with males and whites relative to females and blacks, respectively. Implications of these results are discussed in terms of increased physical morbidity and disruption of family life as persons with alcohol use disorders age, the potential role of physiological and impaired control over drinking indicators of dependence as critical features of the disorder, and the future need to examine the conceptual basis of the abuse category and to conduct longitudinal epidemiological research.

Adolescent↗

PubMed2000

Estimates of US children exposed to alcohol abuse and dependence in the family.

OBJECTIVES: This study sought to provide direct estimates of the number of US children younger than 18 years who are exposed to alcohol abuse or alcohol dependence in the family. METHODS: Data were derived from the National Longitudinal Alcohol Epidemiologic Survey. RESULTS: Approximately 1 in 4 children younger than 18 years in the United States is exposed to alcohol abuse or alcohol dependence in the family. CONCLUSIONS: There is a need for approaches that integrate systems of services to enhance the lives of these children.

Adolescent↗

PubMed1999

Suicidal ideation among the United States drinking population: results from the National Longitudinal Alcohol Epidemiologic Survey.

OBJECTIVE: Data from a national representative sample of adults was used to identify major risk factors of suicidal ideation among the U.S. drinking population. METHOD: Data from a sample of 18,352 current drinkers, 18 years of age and older, were analyzed by means of multiple logistic regression analysis. In these analyses, multivariate associations were examined between risk factors for suicidal ideation and the occurrence of suicidal ideation. RESULTS: For men and women, past year major depression and alcohol dependence were identified as risk factors of suicidal ideation, with major depression having the more sizable impact. Suicidal ideation was increased among men with a past alcohol use disorder, and elevated among women who had used drugs nonmedically and developed a drug use disorder during the past year. The occurrence of a recent physical illness and lifetime treatment for major depression among men and women increased the risk of suicidal ideation, while marriage was protective against ideation for both sexes. Unemployment and having a family history of alcoholism increased the risk of suicidal ideation among men, but not women. CONCLUSIONS: Major findings are discussed in terms of the impact of severity versus chronicity of psychopathology on suicidal ideation, gender roles and differential engagement in suicidal ideation, and the recognition and treatment of major depression as the single most important intervention in reducing suicidal behavior.

Adolescent↗

PubMed1999

Parallels to early onset alcohol use in the relationship of early onset smoking with drug use and DSM-IV drug and depressive disorders: findings from the National Longitudinal Epidemiologic Survey.

This paper endeavored to determine (1) if early onset of regular tobacco use is as predictive of drug use and depressive disorders as it is of alcohol use disorders; and (2) if a biological commonality, as measured by a family history of alcoholism and both early onset and severity of disease, among all three disorders can be evidenced in a large nationally representative sample. Prevalences of lifetime drug use, drug abuse and dependence, and major depressive disorders, as well as indices of their severity, were compared among smoking groups defined by age at onset of regular tobacco use and among nonsmokers. Linear logistic regression analyses, controlling for important covariates, including a family history positive for alcoholism, were conducted to assess the relationship between age at smoking onset and drug use, abuse and dependence, as well as depressive disorders. Both objectives were met. Moreover, results suggest that smoking may play an equally, if not even more, insidious role than drinking in the use and development of dependence on illicit substances and depression.

Adolescent↗

PubMed1998

The relationship between cannabis use and DSM-IV cannabis abuse and dependence: results from the National Longitudinal Alcohol Epidemiologic Survey.

The purpose of-this study was to determine the risk of Diagnostic and Statistical Manual of Mental Disorders--Fourth Edition (DSM-IV) cannabis abuse and dependence at different levels of cannabis use in a nationally representative sample of the U.S. general population. Two separate logistic regression analyses were conducted to determine the association between cannabis use, and abuse and dependence. The risk of cannabis abuse and dependence was found to increase with the frequency of smoking occasions and slightly decreased with age. More severe comorbidity was associated with dependence compared to abuse, suggesting that cannabis might be used to self-medicate major depression. The strength of the association between cannabis use and abuse was also increased as a function of the number of joints smoked among females, but not males. These results were discussed in terms of differential societal reactions, the self-medication hypothesis, and gender biases in diagnosing cannabis abuse.

Adolescent↗

PubMed1998

Age of onset of drug use and its association with DSM-IV drug abuse and dependence: results from the National Longitudinal Alcohol Epidemiologic Survey.

The purpose of this study was to examine the relationship between early onset drug use and the development of lifetime DSM-IV drug abuse and dependence using a representative sample of the U.S. population. Prevalences of lifetime drug abuse and dependence were estimated for each year of age of onset of drug use from ages 13 and younger to 21 and older for the overall sample of drug users by race and gender. Linear logistic analyses were conducted to assess the relationship between age of drug use onset and lifetime drug use disorders controlling for important covariates. The major finding of this study was that early onset drug use is a significant predictor of the subsequent development of drug abuse over the life course. Early onset drug use was also a significant predictor of the subsequent development of lifetime alcohol dependence among males, females, and nonblacks, but not among blacks. After adjusting for important model covariates, the likelihood of lifetime drug abuse and dependence among the total sample of lifetime drug users was reduced by 4% and 5% with each year drug use onset was delayed. Implications of these findings are discussed in terms of the importance of collecting national data on drug use, abuse and dependence and the need for further research and its integration with prevention efforts.

Adolescent↗

PubMed1998

Age at smoking onset and its association with alcohol consumption and DSM-IV alcohol abuse and dependence: results from the National Longitudinal Alcohol Epidemiologic Survey.

The major purpose of this study was to examine the relationship of early onset smoking with lifetime drinking and the subsequent development of DSM-IV alcohol abuse and dependence using a large representative sample of the U.S. general population. Prevalences of lifetime drinking, alcohol abuse and dependence, and their associated severity were compared among smoking groups defined by age at onset of smoking and among nonsmokers. Linear logistic regression analyses were conducted to assess the relationship between age at smoking onset and lifetime drinking, alcohol abuse and dependence, controlling for important covariates. Early onset smoking was a significant predictor of lifetime drinking and the subsequent development of lifetime alcohol abuse and dependence, a relationship that generally remained consistent for males, females, whites and blacks. Early onset smoking was significantly associated with more excessive alcohol consumption and more severe alcohol use disorders relative to late onset smokers and nonsmokers. Early onset smoking was also significantly associated with heavier and longer smoking careers compared to late onset smokers. Implications of these findings are discussed in terms of prevention of adolescent smoking and the need for further research on understanding the mechanisms underlying the associations between early onset smoking and lifetime drinking, alcohol abuse and dependence.

Adult↗

PubMed1998

Alcoholic beverage preference and risks of alcohol-related medical consequences: a preliminary report from the National Longitudinal Alcohol Epidemiologic Survey.

In studying the alcohol-morbidity association, a substantial amount of attention and efforts has been focused on volume of alcohol intake. Considerably less is known about the differential health effects of beverage types. The present study used a most recent national household survey of the U.S. general population on drinking practices, alcohol use disorders, and their associated disabilities. The prevalence of a broad range of alcohol-related diseases was examined with respect to preferred beverage type, as well as consumption level. Our findings showed a reduced health risk associated with beer and wine drinking for a number of physical disorders, and a somewhat favorable cardiovascular effect of these two beverage types in relation to abstention. Among preferrers of beer, wine, and liquor, the results indicate that liquor preference is associated with elevated morbidity for several medical consequences. However, interpretation of results and the public health implications of these findings need to be taken cautiously, because sociodemographic and other behavioral characteristics were not considered in this preliminary report.

Adolescent↗

PubMed1998

Reliability of the Romanian version of the alcohol module of the WHO Alcohol Use Disorder and Associated Disabilities: Interview Schedule --Alcohol/Drug-Revised.

Alcohol Use Disorder and Associated Disabilities Interview Schedule - Alcohol/Drug-Revised (AUDADIS-A/D-R) is a fully structured, standardized and precoded instrument designed to evaluate alcohol and drug use disorders according to DSM-III-R, DSM-IV, and ICD-10 criteria. The AUDADIS-A/D-R has shown good to excellent reliability in both large clinical and general population samples, but prior to the conduct of the present study no data on the reliability of the Romanian version of the AUDADIS-A/D-R existed. The purpose of the present study was to examine the test-retest reliability of the alcohol module of the AUDADIS-A/D-R in a general population and clinical sample in Romania. The overall reliability of ICD-10 and DSM-IV abuse, harmful and dependence diagnoses, was found to be good to excellent, but was somewhat lower for abuse and harmful use diagnoses. The results are discussed in terms of the cultural applicability of the symptom items and within the context of the analysis of discrepant responses between the test and retest interviews.

Adult↗

PubMed1998

Family history of alcoholism and gender: their combined effects on DSM-IV alcohol dependence and major depression.

OBJECTIVE: Data from a representative sample of U.S. adults were used to assess the extent of familial alcoholism, to examine its association with the odds of DSM-IV lifetime alcohol dependence, major depression, and their comorbid occurrence, and to determine whether the magnitude of this association was different for men and women. METHOD: Self-report data from a sample of 42,862 U.S. adults (25,043 women) 18 years of age and over were analyzed by means of multiple logistic regression models that predicted the odds of various combinations of DSM-IV alcohol dependence and major depression. RESULTS: After adjusting for potential confounders through multiple logistic regression, family history saturation was associated with increased odds of dependence only, depression only, and all primary-secondary-concurrent combinations of these two disorders. The estimated effects were greatest for comorbid dependence and depression, next highest for dependence only and lowest for depression only. Differences in odds ratios among these groups increased with degree of family history saturation but were statistically significant at all levels of saturation. The effects of family history were greater for men than women for the outcome of primary depression followed by secondary dependence, but only at the higher levels of saturation. Among persons with lifetime major depression, family history of alcoholism had a positive independent association with the conditional odds of having experienced comorbid alcohol dependence. It had a weaker but still significant association with the odds of comorbid depression, conditional upon having experienced dependence, and this association was stronger among men than among women. For most outcomes, family history effects were stronger for paternal male and maternal female relatives than for paternal female and maternal male relatives. CONCLUSIONS: These findings supported prior research showing more familial alcoholism among persons with comorbid dependence and depression than among those with dependence alone. Gender differences were supportive of the proposed distinction between pure depression and depressive-spectrum disease.

Adult↗

PubMed1998

The impact of a family history of alcoholism on the relationship between age at onset of alcohol use and DSM-IV alcohol dependence: results from the National Longitudinal Alcohol Epidemiologic Survey.

Both the age at onset of alcohol use and a family history of alcoholism can influence a person's risk of becoming alcohol dependent. The relationship between lifetime alcohol dependence, age at first alcohol use, and a family history of alcoholism was investigated using data obtained in the 1992 National Longitudinal Alcohol Epidemiologic Survey. This analysis demonstrated that regardless of the family history of alcoholism, respondents with an earlier age of drinking onset were more likely to become alcohol dependent compared with respondents with a later age of drinking onset. Among all age, race, and gender subgroups studied, however, people with a family history of alcoholism had a higher prevalence of lifetime alcohol dependence than did people without such a history.

Age of Onset↗

PubMed1997

WHO Study on the reliability and validity of the alcohol and drug use disorder instruments: overview of methods and results.

The WHO Study on the reliability and validity of the alcohol and drug use disorder instruments in an international study which has taken place in centres in ten countries, aiming to test the reliability and validity of three diagnostic instruments for alcohol and drug use disorders: the Composite International Diagnostic Interview (CIDI), the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) and a special version of the Alcohol Use Disorder and Associated Disabilities Interview schedule-alcohol/drug-revised (AUDADIS-ADR). The purpose of the reliability and validity (R&V) study is to further develop the alcohol and drug sections of these instruments so that a range of substance-related diagnoses can be made in a systematic, consistent, and reliable way. The study focuses on new criteria proposed in the tenth revision of the International Classification of Diseases (ICD-10) and the fourth revision of the diagnostic and statistical manual of mental disorders (DSM-IV) for dependence, harmful use and abuse categories for alcohol and psychoactive substance use disorders. A systematic study including a scientifically rigorous measure of reliability (i.e. 1 week test-retest reliability) and validity (i.e. comparison between clinical and non-clinical measures) has been undertaken. Results have yielded useful information on reliability and validity of these instruments at diagnosis, criteria and question level. Overall the diagnostic concordance coefficients (kappa, kappa) were very good for dependence disorders (0.7-0.9), but were somewhat lower for the abuse and harmful use categories. The comparisons among instruments and independent clinical evaluations and debriefing interviews gave important information about possible sources of unreliability, and provided useful clues on the applicability and consistency of nosological concepts across cultures.

Adult↗

PubMed1997

Reliability of the alcohol and drug modules of the Alcohol Use Disorder and Associated Disabilities Interview Schedule--Alcohol/Drug-Revised (AUDADIS-ADR): an international comparison.

The purpose of the present study was to examine the test-retest reliability of the alcohol and drug modules of the AUDADIS-ADR in three sites: Bangalore, India, Jebel, Romania and Sydney, Australia. The overall reliability of ICD-10, DSM-IV and DSM-III-R dependence diagnoses was found to be good to excellent for each substance, including alcohol, for each time frame, regardless of whether the total sample or user subsample figured into the calculations. Reliability associated with corresponding harmful use and abuse diagnoses were mixed, but generally lower. Reliability statistics for Bangalore were generally lower than those of the Jebel and Sydney sites, particularly for alcohol diagnostic criteria. Implications of these results are discussed, in conjunction with results from the discrepancy interview protocol analyses within sites, in terms of future revisions to the AUDADIS-ADR and its training procedures tailored to developing countries.

Adult↗

PubMed1997

Concordance of DSM-IV alcohol and drug use disorder criteria and diagnoses as measured by AUDADIS-ADR, CIDI and SCAN.

This study was designed to examine the agreement of DSM-IV alcohol and drug use disorder diagnoses generated by three WHO/NIH diagnostic instruments, the AUDADIS-ADR, the CIDI, and the SCAN. This substudy, conducted in three countries, Greece, Luxembourg, and the United States, was part of the larger joint project on diagnosis and classification of mental disorders and alcohol and drug-related problems, which was initiated to evaluate the cross-cultural applicability of the instruments and the criteria. Overall, concordance among the three assessments was good for alcohol and opiate dependence, fair to good for cocaine and sedative dependence, and low for amphetamine dependence. Cannabis dependence concordance was significantly more discrepant than any other substance. Agreement on abuse was low for all substances examined. In addition, the concordance of DSM-IV criteria for each substance was examined. Finally, reasons for discrepancies in responses among assessments were examined, based on discrepancy interview protocol methodology. Further investigation will help to refine these instruments in order to provide a more thorough understanding of alcohol and drug abuse diagnoses.

Adult↗

PubMed1997

Concordance between ICD-10 alcohol and drug use disorder criteria and diagnoses as measured by the AUDADIS-ADR, CIDI and SCAN: results of a cross-national study.

Agreement between the AUDADIS-ADR, CIDI and SCAN in case identification for ICD-10 alcohol and drug use disorders and diagnostic criteria was investigated in three countries, Luxembourg, Greece and the US. Overall, agreement for ICD-10 dependence diagnoses between the three instruments was fair to good for alcohol, opioids and cocaine, but generally lower for dependence diagnoses for other substance. In contrast, concordance between instruments for harmful use diagnoses was extremely poor for all substances. Implications of these major findings are discussed in terms of the relationship between prevalence, reliability and concordance and indications and cautions regarding cross-instrument comparisons.

Adult↗