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Biomedical subjects

B F Grant

Publications and source records attributed to B F Grant.

At least 37 records · Page 2Linked to original sources
PubMed1997

Nosological comparisons of alcohol and drug diagnoses: a multisite, multi-instrument international study.

International nosological research was conducted to determine cross-system agreement on alcohol and drug dependence and harmful use (abuse). ICD-10, DSM-IV and DSM-III-R diagnoses were compared in 1,811 subjects from a variety of treatment and other types of settings from 12 sites around the world. Three diagnostic instruments were used: the Alcohol Use Disorders and Associated Disabilities Interview Schedule-Alcohol/Drug-Revised (AUDADIS-ADR), the composite international diagnostic interview (CIDI), and the schedules for clinical assessment in neuropsychiatry (SCAN). At seven of the study sites, two or more of these instruments were used. Results for dependence diagnoses showed excellent cross-system agreement across sites and instruments, especially for current diagnoses. Cross-system agreement for harmless use (abuse) was much lower and less consistent. Geographic location or culture appeared to have little influence on the results for either dependence or harmful use.

Adult↗
PubMed1997

The alcohol use disorder and associated disabilities interview schedule (AUDADIS): reliability of alcohol and drug modules in a clinical sample.

The alcohol use disorder and associated disabilities interview schedule (AUDADIS), was designed for use in the general population, and was previously shown to have good reliability in a sample of household residents. However, measurement problems are different in clinical samples. Thus, a test-retest study was conducted of the AUDADIS in a clinical sample of 296 substance-using patients from substance- and psychiatrically-identified treatment settings. Reliability for current drug-specific AUDADIS dependence diagnoses was good to excellent for high-prevalence as well as low-prevalence drug categories. Reliability for abuse diagnoses was not as good, although this was due to the hierarchical nature of the abuse diagnosis itself, rather than its defining criteria. Demographic and other factors were investigated for their potential effects on the reliability of alcohol and cocaine diagnoses; low severity was the only consistent predictor of unreliability for both of these categories. Reliability of consumption variables was generally good, with a few notable exceptions. Results suggest that the AUDADIS can be used in research comparing treated to community samples of individuals with alcohol and drug diagnoses.

Adolescent↗
PubMed1997

Convergent validity of DSM-III-R and DSM-IV alcohol dependence: results from the National Longitudinal Alcohol Epidemiologic Survey.

The purpose of this study was to separately examine the associations between ethanol intake and alcohol dependence, as defined in the DSM-III-R and DSM-IV, in conjunction with an identical set of external correlates, with a view toward assessing the convergent validity of the two diagnostic definitions of dependence. Although the sociodemographic, alcohol, drug and comorbid profiles of respondents classified as DSM-III-R and DSM-IV dependent were similar, the results of the linear logistic regression analyses differed for each of the diagnostic definitions. The risk of DSM-III-R dependence was reduced among blacks and increased among early onset drinkers. Given equivalent levels of ethanol intake, the risk of DSM-III-R dependence was greater for these respondents who had experienced a recent death of close relative compared to those who had not. In contrast, the risk of DSM-IV dependence was greatest among respondents with a current alcoholic spouse or partner relative to those without an alcoholic spouse or partner. Major differences in the content and structure of the two definitions of dependence were useful in predicting the observed discrepancies between the risk gradients associated with the DSM-III-R and DSM-IV classifications. Implications of these findings were discussed in terms of differential coverage of the DSM-III-R and DSM-IV diagnostic categories and the impact of the absence of complete convergent validity on epidemiologic research.

Adolescent↗
PubMed1997

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

Data from 27,616 current and former drinkers interviewed in the 1992 National Longitudinal Alcohol Epidemiologic Survey were used to examine the relationship between age at first use of alcohol and the prevalence of lifetime alcohol abuse and alcohol dependence, among all U.S. adults 18 years of age and over and within subgroups defined by sex and race. The rates of lifetime dependence declined from more than 40% among individuals who started drinking at ages 14 or younger to roughly 10% among those who started drinking at ages 20 and older. The rates of lifetime abuse declined from just over 11% among those who initiated use of alcohol at ages 16 or younger to approximately 4% among those whose onset of use was at ages 20 or older. After using multivariate logistic regression models to adjust for potential confounders, the odds of dependence decreased by 14% with each increasing year of age at onset of use, and the odds of abuse decreased by 8%. These findings are discussed with respect to their implications for prevention policies and the need to integrate epidemiological and intervention research.

Adolescent↗
PubMed1997

Familial aggregation of DSM-IV alcohol use disorders: examination of the primary-secondary distinction in a general population sample.

This study examined the familial aggregation of alcoholism in subgroups of respondents classified with respect to the primary-secondary distinction as it is related to DSM-IV major depression and alcohol use disorders. Rates of alcoholism among specific first- and second-degree relatives of male and female probands with primary, secondary, and concurrent depression (i.e., the comorbid groups) and with major depression only were compared with one another and with a normal control group. The results of this general population survey that uses a large representative sample of the U.S. were at variance with some findings from the clinical literature with regard to familial aggregation. Greater rates of alcoholism were found among first- and second-degree relatives of the major depression only group compared with normal controls. Male and female probands of all three comorbid groups were not shown to convey a greater risk of alcoholism to their offspring compared with the normal control group or the major depression only group. The discrepancy between clinical research findings and those of this general population study were discussed in terms of methodological considerations.

Adolescent↗
PubMed1997

Barriers to alcoholism treatment: reasons for not seeking treatment in a general population sample.

OBJECTIVE: The present study reports responses to numerous direct questions related to reasons for not seeking alcoholism treatment given the perceived need for treatment among respondents classified with an alcohol use disorder (N = 964, 69.8% male, 93.5% nonblack) in a larger representative sample of the United States population. METHOD: Data were derived from the 1992 National Longitudinal Alcohol Epidemiologic Survey, a national probability sample of 42,862 respondents, aged 18 years and older, from the noninstitutionalized population of the contiguous states. RESULTS: Lack of confidence in the alcoholism treatment system and its effectiveness, stigmatization and denial were identified as significant barriers to alcoholism treatment at the aggregate level. In general, enabling factors such as lack of financial resources or facilities for child care were much less important barriers to care than were individual predisposing factors including attitudes towards alcoholism treatment. CONCLUSIONS: Important sociodemographic differences in identified barriers to care are discussed in terms of their minimization through proposed changes in education, screening, outreach, detection, and referral patterns in alcoholism treatment delivery systems.

Adolescent↗
PubMed1997

Prevalence and correlates of alcohol use and DSM-IV alcohol dependence in the United States: results of the National Longitudinal Alcohol Epidemiologic Survey.

OBJECTIVE: The purpose of this study was to present updated estimates of the prevalence of, and to examine the correlates of, alcohol use and DSM-IV alcohol dependence in a representative sample of the U.S. population. METHODS: This study was based on the National Institute on Alcohol Abuse and Alcoholism's National Longitudinal Alcohol Epidemiologic Survey (NLAES), a representative sample (N = 42,862) of the United States population aged 18 years and older. RESULTS: The prevalence of lifetime alcohol use was 66.0%, with 44.4% of the respondents reporting alcohol use during the past 12 months. Lifetime and 12-month prevalences of alcohol dependence were estimated at 13.3% and 4.4%, respectively. Men were significantly more likely than women to use alcohol, and alcohol use and dependence were much more common among cohorts born after Prohibition and after World War II. Members of the youngest cohorts, between the ages of 18 and 24 years at the time of the interview, were more likely to use drugs, to become dependent and to persist in dependence compared to the older cohorts. In addition, the conditional probability of dependence among users was greatest in Cohort 1 (born between 1968 and 1974) after early adolescence compared to Cohort 2 (born between 1958 and 1967), despite the finding that the probability of lifetime use was lower in Cohort 1 compared to Cohort 2. The sociodemographic correlates of first use, onset of dependence and persistence of dependence varied as a function of the stage of progression. CONCLUSIONS: Implications of these findings are discussed in terms of changes over time in drinking patterns, dependence liability and vulnerability among recent alcohol users.

Adolescent↗
PubMed1997

The relationship between drinking and heart disease morbidity in the United States: results from the National Health Interview Survey.

This study, based on data drawn from the responses of 18,323 males and 25,440 females to the 1988 National Health Interview Survey, a nationally representative, multistage probability sample of the United States, attempts to define more precisely the level of drinking at which the relationship between heart disease and alcohol consumption is a protective one. Its attempt at precision derives from (1) using drinking categories that represent various points within the range of moderate drinking (1-6 drinks) defined in the literature as protective; (2) adjusting for underreporting that commonly occurs in population surveys by using consumption at time of heaviest drinking; and (3) controlling for age, body mass, smoking, former drinker, and former smoker status, duration of drinking, and sociodemographic factors. It also examines whether the relationship derived from these levels conforms to the U-shaped curve that demonstrates the protective effect of moderate drinking when abstainers are not used as the reference group. Relative to infrequent drinkers (less than 1 drink per day), men report more heart disease at the level of more than five drinks per day. However, black men also report more heart disease, relative to infrequent drinkers, at the greater than two drinks per day level; and women report more heart disease at the level of more than two drinks per day at the time of their heaviest drinking. Former drinkers of both genders, considered as an independent variable in the regression analysis, were more likely to report having heart disease. Abstainers, light drinkers, and infrequent drinkers were not significantly different in their reports of heart disease. Our results are consistent with studies that suggest protection from heart disease occurs only at lower levels of drinking.

Adolescent↗
PubMed1996

The relationship between DSM-IV alcohol use disorders and DSM-IV major depression: examination of the primary-secondary distinction in a general population sample.

This study examined the primary-secondary distinction with respect to DSM-IV alcohol use disorders and major depression in a large representative sample of the USA. Primary, secondary and concurrent depressives (i.e. the comorbid groups), respondents classified with major depression only and respondents classified with alcohol use disorders only were compared on a large number of sociodemographic, alcohol-related, depression-related and drug-related variables. Results were at variance with a majority of findings from the treatment literature with regard to familial aggregation of alcohol use disorders and sociodemographic, alcohol and depression profiles. Implications of the results are discussed in terms of the diagnostic and prognostic significance of the primary-secondary distinction.

Adolescent↗
PubMed1996

Reducing alcohol-use disorders via decreased consumption: a comparison of population and high-risk strategies.

This study compared three alternative scenarios for effecting a 25% reduction in U.S. alcohol consumption in terms of their respective impacts on the prevalence of alcohol abuse and dependence. The three approaches were (1) an overall 25% reduction in the volume of ethanol intake for all current drinkers, (2) an equivalent absolute reduction taken only among drinkers whose current intake ever exceeds moderate drinking guidelines, and (3) an equivalent reduction taken only among drinkers whose current intake usually exceeds moderate drinking guidelines. The per-occasion cutpoint for moderate consumption was set at the intake level demonstrated to produce psychomotor impairment, and was based on each individual's total body water level. The impact of reducing consumption on the prevalence of alcohol use disorders was estimated by means of a logistic regression model that adjusted for sociodemographic characteristics, family history of alcoholism, and age at first drink, and that took into account interactions between the consumption and other variables. Taking an overall 25% reduction in intake resulted in the same decrease in the prevalence of abuse and dependence (21.7%) as was achieved by taking an equal volume of reduction among only those drinkers whose consumption usually exceeded the moderate drinking cutpoint. Restricting the reduction in consumption to those drinkers whose consumption ever exceeded this cutpoint resulted in a slightly greater reduction in alcohol use disorders, 24.6%.

Adolescent↗
PubMed1996

Prevalence and correlates of drug use and DSM-IV drug dependence in the United States: results of the National Longitudinal Alcohol Epidemiologic Survey.

This study presents updated estimates of the prevalence and examines the correlates of drug use and dependence in a representative sample of the U.S. population. The prevalence of lifetime drug use was 15.6%, with 4.9% of the respondents reporting drug use during the past 12 months. Lifetime and 12-month prevalence of drug dependence were estimated at 2.9% and 0.8%, respectively. Men were significantly more likely to use drugs than women, and drug use and dependence were much more common among cohorts born after World War II. The data indicated that rates of dependence among women were quickly approaching the rates among men in the younger cohorts. Members of the youngest cohort, between the ages of 18 and 24 years at the time of the interview, were more likely to use drugs, to become dependent, and to persist in dependence compared to the older cohorts, including Cohort 2 who experienced adolescence at the height of widespread introduction of illicit drugs among youth in the mid-1960s. The demographic correlates of first use, onset of dependence, and persistence of dependence varied as a function of the stage of progression. Implications of these findings are discussed in terms of changes over time in drugs of choice and dependence liability and vulnerability among recent drug users.

Adolescent↗
PubMed1996

Medical consequences of alcohol consumption--United States, 1992.

There is plenty of evidence in the alcohol literature that chronic excessive use of alcohol poses a threat to every organ system in the body. At the same time, there is a growing consensus that drinking in moderation protects against cardiovascular disease. This study was based on the most recent national household survey of the United States general population on drinking practices, alcohol use disorders, and their associated disabilities. The prevalence of major alcohol-related diseases were examined across different categories of drinking status. Excess morbidity caused by heavy intake of alcohol was also studied. Results were generally in agreement with the popular belief that light or moderate drinking is beneficial relative to abstention, particularly that moderate alcohol consumption confers a beneficial cardiovascular effect. Our findings also pointed toward the injurious effect of heavy alcohol use. However, results on benefits of drinking must be interpreted with caution.

Adolescent↗
PubMed1996

DSM-IV, DSM-III-R, and ICD-10 alcohol and drug abuse/harmful use and dependence, United States, 1992: a nosological comparison.

This study assessed agreement between DSM-IV, DSM-III-R, and ICD-10 diagnoses of alcohol and drug use disorders using data from a large representative sample of the United States population. Agreement between the three diagnostic systems for dependence was good to excellent for past year, prior to the past year, and life-time diagnoses, for both genders, each ethnic group, and younger and older respondents. Cross-system comparisons between DSM-IV and DSM-III-R abuse were good to excellent, but concordance was consistently poor when ICD-10 harmful use diagnoses were compared with DSM-IV and DSM-III-R abuse diagnoses. Implications of these results are discussed in terms of the degree to which future research findings could be integrated with one another and the results from earlier studies using older versions of the DSM, to advance scientific knowledge in the drug and alcohol fields.

Adolescent↗
PubMed1996

Toward an alcohol treatment model: a comparison of treated and untreated respondents with DSM-IV alcohol use disorders in the general population.

The purpose of this study was to compare characteristics of person with alcohol use disorders who sought alcohol treatment with those who did not using data from a nationally representative sample of the United States. Applying an organizing framework from the larger literature on service utilization, a logistic regression analysis was conducted to examine the interaction among factors influencing treatment. The results identified unemployment status and lower educational level as barriers to alcohol treatment, but the impact of these factors differed depending on whether the respondent had previous experience with alcohol treatment. The major findings of this study are discussed in terms of consumer satisfaction, minimizing barriers to alcohol treatment services, and the need to examine individual determinants of alcohol treatment within the larger context of organizational and sociopolitical factors.

Adolescent↗
PubMed1996

Alcohol and drug use, abuse, and dependence among welfare recipients.

OBJECTIVES: This paper presents national estimates of heavy drinking, drug use, and alcohol and drug abuse and/or dependence among recipients of selected welfare programs. METHODS: Data from the 1992 National Longitudinal Alcohol Epidemiologic Survey were analyzed. RESULTS: The percentages of welfare recipients using, abusing, or dependent on alcohol or drugs were relatively small and consistent with the general US population and those not receiving welfare benefits. CONCLUSIONS: Although a minority of welfare recipients have alcohol or drug problems, substance abuse prevention and treatment services are needed among high-risk subgroups.

Adult↗
PubMed1995

The Alcohol Use Disorder and Associated Disabilities Interview schedule (AUDADIS): reliability of alcohol and drug modules in a general population sample.

Using a representative sample of the general population, the test-retest reliability of the alcohol and drug modules of the Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS) was examined. The AUDADIS showed good to excellent reliability for measures of alcohol consumption and use of sedatives, tranquilizers, amphetamines, opioids (other than heroin), cannabis and cocaine. Equally good reliability was demonstrated for diagnoses of alcohol, cannabis, cocaine and heroin abuse or harmful use and dependence defined in terms of the International Classification of Diseases-Tenth Revision (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders-Third Edition-Revised (DSM-III-R) and Fourth Edition (DSM-IV). Results are discussed in terms of the need for future research on the psychometric properties of the AUDADIS in clinical and general population samples.

Adolescent↗
PubMed1995

Comorbidity between DSM-IV alcohol use disorders and major depression: results of a national survey.

The purpose of this study was to describe detailed patterns of comorbidity between Diagnostic and Statistical Manual of Mental Disorders--Fourth Edition (DSM-IV) alcohol use disorders and major depression using a representative sample of the United States. Comorbidity rates and associations between DSM-IV alcohol use disorders and major depression were expressed as odds ratios with confidence intervals adjusted for the complex design characteristics of the NLAES. Comorbidity analyses were presented by sex, ethnicity and age for past year, prior to past year and lifetime diagnoses. Virtually all odds ratios were significantly greater than 1.0, demonstrating that comorbidity of alcohol use disorders and major depression is pervasive in the general population. The magnitude of the association remained stable across the three time frames but diagnostic and subgroup variations in comorbidity were noted. The association between alcohol dependence and major depression was greater than the association between abuse and major depression and the association between alcohol abuse and major depression was consistently greater for females and blacks, compared to their male and non-black counterparts. Implications of the results are discussed in terms of professional help seeking, the self-medication hypothesis, and differential social control theory.

Adolescent↗