Biomedical subjects

B F Grant

Publications and source records attributed to B F Grant.

At least 55 records · Page 3Linked to original sources

PubMed1995

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

This study describes detailed patterns of comorbidity between Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) drug use disorders and major depression in the United States for 1992. Data were derived from the National Longitudinal Alcohol Epidemiologic Survey (NLAES), a national probability survey consisting of 42,862 respondents, 18 years old and older, residing in the contiguous United States. The sampling design included oversampling of Blacks and young adults (18-29 years old). Comorbidity rates and associations between DSM-IV drug use disorders (i.e., prescription drugs, sedatives, tranquilizers, amphetamines, cannabis, cocaine, and hallucinogens) 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 gender, ethnicity, and age for past-year, prior-to-past-year, and lifetime diagnoses. The results showed that virtually all odds ratios were significantly greater than 1, demonstrating that comorbidity of a variety of drug use disorders and major depression is pervasive in the general population. Diagnostic and subgroup variations in comorbidity were noted. As expected, the association between drug dependence and major depression was greater than the association between abuse and major depression. The association between abuse and major depression was greater for women than men for prescription drugs, sedatives, tranquilizers, and amphetamines, but not for cocaine or hallucinogens. Men generally demonstrated stronger relations between drug dependence and major depression. Implications of the results are discussed in terms of professional help seeking, the self-medication hypothesis, and differential social-control theory.

Adolescent↗

PubMed1995

AA and other helpseeking for alcohol problems: former drinkers in the U.S. general population.

Former drinkers comprise 18.5% of the adult U.S. population. However, no epidemiologic data has been published on the histories of seeking help for alcohol problems from Alcoholics Anonymous (AA) or professional or informal sources of help. Using a sample of 8,057 former drinkers surveyed in the 1988 National Health Interview Survey, prevalence and characteristics associated with histories of such helpseeking were investigated. About 7% of the former drinkers had gone to AA or sought other types of help. Characteristics associated with such helpseeking were a diagnosis of DSM-IV alcohol dependence or abuse, a sense of compulsion to drink, social pressure to cut down, and highest ever alcohol consumption. The effects of alcohol consumption were stronger among younger respondents than older ones for professional or informal helpseeking.

Adolescent↗

PubMed1995

Subgroup variation in U.S. drinking patterns: results of the 1992 national longitudinal alcohol epidemiologic study.

Data from the 1992 National Longitudinal Alcohol Epidemiologic Study (NLAES) revealed that 44% of U.S. adults 18 years of age and older were current drinkers who had consumed at least 12 drinks in the year preceding the interview. Twenty-two percent were former drinkers, and 34% were lifetime abstainers. These figures represent an 8% decrease in the prevalence of current drinking relative to 1988. The proportion of current drinkers decreased with age, was higher for men than women, increased with education and income, was lower than average among Black and Hispanic adults, was highest among never-married adults and lowest among those who were widowed, was lower in the South than in other regions, and was lower in rural than urban areas. The probabilities of ever having consumed five or more (5+) drinks or having been intoxicated in the past year revealed similar patterns to those already noted, but the probabilities of heavy drinking or intoxication on a weekly or more frequent basis showed no variation by race or ethnicity. Average daily consumption of more than 1 ounce of ethanol differed from the preceding measure of heavy drinking in its variation across population subgroups, declining less sharply with age and exhibiting a U-shaped pattern with respect to income. Examination of the prevalence of heavy drinking among current drinkers rather than within the total population revealed several differences, the most striking reversal being that the probability of heavy drinking decreased with education and income. Multiple logistic regression models predicting the various drinking outcomes indicated that most of the differentials held true after adjusting for intercorrelation among the sociodemographic variables.

Adolescent↗

PubMed1995

What if Americans drank less? The potential effect on the prevalence of alcohol abuse and dependence.

OBJECTIVES: Several advisory committees have recently recommended that alcohol consumption be limited to moderate levels. Moderate drinking has been defined generally as not more than two drinks per day for healthy men and not more than one drink per day for healthy, nonpregnant women. The impact of reducing alcohol consumption to within the recommended guidelines on the prevalence of two serious alcohol-related problems was examined by modeling the relationship between average daily ethanol intake and alcohol abuse and dependence. METHODS: The recommended drinking guidelines, both in their existing form and modified by a measure of impairment, were applied to the observed distribution of consumption derived from a large representative survey of the US general population. RESULTS: The results demonstrated that restricting drinking to the maximum allowable levels under the existing and the modified guidelines would reduce the prevalence of alcohol abuse and dependence by 14.2% and 47.1%, respectively, in the adult US general population. CONCLUSIONS: Implications of these findings are discussed in terms of the validity of the assumptions underlying the models and the nature and direction of future research that would form the basis of newly developed guidelines for safe drinking limits.

Alcohol Drinking↗

PubMed1995

Variation in the association of alcohol consumption with five DSM-IV alcohol problem domains.

Data from a nationally representative sample of the U.S. adult population were used to investigate the association between alcohol consumption and five discrete problem domains included in the DSM-IV formulations for alcohol abuse and dependence. Two dimensions of consumption were considered in the analysis: average daily ethanol intake and the relative frequency of drinking five or more drinks. The sample consisted of 22,102 adults defined as current drinkers. After controlling for various sociodemographic characteristics, family history of alcoholism, and age at onset of drinking, both consumption measures retained significant levels of association within all five problem domains. The magnitudes of the odds ratios at selected levels of consumption were approximately 50% greater for the domains of impaired control, continued drinking despite problems and hazardous drinking than for the domains of tolerance and withdrawal. Moreover, the factors that modified the effect of the consumption measures varied markedly across domains, with age, college education, and race the most consistent modifiers of the effect of alcohol consumption.

Adolescent↗

PubMed1994

Prevalence and population validity of DSM-III-R alcohol abuse and dependence: the 1989 National Longitudinal Survey on Youth.

This report presents national estimates of The Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R) alcohol abuse and dependence among 24- to 31-year-olds using the 1989 National Longitudinal Survey on Youth (NLS-Y). Population estimates derived from the 1989 NLS-Y are also compared with corresponding estimates from the 1988 National Health Interview Survey (NHIS). The 1-year prevalence of alcohol abuse and dependence was 13.95% in the 1989 NLS-Y. In general, rates of abuse and dependence were greater for men than for women and slightly declined with age. Although the prevalence of abuse was much greater among whites compared to blacks or Hispanics, the rates for dependence among Hispanics and whites exceeded those for their black counterparts. The rates of abuse and dependence were strikingly similar between the 1989 NLS-Y and 1988 NHIS, providing evidence for the population validity or generalizability of the diagnostic measures.

Adult↗

PubMed1994

Alcohol involvement in fatal traffic crashes in the United States: 1979-90.

Trends in alcohol-related traffic crash fatalities for the United States were examined with data from the Fatal Accident Reporting System for the years 1979-90. Alcohol-related traffic crash fatalities have decreased 10% over the 12 years studied, from 20,245 in 1979 to 18,279 in 1990. Fatality rates per 100 million vehicles miles traveled, and per 100,000 population, registered vehicles and licensed drivers have decreased even more sharply. Rates of blood alcohol testing of fatally injured drivers rose substantially among the States, with the nationwide rate increasing from 44% in 1979 to 75% in 1990. Factors that may be affecting these trends are discussed.

Accidents, Traffic↗

PubMed1994

Alcohol consumption, alcohol abuse and alcohol dependence. The United States as an example.

This paper presents national estimates of alcohol consumption and DSM-IV alcohol abuse and dependence in the United States. Fifty-two percent of the adults surveyed were classified as current drinkers and nearly 9.0% met criteria for DSM-IV alcohol abuse or dependence. Greater percentages of males and whites were classified as current drinkers and as alcohol abusers or dependent, compared with females and non-whites, respectively. There is a need for future epidemiological research to collect better data on drinking patterns as an aid to interpreting socio-demographic differentials and to estimate more precisely the association between alcohol consumption and abuse and dependence in multivariate statistical environments. The critical need to examine the unprecedented reversal of the abuse-to-dependence ratio resulting from the application of the DSM-IV classification is emphasized. The role of future longitudinal alcohol epidemiological research in elucidating the initiation and maintenance of consumption patterns and alcohol use disorders is stressed.

Adolescent↗

PubMed1993

Gender effects in diagnosing alcohol abuse and dependence.

Using a national population sample of 43,809 adults, male and female responses were compared for 41 indicators of alcohol abuse and dependence. While men reported all indicators more often than did women, the male to female ratio of positive responses varied according to both the construct represented by the item and its underlying prevalence. Items that might be construed as signs of weakness-physical effects, psychological effects, and loss of control or powerlessness--had lower male/female ratios than other items. Excess male prevalence was greatest for the least prevalent indicators. The paper presents alternative interpretations of these findings and discusses their implications for diagnostic classification.

Adolescent↗

PubMed1993

The relationship between ethanol intake and DSM-III-R alcohol dependence: results of a national survey.

Data from a representative sample of U.S. adults were analyzed to determine the association between average daily ethanol consumption and DSM-III-R (American Psychiatric Association, 1987) alcohol dependence adjusting for heavier drinking (i.e., drinking 5+ drinks on any one occasion) and sociodemographic variables, including age of onset of drinking and family history of alcoholism. Male gender, early onset of drinking, and drinking 5+ drinks on any one occasion during the past year were all associated with an increased risk of dependence. Factors associated with a decreased risk of dependence were age, being currently married, total body water, and income. The risk of dependence varied among population subgroups and was increased by nonblack race and positive family histories of alcoholism in the respondent's relatives.

Adolescent↗

PubMed1993

ICD-10 harmful use of alcohol and the alcohol dependence syndrome: prevalence and implications.

Data from a 1988 survey on United States drinking practices and related problems was used to derive the prevalence and population estimates of harmful use of alcohol and the alcohol dependence syndrome as defined in the ICD-10 Clinical Descriptions and Diagnostic Guidelines Version (ICD-10-CDDG). Corresponding estimates were also presented for ICD-10-CDDG diagnoses that incorporated the duration criterion of the ICD-10-Diagnostic Criteria for Research Version (ICD-10-DCR). The prevalence of ICD-10 harmful use and dependence combined, with and without the duration criterion, were 5.2% and 7.1%, respectively. Corresponding harmful use rates were negligible (0.27%). Implications of the extremely low prevalence of harmful use in the US population and the impact of the duration criterion on the rates are discussed in terms of the fundamental nature of alcohol use disorders as syndromes and the viability of the harmful use of alcohol category as originally conceptualized.

Adolescent↗

PubMed1993

Comparison of DSM-III-R and draft DSM-IV alcohol abuse and dependence in a general population sample.

The purpose of this Data Note was to compare DSM-III-R and Draft DSM-IV formulations of alcohol use disorders in terms of prevalence and overlap in a representative sample of the United States general population. The prevalence of DSM-III-R and DSM-IV alcohol abuse and dependence combined were strikingly similar, despite discrepancies in the separate component diagnoses of abuse and dependence. The major finding of this study showed a reversal of the abuse-to-dependence ratio associated with the DSM-IV classification. Unlike previous surveys using DSM-III-R definitions, the prevalence of DSM-IV abuse exceeded that of dependence in this general population sample. Reasons for this discrepancy were discussed in terms of the differences in the number and content of abuse and dependence criteria and the relationship between abuse and dependence categories. The need for an explicit statement justifying the changes in the DSM-IV classification is highlighted.

Adolescent↗

PubMed1993

ICD-10 and proposed DSM-IV harmful use of alcohol/alcohol abuse and dependence, United States 1988: a nosological comparison.

The purpose of this study was to compare ICD-10 and the proposed DSM-IV (options 1 and 2) diagnostic criteria for harmful use/abuse and dependence in a representative sample of the United States general population. Harmful use/abuse and dependence categories were contrasted in terms of prevalence and overlap. The prevalences of DSM-IV diagnoses of alcohol abuse and dependence combined were much greater than those for the corresponding ICD-10 diagnoses. Disaggregation of the harmful use/abuse and dependence diagnoses showed that the major discrepancy between the classification systems resided between harmful use and abuse categories. The prevalence of the harmful use of alcohol was nearly nonexistent in this general population sample. Reasons for this and other discrepancies are discussed in terms of the hypothesized severity of the harmful use criteria, differences in the number of diagnostic criteria and the content of the ICD-10 and DSM-IV dependence categories, the relationship between the harmful use/abuse and dependence categories, and the impact of the duration criterion.

Adolescent↗

PubMed1992

Empirical subtypes of DSM-III-R alcohol dependence: United States, 1988.

The purpose of the present study was to quantify the degree of heterogeneity of the DSM-III-R alcohol dependence category by comparing the number of potential subtypes of dependence to those empirically observed in a general population survey. Forty-one percent (n = 189) of the 466 potential subtypes of DSM-III-R alcohol dependence were observed, indicating that the category is indeed heterogeneous, but not as heterogeneous as theoretically predicted. Variations in the number, percent and configuration of empirical subtypes of dependence are discussed in terms of coincident morbidity, premature death from alcoholism or death from other competing causes, reporting biases and differences in drinking patterns. The predominance of the 'tolerance' 'withdrawal' and 'impaired control over drinking' criteria among the empirically observed subtypes of dependence are examined within the context of the physiological dependence subtype proposed for the DSM-IV category of alcohol dependence and difficulties encountered in operationalizing these diagnostic criteria. The relevance of study findings to the validation of diagnostic categories in psychiatry is also highlighted.

Adolescent↗

PubMed1992

Parental history of alcoholism and probability of marriage.

Personal interview data for 16,795 U.S. adults 18-39 years of age were analyzed to assess the effect of positive parental history of alcoholism on the probability of ever having been married. The data were collected as part of the 1988 National Health Interview Survey. The effects of parental history were estimated using logistic regression models that adjusted for age, race, gender, and respondent history of alcohol problems. Nonblack adults who lived with one or more alcoholic parents when growing up were 50% more likely ever to have been married than those with no parental history. The effect was of the same magnitude regardless of whether the alcoholic parent was the mother or the father, but was larger if both parents were reported to be alcoholics. Among blacks, positive parental history of alcoholism did not affect the odds of marriage. The greater likelihood of early marriage among children of alcoholics may help explain their excess risk of marital disruption.

Adolescent↗

PubMed1992

Prevalence of the proposed DSM-IV alcohol use disorders: United States, 1988.

Data from a 1988 survey on United States drinking practices and related problems was used to derive the proposed DSM-IV definitions of alcohol abuse and dependence. The prevalence of DSM-IV alcohol abuse and dependence combined, incorporating the DSM-III-R duration criterion, was 6.00% in this general population sample. The majority of respondents were classified as alcohol dependent (5.93%), dependent without abuse (5.24%), and dependent with physiological dependence (5.06%). The rate for DSM-IV alcohol abuse was negligible (0.06%) while elimination of the duration criterion had little impact on the prevalence of DSM-IV alcohol use disorders. Reasons for the extremely low prevalence of DSM-IV alcohol abuse and the slight increase in the prevalence of DSM-IV alcohol use disorders as the result of eliminating the duration criterion are discussed in terms of the content of the abuse category and its relationship to the dependence definition.

Adolescent↗

PubMed1992

Family history, alcohol use and dependence symptoms among young adults in the United States.

Drawing upon data from the National Longitudinal Survey of young adults, this paper examines the effects of family history of alcoholism and current alcohol use by the young adults. A multivariate analysis of the data from the study indicates that there are both main and interaction effects of family history and current alcohol use on dependence symptoms among the young adults.

Adolescent↗

PubMed1992

DSM-III-R and proposed DSM-IV alcohol abuse and dependence, United States 1988: a nosological comparison.

The purpose of the present study was to compare DSM-III-R and the proposed DSM-IV (options 1 and 2) diagnostic criteria for alcohol abuse and dependence in a representative sample of the United States general population. Alcohol abuse and dependence diagnostic categories were contrasted in terms of prevalence and overlap. The prevalences of DSM-III-R and DSM-IV diagnoses of alcohol abuse and dependence combined were remarkably similar. However, disaggregation of abuse and dependence diagnoses showed that there were major discrepancies between the classification systems. Reasons for these discrepancies are discussed in terms of differences in the number of diagnostic criteria and the content of the DSM-III-R and DSM-IV abuse and dependence categories, the requirement for physiological dependence in DSM-IV classifications, the relationship between the abuse and dependence categories, and the impact of the duration criteria.

Adolescent↗