Biomedical subjects

D Hasin

Publications and source records attributed to D Hasin.

At least 19 recordsLinked to original sources

PubMed2001

Differences in drinking patterns among Ashkenazic and Sephardic Israeli adults.

OBJECTIVE: Since its foundation in 1948, Israel has received large waves of immigrants, mainly from Europe (Ashkenazic Jews, or Ashkenazim) and from North Africa and other Middle Eastern countries (Sephardic Jews. or Sephardim). In Israeli society, Ashkenazic Jews are an advantaged ethnic group, whereas Sephardic Jews are relatively disadvantaged. Little is known about the differences in drinking patterns between these two groups. The relationship between ethnicity and alcohol consumption is investigated in a 1995 data set from a sample of 4,984 subjects (60% women). METHOD: The data were collected as part of a national Israeli survey. Standardized questions covered drinking and becoming drunk in the last 12 months and drinking in the last 30 days. Unadjusted odds ratios (ORs) indicated the association of group status with the drinking variables. ORs adjusted for potential confounders were created with logistic regression. RESULTS: Unadjusted ORs indicated a negative association between all alcohol measures and Sephardic group status. ORs adjusted for such factors as socioeconomic status and religiosity produced similar results. CONCLUSIONS: This study indicates that Sephardim were less likely to drink or become drunk than were Ashkenazim. Further work is required to determine if these differences are stable or changing over time and whether such differences can be attributed to cultural or genetic factors. Similarities to U.S. patterns are discussed.

Adolescent↗

PubMed2001

Alcohol drinking patterns among Jewish and Arab men and women in Israel.

OBJECTIVE: Jews and Muslim Arabs comprise the bulk of modern Israeli society. Jewish tradition permits controlled alcohol drinking, whereas Muslim tradition prohibits the use of any alcohol. Increasing exposure of the traditionally conservative Arab sector to the Western culture of modern Israel might impact on and be reflected in the drinking patterns of these two populations. The influence of religiosity and other factors on drinking patterns of Jewish and Arab adults are examined using data from a 1995 national household survey. METHOD: Past month drinking is assessed in this nationally representative sample of nearly 5,000 Jews and 1,000 Arabs (N = 5,954, 60% women). Unadjusted and adjusted odds ratios (ORs) are presented to describe associations between any and heavy drinking and nationality group, religiosity, education and marital status among men and women. Modification of the nationality-drinking relationship by religiosity is also examined. RESULTS: Any past-month drinking was reported more often by Jewish respondents than Arab respondents (OR = 2.9, 95% Cl: 2.5-3.4), and this difference remained statistically significant after accounting for the effects of the other covariables. This cross-nationality difference was more pronounced among women (OR = 6.4, 95% Cl: 4.6-8.8) than men (OR = 2.3, 95% CI: 1.8-2.9). The proportion of drinkers who reported heavy drinking in the past month, however, was lower among Jews (OR = 0.3, 95% CI: 0.2-0.4). Significantly higher rates of drinking were noted for secular men and women than for religious respondents in both nationality groups. Rates of drinking were more similar among secular Arabs and Jews than among religious respondents of these nationality groups. CONCLUSIONS: These results add support to the theory that adherence to religious traditions continues to serve as a barrier against drinking among both Arabs and Jews. Further work is required to determine if these patterns are stable over time and whether genetic factors are contributing to the sociocultural influences.

Adolescent↗

PubMed2001

DSM-IV alcohol dependence and sustained reduction in drinking: investigation in a community sample.

OBJECTIVE: A common clinical conception of alcohol dependence is that it is chronic, and the idea of impaired control figures prominently in an influential definition of alcohol dependence. We investigated the meaning of a diagnosis of DSM-IV alcohol dependence in untreated individuals. METHOD: Household residents screened for elevated drinking were assessed for DSM-IV alcohol dependence and re-interviewed 1 year later. We report on 115 subjects with and 460 subjects without current DSM-IV alcohol dependence at baseline. Follow-up drinking indicators included a measure of sustained reduction in drinking. RESULTS: No support was found for a lower probability of sustained reduction in drinking at follow-up among the group with baseline DSM-IV alcohol dependence. Significant group differences indicated that the dependent group was more likely to reduce drinking. CONCLUSIONS: A diagnosis of DSM-IV alcohol dependence among untreated individuals implies a prognosis that is different from that for the same diagnosis among those seen in treatment settings. This does not necessarily indicate that the diagnosis is invalid, but rather suggests that risk factors for chronic course are more applicable to cases of DSM-IV alcohol dependence seen in treatment settings.

Adult↗

PubMed2001

Course of DSM-IV alcohol dependence in a community sample: effects of parental history and binge drinking.

BACKGROUND: The role of positive family history in the etiology of alcohol dependence has been demonstrated repeatedly but little is known about the effect of this risk factor on the chronicity of alcohol dependence once it has begun. METHODS: We studied the effects of parental and sibling history in conjunction with frequency of binge drinking in a sample of 169 community residents who met criteria for DSM-IV alcohol dependence at the baseline interview. Subjects were re-interviewed approximately 1 year later and the status of their alcohol-dependence disorders (remitted or chronic) was determined. RESULTS: Parental history of alcoholism was significantly related to chronicity of alcohol dependence, as was frequency of binge drinking. CONCLUSIONS: Failure to find an effect for family history on chronicity would have suggested that the effect was transient, perhaps interacting with time-limited environmental vulnerability. The finding of a positive relationship between family history and chronicity suggests that the relationship between familial/ genetic background and alcohol dependence is stable.

Adult↗

PubMed2000

Cytotoxic T lymphocytes are activated following myocardial infarction and can recognize and kill healthy myocytes in vitro.

The damage of myocardial infarction (MI) is often progressive. A possible mechanism for subsequent myocardial damage and heart failure after MI is immune response against cardiac self-antigens. The purpose of our study was to test the hypothesis that cytotoxic T lymphocytes are activated following acute MI and may have a role in producing further myocardial damage. Rats were allocated into three experimental groups: acute MI, Sham MI and non-operated control. One, two and three weeks after surgery, lymphocytes were obtained from rat spleens and incubated with neonatal cardiac myocytes. Lymphocyte proliferation was assessed by a thymidine incorporation assay and calculated as proliferation index (PI). Myocyte destruction was measured by a crystal-violet staining assay and expressed as percentage of cell destruction. Proliferation index was significantly higher among lymphocytes obtained from MI animals (44. 3+/-5.8 and 44.9+/-5.1, at 2 and 3 weeks after MI, respectively) than sham MI (29.3+/-5.3, 27.1+/-4.7) (P<0.05) or control animals (17.1+/-2.5, 16.2+/-2.8) (P=0.03). Cytotoxic activity of the MI lymphocytes against the cultured cardiomyocytes was significantly higher 2 and 3 weeks after MI, (36.4+/-7.3%, 69.3+/-4.9%) compared to sham MI (17.9+/-3.14%, 36.6+/-5.3%) (P<0.001) and control animals respectively (13.3+/-5.4%, 17.4+/-6.1%) (P<0.001). The cytotoxic activity against healthy cardiomyocytes was myocyte-specific, induced by CD8 lymphocytes and major-histocompatibility complex (MHC) restricted. Cytotoxic T lymphocytes (CD8) are activated following MI and can recognize and kill normal cardiomyocytes in vitro. The newly described pathophysiological insights may provide novel oportunities to prevent death of non-ischemic cardiomyocytes and heart failure following myocardial infarction.

Animals↗

PubMed2000

Withdrawal and tolerance: prognostic significance in DSM-IV alcohol dependence.

OBJECTIVE: The clinical and research importance of tolerance and/or withdrawal in the diagnosis of substance dependence has been identified as a key area needing clarification. Earlier longitudinal studies did not identify whether diagnoses of alcohol dependence were current or lifetime. In this study, the prognostic significance of the DSM-IV physiological specifier was investigated among cases of alcohol dependence current at the baseline interview. The role of tremors, required in DSM-III and DSM-III-R, was investigated as well. METHOD: Household residents (N = 130; 57% men) meeting full criteria for current DSM-IV alcohol dependence in a baseline interview were re-interviewed a year later and DSM-IV alcohol dependence was again evaluated. Reliable structured interviews were used to make the diagnoses. The DSM-IV physiologic specifier and its components were tested as predictors of outcome of DSM-IV alcohol dependence, and included an additional definition of alcohol withdrawal that required tremors. Chi-square tests and adjusted odds ratios indicated statistical significance of group differences on outcome. RESULTS: The DSM-IV physiological specifier (tolerance or withdrawal) did not predict 1-year chronicity of DSM-IV alcohol dependence, nor did tolerance when considered separately. However, withdrawal predicted poor outcome (e.g., 1-year chronicity of DSM-IV alcohol dependence). The effect of withdrawal was strengthened when tremors were required as part of the withdrawal syndrome. CONCLUSIONS: In contrast to earlier longitudinal research, this study supports the prognostic relevance of one component of the present DSM-IV physiological specifier--withdrawal. Withdrawal appears to have stronger prognostic meaning when the DSM-III-R version, in which tremors were required, is used. Further studies of the physiological subtype may benefit from studying subjects who have been clearly identified at the baseline evaluation as having a current diagnosis of dependence.

Adolescent↗

PubMed2000

Risk factors for homelessness among indigent urban adults with no history of psychotic illness: a case-control study.

OBJECTIVES: This study identified risk factors for homelessness among indigent urban adults without dependent children and with no history of psychotic illness. METHODS: We conducted a matched case-control study, stratified by sex, of 200 newly homeless men and women and 200 indigent men and women with no history of homelessness. Newly homeless case subjects were recruited from shelter assessment centers in New York City. Never-homeless control subjects, selected from public assistance centers, were single adults applying for home relief. Control subjects were matched with case subjects according to ethnicity, age, and sex. Trained interviewers employed standardized research instruments to probe 3 domains of risk factors: symptom severity and substance use disorder, family support and functioning, and prior use of services. RESULTS: Significant interaction effects by sex were present for symptom severity, heroin use disorder, and prior service use. Greater numbers of the homeless of both sexes lacked a high school diploma and had less income from all sources, including from their families, than of the never homeless. CONCLUSIONS: Newly homeless men and women with no history of psychotic illness differed from their never-homeless counterparts in the 3 domains investigated, but socioeconomic factors were also important.

Adolescent↗

PubMed1999

Dependence symptoms but no diagnosis: diagnostic 'orphans' in a 1992 national sample.

The alcohol dependence syndrome was initially presented as a condition with graded severity. However, to receive a diagnosis that is categorical, a diagnostic threshold must be determined. Much previous research on this issue has focused on setting a threshold that will produce the highest possible consistency in rates between one set of diagnostic criteria and the next. It is possible that a different threshold may be more valid. Results from a community sample supported a minimum diagnostic threshold of three or more dependence symptoms but the sample was not nationally representative. Therefore, we investigated the meaning of the 'orphan' status (one or two dependence symptoms but no DSM-IV alcohol dependence diagnosis) in a large national sample. Two sets of analyses were performed, the first using a current timeframe and the second using a lifetime timeframe. Abstainers were excluded from all analyses. In each set of analyses, three groups were compared: subjects with no symptoms of any alcohol use disorder; diagnostic 'orphans' with one or two symptoms of dependence; and subjects who met full criteria for DSM-IV alcohol dependence. Several variables significantly differentiated the three groups, including heavy drinking and family history of alcoholism. Group differences were reduced among 'orphans' and subjects with no symptoms who had at least one occasion of drinking five or more drinks in the year prior to the interview. The results provide support for the decision to require a minimum of three symptoms to make a diagnosis of alcohol dependence, for scientific as well as pragmatic reasons.

Adolescent↗

PubMed1999

DSM-IV alcohol abuse: investigation in a sample of at-risk drinkers in the community.

OBJECTIVE: Although a category for alcohol abuse has been included in the major nomenclatures since DSM-III, many questions have been raised about the definitions and validity of this category. METHOD: We investigated DSM-IV alcohol abuse in 628 at-risk drinkers residing in households who never met criteria for DSM-IV alcohol dependence at the time of a baseline interview. Cross-sectional and prospective longitudinal information were used. RESULTS: Subjects most often met criteria for abuse with the single criterion, recurrent hazardous use (usually driving after drinking too much, on average 4.5 times per year). Younger and white subjects were more likely to receive the abuse diagnosis at baseline, as were drug users and those who drank five or more drinks per occasion frequently. Very few subjects received a diagnosis of DSM-IV alcohol dependence at follow-up, and those who did were equally likely to come from the abuse and non-abuse baseline groups. A current abuse diagnosis at baseline strongly and significantly predicted an abuse diagnosis at follow-up, although a past-only (remitted) abuse diagnosis at baseline was not clearly predictive of abuse at follow-up. CONCLUSIONS: The DSM-IV alcohol abuse category has some predictive validity. However, given the manner in which respondents met criteria for the disorder, its merits as a diagnostic category remain in question. Researchers should be cautious about combining alcohol dependence and abuse into the same category.

Adult↗

PubMed1999

The validity of DSM-IV alcohol abuse: drunk drivers versus all others.

OBJECTIVE: Prior research in a community sample indicated that almost half the individuals receiving a diagnosis of DSM-IV alcohol abuse did so on the basis of only one symptom, driving after drinking too much. While this is certainly unwise behavior, it may not be a psychiatric disorder. Therefore, we investigated the differential validity of this subgroup of abuse cases by testing the association of a set of external validating criterion variables with three groups: those who met criteria for abuse just for drinking-driving, those who met criteria by other means and those with no alcohol diagnosis. Present status of past cases of abuse was also investigated. METHOD: Subjects were 22,204 U.S. household residents (a subset of a national probability sample) interviewed in 1992 with the Alcohol Use Disorders and Associated Disabilities Interview Schedule. The generalized logit model was the principal means of analysis. RESULTS: Subjects who met criteria for DSM-IV alcohol abuse just for drinking-driving differed from subjects with no diagnosis on about half the variables tested, while those who met criteria for abuse in other ways differed from subjects with no diagnosis on all variables tested. The two abuse groups differed from each other on some but not all variables. Past cases of abuse for drinking-driving and past cases of other abuse were equally likely to have remitted in the last 12 months, and slightly less likely to meet criteria for current dependence. CONCLUSIONS: Further conceptual and empirical work is needed to resolve the difficulties with the DSM-IV alcohol abuse category.

Adolescent↗

PubMed1999

At-risk drinkers in the household and short-term course of alcohol dependence.

OBJECTIVE: Little is known about the effects of contextual factors on the chronicity of alcohol dependence in the general population. Many adults in the United States live with others in a wide range of relationships. The drinking of household members was investigated as a potential risk factor for persistence of DSM-IV alcohol dependence in a prospective study of household residents. METHOD: At-risk drinking (five or more drinks on at least one occasion) in adult household members living with respondents was assessed at the time of the baseline interview for the index subjects in the study (N = 128; 56% men) who lived with other adults and who met DSM-IV criteria for current alcohol dependence. Index subjects' drinking and demographic variables were also measured at baseline. Approximately 1 year later, follow-up interviews determined the status of alcohol dependence in the 128 subjects. RESULTS: Alcohol dependence was significantly more likely to be persistent among subjects with at-risk drinking among household members. CONCLUSIONS: The presence of other adult heavy drinkers in a household increased the risk of persistence of alcohol dependence in this community sample. Considerably more remains to be learned about the relationship and its treatment implications.

Adolescent↗

PubMed1999

The Spanish Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS): reliability and concordance with clinical diagnoses in a Hispanic population.

OBJECTIVE: The study reports the process of translation into Spanish and adaptation to the Hispanic culture of the Alcohol Use Disorder and Associated Disabilities Schedule (AUDADIS). This instrument is a structured diagnostic interview schedule specifically developed for the assessment of substance-related disorders and their comorbid disorders and disabilities. METHOD: A random sample (N = 169) of adults from a primary health care clinic in Puerto Rico was selected. The test-retest reliability of the instrument was examined across time and across interviewers, and the validity was assessed by comparing computer-derived diagnoses obtained through the administration of lay interviewers with best estimate diagnoses given by board-certified psychiatrists. RESULTS: For most diagnoses and symptoms studied, as well as for most of the alcohol consumption measures, the test-retest reliability of the Spanish AUDADIS was consistent with results reported in other national and international studies using this instrument. Good to excellent test-retest reliability was obtained for the diagnoses of alcohol dependence and major depression. Similarly, good to excellent agreement was obtained between the lay administered AUDADIS and best estimate diagnoses for most diagnostic categories, with the exception of dysthymia. As in other studies, the reliability and validity of the substance abuse category was poor. When agreement for this category was estimated independent of lifetime dependence, both the reliability and validity coefficients were considerably improved. CONCLUSIONS: The Spanish AUDADIS generally demonstrates good to excellent levels of reliability and validity that are comparable to findings reported for this instrument in other national and international studies.

Adult↗

PubMed1999

Drinking patterns of recent Russian immigrants and other Israelis: 1995 national survey results.

OBJECTIVES: A large group of Russian Jews has immigrated to Israel since 1989. Russia has one of the highest alcohol consumption levels in the world, while the level in Israel is among the lowest. This study was designed to provide empirical information on the drinking of these Russian immigrants compared with the drinking of other Jewish Israeli residents. METHODS: The data came from a 1995 national survey of drinking in Israel. Of 4984 Israelis, 292 were Russian immigrants who had arrived since 1989. Russians were compared with other respondents on several drinking variables. Logistic regression was the principal method of analysis, allowing the relationship to be tested with demographic and cultural variables controlled. A subsidiary analysis was conducted on data about parents' drinking from a survey of secondary school students. RESULTS: There were significant effects for Russian status for several drinking variables, with significant odds ratios ranging from 1.45 to 2.38. These results indicate that recent Russian immigrants to Israel drink more than their Israeli counterparts. CONCLUSIONS: Further investigation of the stability of these patterns may provide valuable information about cultural effects on drinking.

Adult↗

PubMed1999

Alcohol dependence and abuse diagnoses: concurrent validity in a nationally representative sample.

The Alcohol Dependence Syndrome concept has had a widespread influence on the major nosological classification systems, most recently with its operationalization as DSM-IV alcohol dependence. Although many studies have provided evidence of the validity of the Alcohol Dependence Syndrome in clinical samples, little validation work has been conducted in general population samples on DSM-IV alcohol dependence or the distinction of DSM-IV alcohol dependence from DSM-IV alcohol abuse. We therefore examined the cross-sectional validity of DSM-IV alcohol dependence and abuse in 27,616 household residents who participated in a 1992 national survey on alcohol use disorders. Validity was investigated by testing the association of a set of five "criterion" variables, external to the alcohol diagnostic criteria, with dependence and abuse diagnoses. Results indicated that dependence diagnoses were significantly associated with all criterion variables when compared with those with no diagnosis and also when compared with alcohol abuse. This supported the separation of dependence from abuse. Abuse diagnoses were associated with some, but not all, criterion variables when compared with subjects with no diagnosis. This report replicates many aspects of a similar investigation in a community sample of household residents. Implications for the next steps in research are discussed.

Adult↗

PubMed1998

Dependence symptoms but no diagnosis: diagnostic 'orphans' in a community sample.

To receive a DSM-IV diagnosis of alcohol dependence, an individual must manifest at least three out of seven possible dependence criteria. Thus, individuals may manifest one or two dependence criteria yet not receive the dependence diagnosis. In a sense, these latter individuals may be seen as diagnostic 'orphans', since they have individual symptoms of dependence but no diagnoses. A study of these individuals sheds light on the validity of the three-symptom severity threshold for a diagnosis of DSM-IV alcohol dependence. Thus, we investigated the meaning of the 'orphan' status through cross-sectional and longitudinal research in a general population sample. Three groups were compared at baseline, subjects with no symptoms of any alcohol use disorder (148), diagnostic 'orphans' with one or two symptoms of dependence (136) and subjects who met full criteria for DSM-IV alcohol dependence (140). Several variables significantly differentiated the three groups, including binge drinking and family history of alcoholism. At a 1-year follow-up point, very few of the 'orphans' met criteria for DSM-IV alcohol dependence. The proportion of new onsets from the 'orphan' group and the group with no symptoms did not differ significantly. Binge drinking predicted chronicity of 'orphan' status, but family history of alcoholism did not. The results support the decision to require a minimum of three symptoms to make a diagnosis of alcohol dependence.

Adult↗

PubMed1998

The drinking of earlier and more recent Russian immigrants to Israel: comparison to other Israelis.

OBJECTIVES: Russia has a high level of per capita alcohol consumption, while the level in Israel is low. Since 1989, over 820,000 Russian Jews immigrated to Israel. In the 1970's and early 1980's, a smaller wave of immigration from Russia to Israel occurred (approximately 170,000). The drinking of earlier immigrants was compared to recent immigrants and other Israelis. METHODS: Data came from a 1995 national survey of Israeli household residents. Of 4984 Israeli respondents, 292 were Russian immigrants who arrived since 1989 and 131 were Russians who immigrated earlier. Groups were compared with logistic regression. RESULTS: Recent Russian immigrants were more likely to drink in the last 12 months, to drink frequently and to get drunk than other Israelis. The earlier Russian immigrants were not more likely than other Israelis to report drinking in the last 12 months or frequent drinking, but were more likely to report 30-day drinking and getting drunk. In direct comparison of recent and earlier Russians, recent immigrants reported more frequent drinking than earlier immigrants. CONCLUSIONS: The results for drinking and frequency of drinking are consistent with acculturation effects as well as other explanations. Further investigation in studies with appropriate designs will be necessary to clarify the meaning of these results.

Acculturation↗

PubMed1998

Difficulties with questions on usual drinking and the measurement of alcohol consumption.

Questions about usual drinking play an important role in the construction of alcohol consumption measures. However, little is known about difficulties in answering these questions for respondents with variability in their drinking patterns. We investigated this in a community sample of 945 drinkers and in a clinical sample of 400 patients treated for alcohol and/or drug problems. Demographic variables were not consistently related to self-reported difficulty in answering, but a diagnosis of current DSM-IV alcohol dependence was significantly related in both samples. In modeling the relationship between alcohol consumption and DSM-IV alcohol dependence, the fit of the model to the data was significantly improved by the addition of a variable indicating respondents' difficulty answering the usual drinking questions. Using this information in the development of alcohol consumption questions may provide more precise estimates of the risk from alcohol consumption to outcomes such as alcohol dependence.

Adult↗

PubMed1998

Psychiatric research interview for substance and mental disorders: phenomenologically based diagnosis in patients who abuse alcohol or drugs.

The Psychiatric Research Interview for Substance and Mental Disorders (PRISM) is a psychiatric diagnostic interview designed to diagnose DSM-IV substance and mental disorders in patients who abuse alcohol or drugs. Primary disorders tested in the DSM-III-R version of the interview showed improved reliability over existing instruments, and substantially improved reliability for major depressive disorder (MDD). Developments for DSM-IV include a systematic set of procedures for differentiating primary disorders, substance-induced disorders, and the expected effects of intoxication and withdrawal based on the phenomenology of symptoms in conjunction with alcohol and drug use. A longitudinal version of the PRISM provides data on remission and relapse that can be analyzed with survival methods. Pilot and preliminary testing of the DSM-IV and longitudinal versions of the instruments is presented. By making use of psychometric principles, particularly the need to reduce criterion variance, these instruments can clarify some of the longstanding issues in the diagnosis of patients who abuse alcohol and drugs.

Alcoholism↗