An important new phenotype and some next-step questions: commentary on Sartor et al. (2007).
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Alcoholism↗
Biomedical subjects
Robert A Zucker
Publications and source records attributed to Robert A Zucker.
The developmental behavior genetics of drug involvement: overview and comments.
The papers in this special issue have in common an interest in developmental variations in the heritability of substance use, abuse, and problems. A number of the studies are longitudinal, and even those that are cross-sectional are analytically focused on whether heritability, shared, and nonshared environmentality effects are constant or change over the period from onset of use to the time when problem use is more constant. This commentary provides an overview of the work from a developmental psychopathology perspective. Findings are linked to the existing longitudinal/developmental literature on the epigenesis of substance use disorders and similarities and contradictions are noted. Suggestions for next step work, involving the need for increased differentiation of the substance abuse phenotypes, the utilization of phenotypic measures that delineate heterogeneity of course, and more precise definition of the specific environmental variations that underlie shared and nonshared environmental liability, are provided.
Adolescent↗
Marital interaction in alcoholic and nonalcoholic couples: alcoholic subtype variations and wives' alcoholism status.
The authors examined problem-solving marital interactions of alcoholic and nonalcoholic couples (N = 132). Four alcoholic groups (husband alcoholic with antisocial personality disorder or not, paired with alcoholic or nonalcoholic wives) were compared with each other and with a both-spouses-nonalcoholic group. Consistent with the alcoholic subtypes hypothesis, couples with an antisocial alcoholic husband had higher levels of hostile behavior regardless of wives' alcoholism status. In contrast, rates of positive behaviors and the ratio of positive to negative behaviors were greatest among couples in which either both or neither of the spouses had alcoholic diagnoses and were lowest among alcoholic husbands with nonalcoholic wives. Discussion focuses on possible mechanisms linking antisocial alcoholism and discrepant alcoholic diagnoses to poorer marital outcomes.
Adult↗
Depressive symptoms over time in women partners of men with and without alcohol problems.
In a sample of 202 adult women and their families, the authors examined the effects of their male partners' alcohol problems and antisociality, the women's alcohol problems and antisociality, family conflict, and offspring behavioral problems on the women's depressive symptoms over a 3-year period. The women's antisociality and alcohol problems were more strongly related to family conflict, offspring behavioral problems, and the women's depressive symptoms than were the men's antisociality and alcohol problems. The women's antisociality and family conflict most strongly predicted increases in the women's depressive symptoms over time. In addition, family conflict mediated the effects of maternal antisociality on the women's depressive symptoms.
Adult↗
Poor response inhibition as a predictor of problem drinking and illicit drug use in adolescents at risk for alcoholism and other substance use disorders.
OBJECTIVE: To evaluate the predictive power of executive functions, in particular, response inhibition, in relation to alcohol-related problems and illicit drug use in adolescence. METHOD: A total of 498 children from 275 families from a longitudinal high-risk study completed executive function measures in early and late adolescence and lifetime drinking and drug-related ratings at multiple time points including late adolescence (ages 15-17). Multi-informant measures of attention-deficit/hyperactivity disorder and conduct disorder were obtained in early childhood (ages 3-5), middle childhood, and adolescence. RESULTS: In multilevel models, poor response inhibition predicted aggregate alcohol-related problems, the number of illicit drugs used, and comorbid alcohol and drug use (but not the number of drug-related problems), independently of IQ, parental alcoholism and antisocial personality disorder, child attention-deficit/hyperactivity disorder and conduct symptoms, or age. Multivariate models explained 8% to 20% of residual variance in outcome scores. The incremental predictive power of response inhibition was modest, explaining about 1% of the variance in most outcomes, but more than 9% of the residual variance in problem outcomes within the highest risk families. Other measured executive functions did not independently predict substance use onset. CONCLUSION: Models of alcoholism and other drug risks that invoke executive functions may benefit from specifying response inhibition as an incremental component.
Adolescent↗
Predicting risky drinking outcomes longitudinally: what kind of advance notice can we get?
This paper summarizes the proceedings of a symposium presented at the 2005 Research Society on Alcoholism meeting in Santa Barbara, California, that spans the interval from toddlerhood to early middle adulthood and addresses questions about how far ahead developmentally we can anticipate alcohol problems and related substance use disorder and how such work informs our understanding of the causes and course of alcohol problems and alcohol use disorder. The context of these questions both historically and developmentally is set by Robert Zucker in an introductory section. Next, Maria Wong and colleagues describe the developmental trajectories of behavioral and affective control from preschool to early adolescence in a high risk for alcoholism longitudinal study and demonstrate their ability to predict alcohol and drug outcomes in adolescence. Duncan Clark and Jack Cornelius follow with a report on the predictive utility of parental disruptive behavior disorders in predicting onset of alcohol problems in their adolescent offspring in late adolescence. Next, Kenneth Leonard and Gregory Homish report on adult development study findings relating baseline individual, spouse, and peer network drinking indicators at marriage onset that distinguish different patterns of stability and change in alcohol problems over the first 2 years of marriage. In the final paper, John Schulenberg and colleagues, utilizing national panel data from the Monitoring the Future Study, which cover the 18- to 35-year age span, show how trajectories of alcohol use in early adulthood predict differential alcohol abuse and dependence outcomes at age 35. Finally, Robert Zucker examines the degree to which the core symposium questions are answered and comments on next step research and clinical practice changes that are called for by these findings.
Adolescent↗
Edith Silverglied Lisansky Gomberg, PhD 1920-2005.
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Alcoholism↗
Social environmental influences on the development and resolution of alcohol problems.
This article summarizes the proceedings of a symposium presented at the 2005 Annual Meeting of the Research Society on Alcoholism, Santa Barbara, California, June 25-30. The overall goal of the symposium was to consider the broad impact of the social environment on the development of and successful or unsuccessful resolution of drinking problems. The presentations addressed multiple social environmental influences including: the influence of children on parents (Dr. Zucker), the influence of peers and parents on adolescents (Dr. Molina), the influence of family members on adult drinking (Dr. McCrady), the influence of adult peers/friends (Dr. Kaskutas), and the influence of the occupational environment (Dr. Ames). Dr. Longabaugh, the symposium discussant, addressed models for understanding the relationships between social influences and drinking problems.
Adolescent↗
Forgiveness and alcohol problems among people entering substance abuse treatment.
Forgiveness is argued to be highly relevant to problematic substance use, yet supportive empirical evidence is lacking. Findings are presented from a longitudinal study exploring the relationship between religiousness and spirituality (RS) variables and alcohol use disorders. We examined forgiveness of self (ForSelf), of others (ForOthers), and by God (ByGod), hypothesizing positive relationships with RS and negative relationships with alcohol use and consequences, at both baseline (N = 157) and six-month follow-up (N = 126). ForSelf scores were significantly lower than ForOthers and ByGod scores, and ForOthers scores increased modestly over time. ByGod was most consistently associated with other RS variables. ForSelf and ForOthers were associated with alcohol-related variables at both time points, and baseline ForSelf and ForOthers were associated with fewer drinking consequences at follow-up, but not after controlling for other pertinent variables. ForSelf may be most difficult to achieve and thus most important to recovery, thereby preventing full recovery and fostering relapses.
Adult↗
Smoking is associated with neurocognitive deficits in alcoholism.
BACKGROUND: Impaired problem solving, visual-spatial processing, memory, and cognitive proficiency are consequences of severe alcoholism. Smoking is much more prevalent among alcoholics than the general population, yet the possible neurocognitive effects of cigarette smoking in alcoholism have not been studied, despite evidence that long-term smoking is associated with neurocognitive deficits. OBJECTIVE: Determine whether smoking contributes to neurocognitive deficits associated with alcoholism. DESIGN: Neurocognitive function was examined in a community-recruited (n=172) sample of men. Alcohol problems/alcoholism were measured by the lifetime alcohol problems score (LAPS), DSM-IV diagnosis, and monthly drinking rate. Smoking was measured in pack-years. Neurocognitive function was measured with IQ (short version of WAIS-R), and cognitive proficiency (fast, accurate performance). RESULTS: Both alcoholism and smoking were negatively correlated with neurocognitive function. When alcoholism and smoking were included in regression models, smoking remained a significant predictor for both measures, but alcoholism remained significant only for IQ. CONCLUSIONS: Both smoking and alcoholism were related to neurocognitive function. Smoking may explain some of the relationship between alcoholism and neurocognitive function, perhaps especially for measures that focus on proficiency. Future studies are necessary to more fully understand the effects of smoking on neurocognitive function in alcoholism.
Adult↗
Normative Symbol Digit Modalities Test performance in a community-based sample.
The Symbol Digit Modalities Test is a substitution task that is the inverse of the Digit Symbol Test. The familiar task of filling numbers in boxes, and the availability of an oral administration, make this a popular screening instrument for brain impairment. Normative data were previously reported for a variety of clinical groups, but complete information on non-clinical samples across age, education, gender, and socioeconomic status is limited. The present study examines the performance of a community-dwelling control sample across age, education, gender, and income groupings. In a multivariate model, these four variables did not impact test performance. These results support the utilization of the SDMT as a robust screening test for adult neuropsychological impairment.
Adult↗
Prevention for children of alcoholics and other high risk groups.
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Adolescent↗
Social competence in children of alcoholic parents over time.
In the current study, the authors tested the hypothesis that children of alcoholic parents (COAs) show deficits in social competence that begin in early childhood and escalate through middle adolescence. Teachers, parents, and children reported on the social competence of COAs and matched controls in a community sample assessed from ages 6 to 15. Hierarchical linear growth models revealed different patterns of change in social competence across development as a function of the reporter of various indicators of competence. Moreover, female COAs showed deficits in social competence in early childhood that receded in adolescence and that varied across subtypes of parent alcoholism. Implications of these findings for understanding the development of social competence in children, and at-risk children in particular, are discussed.
Alcoholism↗
Individual and partner predictors of recovery from alcohol-use disorder over a nine-year interval: findings from a community sample of alcoholic married men.
OBJECTIVE: Numerous studies have focused on the predictors of recovery in persons with alcohol use disorder (AUD). Most have been retrospective and have measured only predictors of short-term recovery after the completion of treatment. This prospective study evaluates the role of psychological and social factors in a community sample of both alcoholics and their partners in predicting recovery over a 9-year interval. METHOD: Alcoholic diagnostic status and life functioning of 134 community-recruited, initially coupled men meeting criteria for a 3-year Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, AUD diagnosis at baseline were assessed over the 9-year period. Their partners also were assessed. Prediction involved comparing those who still had an AUD diagnosis at 9-year follow-up against those who no longer met AUD criteria. RESULTS: Predictors of recovery included number of experiences with treatment, education, number of years of intervening recovery over the follow-up period, partner baseline AUD status and partner's social support network. Alcoholics' initial severity of drinking did not predict long-term outcome. Furthermore, recovered men's partners decreased their AUD in the interim, whereas nonremitters' partners increased their AUD. The findings highlight the transitions in and out of AUD, with 62% of the men having stable drinking patterns of either remission or unremitting AUD diagnosis over the entire follow-up period. CONCLUSIONS: This study demonstrated the importance of interpersonal factors in maintaining AUD or promoting recovery. Consideration of partner characteristics and the marital context as factors in the recovery process is essential. Future research should examine the predictors of recovery in women, in adolescents and in racial groups other than white.
Adult↗
Inattention/hyperactivity and aggression from early childhood to adolescence: heterogeneity of trajectories and differential influence of family environment characteristics.
Inattention/hyperactivity and aggressive behavior problems were measured in 335 children from school entry throughout adolescence, at 3-year intervals. Children were participants in a high-risk prospective study of substance use disorders and comorbid problems. A parallel process latent growth model found aggressive behavior decreasing throughout childhood and adolescence, whereas inattentive/hyperactive behavior levels were constant. Growth mixture modeling, in which developmental trajectories are statistically classified, found two classes for inattention/hyperactivity and two for aggressive behavior, resulting in a total of four trajectory classes. Different influences of the family environment predicted development of the two types of behavior problems when the other behavior problem was held constant. Lower emotional support and lower intellectual stimulation by the parents in early childhood predicted membership in the high problem class of inattention/hyperactivity when the trajectory of aggression was held constant. Conversely, conflict and lack of cohesiveness in the family environment predicted membership in a worse developmental trajectory of aggressive behavior when the inattention/hyperactivity trajectories were held constant. The implications of these findings for the development of inattention/hyperactivity and for the development of risk for the emergence of substance use disorders are discussed.
Adolescent↗
Neuropsychological executive functioning in children at elevated risk for alcoholism: findings in early adolescence.
One component of individual risk for alcoholism may involve cognitive vulnerabilities prodromal to alcoholism onset. This prospective study of 198 boys followed between 3 and 14 years of age evaluated neurocognitive functioning across three groups who varied in familial risk for future alcoholism. Measures of intelligence, reward-response, and a battery of neuropsychological executive and cognitive inhibitory measures were used. Executive functioning weaknesses were greater in families with alcoholism but no antisocial comorbidity. IQ and reward-response weaknesses were associated with familial antisocial alcoholism. Executive function effects were clearest for response inhibition, response speed, and symbol-digit modalities. Results suggest that executive deficits are not part of the highest risk, antisocial pathway to alcoholism but that some executive function weaknesses may contribute to a secondary risk pathway.
Adolescent↗
Really underage drinkers: alcohol use among elementary students.
Despite the current societal concern with underage drinking, little attention has been paid to alcohol use within the preadolescent population. This article presents the proceedings of a symposium held at the 2003 Research Society on Alcoholism meeting in Fort Lauderdale, Florida, that was organized and chaired by John E. Donovan. The intent of the symposium was to kick start research on alcohol use among elementary school children by reviewing what is known regarding drinking in childhood. Presentations included (1) The Epidemiology of Children's Alcohol Use, by John E. Donovan; (2) The Validity of Children's Self-Reports of Alcohol Use, by Sharon L. Leech; (3) Predicting Onset of Drinking From Behavior at Three Years of Age: Influence of Early Child Expectancies and Parental Alcohol Involvement Upon Early First Use, by Robert A. Zucker; and (4) Parent, Peer, and Child Risk Factors for Alcohol Use in Two Cohorts of Elementary School Children, by Carol J. Loveland-Cherry. Presentations indicated the need for better nationwide surveillance of children's experience with alcohol; suggested that children's reports of their use of alcohol tend to be reliable and valid; supported children's alcohol use schemas and parental drinking and alcoholism at child age three as independent predictors of early onset drinking; and showed that onset of drinking before fourth or fifth grade, peer pressure, and parental norms and monitoring predict elementary student alcohol use and misuse.
Age Factors↗
Sleep problems in early childhood and early onset of alcohol and other drug use in adolescence.
BACKGROUND: No prospective studies exist on the relationship between sleep problems early in life and subsequent alcohol use. Stimulated by the adult literature linking sleep problems to the subsequent onset of alcohol use disorders in some adults, we examined whether sleep problems in early childhood predicted the onset of alcohol and other drug use in adolescence and whether such a relationship was mediated by other known predictors of this relationship, namely, attention problems, anxiety/depression, and aggression in late childhood. METHODS: This study is part of an ongoing longitudinal study of the development of risk for alcohol and other substance use disorders. Study participants were 257 boys from a community-recruited sample of high-risk families. RESULTS: Mothers' ratings of their children's sleep problems at ages 3 to 5 years significantly predicted an early onset of any use of alcohol, marijuana, and illicit drugs, as well as an early onset of occasional or regular use of cigarettes by age 12 to 14. Additionally, although sleep problems in early childhood also predicted attention problems and anxiety/depression in later childhood, these problems did not mediate the relationship between sleep problems and onset of alcohol and other drug use. CONCLUSIONS: This is, to our knowledge, the first study that prospectively examines the relationship between sleep problems and early onset of alcohol use, a marker of increased risk for later alcohol problems and alcohol use disorders. Moreover, early childhood sleep problems seem to be a robust marker for use of drugs other than alcohol. Implications for the prevention of early alcohol and other drug use are discussed.
Adolescent↗