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PubMed2005

The stages of change questionnaire as a predictor of trauma patients most likely to decrease alcohol use.

BACKGROUND: Research has shown that negative trauma-related consequences of drinking can predict readiness to change drinking behavior. These findings are confined to patients with positive blood alcohol levels at admission. The current study extends such findings by examining whether stage of readiness to change among all adult trauma activations admitted to the emergency department for 24 hours or more can be used to predict a change in behavior at followup. STUDY DESIGN: Patients 18 years of age or older admitted to a Level II trauma center between December 1, 2001, and January 31, 2003, with a trauma activation were eligible to participate. Enrolled patients were screened for alcohol use and readiness to change with the Alcohol Use Disorders Identification Test (AUDIT) and Short Form Stages of Change (SFSC), respectively, within 2 days of discharge. Blood alcohol level (BAL) was obtained for all study patients. Six to 18 months after discharge, patients were followed up with the AUDIT. The ability of the SFSC to predict change in alcohol behavior at followup was analyzed by multiple regression. RESULTS: Of 253 eligible patients, 146 patients were enrolled and had BAL taken. Most were men (64%) and 36% were women. Mean positive BAL (n = 57) was 186 mg/dL (range 10 to 537 mg/dL). Of these, 23% (13 of 57) met AUDIT criteria for harmful drinking and 47% (27 of 57) met criteria for dependent drinking. Even among those with undetectable BAL (n = 89), harmful or dependent drinking was identified by the AUDIT for 11% (10 of 89). A readiness to change was common among those reporting harmful or dependent drinking (26%) at baseline. The SFSC independently and significantly predicted change in drinking behavior among the 72 patients with followup (p = 0.05). Patients indicating greater readiness to change at baseline were those more likely to decrease their consumption pattern at followup. CONCLUSIONS: Findings suggest that administering the brief SFSC questionnaire to all trauma patients and providing assistance to those demonstrating a willingness to change may prove to be an effective strategy for reducing problem alcohol use.

Adult↗

PubMed2004

Genetics and alcoholism among at-risk relatives II: interest and concerns about hypothetical genetic testing for alcoholism risk.

One purpose of this study was to examine hypothetical interest in genetic predisposition testing for alcoholism among at-risk relatives. Qualitative interviews and several quantitative tools were administered to 27 individuals who had at least one first-degree relative affected by alcoholism. Data analysis revealed that participants' interest in genetic testing for susceptibility to alcoholism was moderate. Lower educational level and a stronger belief in 'others' influencing health were related to participants' having a stronger interest in genetic testing. Participants' concerns about future use of genetic testing ranged from doubts about its usefulness in affecting behavior to apprehension regarding detrimental societal effects such as breaches in confidentiality and fear of being labeled an 'alcoholic.' Younger age and stronger interest in genetic testing were associated with deterministic or fatalistic beliefs, while drinking behaviors, gender, and other demographics were not. Participants questioned the utility of this type of testing. Their interest in testing and concerns about its hypothetical use may prove important for at-risk relatives who may face decisions about genetic testing in the future. Data from this study can provide direction for researchers and health care providers as genetic testing for this and other behavioral conditions emerges. Scientists and the public should address the social concerns expressed by participants, including the fear of labeling. Also, we can begin to anticipate characteristics common in those who may have fatalistic responses, and who may possibly make adverse behavior choices, to results from alcoholism susceptibility testing.

Adolescent↗

PubMed1975

Orogastric, hydrational, and behavioral controls of drinking following water deprivation in rats.

Drinking and its associated behaviors were studied in rats deprived of fluid for 8,24, or 48 hr. The behavior of rats drinking water could be divided into three successive stages: (a) an initial intense burst of drinking that could not be easily disrupted; (b) intermittent drinking, often distinguished by the brief appearance of conflict behavior directed at the drinking spout; and (c) termination of drinking. Drinking stopped well before the fluid loss, reflected in a sizable extracellular deficit, was restored. Intake of water was terminated when serum hyponatremia and hypoosmolality (and presumably cellular overhydration) developed in temporal continguity with drinking. These and other considerations suggest that the cellular fluid phase exerts significant inhibitory as well as excitatory control over drinking.

Animals↗

PubMed1992

Differential expression of angiotensin II receptor subtype mRNAs (AT-1A and AT-1B) in the brain.

Two highly similar rat angiotensin II, type 1 receptor cDNAs (AT1) have been described that probably are encoded by separate genes. AT1A subtype mRNA was expressed in vascular smooth muscle whereas AT1B mRNA was expressed in adrenal and pituitary. Here we measured the two AT1 subtype mRNAs in brain using reverse transcriptase/polymerase chain reactions. AT1B mRNA was predominant in subfornical organ (SFO) and organum vasculosum of the lamina terminalis (OVLT), the two regions that mediate angiotensin II-induced drinking behavior, and also in cerebellum. AT1A mRNA was predominant in the hypothalamus. Thus, the two AT1 receptor subtypes established to reside in peripheral tissues also are found in the central nervous system where the AT1B subtype may mediate drinking behavior.

Animals↗

PubMed2005

Psychosocial, cultural and genetic influences on alcohol use in Asian American youth.

OBJECTIVE: Environmental and cultural factors, as well as a genetic variant of the aldehyde dehydrogenase gene (the ALDH2*2 allele) have been identified as correlates of alcohol use among Asian Americans. However, concurrent examination of these variables has been rare. The present study assessed parental alcohol use, acculturation and ALDH2 gene status in relation to lifetime, current and heavy episodic drinking among Chinese and Korean American undergraduates. METHOD: Participants (N = 428, 51% women; 52% Chinese American, age 18-19 years) were first-year college students in a longitudinal study of substance use initiation and progression. Data were collected via structured interview and self-report, and participants provided a blood sample for genotyping at the ALDH2 locus. RESULTS: Gender, parental alcohol use and acculturation significantly predicted drinking behavior. However, none of the hypothesized moderating relationships were significant. In contrast with previous studies, ALDH2 gene status was not associated with alcohol use. CONCLUSIONS: Results indicate that although the variables examined influence alcohol use, moderating effects were not observed in the present sample of Asian American college students. Findings further suggest that the established association of ALDH2 status and drinking behavior in Asians may not be evident in late adolescence. It is possible that ALDH2 status is associated with alcohol consumption only following initiation and increased drinking experience.

Acculturation↗

PubMedDate not supplied

Use of behavioral risk factor surveys to predict alcohol-related motor vehicle events.

The relationship between acute alcohol intoxication and increased risk of traffic violations, crashes, and injuries is well known. We designed this study to investigate the usefulness of behavioral risk factor surveys (BRFSs) in identifying drivers at risk for subsequent motor vehicle violations and crashes. We carried out a retrospective cohort study in a random sample of members of a health maintenance organization, who were followed for five years after ascertainment of alcohol use. Reported problem drinking behavior increased the risk of motor vehicle violations or crashes for women drivers and older drivers (older than 65 years of age) of both sexes. Women "binge drinkers" had an age-adjusted relative risk (RR) for violations of 1.7 (95% confidence interval [CI] = 1.1, 2.8) and an age-adjusted RR for crashes of 1.9 (95% CI = 1.1, 3.2). Older drivers reporting drinking and driving or multiple drinking problems had an increased risk of motor vehicle crashes (sex-adjusted RR = 2.7; 95% CI = 1.2, 5.8, and 3.0; 95% CI = 1.1, 8.4). A CAGE score of 2 or more identified older drivers at increased risk for both violations and crashes. We found no increased risk for male drivers under 65 years of age for any of the problem drinking behaviors. We conclude that BRFSs in a general population can help identify high-risk drivers among women and drivers older than 65 years of age.

Accidents, Traffic↗

PubMedDate not supplied

Parental problem drinking and anxiety disorder symptoms in adult offspring: examining the mediating role of anxiety sensitivity components.

Preliminary studies have implicated childhood exposure to parental problem drinking as a possible factor in the development of anxiety sensitivity (AS). The present retrospective study was designed to examine the role of exposure to distressing parental problem drinking behaviors, over and above the role of parental alcoholism, in the development of various AS components (psychological, physical, and social concerns) in the offspring. We also examined the possible mediating role of AS components in explaining relations between parental drinking problems and anxiety-related symptoms in the adult offspring. A sample of 213 university students provided retrospective reports of both distress related to parental drinking [Children of Alcoholics Screening Test (CAST)] and parental alcoholism [maternal and paternal forms of the Short Michigan Alcoholism Screening Test (SMAST)]. Participants also reported on their own current AS levels [AS Index (ASI)], general anxiety symptoms [State-Trait Anxiety Inventory-Trait subscale (STAI-T)], and lifetime history of uncued panic attacks [Panic Attack Questionnaire-Revised (PAQ-R)]. Scores on the CAST predicted AS psychological and physical concerns (but not social concerns) over and above participant gender and parental alcoholism measured by the SMASTs. Moreover, AS psychological concerns proved a consistent modest mediator of the relations between parental problem drinking on the CAST and both general anxiety and uncued panic outcomes in the offspring. Thus, exposure to distressing parental problem drinking behavior may be one factor that contributes to elevated AS psychological concerns in the child, which in turn may contribute to the development of anxiety disorder symptoms in the offspring.

Adolescent↗

PubMed2001

Alcohol and mortality: if you drink, do not forget fruits and vegetables.

Moderate amounts of alcohol may have cardioprotective effects. Several studies reported a higher protection by the consumption of wine. The favorable effects of wine have been attributed to different polyphenolic compounds, among others. However, these biochemical compounds are also found in other beverages. In view of the present evidence, there is no "right" or "wrong" drink, only a "right" and "wrong" drinking behavior regarding absolute amounts, drinking frequency, and accompanying lifestyle and eating pattern.

Alcohol Drinking↗

PubMed1995

Alcohol consumption and flushing response in natives of Chukotka, Siberia.

OBJECTIVE: Drinking patterns and flushing response were investigated among indigenous natives of Chukotka, Siberia (162 women, 139 men). The quantification of drinking behavior could be used for comparison with other northern peoples and as a baseline for future intervention. METHOD: Interviews, physical examinations and blood tests were performed in the Chukotka region of Siberia. RESULTS: 28% of the men and 4.5% of the women drank at least once per week. High doses per typical drinking occasion, which averaged 177.6 g of pure alcohol in men and 74.3 g in women, were reported; 10.3% of the men and 25.5% of the women reported that they experienced facial flushing after drinking. In most cases more than 20 g of alcohol was necessary to induce flushing, and two-thirds of the flushers were able to continue drinking after flushing began. No significant relationship between flushing and frequency and quantity of drinking and the prevalence of alcohol-related symptoms was found. There was a significant association between flushing by women and reports by them of their parent's flushing. CONCLUSIONS: Flushing by Chukotka natives and its relationship to drinking behavior is different from Oriental ALDH2-deficient flushing.

Adult↗

PubMed1983

Naloxone-induced hypodipsia: a CNS mapping study.

Opiate antagonists have been shown to reliably attenuate drinking behavior. Recent research points to a central site of action for this antidipsogenic effect. To pursue this issue of site specificity, naloxone, a specific opiate antagonist, was delivered into a number of discrete subcortical areas in 23 hour water-deprived rats. Water intake was measured at 5, 15, 30 and 60 minutes post drug injection. Compared to saline control injections, naloxone reliably depressed water intake, in a dose-related manner, in lateral hypothalamus, preoptic area and zona incerta. Previous research has repeatedly implicated these areas in drinking behavior. Placements which were not generally effective included lateral ventricle, nucleus accumbens, substantia nigra and cortex/corpus callosum. Latency to drink was never affected by any dose of naloxone injected into any site, suggesting an opioid influence on mechanisms involved in termination and/or maintenance rather than on initiation of drinking.

Animals↗

PubMed1997

The relationship of gender balance at work, family responsibilities and workplace characteristics to drinking among male and female attorneys.

OBJECTIVE: The purpose of this study was to investigate the relationship of gender balance at work, family and home responsibilities and workplace factors to the drinking behaviors of attorneys. METHOD: Using a stratified random sampling procedure, attorneys were selected from the bar associations of two large Midwestern cities. Telephone interviews were completed with 300 men and 257 women (37.3% of those originally selected), who were asked about characteristics of their work, the numbers of female attorneys they had contact with in four types of working relationships, overall and work-related drinking, and family and home responsibilities. Multiple regression and discriminant analyses were used to study the influence of these variables on drinking. RESULTS: Gender balance variables entered several of the analyses. For both men and women the frequency of work-related drinking positively correlated with the number of female attorneys in the organization, but was negatively related to the number of women who were peers. Family and home responsibilities entered predictive equations, both positively and negatively, for both men and women. Size of firm was positively correlated with frequency of business-related drinking and, for men, with frequency of social drinking related to work. CONCLUSIONS: The influence of the gender composition of the workplace on drinking behaviors may vary, for both men and women, by the type of contact involved, with closer or more active involvement with female colleagues associated with decreased frequency of drinking. Work-related drinking may also be related to home and family demands and the size of the firm, again for both genders.

Adult↗

PubMed2000

Childhood physical and sexual abuse as risk factors for heavy drinking among African-American women: a prospective study.

OBJECTIVE: This study examines the associations among characteristics of child sexual abuse. childhood physical abuse, lack of parental care, and heavy drinking in a relatively young, urban population of African-American women all of whom have documented histories of child sexual abuse. METHODOLOGY: The sample consists of 113 African American child victims who were brought to a city hospital emergency room for treatment and collection of forensic evidence in the 1970s and re-interviewed as adults in the 1990s. RESULTS: The results of this research suggest that multiple incidents of child sexual abuse, more than the characteristics of such abuse is an important predictor of adult heavy alcohol use and binge drinking. These results remain even after controlling for the effects of parental drinking behavior. CONCLUSION: Although the victim of multiple child sexual assaults is more likely to suffer force and penetration, these analyses suggest that it is the multiple victimization and not the force or penetration that drives the relationship between child sexual assault and drinking behaviors.

Adolescent↗

PubMed1992

Feeding behavior and ambulatory activity in rats with D-galactosamine-induced hepatic failure.

This study was undertaken to investigate changes in feeding behavior and ambulatory activity, in rats with D-galactosamine (D-GAL)-induced hepatic failure. D-GAL was administered (1000 mg/kg) IP at 1800, just before the dark phase. The first significant decrease of ambulatory activity in rats with hepatic failure was observed between 0000 and 0300 h. A significant increase in drinking behavior was observed between 1800 and 2100 h, and a significant decrease was observed between 2100 and 0300 h. A significant decrease in food intake occurred between 1800 and 2400 h. Thereafter, there was no difference in food intake. In conclusion, we demonstrated significant changes in ambulatory activity, drinking behavior and food intake produced by D-GAL. A wide variation in systems, including monoamine turnover, and amino acid disturbance could be expected in these animals, and such changes might also have contributed to the results observed.

Amino Acids, Branched-Chain↗

PubMed1993

The value of ethnographic alcohol studies: a psychologist's perspective.

Drinking behavior has been studied by scientists from a variety of social science disciplines including anthropology, economics, sociology, and psychology. The very nature of their narrow, discipline-based training and work, however, has often prevented these scientists from appreciating each other's different methodologies and from conducting cooperative, interdisciplinary studies. In this paper, I discuss how my own experience with ethnographic alcohol studies influenced my research on drinking behavior. I then outline a research strategy that could be used to foster interdisciplinary alcohol studies.

Alcohol Drinking↗

PubMed1996

Serotonin2C receptors and serotonin2C receptor-mediated phosphoinositide hydrolysis in the brain of alcohol-preferring and alcohol-nonpreferring rats.

To examine the role of serotonin2C (5HT2C) receptors in alcohol drinking behavior, the binding indices of 5HT2C receptors were determined in various brain regions of alcohol-preferring (P) and alcohol-nonpreferring (NP) rats. 5HT2C receptor-mediated phosphoinositide hydrolysis in the choroid plexus of P and NP rats was also determined. It was observed that the densities of 5HT2C receptors are significantly higher in the hippocampus, the amygdala, and the choroid plexus, but not in the cortex of P rats compared with NP rats. The Kd values of [3H]mesulergine binding to 5HT2C receptors were not different in these brain regions of P rats compared with NP rats. It was also observed that 5HT-stimulated [3H]inositol 1-phosphate formation was significantly higher in the choroid plexus of P rats compared with NP rats. The results of this study indicate that the numbers of 5HT2C receptors are higher in the hippocampus, the amygdala, and the choroid plexus, and that 5HT2C receptor-mediated phosphoinositide hydrolysis is more elevated in the choroid plexus of P rats compared with NP rats. Thus, it seems from these results that increased 5HT2C receptors may be involved in the genetic vulnerability to alcohol drinking behavior.

Alcohol Drinking↗

PubMed1983

Psychological factors of familial alcoholism in American Indians and Caucasians.

Previous studies have reported on the familial transmission of alcoholism and its psychological concomitants. To date, investigators have not studied the familial factor and its relationship to transmission/risk in a group of American Indians (doubly at risk for alcoholism). In two related studies, we have assessed psychological adjustment and drinking behavior of (1) a group of Indians with one or more first-degree alcoholic relatives and a group of Indians without a history of familial alcoholism; and (2) Indians with a history of familial alcoholism compared to Caucasians with a history of familial alcoholism. Results indicate no psychological functioning differences between familial and nonfamilial Indians. However, the familial Indian group reported a style of drinking that more closely resembled that of an alcoholic group. Looking at these data cross-culturally, there are differences between Indians and Caucasians on psychological adjustment, as well as drinking behavior. These differences are present in spite of a shared familial history of alcoholism.

Adult↗

PubMed1996

Role of taste aversion in calcium channel inhibitor-induced suppression of saccharin and alcohol drinking in rats.

L-type calcium (Ca2+) channel inhibitors suppress drinking of highly preferred solutions of simple carbohydrates, saccharin, or alcohol. The present study was designed to examine whether this decrease in drinking behavior can be explained by the development of consummatory aversion. In the first experiment, the propensity of Ca2+ channel inhibitors to induce conditioned taste aversion (CTA) to 0.1% saccharin was examined using two saccharin/drug injection pairings in saccharin-naive rats. We compared three chemically different drugs: diltiazem, isradipine, and nicardipine. A dose-dependent CTA was observed after both conditioning sessions for all three drugs tested. Interestingly, the lowest dose of nicardipine (i.e., 1.25 mumol/kg), significantly increased saccharin intake. A nonsignificant trend to increase saccharin intake was also observed with the lowest dose of isradipine. We then examined whether nicardipine could similarly induce CTA to a novel taste of alcohol (6%, v/v). The drug failed to produce a significant effect. In the third experiment, we found that nicardipine did not induce CTA (or preference) if the saccharin taste was familar to rats. In the final experiment, the interaction of nicardipine (1.25 and 2.5 mumol/kg) with the ethanol (1.5 g/kg)-induced CTA to saccharin was investigated. The higher dose of nicardipine potentiated the aversive effect of ethanol in the test. Overall, the present results suggest that CTA does not play a major role in Ca2+ channel inhibitor-induced suppression of drinking behavior.

Alcohol Drinking↗

PubMed2005

Pain and use of alcohol to manage pain: prevalence and 3-year outcomes among older problem and non-problem drinkers.

AIMS: Most older adults report having recently experienced pain, and many older adults have late-life drinking problems. However, to our knowledge, the intersection of pain and alcohol misuse by older adults has not been studied. This research focuses on the implications of pain for older individuals who have problems with alcohol. DESIGN: Longitudinal survey. SETTING, PARTICIPANTS AND MEASUREMENT: Older community-residing adults (n = 401) were classified as problem and non-problem drinkers. At baseline and 3 years later they were asked to provide information about their pain, use of alcohol to manage pain, drinking behavior, chronic health problems and recent serious injury. FINDINGS: At baseline, older problem drinkers reported more severe pain, more disruption of daily activities due to pain and more frequent use of alcohol to manage pain than did older non-problem drinkers. More pain was associated with more use of alcohol to manage pain; this relationship was stronger among older adults with drinking problems than among those without drinking problems. Among older men, more baseline drinking problems interacted with use of alcohol to manage pain to predict more health problems and serious injury 3 years later. Among older women, more baseline drinking problems interacted with use of alcohol to manage pain to predict more drinking problems 3 years later. CONCLUSIONS: The results highlight the importance of monitoring the drinking behavior of older patients who present with pain complaints, especially patients who have pre-existing problems with alcohol.

Activities of Daily Living↗