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PubMed1987

A double-blind, placebo-controlled trial of lithium carbonate therapy for alcoholism.

The efficacy of lithium carbonate as a treatment for alcoholism was examined in a double-blind, placebo-controlled study of 104 men and women meeting DSM-III criteria for alcohol dependence. Subjects entered the study during inpatient treatment and were subsequently followed up for 12 months. Survival analysis disclosed essentially three categories of treatment response: one for noncompliant subjects (0% to 7% abstinent), one for compliant subjects not attaining therapeutic serum lithium levels (31% to 44% abstinent), and one for compliant subjects with therapeutic serum levels (67% abstinent). Two findings led us to believe that therapeutic serum levels of lithium were associated with better outcome over and above a behavioral compliance effect. First, in a dose-response analysis, serum lithium levels and abstinence rates were not linearly associated. Second, all subjects who started lithium carbonate therapy as inpatients were significantly less likely to relapse to drinking during the first month than were placebo-compliant subjects. There was no evidence that depressed alcoholics showed a better treatment response than nondepressed alcoholics or that lithium had any significant impact on the mood or social adjustment of alcoholics. Although the sample size and the difficulties of ascertaining placebo compliance caution against drawing firm conclusions, the data add further support to the hypothesis that lithium has an effect on drinking behavior not related to the treatment of affective symptoms.

Adult↗

PubMedDate not supplied

Interactions between psychotherapy procedures and patient attributes that predict alcohol treatment effectiveness: a preliminary report.

This study examined interactions between patient attributes and therapist interventions on alcoholism treatment outcome. Process analyses of an early psychotherapy session from either cognitive-behavioral (CBT) or family systems (FST) therapy and baseline patient information (N=47) were used to measure theory-based therapy and patient variables. Hierarchical linear regression was used to test the effect of each patient-therapy interaction on changes in drinking behavior. Two disordinal interactions were predictors of alcohol use during the maintenance phase of treatment. Patients high in emotional distress did best when their therapy addressed emotional experiences, and the converse was observed for patients low in distress. Patients high in reactance had better drinking outcomes when their therapy was nondirective, and patients low in reactance improved more with directive therapy. In contrast to the interactions between patient attributes and the therapy process, the interactions between patient attributes and treatment model (CBT versus FST) were not reliable predictors of alcohol use.

Adaptation, Psychological↗

PubMed1998

Effect of religion and religiosity on alcohol use in a college student sample.

Two hundred and sixty-three alcohol using college students completed a questionnaire on their levels of alcohol use, problems with alcohol use, reasons for drinking, perceptions of control over drinking, impulsivity, venturesomeness, irrational beliefs, neuroticism, expectations of alcohol effects, depression, social norms, religious affiliation and intrinsic and extrinsic religiosity. Analyses of variance revealed that students with no religious affiliation reported significantly higher levels of drinking frequency and quantity, getting drunk, celebratory reasons for drinking and perceived drinking norms than those of either Catholic or Protestant religious affiliation, while no significant differences across groups were found for alcohol use problems. Protestants reported significantly higher levels of perceived drinking control than Catholics. Intrinsic religiosity, reflecting one's ego involvement with the tenets of one's religion, appeared to play a more important positive role over drinking behavior for Protestants than for Catholics.

Adult↗

PubMed2000

Beverage-specific alcohol consumption and cirrhosis mortality in a group of English-speaking beer-drinking countries.

AIMS: To compare beverage-specific per capita consumption and total alcohol consumption's associations with cirrhosis mortality rates in multiple countries. DESIGN: Pooled cross-sectional time-series analysis. SETTING: Australia, Canada, New Zealand, the United Kingdom and the United States during the years 1953-1993. MEASUREMENTS: National level data on per capita total alcohol, beer, wine and spirits consumption and standardized all-cause cirrhosis mortality rates. FINDINGS: Significant associations with cirrhosis mortality are found for both total ethanol and spirits. Spirits consumption is found to make up the majority of the effect of alcoholic beverage consumption on cirrhosis mortality and the model including only spirits is found to fit the data at least as well as the model including only total ethanol consumption. The lag relationship between all alcohol types and cirrhosis is found to be short with only present and 1 year's lagged consumption having significant associations. CONCLUSIONS: Spirits consumption rather than beer or wine is associated with cirrhosis mortality in this group of primarily beer-drinking countries. This finding offers important clues to understanding the drinking behaviors associated with cirrhosis mortality on the individual level.

Adolescent↗

PubMed1988

Toward an analogue of alcoholism in mice: analysis of nongenetic variance in consumption of alcohol.

Drinking behavior of the isogenic mouse strain C57BL/6J was analyzed into nongenetic components: stochastic fluctuations, responses to fluctuations in the current environment, and persistent differences between individual animals. The latter accounted for the major part of the variance. The variance was neither increased by differences in diet during the postweaning rapid growth period (prior to assay for drinking choice) nor diminished by uniformity of treatment during this period, suggesting that significant differentiation had occurred prior to weaning. The large variance between animals could be explained by assuming that the genetic role in consumption of alcohol by C57BL mice is permissive--a relative insensitivity to the aversive orosensory and pharmacological effects of 10% alcohol--rather than a specific drug-seeking predisposition.

Alcohol Drinking↗

PubMed1998

Alcohol use and behaviors in women long-distance race participants reporting a history of bulimia and/or anorexia nervosa.

OBJECTIVE: To describe the relationship between a reported a history of an eating disorder, a history of problem alcohol behavior and current alcohol consumption in women long-distance runners. DESIGN: Survey. SETTING: General community. PARTICIPANTS: Women participating in a 20-mile road race (n = 398) and age-matched non-exercising women enrolled in a family practice health maintenance organization (n = 121) (mean age, 37.1 +/- 9.4 years). INTERVENTION: Not applicable. MEASURES: Responses to questions relating to 1) a past history of an eating disorder; 2) weight; 3) running and exercise habits; 4) drinking behaviors using alcoholism screening tests; 5) quantity-frequency data of the previous two week alcohol consumption. RESULTS: Ten percent of racers and 4.1% of controls reported a history of an eating disorder. Those racers reporting a history of bulimia nervosa without anorexia were more likely to report feeling guilty about their drinking, drunk-driving arrests, an elevated score on an alcoholism screening test (suggestive of problem drinking), alcoholism, and seeking help for problem drinking than other racers or the control population without a history of an eating disorder. However, bulimic racers did not report either increased current alcohol consumption or occasions of drinking, including binge drinking (five or more drinks in one episode). CONCLUSIONS: Women racers reporting a history of bulimia nervosa are more likely to report a history of problem behaviors with alcohol but not differences in current alcohol consumptions from that reported by other women racers or women without a history of an eating disorder from the control population.

Adult↗

PubMed2004

Changes in alcohol involvement, cognitions and drinking and driving behavior for youth after they obtain a driver's license.

OBJECTIVE: This study tested whether obtaining a driver's license was associated with increases in alcohol and other drug involvement and changes in alcohol-related cognitions for youth, and whether drinking and driving behavior increased with driving experience. METHOD: Confidential, anonymous surveys were conducted at two time points (fall, spring) with students at four high schools in San Diego county (N = 2,865, 51% female). Data were collected on alcohol, cigarette and marijuana use, license status, alcohol use by peers, attitudes towards drinking and driving and drinking and driving behaviors. RESULTS: Nondrivers (60%), new drivers (obtained a license between Time 1 and Time 2) and experienced drivers (26%) were compared on study variables at both time points and over time. Initially obtaining a driver's license was associated with increased frequency of substance use. Results were not significant for quantity of alcohol use, frequency of heavy drinking or perceived alcohol use norms. Attitudes towards drinking and driving reflected an increase in the perceived dangerousness of this behavior for new drivers. Drinking and driving behavior during the last 30 days increased with increased driving experience. CONCLUSIONS: The results indicate a number of changes in substance involvement after obtaining a driver's license. However, initially this transition may also indicate a period of protection against drinking and driving. These results may have implications for the target and content of drinking and driving interventions.

Adolescent↗

PubMed1991

Ibotenic acid-induced lesions of the medial zona incerta decrease lordosis behavior in the female rat.

To examine the role of the medial zona incerta (mZI) in female sexual behavior, ovariectomized estrogen- and progesterone-treated female rats were tested for sexual receptivity after bilateral injections of the selective neurotoxin ibotenic acid (3 micrograms/0.3 microliter) directly into the mZI. These injections produced a significant attenuation of lordosis behavior in highly receptive females when compared with saline-injected controls. This decrease in sexual receptivity was also reflected in a significant increase of rejections of male mount attempts. However, these lesions did not abolish the display of lordosis behavior. In addition, the frequency of hopping and darting was decreased in ibotenic acid-injected females when compared with controls. Consistent with previous studies, these lesions also produced a transient impairment of drinking behavior (hypodipsia) typical of rats with large electrolytic lesions of the mZI. This study demonstrates that mZI neurons play a role in mediating sexual receptivity in the female rat. Collectively, these results suggest that in addition to the projection from the ventromedial nucleus of the hypothalamus to the midbrain central gray, the functional integrity of the mZI is of crucial importance for the expression of sexual receptivity in the female rat.

Animals↗

PubMed2005

Drinking control attempts and encouragement of alcohol use in couple relationship--a qualitative approach.

The present study addresses previously neglected research areas among couples with normal drinking habits, namely control attempts and encouragement of drinking. In this study, semistructured interviews were conducted in 2001 with 27 individuals living in steady couple relationships in Helsinki. Forms of active social control of drinking were classified into four categories and were investigated on the dimensions of indirect-direct and mild-strong. Further analysis suggests that the form of control reflects the degree of individualization in relationships, at least when drinking is concerned. Later, the exploration of encouragement of drinking shows that the culturally crucial feature of the qualified drinker is the preservation of one's own will. Then, it is concluded that in a couple relationship, social control and encouragement of drinking are, above all, complementary. Finally, the significance of drinking's social control is not restricted to alcohol use only, and it is surprisingly great in couple relationships, especially in preventing deviant drinking behavior. Several factors are presented that contribute to the increase of social control's importance.

Adult↗

PubMed1989

Laboratory markers as compared to drinking measures before and after inpatient treatment for alcoholism.

A study group, consisting of 60 male and 13 female alcohol-dependent patients, participated in an inpatient treatment for alcoholism. They were interviewed about their alcohol use before the treatment period and bimonthly for 8 months after it. It was found that the correlations between laboratory markers and average daily alcohol intake are very low (range, -0.01-0.23) in alcoholics with high alcoholic intake level (before the treatment period). It was also found that the correlations between the laboratory tests and the drinking measures after the initial assessment undergo large changes. The correlation between GGT and average daily alcohol intake before the treatment period was 0.07 (p = NS) and 2 months after the treatment period 0.55 (p less than 0.001). The long period of abstinence, the change to a lower level of alcohol consumption, and improved accuracy of reporting alcohol intake were probably causative in this change. GGT proved to have the highest correlations with the drinking measures during the follow-up and MCV before the treatment period. The frequency measure, number of drinking days, gave consistently higher correlations with the laboratory markers than the measure of drinking amount, average daily alcohol intake. Laboratory markers, GGT and MCV, are well suited for outcome evaluation of drinking behavior of alcoholics after inpatient treatment for alcoholism or other comparative periods of abstinence.

Adult↗

PubMed1998

The differential role of alcohol expectancies and drinking refusal self-efficacy in problem and nonproblem drinkers.

OBJECTIVE: The present study aimed to examine the discriminatory ability of alcohol expectancies and drinking refusal self-efficacy and to identify the differential role of these constructs in social and problem drinkers. METHOD: Drinkers (N = 276) were self-selected from general (n = 185) and clinical (n = 91) populations to complete a 40-minute questionnaire that asked about alcohol expectancies, drinking refusal self-efficacy, consumption, degree of dependence and demographics. RESULTS: The results showed that in social drinkers both the expectancy and self-efficacy constructs were reliably able to discriminate between types of drinker. Expectancy was related to consumption in social drinkers, but did not appear to account for a significant proportion of the variance in problem drinkers. CONCLUSIONS: The findings are discussed in terms of a two-process model of drinking behavior that suggests that expectancies operate differently in social and problem drinkers.

Adult↗

PubMed1999

Employee drinking practices and work performance.

OBJECTIVE: The purpose of this study was to examine the independent effects of a variety of drinking indicators on self-reported work performance. METHOD: Data from a cross-sectional mailed survey (response rate = 71%) of managers, supervisors and workers (N = 6,540) at 16 worksites were analyzed. Average daily volume was computed from frequency and usual quantity reports. Drinking on the job included drinking during any of six workday situations. The CAGE was used to indicate alcohol dependence. Employees were also asked how frequently they drank to get high or drunk. Work performance was measured through a series of questions about work problems during the prior year. The number of times respondents experienced work performance problems was regressed on the four drinking measures, and a variety of demographic characteristics, job characteristics and life circumstances that might also negatively affect work performance. RESULTS: The frequency of self-reported work performance problems increased, generally, with all four drinking measures. In a multivariate model that controlled for a number of demographics, job characteristics and life-situations, average daily volume was no longer significantly associated with work performance but the other three drinking measures were. Interestingly, although moderate-heavy and heavy drinkers reported more work performance problems than very light, light, or moderate drinkers, the lower-level-drinking employees, since they were more plentiful, accounted for a larger proportion of work performance problems than did the heavier drinking groups. CONCLUSIONS: Employers should develop clear policies limiting drinking on the job and, in addition to employee assistance programs for problem drinkers, should develop worksite educational interventions aimed at informing all employees about the relationship between drinking behaviors and work performance.

Absenteeism↗

PubMed2006

Gender, alcohol consumption, and parental monitoring.

The authors examined the relationships among gender, alcohol consumption, and parental monitoring, including television monitoring. Student volunteers (N = 150; 90% Caucasian, 79% women) participated by reporting retrospective general parental monitoring, television monitoring, and recent drinking behaviors. On the basis of the retrospective reports by the participants, when they were growing up the men received less overall parental monitoring but not less television monitoring than the women. Women's drinking quantity was correlated with parental monitoring, whereas men's drinking frequency was associated with both parental monitoring and television monitoring. Interestingly, men's binge drinking frequency was correlated with television monitoring but not with overall parental monitoring, whereas women's binge drinking frequency was correlated with overall parental monitoring but not with television monitoring. Implications for preventing alcohol misuse and ideas for future research are discussed.

Adolescent↗

PubMedDate not supplied

Perceptions of risks of smoking and heavy drinking during pregnancy: 1985 NHIS findings.

As part of the Health Promotion and Disease Prevention Questionnaire administered in the 1985 National Health Interview Survey, nearly 20,000 respondents ages 18-44 answered questions about their awareness of the risks of smoking and heavy drinking during pregnancy. In reference to smoking, interviewers asked about miscarriage, stillbirth, prematurity, and low birth weight; in reference to heavy drinking, they asked about miscarriage, mental retardation, low birth weight, and birth defects, as well as fetal alcohol syndrome. For each of these adverse outcomes, a majority of subjects acknowledged increased risk because of smoking or heavy drinking during pregnancy. The range was 66-80 percent of respondents for the four questions on smoking, with the perceived association to smoking strongest for low birth weight. Approximately 84 percent of respondents associated heavy drinking with increased risk for each of the suggested pregnancy outcomes. Smoking seemed to be perceived to pose a lesser risk to pregnancy than heavy drinking. This relative lack of awareness of the pregnancy risks of smoking was more apparent among respondents with less education and more pronounced among blacks than whites. Women were more likely than men to express some opinion on these pregnancy-related questions and were more cognizant than men of the risks. On this limited survey, Americans ages 18-44 were not very knowledgeable about fetal alcohol syndrome. Among the 55 percent who had heard of fetal alcohol syndrome, fewer than one in four correctly identified it as a set of birth defects when offered three possible definitions. It will be interesting to correlate responses to these "knowledge" questions with NHIS data still forthcoming on reported actual smoking and drinking behavior among women respondents who were recently pregnant.

Adolescent↗

PubMed1986

Patterns of alcohol use among rural and small-town adolescents.

Much research has indicated that age, gender, grade in school, religiosity, socioeconomic status, and involvement in extracurricular activities are all related to adolescent alcohol use. However, most of such research focuses on urban youth. The present study examines patterns of rural adolescent alcohol use and factors associated with such use. The Student Alcohol Inventory was administered to 650 students in grades 7-12 in a small, middle-Atlantic town and surrounding county. The survey contained sections addressing demographic data, attitudes regarding students' alcohol use, and their parents' use. Along with standard SES measures, items were included on unemployment and receipt of government assistance. The dependent variables included age at first drink, frequency of drinking, amount of drinking, and a composite heavy-drinking index. Eighty-three percent of the respondents indicated that they had drunk alcohol and 57% had had their first drink by age 12. Gender and grade in school were significant predictors of alcohol use for all four dependent variables. Time spent in social activities was significant in predicting all but age at first drink. Religiosity was a significant predictor for only one dependent variable--age at first drink. The SES measures were also weak predictors of drinking behavior. Policy implications and directions for future research are discussed.

Achievement↗

PubMedDate not supplied

The relationship between sexual insecurity, the alcohol expectation for enhanced sexual experience, and consumption patterns.

Alcohol expectancies have been shown to correlate with and predict a range of drinking behaviors. This investigation expanded on previous research by examining the differential reinforcement value of alcohol as a means of achieving enhanced sexual pleasure. Results from 303 participants showed that the expectation of enhanced sexual experience was a significant predictor of typical quantity, maximum quantity, and frequency of drinking by sexually secure men. For insecure men and women (both insecure and secure), the expectation that alcohol enhances sexuality was not a significant predictor of drinking patterns. Gender differences are highlighted and the clinical implications for intervention are presented.

Adult↗

PubMed1998

Is propranolol effective in primary polydipsia?

OBJECTIVE: Psychiatric patients presenting with polydipsia are often difficult to treat with standard psychiatric interventions. Pharmacological intervention was attempted in these patients based on the hypothesis that angiotensin II, a potent dipsinogen, may be involved in the drinking behavior of patients with polydipsia. Beta-blockers inhibit renin release (and thus indirectly angiotensin II) by blocking beta receptors in the kidney. METHODS: Three patients were identified as excessive water drinkers during their hospital admissions. All three patients were eunatremic but polydipsic at the time of study. Two of the three had histories of hyponatremia and required emergency medical treatment on more than one occasion. No patients had been controlled by strict fluid restriction. Trials of propranolol were initiated to control their water drinking. RESULTS: After starting propranolol, two patients responded quickly. In one patient, fluid intake decreased from 2650 +/- 647 to 1577 +/- 361, p < .001. In the other, fluid intake decreased from over 7000 ml before starting propranolol to around 3000 ml. The mean noon body weight of the third patient, in whom it was not possible to document fluid intake or urine volume before and after administering beta-blocker, was 72.6 +/- 2.6 Kg and 66.0 +/- 1.0 Kg, respectively (p < .0001). CONCLUSIONS: These results suggest that propranolol may be useful for the treatment of polydipsia in patients with schizophrenia. Its efficacy could be related to inhibition of the renin-angiotensin system. Additional research using the controlled pharmacotherapeutic trials is required to confirm these findings.

Adrenergic beta-Antagonists↗

PubMed1984

Effects of Leu5-enkephalin on natural and angiotensin II-induced drinking in the Japanese quail (Coturnix coturnix japonica).

Natural drinking behavior was inhibited by intracranial (ic) injections of Leu5-enkephalin (LEN) (30 and 60 micrograms/100 g) for 60 min, but not by iv injections (30 and 100 micrograms/100 g) in the Japanese quail. Drinking induced by angiotensin II (AII) (30 and 50 micrograms/bird, ip) was also inhibited for 60 min by LEN (40, 60, and 100 micrograms/100 g, ic), given 5 min after the AII injections. Naloxone (3 mg/bird, ip) attenuated the inhibition of LEN (60 micrograms/100 g, ic) and when administered alone (3 mg/bird, ip) induced copious drinking. These results indicated that LEN binds with central opiate receptors to inhibit natural and AII-induced drinking and that endogenous enkephalins physiologically inhibit drinking.

Angiotensin II↗