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PubMed2003

Methodological issues in measuring alcohol use.

Various methodological issues influence the measurement of alcohol consumption in surveys. One factor is the reference period for which questions are asked--that is, whether respondents are asked for an exact recall of their intake during a short, recent period or for a summary of their drinking behavior over a longer period, such as the past year. Longer recall periods provide sufficient time to link consumption data with concurrently collected data on the prevalence of alcohol-related outcomes. Another factor influencing survey results is the approach used to measure alcohol consumption. Two commonly used measures are the usual quantity/frequency (QF) and graduated frequency (GF) approaches, both of which allow researchers to estimate the volume of alcohol intake. Other issues that researchers conducting surveys should consider include the use of beverage-specific versus overall questions, open-ended versus categorical responses, and measurement of standard versus actual drink sizes. Finally, features of the overall survey design--such as the mode of interview (i.e., in person versus by telephone), the use of computerized survey instruments, and measures to ensure confidentiality--influence the reliability and validity of the data.

Alcohol Drinking↗

PubMed2004

Nefazodone treatment of comorbid alcohol dependence and major depression.

BACKGROUND: Major depression is a common comorbid condition among individuals with alcohol dependence. This study examined the effects of nefazodone, a norepinephrine and serotonin reuptake blocker and 5-hydroxytryptamine-2 receptor antagonist, on mood and anxiety symptoms and drinking behavior in a sample of depressed alcoholics. METHODS: This study was a double-blind, placebo-controlled comparison of nefazodone (200-600 mg/day) or placebo in a sample of alcohol-dependent subjects (n = 41; 52% women) with current major depression. After a 1-week placebo lead-in period, subjects were randomly assigned to receive study medication and supportive psychotherapy for 10 weeks. RESULTS: Depressive and anxiety symptoms declined significantly over time. Although the nefazodone group showed greater reductions in these symptoms, the effects did not reach statistical significance. Nonetheless, nefazodone-treated subjects showed a significantly greater reduction in heavy drinking days and in total drinks compared with placebo-treated subjects. CONCLUSIONS: The lack of significant effects on depression and anxiety symptoms may reflect limited statistical power. Despite the small sample size, nefazodone significantly reduced some measures of alcohol consumption in this sample of depressed alcoholics.

Adult↗

PubMed1993

A program of screening and prompting improves short-term physician counseling of dependent and nondependent harmful drinkers.

BACKGROUND: Physicians in the general medical setting commonly encounter but rarely counsel patients with dependent or harmful drinking behaviors. We tested whether providing physicians with their patients' results on the alcohol module of the Diagnostic Interview Schedule and counseling directives would prompt them to counsel these patients. METHODS: We randomly assigned 83 first-, second-, and third-year medical residents to receive or not to receive diagnostic information and counseling directives on 214 patients who reported at least one symptom of alcohol impairment as defined in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition. Using binary logistic regression, we examined the effect of specific covariables on rates of physician counseling. These variables included physician information status, patient gender, and drinking disorder severity and recency. We also examined the effect of physician prompting on counseling of female patients, patients with inactive disorders, and nondependent but harmful drinkers. We determined counseling by post-visit patient interviews. RESULTS: Physician prompting, dependent drinking, and recent disorder activity were significant correlates of physician counseling (P < .05), while male gender was a marginally significant correlate (P = .08). Informed physicians counseled female patients, harmful but nondependent drinkers, and patients with inactive disorders more often than their uninformed colleagues, although only the last variable achieved statistical significance. CONCLUSIONS: Providing physicians with the results of the Diagnostic Interview Schedule and counseling directives resulted in short-term improvement in their rates of counseling patients with a history of dependent or nondependent but harmful drinking. Further research is necessary to determine long-term gains in rates of physician counseling and improvements in the course of these patients.

Alcoholism↗

PubMed1990

Cognitive functioning in young "social drinkers": is there impairment to detect?

Literature on the cognitive effects of nonexcessive alcohol use suggests that relatively high-quantity-per-occasion use may be related to subsequent decreases in sober-state abstracting skills in adults, but provides no clear prediction for youth. The need to identify persistent alcohol-intake effects on cognition is particularly acute for the period of adolescence and young adulthood because even slight damage may impair developmentally significant skills. We examine the relation between multiple measures of neuropsychological status and both continuous and categorical measures of alcohol-use patterns in an age- and sex-stratified sample of 1,308 18-, 21-, and 24-year-olds. The results of correlational and hierarchial regression analyses suggest that cognitive performance bears little direct relation to drinking behaviors in young nonclinical males and females. Although the data provide no strong support for the hypothesis of a causal relationship between alcohol use and cognitive functioning, there is a slight suggestion that frequent high-quantity consumption may become a salient parameter of use as subjects age. Prospective longitudinal data are needed to explore the directional causality of effects.

Adolescent↗

PubMed1995

CYP2E1 and ALDH2 genotypes and alcohol dependence in Japanese.

The genotypes of the CYP2E1 and ALDH2 loci of alcoholic (alcohol dependence) and nonalcoholic (healthy) Japanese were investigated to examine the relationship between the polymorphism of CYP2E1 (C1/C2) and ALDH2 (ALDH2*1/ALDH2*2), and the susceptibility to alcoholism. There was no significant difference in C2 gene frequency between alcoholics (0.19) and nonalcoholics (controls) (0.20), whereas there was a significant difference in ALDH2 allele frequency, suggesting that, in Japanese, the C2 genotype of CYP2E1 may have nothing to do with the risk of developing alcohol dependence. However, the ALDH2*1 allele may influence drinking behavior and the development of alcohol dependence. Furthermore, racial interethnic differences in the frequency of the mutated allele of the CYP2E1 gene (C2) were found, like the ALDH2 gene. Japanese healthy controls showed a significantly higher frequency of the C2 allele than did Swedish healthy controls (0.05; reported by Persson et al., FEBS Lett. 319:207-211, 1993).

Alcohol Drinking↗

PubMed2000

Building mental health professionals' decisional models into tests of predictive validity: the accuracy of contextualized predictions of violence.

To safely manage potentially violent patients in the community, mental health professionals (MHPs) must assess when and under what conditions a patient may be involved in a violent act. This study applies a more ecologically sensitive approach than past research by building the conditions that MHPs believe make patient violence more likely into tests of their predictive validity. In specific, the accuracy of MHPs' predictions that patients were more likely to become violent when they consumed alcohol was assessed based on a sample of 714 patients. The results indicate that MHPs do not discriminate well between patients who are likely to become violent during periods in which they drink from those who are not. MHPs' predictions appear more descriptive of the drinking behavior of a high-risk group than predictive of alcohol-related violent incidents. Thus, even when their apparent decisional processes are considered in tests of accuracy, MHPs' predictions of violence are only moderately more accurate than chance. This paper analyzes the implications of these findings for risk assessment practice and for conducting further clinically relevant research.

Adolescent↗

PubMed1993

Alcohol use and aquatic activities--United States, 1991.

Drowning, a leading cause of death from unintentional injury in the United States, accounted for approximately 4600 fatalities in 1991 (1,2). Although 25%-50% of adolescents and adults who drowned had consumed alcohol near the time of death (3), information regarding drinking behaviors during aquatic activities is limited. To assist in refining strategies for prevention of alcohol-related injury in aquatic settings, during July 15-September 30, 1991, the Boston University School of Public Health surveyed a national sample of adolescents and adults regarding their participation in aquatic activities and associated alcohol use. This report summarizes these findings.

Accident Prevention↗

PubMed1983

Stimulation of blowfly feeding behavior by octopaminergic drugs.

Adult blowflies (Phormia regina Meigen) injected with the octopaminergic drug demethylchlordimeform (10 mug per fly) exhibited enhanced proboscis extension responses when their tarsae were touched to water or aqueous sucrose. They drank more water than saline-injected control flies did but the quantity imbibed was within the normal fluid intake capacity. They became grossly hyperphagic when offered 1 M sucrose, doubling (and in some cases even tripling) their initial body weights. Three other drugs enhanced tarsal responsiveness and induced hyperphagia: DL-octopamine, clonidine (which is known to stimulate octopaminergic receptors in insects), and pargyline, a monoamine oxidase inhibitor. Yohimbine, an antagonist of one class of octopaminergic receptor in insects, prevented the hyperphagia induced by all four drugs. Dopamine, 5-hydroxytryptamine, and DL-norepinephrine failed to cause hyperphagia. These results suggest that octopaminergic receptors in the nervous system of the blowfly positively modulate feeding and drinking behavior.

Journal Article↗

PubMed1997

Mechanism of attenuated thirst in aging: role of central volume receptors.

To test the hypothesis that the inhibitory action of central blood volume expansion on thirst and renal fluid regulation is attenuated with aging, we monitored the drinking and renal responses of dehydrated older (70 +/- 2 yr, n = 6) and younger (24 +/- 1 yr, n = 6) subjects during 195 min of head-out water immersion (HOI), which shifts blood centrally and increases plasma volume (PV). Subjects dehydrated by exercising for 2 h at 36 degrees C in the evening and refraining from fluids overnight before HOI in 34 degrees C water or a seated control in water perfusion suit [time control (TC)] the next morning. Ad libitum water intake was allowed after 15 min of HOI. Dehydration decreased PV by 10.6 +/- 1 and 7.3 +/- 1.8% (P < 0.05) and increased plasma osmolality by 6 +/- 2 and 7 +/- 1 mosmol/kg H2O (P < 0.05) in older and younger subjects, respectively. Thirst ratings increased in both groups, but pre-HOI thirst perception on a line rating scale was lower in older (69 +/- 8 mm) than younger (94 +/- 6 mm, P < 0.05) subjects. Fifteen minutes of HOI restored PV by 7.8 +/- 1.0 and 5.7 +/- 1.0% in older and younger subjects, respectively, but suppressed thirst rating in younger subjects only (P < 0.05). Fluid intake was reduced in HOI compared with TC in younger (6.3 +/- 0.5 vs. 14.3 +/- 2.2 ml/kg, P < 0.05) but not in older (6.7 +/- 2.1 vs. 8.4 +/- 3.3 ml/kg) subjects. During HOI, older subjects had smaller suppression of plasma renin activity and aldosterone concentration but a greater increase in the plasma atrial natriuretic peptide concentration (P[ANP], P < 0.05). HOI increased fractional sodium excretion in both groups, but mean arterial pressure increased only in the older subjects (P < 0.05). We conclude that the inhibitory influence of central volume expansion on thirst and drinking behavior is diminished with aging. Furthermore, in contrast to younger people, HOI natriuresis is associated with exaggerated increases in P[ANP] and arterial blood pressure in older people, suggesting arterial baroreceptors may be involved in the fluid regulatory response to central blood volume expansion in older people.

Adult↗

PubMed2005

[Nationwide survey of alcohol drinking and alcoholism among Japanese adults].

PURPOSE: To investigate the characteristics of alcohol use among Japanese adults and prevalence of alcohol dependence in Japan, we conducted a nationwide survey on alcohol drinking behavior and alcohol dependence among Japanese adults using a representative sampling method. METHODS: We sampled 3500 adults from throughout the entire country using a stratified random sampling method with two-step stratification, and carried out a home visit interview survey. A total of 2547 people (72.8%) responded to the survey. The survey period was June, 2003. The questionnaire contained questions about the frequency and quantity of alcohol use, 'hazardous use of alcohol' and 'alcohol dependence' according to the ICD-10 definition, several screening scales on problem use of alcohol (CAGE, KAST, AUDIT), life-time prevalence of 24 alcohol related diseases, smoking status, dysgryphia, and nightcap drinking. RESULTS: The number of respondents was, 1184 males, and 1363 females. Lifetime alcohol drinking, and weekly drinking, and daily drinking rates were 95.1%, 64.4%, and 36.2% for males, 79.0%, 27.5%, and 7.5% for females, respectively. Average daily alcohol consumption was 3.7 units for males, and 2.0 units for females (1 unit = 10 g pure alcohol). The proportion of drinkers who drank alcohol 4 units or more daily was 28.9% for males, and 7.6% for females, and that for 6 units or more was 12.7% for males, and 3.4% for females. The proportion of flasher was 41.2% for males, and 35.0% for females. Among screening questions, problem drinking was most frequently identified using AUDIT (score 12 points or more, 150 persons), followed by KAST (2 points or more, 100 persons) and CAGE (2 points or more, 98 persons). The number of subjects who met the ICD-10 criteria for alcohol dependence was 24, while the number who engaged in hazardous alcohol use was 64. CONCLUSIONS: This study revealed that problem drinking and alcohol dependence are a serious problem in Japanese general population. The problem of females drinking may be growing. The government should emphasize the prevention of alcohol drinking problems in adults and continue the conduct of nationwide prevalence surveys to monitor the problem.

Adult↗

PubMed1994

Modifying alcohol-related expectancies in grade-school children.

Expectancies for reinforcement from alcohol appear to form during the grade-school years and play a causal role in problem drinking behavior. Using a sample of 268 second through fourth graders, we investigated whether children's expectancies could be modified successfully. Children were randomly assigned to one of four conditions: two experimental expectancy modification conditions (using 10-minute video interventions), one control condition involving a 10-minute video presenting facts concerning alcohol's deleterious effects, and one no-intervention control condition. Relative to controls, expectancies were increased by one experimental condition and decreased by the other; these changes were sustained at 4-week follow-up. This suggests expectancy modification should be tested as an adjunct to current prevention programs. Relations of gender and family history of problem drinking or alcoholism to expectancy endorsement are described.

Alcohol Drinking↗

PubMed2002

betagamma Dimers mediate synergy of dopamine D2 and adenosine A2 receptor-stimulated PKA signaling and regulate ethanol consumption.

Dopamine release is activated by ethanol and addicting drugs, but molecular mechanisms linking dopaminergic signaling to neuronal responses and drinking behavior are poorly understood. We report that dopamine-D2 receptors induce PKA Calpha translocation and increase CRE-regulated gene expression. Ethanol also activates PKA signaling. Subthreshold concentrations of the D2 agonist NPA and ethanol, without effect alone, together cause synergistic PKA translocation and CRE-mediated gene transcription. D2 or adenosine A2 receptor blockade, pertussis toxin, Rp-cAMPS, or overexpression of dominant-negative peptides that sequester betagamma dimers prevent synergy. Importantly, overexpression of a betagamma inhibitor peptide in the nucleus accumbens strikingly reduces sustained alcohol consumption. We propose that synergy of D2 and A2 confers ethanol hypersensitivity and that betagamma dimers are required for voluntary drinking.

Adenoviridae↗

PubMed1986

Sex differences in drinking among medical students: patterns and psychosocial correlates.

Societal changes in sex roles have led to an increased interest in the comparative drinking behaviors of men and women and in their psychosocial antecedents. The differential prevalence and psychosocial correlates of alcohol consumption in a cohort of 107 men and 46 women first-year medical students are addressed. Self-report questionnaires assessed quantity, frequency and variability in the consumption of beer, wine and distilled spirits; early parent-child relationships; internal-external locus of control; interpersonal dependency; social supports; and depressive symptomatology. From analyses of variance, the data show that the men consume beer more frequently and in greater quantities. The sexes do not differ in the consumption of wine or distilled spirits. In addition, several psychosocial variables relate to drinking patterns in opposite directions for men and women. Heavier drinking among women is significantly associated with perceived childhood parental warmth and low depressive symptomatology. The opposite is true for men, although these relationships are much weaker. Future research should address sex differences in the symbolic meaning and implications of alcohol use in different socioeconomic and occupational groups.

Adult↗

PubMed2006

It does the job: Young adults discuss their malt liquor consumption.

Young adult men and women (N=53) who regularly consume malt liquor (i.e., 40 oz/week) participated in 10 semi-structured focus groups. Group transcripts were analyzed using a multilevel process that focused on recurring themes across multiple groups. Commonly identified themes encompassed positive and negative qualities of malt liquor as well as contexts in which malt liquor was consumed. Some of the themes were corroborated by quantitative data on drinking behavior and other variables. The focus groups were designed to explore the unique characteristics of malt liquor (low price, high alcohol content, large volume packaging) that enhance consumption patterns and increase risk for excessive alcohol use. The combination of qualitative and quantitative data provides a unique and useful perspective for identifying issues for future research on malt liquor consumption.

Adult↗

PubMed2006

A within-subjects validation of a group-administered timeline followback for alcohol use.

OBJECTIVE: The current study uses a within-subjects randomized design with the Timeline Followback (TLFB) method administered in groups or to individuals to determine the equivalence of these methods. METHOD: One hundred and four male and female college students who reported drinking at least once in the past 3 months completed the TLFB during a one-on-one interview, as well as in a group setting days apart. The two administrations were counterbalanced among the participants. Drinking variables assessed were drinking days, average drinks, total drinks, and maximum drinks consumed both during a 3-month (90 days) and a 1-month (30 days) period. RESULTS: Repeated measures analyses revealed no differences within subjects between the individual TLFB and the group TLFB on any of the four assessed drinking variables in the past 3 months and the past 1 month. Pearson's correlation coefficients revealed strong and significant correlations between the two administration styles. Heavy episodic drinking behavior was similar across administration styles as well. No differences between administration styles were consistent regardless of which administration was received first. CONCLUSIONS: The study suggests that the group TLFB yields similarly accurate results to the previously validated individual TLFB. The group-administered TLFB could be used in clinical and research settings as an efficient means of collecting information from large numbers of individuals.

Adolescent↗

PubMed1993

Imipramine treatment of alcoholism with comorbid depression.

Of 60 depressed alcoholics who completed an open trial of imipramine, 27 (45%) responded with improvement in both mood and drinking behavior, and eight (13%) responded after further dosage increases or treatment with disulfiram. In a subsequent 6-month, randomized discontinuation trial, four of 13 subjects (31%) relapsed during imipramine treatment and seven of 10 (70%) relapsed while taking placebo. This suggests a potential treatment approach for a high-risk subgroup of alcoholics.

Adult↗

PubMedDate not supplied

Formative and effectiveness evaluation of a worksite program promoting healthy alcohol consumption.

PURPOSE: This project involved the formative and effectiveness evaluation of a program aiming to enable working, nondependent drinkers to consume alcohol in a healthy and socially responsible fashion. DESIGN: A baseline survey (n=387) of employee needs and interests was followed by a formative evaluation testing accessibility, interest/resistance, and potential effectiveness. The formative evaluation used successive iterations of focus groups. The subsequent effectiveness evaluation (n=268) used a randomized pre-post design with three conditions: alcohol program, placebo (nutrition) program, or no program. SETTINGS AND SUBJECTS: The program was implemented in a multi-branch, blue-collar, shiftworking organization (n=813) in four Quebec cities with many mobile workers. INTERVENTION: The worksite alcohol program consisted of two, half-hour sessions delivered one week apart by a health professional during paid time. The program provided information on the social and personal costs of alcohol, on strategies for promoting socially responsible drinking, and for the prevention of negative consequences of intoxication for oneself and one's family and friends. MEASURES: Constructs measured using self-administered questionnaires were: alcohol knowledge, socially responsible attitudes, perceived self-efficacy for drinking management, and self-reported drinking behavior. RESULTS: Despite the lack of interest in the topic (as found in the needs and interests survey), the program was effective in promoting socially responsible attitudes and reducing self-reported weekly consumption among participants. Some placebo effects were also present. Participants were not completely representative of all employees. CONCLUSION: Worksite alcohol health promotion programs can be effective especially when promoting socially responsible attitudes.

Alcohol Drinking↗

PubMed2002

The neuronal nitric oxide synthase gene is critically involved in neurobehavioral effects of alcohol.

In the present study, we describe a new role of the neuronal nitric oxide synthase (nNOS) gene in the regulation of alcohol drinking behavior. Mice deficient in the nNOS gene (nNOS -/-) and wild-type control mice were submitted to a two-bottle free-choice procedure with either water or increasing concentrations of alcohol (2-16%) for 6 weeks. nNOS -/- mice did not differ in consumption and preference for low alcohol concentrations from wild-type animals; however, nNOS -/- mice consumed sixfold more alcohol from highly concentrated alcohol solutions than wild-type mice. Taste studies with either sucrose or quinine solutions revealed that alcohol intake in nNOS -/- and wild-type mice is associated, at least in part, with sweet solution intake but not with the taste of bitterness. When compared with wild-type mice, the nNOS -/- mice were found to be less sensitive to the sedative effects of ethanol as measured by shorter recovery time from ethanol-induced sleep and did not develop rapid tolerance to ethanol-induced hypothermia, although plasma ethanol concentrations were not significantly different from those of controls. Our findings contrast with previous reports that showed that nonselective NOS inhibitors decrease alcohol consumption. However, because alcohol consumption was suppressed in wild-type as well as nNOS -/- mice by the NOS inhibitor N(G)-nitro-L-arginine methyl ester, we conclude that the effect of nonselective NOS inhibitors on alcohol drinking is not mediated by nNOS. Other NOS isoforms, most likely in the periphery or other splice variants of the NOS gene, might contribute to the effect of nonselective NOS inhibitors on alcohol drinking. In summary, the nNOS gene is critically involved in the regulation of neurobehavioral effects of alcohol.

Administration, Oral↗