Patterns of Alcohol-dependence Symptoms Using a Latent Empirical Approach: Associations with Treatment Usage and Other Correlates

Overview

Journal J Stud Alcohol Drugs

Specialty Psychiatry

Date 2010 Oct 16

PMID 20946744

Citations 9

Authors

Jean Y Ko

Silvia S Martins

S Janet Kuramoto

Howard D Chilcoat

Affiliations

Soon will be listed here.

Abstract

Objective: The aim of this study was to understand the variation in response to alcohol use by identifying classes of alcohol users based on alcohol-dependence symptoms and to compare these classes across demographic characteristics, abuse symptoms, and treatment usage.

Method: Data from combined 2002-2005 National Survey on Drug Use and Health identified 110,742 past-year alcohol users, age 18 years or older. Latent class analysis defined classes based on observed clustering of alcohol-dependence symptoms based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Chi-square statistics were used to test differences in sociodemographic and alcohol-abuse characteristics across classes. Multivariable latent class regressions were used to compare treatment usage across classes.

Results: The four-class model had the best overall fit and identified classes that differed quantitatively and qualitatively, with 2.3% of the users in the most-severe class and 83.8% in the least-severe/ not-affected class. These classes differed in a number of demographic characteristics and alcohol-abuse symptoms. All individuals in the most severe class met DSM-IV criteria for alcohol dependence; 80% of this class had alcohol-abuse symptoms. Twenty-six percent of the moderate and 50% of the moderate-high class met dependence criteria. Approximately 19% of the most-severe class and less than 5% of the moderate and moderate-high class received treatment for alcohol in the past year.

Conclusions: This study demonstrates that meeting dependence criteria only partially captures variations in responses to severity of alcohol problems. Although individuals in the most-severe class were more likely to perceive need and receive treatment, the percentage of individuals receiving treatment was low.

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References

Wu L, Ringwalt C . Alcohol dependence and use of treatment services among women in the community. Am J Psychiatry. 2004; 161(10):1790-7. PMC: 1283120. DOI: 10.1176/ajp.161.10.1790. View

Grant B, Compton W, Crowley T, Hasin D, Helzer J, Li T . Errors in assessing DSM-IV substance use disorders. Arch Gen Psychiatry. 2007; 64(3):379-80. DOI: 10.1001/archpsyc.64.3.379. View

Cohen E, Feinn R, Arias A, Kranzler H . Alcohol treatment utilization: findings from the National Epidemiologic Survey on Alcohol and Related Conditions. Drug Alcohol Depend. 2006; 86(2-3):214-21. DOI: 10.1016/j.drugalcdep.2006.06.008. View

Lynskey M, Nelson E, Neuman R, Bucholz K, Madden P, Knopik V . Limitations of DSM-IV operationalizations of alcohol abuse and dependence in a sample of Australian twins. Twin Res Hum Genet. 2005; 8(6):574-84. DOI: 10.1375/183242705774860178. View

Kessler R, Chiu W, Demler O, Merikangas K, Walters E . Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005; 62(6):617-27. PMC: 2847357. DOI: 10.1001/archpsyc.62.6.617. View

Desai R, Potenza M . Gender differences in the associations between past-year gambling problems and psychiatric disorders. Soc Psychiatry Psychiatr Epidemiol. 2007; 43(3):173-83. PMC: 3700360. DOI: 10.1007/s00127-007-0283-z. View

Hasin D, Paykin A . Alcohol dependence and abuse diagnoses: concurrent validity in a nationally representative sample. Alcohol Clin Exp Res. 1999; 23(1):144-50. View

Grant B, Harford T, Muthen B, Yi H, Hasin D, Stinson F . DSM-IV alcohol dependence and abuse: further evidence of validity in the general population. Drug Alcohol Depend. 2006; 86(2-3):154-66. DOI: 10.1016/j.drugalcdep.2006.05.019. View

Hasin D, Stinson F, Ogburn E, Grant B . Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry. 2007; 64(7):830-42. DOI: 10.1001/archpsyc.64.7.830. View

10.

Hasin D, Grant B, Endicott J . The natural history of alcohol abuse: implications for definitions of alcohol use disorders. Am J Psychiatry. 1990; 147(11):1537-41. DOI: 10.1176/ajp.147.11.1537. View

11.

Bucholz K, Heath A, Reich T, Hesselbrock V, Kramer J, Nurnberger Jr J . Can we subtype alcoholism? A latent class analysis of data from relatives of alcoholics in a multicenter family study of alcoholism. Alcohol Clin Exp Res. 1996; 20(8):1462-71. DOI: 10.1111/j.1530-0277.1996.tb01150.x. View

12.

Moss H, Chen C, Yi H . DSM-IV criteria endorsement patterns in alcohol dependence: relationship to severity. Alcohol Clin Exp Res. 2007; 32(2):306-13. DOI: 10.1111/j.1530-0277.2007.00582.x. View

13.

Grant B, Dawson D, Stinson F, Chou S, Dufour M, Pickering R . The 12-month prevalence and trends in DSM-IV alcohol abuse and dependence: United States, 1991-1992 and 2001-2002. Drug Alcohol Depend. 2004; 74(3):223-34. DOI: 10.1016/j.drugalcdep.2004.02.004. View

14.

Turner C, Ku L, Rogers S, Lindberg L, Pleck J, Sonenstein F . Adolescent sexual behavior, drug use, and violence: increased reporting with computer survey technology. Science. 1998; 280(5365):867-73. DOI: 10.1126/science.280.5365.867. View

15.

Hasin D, Hatzenbuehler M, Keyes K, Ogburn E . Substance use disorders: Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) and International Classification of Diseases, tenth edition (ICD-10). Addiction. 2006; 101 Suppl 1:59-75. DOI: 10.1111/j.1360-0443.2006.01584.x. View

16.

Nelson C, Heath A, Kessler R . Temporal progression of alcohol dependence symptoms in the U.S. household population: results from the National Comorbidity Survey. J Consult Clin Psychol. 1998; 66(3):474-83. DOI: 10.1037//0022-006x.66.3.474. View

17.

Delucchi K, Matzger H, Weisner C . Dependent and problem drinking over 5 years: a latent class growth analysis. Drug Alcohol Depend. 2004; 74(3):235-44. DOI: 10.1016/j.drugalcdep.2003.12.014. View

18.

Edwards G, Gross M . Alcohol dependence: provisional description of a clinical syndrome. Br Med J. 1976; 1(6017):1058-61. PMC: 1639901. DOI: 10.1136/bmj.1.6017.1058. View

19.

McLellan A, Lewis D, OBrien C, KLEBER H . Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation. JAMA. 2000; 284(13):1689-95. DOI: 10.1001/jama.284.13.1689. View