1
|
Slade T, O'Dean SM, Chung T, Mewton L, McCambridge J, Clare P, Bruno R, Yuen WS, Tibbetts J, Clay P, Henderson A, McBride N, Mattick R, Boland V, Hutchinson D, Upton E, Isik A, Johnson P, Kypri K. The key role of specific DSM-5 diagnostic criteria in the early development of alcohol use disorder: Findings from the RADAR prospective cohort study. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:1395-1404. [PMID: 38923856 DOI: 10.1111/acer.15379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 05/03/2024] [Accepted: 05/04/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Prevention and early intervention of alcohol use disorder (AUD) is a public health priority, yet there are gaps in our understanding of how AUD emerges, which symptoms of AUD come first, and whether there are modifiable risk factors that forecast the development of the disorder. This study investigated potential early-warning-sign symptoms for the development of AUD. METHODS Data were from the RADAR study, a prospective cohort study of contemporary emerging adults across Australia (n = 565, mean age = 18.9, range = 18-21 at baseline, 48% female). Participants were interviewed five times across a 2.5-year period. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) AUD criteria and diagnoses were assessed by clinical psychologists using the Structured Clinical Interview for DSM-IV (SCID-IV), modified to cover DSM-5 criteria. Hazard analyses modeled the time from first alcoholic drink to the emergence of any AUD criteria and determined which first-emergent AUD criteria were associated with a faster transition to disorder. RESULTS By the final time point, 54.8% of the sample had experienced at least one DSM-5 AUD criterion and 26.1% met criteria for DSM-5 AUD. The median time from first AUD criterion to a diagnosis of AUD was 4 years. Social problems from drinking (hazard ratio [HR] = 3.24, CI95 = 2.14, 4.92, p < 0.001), major role (HR = 2.53, CI95 = 1.58, 4.06, p < 0.001), and drinking larger amounts/for longer than intended (HR = 2.04, CI95 = 1.20, 3.46, p = 0.008) were first-onset criteria associated with a faster transition to AUD. CONCLUSION In the context of a prospective general population cohort study of the temporal development of AUD, alcohol-related social problems, major role problems, and using more or for longer than intended are key risk factors that may be targeted for early intervention.
Collapse
Affiliation(s)
- Tim Slade
- The Matilda Centre for Research on Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Siobhan M O'Dean
- The Matilda Centre for Research on Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Tammy Chung
- Department of Psychiatry, Rutgers, Institute for Health, Healthcare Policy and Aging Research, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Louise Mewton
- The Matilda Centre for Research on Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Philip Clare
- National Drug and Alcohol Research Centre, UNSW, Sydney, New South Wales, Australia
- Prevention Research Collaboration, University of Sydney, Sydney, New South Wales, Australia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, UNSW, Sydney, New South Wales, Australia
- School of Psychological Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | - Wing See Yuen
- National Drug and Alcohol Research Centre, UNSW, Sydney, New South Wales, Australia
| | - Joel Tibbetts
- The Matilda Centre for Research on Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Peter Clay
- The Matilda Centre for Research on Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Alexandra Henderson
- National Drug and Alcohol Research Centre, UNSW, Sydney, New South Wales, Australia
| | - Nyanda McBride
- National Drug Research Institute and enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Richard Mattick
- National Drug and Alcohol Research Centre, UNSW, Sydney, New South Wales, Australia
| | - Veronica Boland
- National Drug and Alcohol Research Centre, UNSW, Sydney, New South Wales, Australia
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, UNSW, Sydney, New South Wales, Australia
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Murdoch Children's Research Institute, Centre for Adolescent Health, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, The Royal Children's Hospital Campus, University of Melbourne, Parkville, Victoria, Australia
| | - Emily Upton
- National Drug and Alcohol Research Centre, UNSW, Sydney, New South Wales, Australia
| | - Ashling Isik
- The Matilda Centre for Research on Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Phoebe Johnson
- The Matilda Centre for Research on Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia
| | - Kypros Kypri
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| |
Collapse
|
2
|
Slade T, Mewton L, O'Dean S, Tibbetts J, Clay P, Isik A, Johnson P, McCraw S, Upton E, Kypri K, Butterworth P, McBride N, Swift W. DSM-5 and ICD-11 alcohol use disorder criteria in young adult regular drinkers: Lifetime prevalence and age of onset. Drug Alcohol Depend 2021; 229:109184. [PMID: 34813987 DOI: 10.1016/j.drugalcdep.2021.109184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 10/28/2021] [Accepted: 10/31/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Alcohol Use Disorder (AUD) is a significant contributor to global disease burden. AUD has a relatively early onset during young adulthood (Teesson et al., 2010). However, compared to AUD in adults, we have relatively little understanding of AUD in adolescents and emerging adults. METHODS The RADAR study is a prospective cohort study designed to investigate the emergence of AUD in community-dwelling adolescents and emerging adults across Australia (age range = 18-21 at baseline). At 6 monthly intervals over 2.5 years, participants were interviewed regarding alcohol consumption and alcohol use disorder criteria by clinical psychologists using the SCID-IV-RV. This paper reports the baseline findings of the RADAR cohort. RESULTS Proportions of lifetime criteria endorsement among regular drinkers varied considerably. Tolerance was the most endorsed criterion (50.3%), followed by Social Problems (10.4%) and Larger/Longer (9.0%). The median age of onset for most individual AUD criteria was 18 years of age. 18.4% of our cohort met DSM-5 AUD diagnosis in their lifetime to date, and 16.8% met ICD-11 dependence. When removing Tolerance from the AUD criteria, DSM-5 AUD lifetime prevalence reduced to 11.0%, and ICD-11 AUD lifetime prevalence fell to 7.1% in our cohort. CONCLUSIONS Variable rates of criteria endorsement likely reflect both true differences in the experience of AUD criteria and methodological challenges in the assessment of AUD in an emerging adult age group. High rates of tolerance to the effects of alcohol, and relatively low rates of drinking larger/longer than intended are discussed considering methodological challenges in assessing these criteria in young adults.
Collapse
Affiliation(s)
- Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia.
| | - Louise Mewton
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
| | - Siobhan O'Dean
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Joel Tibbetts
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Peter Clay
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Ashling Isik
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Phoebe Johnson
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Stacey McCraw
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Emily Upton
- National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
| | - Kypros Kypri
- School of Medicine and Public Health, University of Newcastle, NSW, Australia
| | - Peter Butterworth
- Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Wendy Swift
- AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| |
Collapse
|
3
|
Vergés A, Lee MR, Martin CS, Trull TJ, Martens MP, Wood PK, Sher KJ. Not all symptoms of alcohol dependence are developmentally equivalent: Implications for the false-positives problem. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2021; 35:444-457. [PMID: 33956473 PMCID: PMC8184633 DOI: 10.1037/adb0000723] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Recent studies have examined the extent to which alcohol dependence (AD) criteria prospectively predict the course of AD. Critically, these studies have lacked a developmental perspective. However, the differential performance of criteria by age might indicate overendorsement in younger individuals. The current study examined AD criteria in terms of persistence and prediction of AD course and alcohol use by age in order to identify criteria that are likely to be overly endorsed by younger individuals. METHOD The current study used longitudinal data from the National Epidemiologic Survey on Alcohol and Related Conditions to depict age differences in rates of new onset, recurrence, and persistence for each AD criterion, thereby showing how these three factors contribute to the overall age-prevalence curve of each criterion. Additionally, we tested age moderation of the predictive association between each criterion at baseline and new onset, recurrence, and persistence of syndromal AD. RESULTS Some criteria (particularly, persistent desire or unsuccessful efforts to cut down or control drinking, and drinking despite physical/psychological problems) are both less persistent and less predictive of AD course among younger adults compared to older adults. CONCLUSIONS These findings raise the possibility of elevated rates of false-positive AD among younger adults and suggest ways to improve the assessment of AD criteria. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
|
4
|
Wright CJC, Clifford S, Miller M, D'Abbs P, Giorgi C, Crane M, Smith JA. While Woolworths reaps the rewards, the Northern Territory community will be left to clean up the mess. Health Promot J Austr 2021; 32:158-162. [PMID: 33825255 DOI: 10.1002/hpja.488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Cassandra J C Wright
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Australia
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- Burnet Institute, Melbourne, Australia
| | - Sarah Clifford
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Australia
| | - Mia Miller
- The George Institute for Global Health, Newtown, 2042, Australia
| | - Peter D'Abbs
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Australia
| | - Caterina Giorgi
- Foundation for Alcohol Research and Education, Canberra, Australia
| | - Meredythe Crane
- Foundation for Alcohol Research and Education, Canberra, Australia
| | - James A Smith
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Australia
- Freemasons Centre for Male Health and Wellbeing, Menzies School of Health Research
- Collaboration for Evidence, Research and Impact in Public Health, Curtin University, Perth, Australia
| |
Collapse
|
5
|
Identification of heavy drinking in the 10-item AUDIT: Results from a prospective study among 18–21 years old non-dependent German males. J Subst Abuse Treat 2018; 86:94-101. [DOI: 10.1016/j.jsat.2017.12.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 12/21/2017] [Accepted: 12/22/2017] [Indexed: 02/06/2023]
|
6
|
Aiken A, Clare PJ, Wadolowski M, Hutchinson D, Najman JM, Slade T, Bruno R, McBride N, Kypri K, Mattick RP. Age of Alcohol Initiation and Progression to Binge Drinking in Adolescence: A Prospective Cohort Study. Alcohol Clin Exp Res 2017; 42:100-110. [PMID: 29160941 DOI: 10.1111/acer.13525] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 10/09/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Early alcohol initiation is common and has been associated with the development of alcohol problems. Yet, past research on the association of age of initiation with later problem drinking has produced inconsistent findings. Using prospective data from the Australian Parental Supply of Alcohol Longitudinal Study cohort, this study examined age of alcohol initiation, and of first drunkenness, and associations with subsequent drinking in adolescence. METHODS A total of 1,673 parent-child dyads recruited through Australian secondary schools completed annual surveys for 5 years (grades 7 to 11). Limiting the sample to those adolescents who had initiated alcohol use by age 17 (n = 839), multinomial logistic regression models were used to examine associations between (i) age of initiation to alcohol use (consuming at least 1 full serve) and (ii) age of first drunkenness, and 2 outcomes: (i) binge drinking (consuming >4 standard drinks on a single occasion), and (ii) the total number of alcoholic drinks consumed in the past year, adjusted for a range of potential child, parent, family, and peer covariates. RESULTS Fifty percent of adolescents reported alcohol use and 36% reported bingeing at wave 5 (mean age 16.9 years), and the mean age of initiation to alcohol use for drinkers was 15.1 years. Age of initiation was significantly associated with binge drinking and total quantity of alcohol consumed in unadjusted and adjusted models. Age of first drunkenness was associated with total quantity of alcohol consumed in unadjusted models but not adjusted models and was not associated with subsequent bingeing. CONCLUSIONS Initiating alcohol use earlier in adolescence is associated with an increased risk of binge drinking and higher quantity of consumption in late secondary school, supporting an argument for delaying alcohol initiation for as long as possible to reduce the risk for problematic use in later adolescence and the alcohol-related harms that may accompany this use.
Collapse
Affiliation(s)
- Alexandra Aiken
- National Drug & Alcohol Research Centre, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia
| | - Philip J Clare
- National Drug & Alcohol Research Centre, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia
| | - Monika Wadolowski
- Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Delyse Hutchinson
- Faculty of Health, Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Jackob M Najman
- Queensland Alcohol and Drug Research and Education Centre, University of Queensland, Brisbane, Queensland, Australia
| | - Tim Slade
- National Drug & Alcohol Research Centre, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia
| | - Raimondo Bruno
- School of Psychology, University of Tasmania, Hobart, Tasmania, Australia
| | - Nyanda McBride
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Kypros Kypri
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Richard P Mattick
- National Drug & Alcohol Research Centre, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia
| |
Collapse
|
7
|
From alcohol initiation to tolerance to problems: Discordant twin modeling of a developmental process. Dev Psychopathol 2016; 29:845-861. [PMID: 27417028 DOI: 10.1017/s0954579416000523] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The current study examined a stage-based alcohol use trajectory model to test for potential causal effects of earlier drinking milestones on later drinking milestones in a combined sample of two cohorts of Australian monozygotic and same-sex dizygotic twins (N = 7,398, age M = 30.46, SD = 2.61, 61% male, 56% monozygotic twins). Ages of drinking, drunkenness, regular drinking, tolerance, first nontolerance alcohol use disorder symptom, and alcohol use disorder symptom onsets were assessed retrospectively. Ages of milestone attainment (i.e., age-of-onset) and time between milestones (i.e., time-to-event) were examined via frailty models within a multilevel discordant twin design. For age-of-onset models, earlier ages of onset of antecedent drinking milestones increased hazards for earlier ages of onset for more proximal subsequent drinking milestones. For the time-to-event models, however, earlier ages of onset for the "starting" milestone decreased risk for a shorter time period between the starting and the "ending" milestone. Earlier age of onset of intermediate milestones between starting and ending drinking milestones had the opposite effect, increasing risk for a shorter time period between the starting and ending milestones. These results are consistent with a causal effect of an earlier age of drinking milestone onset on temporally proximal subsequent drinking milestones.
Collapse
|
8
|
Morgenstern M, DiFranza JR, Wellman RJ, Sargent JD, Hanewinkel R. Relationship between early symptoms of alcohol craving and binge drinking 2.5 years later. Drug Alcohol Depend 2016; 160:183-9. [PMID: 26832933 DOI: 10.1016/j.drugalcdep.2016.01.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 01/06/2016] [Accepted: 01/07/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND The first self-reported symptoms of nicotine dependence (e.g., as craving) can appear within days to weeks of the onset of occasional use, and the appearance of symptoms predicts future consumption and dependence. We sought to determine whether craving for alcohol occurs in early stages of adolescent alcohol use, and whether it predicts future binge drinking, a prevalent and problematic behavior. METHODS Longitudinal (30-month) four-wave study of 3415 students (M=12.5 years at baseline) from 29 German schools. Students reported five symptoms of alcohol craving on a scale developed based on well-validated measures for tobacco. Multilevel mixed-effects logistic regression was used to predict having five or more binge episodes by last follow-up, based on the number of symptoms reported before the first lifetime binge. Multiple imputation was used to address study drop-out. RESULTS At baseline, 23% reported at least one symptom, increasing to 54% at wave 4. Any report of symptoms at baseline was associated with frequency of alcohol use, being present in 100% of daily, 93% of weekly, 87% of monthly, 48% of infrequent drinkers, and 16% of ever drinkers reporting no current alcohol use. Moreover, symptoms at baseline independently predicted frequent binge drinking 2.5 years later, AOR=2.08 (95% CI 1.39, 3.11; p<0.001) among baseline never-bingers, after adjusting for covariates. CONCLUSIONS Some early-onset drinkers reported symptoms of alcohol craving and loss of control after minimal exposure to alcohol. If replicated, an early screener could be developed to identify those at risk for frequent binge drinking.
Collapse
Affiliation(s)
- Matthis Morgenstern
- Institute for Therapy and Health Research, Kiel, Germany; Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
| | - Joseph R DiFranza
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA, USA
| | - Robert J Wellman
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA, USA
| | - James D Sargent
- Institute for Therapy and Health Research, Kiel, Germany; Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | | |
Collapse
|
9
|
Beesdo-Baum K, Knappe S, Asselmann E, Zimmermann P, Brückl T, Höfler M, Behrendt S, Lieb R, Wittchen HU. The 'Early Developmental Stages of Psychopathology (EDSP) study': a 20-year review of methods and findings. Soc Psychiatry Psychiatr Epidemiol 2015; 50:851-66. [PMID: 25982479 DOI: 10.1007/s00127-015-1062-x] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 04/27/2015] [Indexed: 01/03/2023]
Abstract
PURPOSE The "Early Developmental Stages of Psychopathology (EDSP)" study is a prospective-longitudinal study program in a community sample (Munich, Germany) of adolescents and young adults. The program was launched in 1994 to study the prevalence and incidence of psychopathological syndromes and mental disorders, to describe the natural course and to identify vulnerability and risk factors for onset and progression as well as psychosocial consequences. This paper reviews methods and core outcomes of this study program. METHODS The EDSP is based on an age-stratified random community sample of originally N = 3021 subjects aged 14-24 years at baseline, followed up over 10 years with up to 3 follow-up waves. The program includes a family genetic supplement and nested cohorts with lab assessments including blood samples for genetic analyses. Psychopathology was assessed with the DSM-IV/M-CIDI; embedded dimensional scales and instruments assessed vulnerability and risk factors. RESULTS Beyond the provision of age-specific prevalence and incidence rates for a wide range of mental disorders, analyses of their patterns of onset, course and interrelationships, the program identified common and diagnosis-specific distal and proximal vulnerability and risk factors including critical interactions. CONCLUSIONS The EDSP study advanced our knowledge on the developmental pathways and trajectories, symptom progression and unfolding of disorder comorbidity, highlighting the dynamic nature of many disorders and their determinants. The results have been instrumental for defining more appropriate diagnostic thresholds, led to the derivation of symptom progression models and were helpful to identify promising targets for prevention and intervention.
Collapse
Affiliation(s)
- Katja Beesdo-Baum
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany,
| | | | | | | | | | | | | | | | | |
Collapse
|