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Adams RS, McKetta SC, Jager J, Stewart MT, Keyes KM. Cohort effects of women's mid-life binge drinking and alcohol use disorder symptoms in the United States: Impacts of changes in timing of parenthood. Addiction 2023; 118:1932-1941. [PMID: 37338343 PMCID: PMC10527386 DOI: 10.1111/add.16262] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/02/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND AND AIMS Alcohol use is increasing among women in mid-life concurrently with societal changes in timing of parenthood and changing cultural norms, which may influence alcohol use. The aim of this study was to determine if age of first parenting was associated with excessive drinking [i.e. past 2-week binge drinking and past 5-year alcohol use disorder (AUD) symptoms] among women during mid-life in the United States and to determine if there were pronounced cohort effects influencing these relationships. DESIGN This was a retrospective cohort, longitudinal study. SETTING, PARTICIPANTS AND MEASUREMENTS Data were drawn from the Monitoring the Future survey, an annual ongoing survey of high school students' substance use behaviors in the United States. Participants were women who completed the age 35 survey between 1993 and 2019, corresponding to high school senior years 1976-2002 (n = 9988). Past 2-week binge drinking and past 5-year AUD symptoms were self-reported. Age of first parenting was self-reported. FINDINGS Binge drinking and AUD symptoms were higher among women in recent than in older cohorts. Women from the 2018-19 cohort had increased odds of binge drinking [odds ratio (OR) = 1.73, 95% confidence interval (CI) = 1.41-2.12] and AUD symptoms (OR = 1.51, CI = 1.27-1.80) relative to women from the 1993-97 cohort. Throughout cohorts, there was an inverse association between transition to parenthood and excessive drinking outcomes (e.g. range for ORs for binge drinking among those without children compared with those who had had children between the ages of 18 and 24: 1.22-1.55). Simultaneously, there was a population shift towards delaying parenting in recent cohorts (i.e. 54% of women in the 1993-97 cohort had children before age 30 compared with 39% in the two recent cohorts), increasing the size of the group at highest risk for excessive drinking. CONCLUSIONS In the United States, subgroups of women at highest risk of excessive drinking appear to be expanding, probably supported in part by a trend towards delayed parenting.
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Affiliation(s)
- Rachel Sayko Adams
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
- Rocky Mountain Mental Illness Research Education and Clinical Center, Veterans Health Administration, Aurora, CO, USA
| | - Sarah C McKetta
- Department of Population Medicine, Harvard Medical School, Boston, MA, USA
| | - Justin Jager
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
| | - Maureen T Stewart
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
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Ventura CAA, Moll MF, Zanardo ABR, Ferreira PS, Eugenio SJ, de Ávila Domingos SG. Risk and Protective Factors for the Use of Illicit Drugs: Perspective of the Users. J Addict Nurs 2023; 34:E65-E73. [PMID: 37669346 DOI: 10.1097/jan.0000000000000541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
ABSTRACT This article aimed to describe the perspective of people who make harmful use of illicit substances on the contributions of risk and protective factors to the development of problems related to drug use. One hundred eleven participants were recruited from a health service for drug users in a city in the interior of the state of São Paulo through posters with information, distribution of brochures, and snowball sampling technique. The sample consists of 51.9% men and 48.1% women, with 81.3% single and 10.3% married. Among them, 54.2% of participants completed high school, 64.1% were Catholic, and 34% rarely practiced their religion. The results on risk factors were classified into three domains, namely, "personal characteristics and behaviors," "family circumstances," and "other social pressures," and those on protective factors were also classified into three domains, namely, "personal characteristics and behaviors," "family circumstances," and "circumstances in the community." The data make it possible to guide the incorporation of multiple strategies to protect the consumption of illicit drugs in human biopsychosocial development, especially among children and adolescents.
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Edwards AC, Ohlsson H, Barr PB, Sundquist J, Kendler KS, Sundquist K. Military service and risk of subsequent drug use disorders among Swedish men. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1039-1048. [PMID: 36680575 PMCID: PMC10916707 DOI: 10.1007/s00127-023-02426-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 01/12/2023] [Indexed: 01/22/2023]
Abstract
PURPOSE Environmental factors contribute substantially to risk for drug use disorders (DUD). The current study applies multiple methods to empirically test whether military service is associated with subsequent DUD, as previous findings are inconsistent. METHODS Longitudinal Swedish national registry data on a cohort of male conscripts born 1972-1987 (maximum N = 485,900) were used to test the association between military service and subsequent registration for DUD. Cox proportional hazard models were used in preliminary analyses, followed by three methods that enable causal inference: propensity score models, co-relative models, and instrumental variable analysis. RESULTS Across all methods, military service was causally associated with lower risk of DUD. Hazard ratios ranged from HR = 0.43 (95% confidence intervals [CI] 0.37; 0.50) in the instrumental variable analysis to 0.77 (0.75; 0.79) in the multivariate propensity score matching analysis. This effect diminished across time. In the model including a propensity score, HRs remained below 1 across the observation period, while confidence intervals included 1 after ~ 11 years in the co-relative analysis and after ~ 21 years in the instrumental variable analysis. CONCLUSIONS In this cohort of Swedish men, complementary methods indicate that military service conferred substantial but time-limited protection against subsequent DUD. The observed effect could be due to reduced opportunity for substance use during service, social cohesion experienced during and after service, and/or socioeconomic advantages among veterans. Additional research is necessary to clarify these protective mechanisms and determine how other environmental contexts can provide similar benefits.
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Affiliation(s)
- Alexis C Edwards
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Box 980126, RichmondRichmond, VA, 23298-0126, USA.
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Peter B Barr
- Department of Psychiatry and Behavioral Sciences, State University of New York-Downstate, Brooklyn, NY, USA
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kenneth S Kendler
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Box 980126, RichmondRichmond, VA, 23298-0126, USA
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Zhang T, Yang C, Shu G, Gao C, Ma H, Zou L, Zuo J, Liu S, Yan J, Hu Y. The direct and mediating effects of cognitive impairment on the occurrence of falls: a cohort study based on community-dwelling old adults. Front Med (Lausanne) 2023; 10:1190831. [PMID: 37359023 PMCID: PMC10285398 DOI: 10.3389/fmed.2023.1190831] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/18/2023] [Indexed: 06/28/2023] Open
Abstract
Background Cognitive impairment has been reported to be associated with falls in older adults. However, the complex relationship among falls, cognitive impairment and its associated factors, which could be targeted with specific interventions, remains to be elucidated. This study aimed to examine the direct effects of cognitive impairment on falls, to identify the factors associated with cognitive impairment and to explore the mediation role of cognitive impairment in the association of fall with cognition related factors. Methods This 1-year follow-up cohort study enrolled old adults aged 60 years or over. Information about demographic and anthropometric characteristics, fall outcomes, function and nutritional status were collected through face-to-face interview. Cognitive function was evaluated by the Montreal Cognitive Assessment (MoCA). Multivariable regression analyses were used to test the association between cognitive impairment and falls and to identify the factors related to cognitive impairment. Additionally, we conduct causal mediation analyses to estimate the mediation effects of cognitive impairment in the pathways of fall occurrence. Results Of the 569 participants included in this study, 366 (64.32%) had cognitive impairment, 96 (16.87%) had fall history in the past 1 year, 81 (14.24%) experienced fall and 47 (8.26%) received treatment because of falling during the 1-year follow-up. The association between cognitive impairment and 1-year fall risk was confirmed after adjusting for multiple covariates [odds ratio (OR):2.03, 95% confidence interval (CI): 1.13-3.80]. IADL disability, depression and low grip strength were associated with a higher prevalence of cognitive impairment. While overweight, higher education and higher income level were found to be related to a lower risk of cognitive impairment. Among these associated factors, cognitive impairment mediated the positive association of falling with IADL ability and depression, and a negative relationship with education and income level. Conclusion Our study not only confirmed the direct influence of cognitive impairment on fall risk in older adults, but also suggested a mediating role that cognitive impairment played in the pathways of fall occurrence. Our finding could help develop more specific interventions for fall prevention.
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Affiliation(s)
- Tianyi Zhang
- Institution of Hospital Management, Department of Medical Innovation and Research, Chinese PLA General Hospital, Beijing, China
| | - Cunmei Yang
- Geriatric Health Care Department 4th of The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Gangming Shu
- Geriatric Health Care Department 4th of The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Chang Gao
- Geriatric Health Care Department 4th of The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Hongying Ma
- Geriatric Health Care Department 4th of The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Lin Zou
- Geriatric Health Care Department 1st of The Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jing Zuo
- Geriatric Health Care Department 1st of The Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Shaoni Liu
- Geriatric Health Care Department 1st of The Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jin Yan
- Graduate School of Chinese PLA General Hospital, Beijing, China
| | - Yixin Hu
- Geriatric Health Care Department 4th of The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
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Patrick ME, Pang YC, Jang BJ, Arterberry B, Terry-McElrath YM. Alcohol Use Disorder Symptoms Reported during Midlife: Results from the Monitoring the Future Study among US Adults at Modal Ages 50, 55, and 60. Subst Use Misuse 2023; 58:380-388. [PMID: 36617891 PMCID: PMC9892341 DOI: 10.1080/10826084.2022.2161826] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The extent to which adolescent substance use is associated with alcohol use disorder (AUD) symptoms in midlife is not yet fully explored. METHODS Longitudinal data from the national Monitoring the Future study was used. The sample included 11,830 12th graders (1976-1987) who were surveyed again at modal ages 50 (37.8%), 55 (46.3%), or 60 (15.8%) in 2008-2019. Approximately 48.7% were male; 81.5% identified as non-Hispanic White. Weighted logistic and multinomial logistic regressions were used to examine associations between past 30-day use of cigarettes, marijuana, and alcohol at age 18, sociodemographics, and a midlife AUD symptom outcome (coded as non-drinking, drinking without AUD [endorsed ≤1 criterion], or AUD symptoms [endorsed 2+ criteria]). RESULTS Prevalence of midlife AUD symptoms was 27.1%. Higher relative risk of reporting AUD symptoms (vs. drinking without AUD) was associated with age 18 substance use (any cigarette use [vs. no use], any marijuana use [vs. no use], binge drinking [vs. both no use and drinking at less than binge levels]), being male (vs. female), being non-Hispanic White (vs. non-Hispanic Black), and having a 4-year college degree. Higher relative risk of reporting non-drinking (vs. drinking without AUD) was associated with no 30-day alcohol use at age 18, being non-Hispanic Black or non-Hispanic other (vs. non-Hispanic White), and not having a 4-year college degree. CONCLUSIONS Findings suggest substance use at age 18 has meaningful associations with midlife AUD symptoms. Dissemination of prevention and intervention efforts in adolescence and early adulthood may be important for reducing hazardous midlife drinking.
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Affiliation(s)
- Megan E. Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Yuk C. Pang
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Bohyun Joy Jang
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Brooke Arterberry
- Institute for Social Research, University of Michigan, Ann Arbor, MI
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Mohammed F, Geda B, Yadeta TA, Dessie Y. Profiles and factors associated with schizophrenia in eastern Ethiopia: A matched case-control study. Front Psychiatry 2022; 13:1016005. [PMID: 36311517 PMCID: PMC9606421 DOI: 10.3389/fpsyt.2022.1016005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/27/2022] [Indexed: 11/25/2022] Open
Abstract
Background Despite its strong hereditary and genetic connections, there are other factors reported to be linked to schizophrenia, but not well studied in eastern Ethiopia. Objective This study was aimed to investigating the potential profiles and factors associated with schizophrenia in eastern Ethiopia. Materials and methods A matched case-control study was conducted in two public hospitals from December 1, 2021, to January 30, 2022. Cases were patients with schizophrenia who visited the hospitals, and controls were healthy individuals without any mental illness who visited the same hospitals. A questionnaire was used to collect the data. Cases and controls were matched using age and sex. STATA-14 was used for analysis. A conditional logistic regression with an adjusted odds ratio (AOR) and a 95% confidence interval (CI) was applied to identify the determinants. P-values of <0.05 were used to build the final model as a measure of statistical significance. Results The mean age of the study participants group was 28.6 (±8.44) years, mean age for cases was 28.7(±8.5) ranging from 18 to 56 years and the mean age for the controls was 28.4 (±8.5), ranging from 18 to 60 years. About 181 (83.03%) of the participants were male. The odds of having schizophrenia was about 12.2 times higher among participants with family history of mental illness (AOR: 12.21; 95% CI: 4.83-30.00). The odds of having schizophrenia was 4.5 times higher among polysubstance users (AOR: 4.45; 95% CI: 1.28-5.45) and 2.8 times higher among khat consumers (AOR: 2.82; 95% CI: 1.23-6.45) compared to their counterparts. Conclusion Our findings show that genetic risk factors as well as some modifiable behaviors are associated to schizophrenia in eastern Ethiopia. At all levels, special attention should be given to those who are at risk.
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Affiliation(s)
- Fethia Mohammed
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Biftu Geda
- Department of Nursing, School of Health Sciences, Madda Walabu University, Shashamane, Ethiopia
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Creswell KG, Terry-McElrath YM, Patrick ME. Solitary alcohol use in adolescence predicts alcohol problems in adulthood: A 17-year longitudinal study in a large national sample of US high school students. Drug Alcohol Depend 2022; 238:109552. [PMID: 35835632 PMCID: PMC9639649 DOI: 10.1016/j.drugalcdep.2022.109552] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Identifying risk factors for alcohol use disorder (AUD) is important for public health. The social context of drinking-such as drinking alone-may be an independent and robust early risk marker for AUD symptoms later in life. We evaluated whether solitary alcohol use in adolescence (age 18) and young adulthood (age 23/24) was concurrently associated with binge drinking and prospectively predicted age 35 AUD symptoms, and whether associations differed by sex. METHODS Longitudinal data were from the Monitoring the Future study. Surveys were completed by adolescents in 12th grade at age 18 (1976-2002), young adults at age 23/24 (1981-2008), and adults at age 35 (1993-2019). Analyses included past 12-month alcohol users (n = 4464 for adolescent models; n = 4561 for young adult models). Multivariable regression analyses tested whether adolescent and young adult solitary alcohol use was associated concurrently with binge drinking frequency and prospectively with age 35 AUD symptoms. RESULTS Solitary alcohol use in adolescence and young adulthood was associated (a) concurrently with binge drinking and (b) prospectively with increased risk of age 35 AUD symptoms (even after controlling for earlier binge drinking, alcohol use frequency, and sociodemographic covariates). Adolescent solitary alcohol use was associated with age 35 AUD symptoms particularly among females; no interaction was observed between sex and young adult solitary alcohol use in predicting age 35 AUD symptoms. CONCLUSIONS Adolescent and young adult solitary alcohol use was associated with increased adult AUD symptoms above and beyond other risk factors; adolescent female solitary alcohol users were especially at risk.
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Affiliation(s)
- Kasey G Creswell
- Department of Psychology, Carnegie Mellon University, Pittsburgh, USA.
| | | | - Megan E Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, USA
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Dokkedal-Silva V, Fernandes GL, Morelhão PK, Pires GN, Rowlett JK, Galduróz JCF, Berro LF, Tufik S, Andersen ML. Sleep, psychiatric and socioeconomic factors associated with substance use in a large population sample: A cross-sectional study. Pharmacol Biochem Behav 2021; 210:173274. [PMID: 34547353 DOI: 10.1016/j.pbb.2021.173274] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 08/16/2021] [Accepted: 09/14/2021] [Indexed: 12/19/2022]
Abstract
Multiple elements modulate drug use, including sleep, which is increasingly being considered as an important contributor to substance use and abuse. The present study aimed to evaluate the association between sleep, psychiatric and socioeconomic/demographic factors and substance use in a large-scale representative sample from the city of São Paulo, Brazil. Data from the 2007 São Paulo Epidemiological Sleep Study (EPISONO) database were used. In the EPISONO study, volunteers underwent a polysomnographic exam and completed a series of questionnaires to assess objective and subjective sleep quality and associated comorbidities. Drug use was assessed using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Linear (univariate and multivariate) and logistic regressions were performed to identify factors associated with the use of the 4 most commonly used substances in the sample (tobacco, alcohol, cannabis and cocaine/crack). Structural equation models were used to establish theoretical networks to explain the relationship between sleep, psychiatric and socioeconomic factors and use of these substances. The logistic regression results showed that psychiatric symptoms, lower income, and poorer subjective sleep were the main factors associated with tobacco consumption; gender and occupational status with alcohol intake; age and occupation with cannabis use; and education with cocaine/crack use. The structural equation models partially supported these findings and identified significant effects of psychiatric symptoms on tobacco consumption, both directly and mediated by sleep. Our results reinforce previous findings concerning factors associated with generally misused substances and suggest that sleep should be considered as an important element in future substance use disorder studies.
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Affiliation(s)
- Vinícius Dokkedal-Silva
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo 04024-002, Brazil
| | - Guilherme L Fernandes
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo 04024-002, Brazil
| | - Priscila K Morelhão
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo 04024-002, Brazil
| | - Gabriel N Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo 04024-002, Brazil
| | - James K Rowlett
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 N State St, Jackson, 39216 Jackson, United States
| | - José Carlos F Galduróz
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo 04024-002, Brazil
| | - Laís F Berro
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 N State St, Jackson, 39216 Jackson, United States.
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo 04024-002, Brazil
| | - Monica L Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925, São Paulo 04024-002, Brazil
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Jager J, Keyes KM, Son D, Kloska D, Patrick ME, Schulenberg JE. Cohort and age trends in age 35-45 prevalence of alcohol use disorder symptomology, by severity, sex, race, and education. Drug Alcohol Depend 2021; 226:108820. [PMID: 34245999 PMCID: PMC8355144 DOI: 10.1016/j.drugalcdep.2021.108820] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 04/29/2021] [Accepted: 05/03/2021] [Indexed: 11/25/2022]
Abstract
AIMS To present national trends by age and cohort among middle-aged adults in the prevalence of AUD symptomology, by severity, sex, race, and education. DESIGN National, multi-cohort longitudinal probability samples of US adults, with data collected at ages 35, 40, and 45 among 14 cohorts who reached age 45 between 2003 and 2016. SETTING Data were collected via self-administered questionnaires to adults in the United States. PARTICIPANTS The sample consisted of 20,634 individuals. MEASUREMENTS 5-year prevalence of symptoms consistent with a DSM-5 AUD. FINDINGS Between ages 35-45 prevalence of any AUD symptoms decreased 19 %; decreases were most evident between ages 35-40. From 2003 to 2016, AUD symptoms were steady across cohort. However, because the pace of decrease across ages 35-45 slowed across cohort, cohort differences emerged at specific ages: age 35 prevalence decreased 18 % across cohort, but age 45 prevalence was equivalent across cohort. Age and cohort effects, and their interaction, did not vary by AUD severity level. Declines in AUD symptoms across age were 17 % slower for women, and declines in AUD symptoms across age and cohort were 11 % and 29 % slower, respectively, for those with a college degree. The protection afforded by a college degree was reversed among mild AUD and most pronounced for severe AUD. CONCLUSIONS AUDs may be more plastic and responsive to intervention during early mid-life than later. Despite progress in reducing the burden of AUD in the US population among younger middle-aged adults, an increased focus remains necessary as they continue to age.
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Affiliation(s)
- Justin Jager
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, PO Box 873701, Tempe, AZ 85287-3701, United States.
| | - Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Daye Son
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, PO Box 873701, Tempe, AZ 85287-3701
| | - Deb Kloska
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Megan E. Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - John E. Schulenberg
- Institute for Social Research, University of Michigan, Ann Arbor, MI,Department of Psychology, University of Michigan, Ann Arbor, MI
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Patrick ME, Evans-Polce RJ, Parks MJ, Terry-McElrath YM. Drinking Intensity at Age 29/30 as a Predictor of Alcohol Use Disorder Symptoms at Age 35 in a National Sample. J Stud Alcohol Drugs 2021; 82:362-367. [PMID: 34100704 PMCID: PMC8328234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 01/07/2021] [Indexed: 11/08/2023] Open
Abstract
OBJECTIVE The purpose of this longitudinal study was to identify associations of drinking intensity at age 29/30 with symptoms of alcohol use disorder (AUD) at age 35. METHOD Analyses used national longitudinal data from 1,253 individuals (53.5% female) participating in the Monitoring the Future study. Age 29/30 data were collected from 2005 to 2013; age 35 data were collected from 2010 to 2018. Multivariable models regressed age 35 past-5-year AUD symptoms (vs. nondisordered drinking/abstinence) on age 29/30 past-2-week drinking intensity (no/low [0-4] drinking, binge [5-9] drinking, high-intensity [10+] drinking), with key covariates being controlled for. RESULTS At age 35, 32.6% (SE = 1.50) of respondents reported AUD symptoms. AUD symptoms at age 35 were reported by 77.5% (SE = 4.79) of participants who reported age 29/30 high-intensity drinking and 60.6% (SE = 3.95) of participants who reported age 29/30 binge drinking. Age 35 past-5-year abstinence was reported by almost no respondents reporting age 29/30 binge drinking or high-intensity drinking. AUD symptoms at age 35 were significantly more likely for those who reported binge (adjusted multivariable odds ratio [AOR] = 5.61, 95% CI [3.79, 8.30], p < .001) or high-intensity (AOR = 12.26, 95% CI [6.70, 22.41], p < .001) drinking versus no/low drinking at age 29/30. The likelihood of having AUD symptoms was significantly higher for high-intensity than for binge drinkers (AOR = 2.18, 95% CI [1.14, 4.19], p = .019). CONCLUSIONS Nearly 80% of those young adults who reported engaging in high-intensity drinking (10+ drinks in a row) at age 29/30 later reported AUD symptoms at age 35. High-intensity drinking appears to be a strong prospective marker of risk for AUD symptoms among adults in the United States.
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Affiliation(s)
- Megan E. Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Rebecca J. Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan
| | - Michael J. Parks
- Institute for Translational Research in Children's Mental Health, Minneapolis, Minnesota
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Tao R, Jiang F, Min K, Liu T, Liu Y, Xia L, Wang J, Liu H, Tang YL. Alcohol Use Among Mental Health Professionals in China: A Nationwide Cross-sectional Survey. Alcohol Alcohol 2020; 56:351-359. [PMID: 32696947 DOI: 10.1093/alcalc/agaa065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/12/2020] [Accepted: 06/12/2020] [Indexed: 01/31/2023] Open
Abstract
AIM To survey the use of alcohol, and its correlates by mental health professions in China, a nation where there is rapid increase in alcohol consumption and problems. METHODS As a part of a large-scale, nation-wide online survey of healthcare professionals, we collected demographic variables and other health-related variables anonymously. The Alcohol Use Disorder Identification Test-Concise (AUDIT-C) was used to collect data on alcohol use. RESULTS 13,980 mental health professionals completed the survey (4382 doctors, 9339 nurses and 259 clinical psychologists), representing 64% of the total targeted. Respondents were predominantly female (75.1%). Alcohol consumption was reported by 41.8% of participants (by 53.9% of doctors, 36.2% of nurses and 40.5% of clinical psychologists). Based on the cut-off scores of the AUDIT-C (≥3 for women and ≥4 for men), 7.5% were classified as probable alcohol misusers in the past year, and the rates were 10.2% in doctors, 6.3% in nurses and 5.8% in clinical psychologists. Multiple logistic regression showed that male sex (OR = 3.772; CI = 3.206-4.439), being a doctor (OR = 1.259; CI = 1.052-1.506), being divorced or widowed (OR = 1.979; CI = 1.467-2.666), having an associate degree or less (OR = 1.809; CI = 1.040-3.147), working in Northeast China (OR = 1.538; CI = 1.281-1.848) and the habit of smoking (OR = 3.345; CI = 2.280-3.967) were significantly associated with alcohol misuse. CONCLUSIONS Alcohol use and misuse were relatively common among mental health professionals in China, and male sex, being a doctor, with lower education, working in Northeast China and cigarette smoking were significant associations. Awareness and interventions are recommended to promote healthier use of alcohol in this professional group, especially among risk subgroups.
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Affiliation(s)
- Rui Tao
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu Road, Chaohu District, Hefei, 238000, China.,Department of Substance-Related Disorders, Hefei Fourth People's Hospital, 316 Huangshan Road, Shushan District, Hefei, 230022, China
| | - Feng Jiang
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing, 100730, China
| | - Kaiyuan Min
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing, 100730, China
| | - Tingfang Liu
- Institute for Hospital Management of Tsinghua University, Haidian District, Beijing, 100091, China
| | - Yuanli Liu
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing, 100730, China
| | - Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu Road, Chaohu District, Hefei, 238000, China
| | - Juan Wang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu Road, Chaohu District, Hefei, 238000, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu Road, Chaohu District, Hefei, 238000, China
| | - Yi-Lang Tang
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA, 30033, USA.,Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, 30329, USA
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12
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Ünübol H, Sayar GH. Substance use and its risk factors in Turkey: a nationally representative sample study. J Ethn Subst Abuse 2020; 21:476-498. [DOI: 10.1080/15332640.2020.1781731] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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13
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Evans-Polce RJ, Jang BJ, Maggs JL, Patrick ME. Gender and age differences in the associations between family social roles and excessive alcohol use. Soc Sci Med 2019; 244:112664. [PMID: 31726267 DOI: 10.1016/j.socscimed.2019.112664] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 10/22/2019] [Accepted: 11/02/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Familial social roles are known to have important links with both acute and chronic excessive alcohol use. However, whether and how these links vary across adulthood and by gender is not well understood and would provide insight into populations most at risk for excessive alcohol use. METHODS This study used data from those ages 18 to 60 in the National Epidemiologic Study of Alcohol and Related Conditions-III survey (N=28,475). We examined the gender- and age-varying associations of current marital status (married vs. divorced/separated vs. never married) and parental status (parent vs. not) with acute (binge drinking) and chronic (exceeding weekly drinking guidelines) excessive alcohol use using time-varying effect modelling. RESULTS Both marital and parental statuses were inversely associated with acute and chronic excessive alcohol use at most ages, however the magnitude of these associations and gender differences in these associations varied by age. There were greater differences between adults who were married vs. never married and parents vs. not in excessive alcohol use during young adulthood as compared to later adulthood. The association of parental status with acute excessive alcohol use was stronger for women compared to men in young adulthood. CONCLUSIONS Gender and age should be considered when examining risk and protective factors, particularly in examining the role of parenthood in acute excessive alcohol use. These findings will help target populations most at risk for chronic and acute excessive alcohol use.
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Affiliation(s)
- Rebecca J Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, USA.
| | - Bohyun Joy Jang
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Jennifer L Maggs
- Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
| | - Megan E Patrick
- Institute for Translational Research in Children's Mental Health and Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
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Jang BJ, Schuler MS, Evans-Polce RJ, Patrick ME. College attendance type and subsequent alcohol and marijuana use in the U.S. Drug Alcohol Depend 2019; 204:107580. [PMID: 31585359 PMCID: PMC6923146 DOI: 10.1016/j.drugalcdep.2019.107580] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 08/08/2019] [Accepted: 08/13/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND College attendance is a risk factor for frequent and heavy drinking and marijuana initiation but less is known about the extent to which risk varies by type of college attendance and across age. METHODS Using panel data of young adults who were high school seniors in 1990-1998 from the Monitoring the Future study (n = 13,123), we examined the associations between college attendance at age 19/20 (4-year college full-time, other college, and non-attendance) and subsequent alcohol and marijuana use at age 21/22, 25/26, 29/30 and 35. Inverse propensity score weighting was used to balance the three college groups on pre-existing differences when examining associations with substance use outcomes. RESULTS Compared to non-attendance, attending a 4-year college full-time was associated with significantly greater odds of binge drinking at age 21/22 (aOR = 1.20) and 25/26 (aOR = 1.12) and lower odds of alcohol abstinence at age 35 (aOR = 0.51). Similarly, other college attendance was associated with greater odds of binge drinking at age 21/22 (aOR = 1.08) and 25/26 (aOR = 1.04) and lower odds of abstinence at age 35 (aOR = 0.70). Four-year college full-time attendance was associated with greater odds of marijuana use at age 21/22 (aOR = 1.07) and 25/26 (aOR = 1.02) but lower odds at age 29/30 (aOR = 0.99). Other college attendance was associated with lower odds of marijuana use at age 25/26 (aOR = 0.98) and 29/30 (aOR = 0.97). Marijuana use at age 35 did not differ by college attendance. CONCLUSIONS College attendance may confer elevated risk of substance use post-college. The magnitude and duration of risk vary by type of college attendance and substance.
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Affiliation(s)
- Bohyun Joy Jang
- Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI 48104, USA
| | | | - Rebecca J. Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI 48109, USA
| | - Megan E. Patrick
- Institute for Translational Research in Children’s Mental Health and Institute of Child Development, University of Minnesota, 1100 Washington Avenue S., Minneapolis, MN 55415, USA
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Schuler MS, Stein BD, Collins RL. Differences in Substance Use Disparities Across Age Groups in a National Cross-Sectional Survey of Lesbian, Gay, and Bisexual Adults. LGBT Health 2019; 6:68-76. [PMID: 30735084 DOI: 10.1089/lgbt.2018.0125] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Lesbian, gay, and bisexual (LGB) adults have elevated rates of substance use (SU) relative to heterosexual adults, yet the extent to which these disparities vary across age groups is unknown. Using national survey data, we test for age group differences in lifetime and recent SU disparities among LGB adults. METHODS Using data on 67,354 adults (including 4868 LGB adults) from the 2015 and 2016 National Survey on Drug Use and Health (NSDUH), we examined LGB disparities in lifetime and recent use of cigarettes, marijuana, and illicit drugs. Analyses were stratified by age groups (18-25, 26-34, and 35-49 years) and compared lesbian/gay (L/G) and bisexual adults, respectively, with heterosexual adults of the same gender and age group. RESULTS Among L/G women, disparities (relative to same-age heterosexual women) were significantly larger in the youngest age group compared with the older age groups for numerous measures of lifetime and recent SU. Conversely, among bisexual men and bisexual women, multiple SU disparities (relative to heterosexual adults of the same age and gender) were significantly smaller among the youngest age group compared with the oldest age group. CONCLUSION Contrary to hypotheses of decreased minority stress among more recent generations of LGB individuals, we found that SU disparities were not systematically smaller in younger age groups. Rather, disparities exhibited distinct trends across age groups. As NSDUH data are cross-sectional, differences by age group may reflect the influence of both age-varying developmental factors as well as time-varying social and contextual factors.
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