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McGuire FH, Beccia AL, Peoples J, Williams MR, Schuler MS, Duncan AE. Depression at the intersection of race/ethnicity, sex/gender, and sexual orientation in a nationally representative sample of US adults: A design-weighted MAIHDA. medRxiv 2023:2023.04.13.23288529. [PMID: 37131598 PMCID: PMC10153310 DOI: 10.1101/2023.04.13.23288529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
This study examined how race/ethnicity, sex/gender, and sexual orientation intersect to socially pattern depression among US adults. We used repeated, cross-sectional data from the 2015-2020 National Survey on Drug Use and Health (NSDUH; n=234,772) to conduct design-weighted multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) for two outcomes: past-year and lifetime major depressive episode (MDE). With 42 intersectional groups constructed from seven race/ethnicity, two sex/gender, and three sexual orientation categories, we estimated group-specific prevalence and excess/reduced prevalence attributable to intersectional effects (i.e., two-way or higher interactions between identity variables). Models revealed heterogeneity between intersectional groups, with prevalence estimates ranging from 3.4-31.4% (past-year) and 6.7-47.4% (lifetime). Model main effects indicated that people who were Multiracial, White, women, gay/lesbian, or bisexual had greater odds of MDE. Additive effects of race/ethnicity, sex/gender, and sexual orientation explained most between-group variance; however, approximately 3% (past-year) and 12% (lifetime) were attributable to intersectional effects, with some groups experiencing excess/reduced prevalence. For both outcomes, sexual orientation main effects (42.9-54.0%) explained a greater proportion of between-group variance relative to race/ethnicity (10.0-17.1%) and sex/gender (7.5-7.9%). Notably, we extend MAIHDA to calculate nationally representative estimates to open future opportunities to quantify intersectionality with complex sample survey data.
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Affiliation(s)
- F. Hunter McGuire
- The Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - Ariel L. Beccia
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - JaNiene Peoples
- The Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | | | | | - Alexis E. Duncan
- The Brown School, Washington University in St. Louis, St. Louis, MO, USA
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McGuire FH, Goldbach JT, Senese JG, Cabrera JR, Schrager SM, Duncan AE. Longitudinal association of homonegative school climate with body dysmorphic disorder among cisgender sexual minority adolescents: Testing mediation through proximal minority stressors. Body Image 2023; 45:86-93. [PMID: 36842424 DOI: 10.1016/j.bodyim.2023.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 02/19/2023] [Accepted: 02/19/2023] [Indexed: 02/27/2023]
Abstract
In a US national cohort study of cisgender sexual minority adolescents (SMAs), we prospectively (1) assessed whether within-person changes in homonegative school climate (i.e., school contextual factors that lead SMAs to feel unsafe or threatened) were associated with risk of probable body dysmorphic disorder (BDD) and (2) tested whether internalized homonegativity and negative expectancies mediated this association. Data came from consecutive time points (18-month, 24-month, 30-month) of the Adolescent Stress Experiences over Time Study (ASETS; N = 758). The Body Dysmorphic Disorder Questionnaire measured probable BDD. Sexual Minority Adolescent Stress Inventory subscales measured past 30-day minority stress experiences. Multilevel models were specified with person mean-centered predictor variables to capture within-person effects. Across one year of follow-up, 26.86% screened positive for probable BDD at least once. Model results indicated significant total (risk ratio [RR]=1.43, 95% credible interval [CI]=1.35-1.52) and direct effects (RR=1.18, 95% CI=1.05-1.34) of homonegative school climate. Internalized homonegativity was independently associated with probable BDD (RR=1.28, 95% CI=1.12-1.46) and mediated 49.7% (95% CI=12.4-82.0) of the total effect. There was limited evidence of mediation via negative expectancies. Implementing SMA-protective school policies and targeting internalized homonegativity in clinical practice may reduce the prevalence and incidence of probable BDD among cisgender SMAs.
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Affiliation(s)
- F Hunter McGuire
- The Brown School, Washington University in St. Louis, St. Louis, MO, USA.
| | - Jeremy T Goldbach
- The Brown School, Washington University in St. Louis, St. Louis, MO, USA.
| | - John G Senese
- Center for LGBTQ+ Health Equity, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.
| | - Juan R Cabrera
- The Brown School, Washington University in St. Louis, St. Louis, MO, USA.
| | | | - Alexis E Duncan
- The Brown School, Washington University in St. Louis, St. Louis, MO, USA.
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Zhong Y, McGuire FH, Duncan AE. Who is trying to lose weight? Trends and prevalence in past-year weight loss attempts among US adults 1999-2018 at the intersection of race/ethnicity, gender, and weight status. Eat Behav 2022; 47:101682. [PMID: 36413874 PMCID: PMC9973002 DOI: 10.1016/j.eatbeh.2022.101682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 10/25/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022]
Abstract
Common stereotypes of those who desire or attempt to lose weight often center on the experience of White, thin women. However, prior studies have neglected how systems of oppression at intersection of race/ethnicity, gender, and weight status may interact to place certain subpopulations at elevated risk. Repeated cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018 (n = 53,528), a population-representative sample of US adults, were used to 1) assess trends in past-year weight loss attempts using the Kendall-Mann trend test stratifying by race/ethnicity, gender, and weight status, and 2) estimate the adjusted prevalence of weight loss attempts over the combined 20-year period for combinations of race/ethnicity, gender, and weight status using logistic regression. There were significant monotonic trends from 1999 to 2018 for non-Hispanic Black men (43.8% to 67.8%, FDR adjusted p = .022) with an obese BMI, but not for any other groups. After adjusting for covariates, weight loss attempt prevalence was positively associated with BMI category for all race/ethnicity-gender combinations, although the degree of association differed. These findings underscore the need to use an intersectional lens in weight-related research. Despite limited long-term beneficial health impact, certain population subgroups, particularly Black men with an obese BMI, are increasingly trying to lose weight.
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Affiliation(s)
- Yongqi Zhong
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - F Hunter McGuire
- The Brown School, Washington University in St. Louis, One Brookings Drive, Box 1196, St. Louis, MO 63130, USA
| | - Alexis E Duncan
- The Brown School, Washington University in St. Louis, One Brookings Drive, Box 1196, St. Louis, MO 63130, USA.
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Ziobrowski HN, Buka SL, Austin SB, Duncan AE, Sullivan AJ, Horton NJ, Field AE. Child and Adolescent Abuse Patterns and Incident Obesity Risk in Young Adulthood. Am J Prev Med 2022; 63:809-817. [PMID: 35941047 DOI: 10.1016/j.amepre.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 05/12/2022] [Accepted: 06/23/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Child abuse is associated with adult obesity. Yet, it is unknown how the developmental timing and combination of abuse types affect this risk. This report examined how distinct child and adolescent abuse patterns were associated with incident obesity in young adulthood. METHODS Data came from 7,273 participants in the Growing Up Today Study, a prospective cohort study in the U.S. with 14 waves from 1996 to 2016 (data were analyzed during 2020-2021). An abuse group variable was empirically derived using latent class analysis with indicators for child (before age 11 years) and adolescent (ages 11-17 years) physical, sexual, and emotional abuse. Risk ratios for obesity developing during ages 18-30 years were estimated using modified Poisson models. Associations of abuse groups with BMI across ages 18-30 years were then examined using mixed-effects models. All models were stratified by sex. RESULTS Among women, groups characterized by abuse had higher BMIs entering young adulthood and greater changes in BMI per year across young adulthood. Groups characterized by multiple abuse types and abuse sustained across childhood and adolescence had approximately twice the risk of obesity as that of women in a no/low abuse group. Associations were substantially weaker among men, and only a group characterized by physical and emotional abuse in childhood and adolescence had an elevated obesity risk (risk ratio=1.38; 95% CI=1.04, 1.83). CONCLUSIONS Obesity risk in young adulthood varied by distinct abuse groups for women and less strongly for men. Women who experience complex abuse patterns have the greatest risk of developing obesity in young adulthood.
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Affiliation(s)
- Hannah N Ziobrowski
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
| | - Stephen L Buka
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island
| | - S Bryn Austin
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alexis E Duncan
- Brown School, Washington University in St. Louis, St. Louis, Missouri; Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | | | - Nicholas J Horton
- Department of Mathematics & Statistics, Amherst College, Amherst, Massachusetts
| | - Alison E Field
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island; Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Pediatrics, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
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Ziobrowski HN, Buka SL, Austin SB, Duncan AE, Simone M, Sullivan AJ, Horton NJ, Field AE. Child and adolescent maltreatment patterns and risk of eating disorder behaviors developing in young adulthood. Child Abuse Negl 2021; 120:105225. [PMID: 34352683 PMCID: PMC8493560 DOI: 10.1016/j.chiabu.2021.105225] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 06/01/2021] [Accepted: 07/22/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Child maltreatment may be an important risk factor for eating disorder (ED) behaviors. However, most previous research has been limited to clinical, female, and cross-sectional samples, and has not adequately accounted for complex abuse patterns. OBJECTIVE To determine whether women and men with distinct patterns of child and adolescent maltreatment have higher risks of developing ED behaviors in young adulthood than individuals with a low probability of maltreatment. PARTICIPANTS AND SETTING Data came from 7010 U.S. women and men (95% White) in the Growing Up Today Study, a prospective, community-based cohort study (14 waves between 1996 and 2016). METHODS We used a previously created maltreatment variable that was empirically derived using latent class analysis. Maltreatment groups were characterized as: "no/low abuse," "child physical abuse," "adolescent emotional abuse," "child and adolescent physical and emotional abuse," and "child and adolescent sexual abuse." We estimated risk ratios for ED behaviors developing in young adulthood using the modified Poisson approach with generalized estimating equations. We stratified models by sex. RESULTS Groups characterized by maltreatment had elevated risks of incident ED behaviors compared with the "no/low abuse" group among both women and men. For women, risks tended to be strongest among the "child and adolescent sexual abuse" group. For men, risks tended to be strongest among the "child and adolescent physical and emotional abuse" group. Risks were particularly strong for purging behaviors. CONCLUSION Risk of incident ED behaviors in young adulthood varied by distinct maltreatment groups. Detecting maltreatment early may help prevent EDs and subsequent maltreatment.
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Affiliation(s)
| | - Stephen L Buka
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - S Bryn Austin
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Channing Division of Network Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Alexis E Duncan
- Brown School at Washington University in St. Louis, St. Louis, MO, USA; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Melissa Simone
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | | | - Nicholas J Horton
- Department of Mathematics and Statistics, Amherst College, Amherst, MA, USA
| | - Alison E Field
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; Channing Division of Network Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, USA
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Duncan AE, Sessler DI. Hydroxyethyl starch on kidney and haemostatic function in cardiac surgical patients: is a non-inferiority study design appropriate for this setting? A reply. Anaesthesia 2021; 76:577-578. [PMID: 33507542 DOI: 10.1111/anae.15399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 11/29/2022]
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Van Alsten SC, Duncan AE. Lifetime patterns of comorbidity in eating disorders: An approach using sequence analysis. Eur Eat Disord Rev 2020; 28:709-723. [PMID: 32748537 DOI: 10.1002/erv.2767] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 06/05/2020] [Accepted: 06/29/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Eating disorders (EDs) have high rates of psychiatric comorbidity. This study aimed to characterize longitudinal patterns of comorbidities in adults with EDs. METHODS Sequence analysis and hierarchical clustering were applied to ages of onset and recency for select eating, substance, mood, and anxiety disorders from the 479 participants in the Collaborative Psychiatric Epidemiology Surveys with lifetime DSM-IV bulimia nervosa, binge eating disorder, or anorexia nervosa. External validators were compared across clusters using chi-square tests. RESULTS Five clusters were identified among individuals with any lifetime ED based on longitudinal sequence of psychiatric disorder onset and remission, characterized as: (1) multi-comorbid with early onset of comorbid disorder (46%); (2) moderate preeminent anxiety with moderate comorbidity and low ED persistence (20%); (3) late ED onset with low comorbidity (15%); (4) early onset, persistent ED with low comorbidity (14%); and (5) chronic, early onset depression (5%). Clusters were well differentiated by significant differences in age, body mass index, race, and psychiatric indicators. CONCLUSIONS This study demonstrates a new method to assess clustering of comorbidity among individuals with lifetime EDs. Having a psychiatric diagnosis prior to an ED was associated with greater psychopathology and illness duration. Information on timing of diagnoses may allow for more refined comorbidity classification.
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Affiliation(s)
- Sarah C Van Alsten
- Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Alexis E Duncan
- Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
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Munn-Chernoff MA, Few LR, Matherne CE, Baker JH, Men V(Y, McCutcheon VV, Agrawal A, Bucholz KK, Madden PAF, Heath AC, Duncan AE. Eating disorders in a community-based sample of women with alcohol use disorder and nicotine dependence. Drug Alcohol Depend 2020; 212:107981. [PMID: 32442752 PMCID: PMC7293939 DOI: 10.1016/j.drugalcdep.2020.107981] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 03/17/2020] [Accepted: 03/22/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Studies consistently report a higher prevalence of substance use disorders (SUDs) among women with eating disorders than control women. However, limited research exists on the prevalence of eating disorder symptoms and diagnoses in women with SUDs, especially in community-based populations. We examined the prevalence of eating disorder symptoms and diagnosis by the presence or absence of lifetime alcohol use disorder (AUD) and/or nicotine dependence (ND) in a community-based sample of women. METHODS 3756 women (median age = 22 years) from the Missouri Adolescent Female Twin Study completed a modified semi-structured interview assessing lifetime DSM-IV psychiatric disorders and SUDs. Logistic regression models adjusted for demographic characteristics and other psychopathology, and robust standard errors accounted for the non-independence of twin data. RESULTS In general, women with comorbid AUD and ND had a higher prevalence of eating disorder symptoms and diagnoses than women with AUD or ND Only, who in turn had a higher prevalence than those without either SUD. After adjustment for covariates, women with AUD and ND had significantly greater risk of broad anorexia nervosa (RRR = 3.17; 99 % CI = 1.35, 7.44), purging disorder (2.59; 1.24, 5.43), and numerous eating disorder symptoms than women with neither disorder. Significant differences emerged between individuals with both AUD and ND versus women with AUD Only or ND Only for some eating disorder symptoms. CONCLUSIONS Women with lifetime AUD or ND diagnoses are at high risk for eating disorder symptoms and diagnoses, underscoring the importance of assessing eating disorder symptoms among women with these disorders.
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Affiliation(s)
- Melissa A. Munn-Chernoff
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, CB 7160, Chapel Hill, NC 27599 USA
| | - Lauren R. Few
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid, CB 8134, St. Louis, MO 63110 USA
| | - Camden E. Matherne
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, CB 7160, Chapel Hill, NC 27599 USA
| | - Jessica H. Baker
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, CB 7160, Chapel Hill, NC 27599 USA
| | - Vera (Yu) Men
- Department of Social Work and Social Administration, University of Hong Kong, Pokfulam, Hong Kong
| | - Vivia V. McCutcheon
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid, CB 8134, St. Louis, MO 63110 USA
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid, CB 8134, St. Louis, MO 63110 USA
| | - Kathleen K. Bucholz
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid, CB 8134, St. Louis, MO 63110 USA
| | - Pamela A. F. Madden
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid, CB 8134, St. Louis, MO 63110 USA
| | - Andrew C. Heath
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid, CB 8134, St. Louis, MO 63110 USA
| | - Alexis E. Duncan
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid, CB 8134, St. Louis, MO 63110 USA,George Warren Brown School of Social Work, Washington University, One Brookings Drive, CB 1196, St. Louis, MO 63130 USA
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Kondratenko K, Boussoualem Y, Singh DP, Visvanathan R, Duncan AE, Clark NA, Legrand C, Daoudi A. Molecular p-doping in organic liquid crystalline semiconductors: influence of the charge transfer complex on the properties of mesophase and bulk charge transport. Phys Chem Chem Phys 2019; 21:18686-18698. [PMID: 31423509 DOI: 10.1039/c9cp03076j] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We explore the molecular nature of doping in organic semiconductors (OSCs) by employing a liquid crystalline organic semiconductor based on phenyl naphthalene as a model. The mesophase nature of composites that include a charge transfer complex (CTC) between the OSC (8-PNP-O12) and an electron acceptor (F4TCNQ) has been investigated by means of differential scanning calorimetry, polarized optical microscopy and X-ray scattering. Optical and vibrational spectroscopies allow us to explore the characteristics and the amount of charge transfer in the CTC and expose some properties that appear only in the complexed state. We have found this system to exhibit partial charge transfer, which manifests itself in all the phase states of the host 8-PNP-O12, as well as in solution. Due to the lowering of molecular symmetry as a result of the charge transfer, one of the previously IR-only vibrational bands of the nitrile group is found to be now active in the Raman spectrum. We have also made an attempt to further investigate the influence of dopant introduction on the bulk hole mobility of 8-PNP-O12. It is found that the presence of the CTC promotes the hole transport in the Smectic B mesophase, however it seems to have a somewhat negative influence in the less ordered smectic A mesophase. This work aims to establish the link between the inevitable change of molecular geometry that occurs on charge transfer with the results obtained by spectroscopic techniques and electronic charge carrier mobility measurements.
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Affiliation(s)
- K Kondratenko
- Univ. Littoral Côte d'Opale, EA 4476 - UDSMM - Unité de Dynamique et Structure de Matériaux Moléculaires, 59140 Dunkerque, France.
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Sartor CE, Grant JD, Few LR, Werner KB, McCutcheon VV, Duncan AE, Nelson EC, Madden PAF, Bucholz KK, Heath AC, Agrawal A. Childhood Trauma and Two Stages of Alcohol Use in African American and European American Women: Findings from a Female Twin Sample. Prev Sci 2019; 19:795-804. [PMID: 28875252 DOI: 10.1007/s11121-017-0838-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The current investigation assessed for moderating effects of childhood trauma on genetic and environmental contributions to timing of alcohol use initiation and alcohol use disorder in African American (AA) and European American (EA) women. Data were drawn from diagnostic telephone interviews conducted with 3786 participants (14.6% AA) in a longitudinal female twin study. Childhood trauma was defined alternately as child maltreatment and more broadly to include other events (e.g., witnessing violence). Phenotypic associations between childhood trauma and alcohol outcomes were estimated using logistic regression analyses. Twin modeling was conducted to test for moderating effects of childhood trauma on the contributions of genetic and environmental factors to timing of initiation and alcohol use disorder. Under both definitions, childhood trauma was associated with early initiation (relative risk ratios: 1.90, 1.72) and alcohol use disorder (odds ratios: 1.92, 1.76). Yet gene by environment effects were observed only for child maltreatment and timing of initiation in EA women, with heritable influences less prominent in those who had experienced child maltreatment (0.35, 95% CI: 0.05-0.66 vs. 0.52, 95% CI: 0.30-0.73). We found more similarities than differences in the association of childhood trauma with alcohol outcomes across racial/ethnic groups, trauma type, and stages of alcohol use. However, findings suggest that the relative contribution of genetic factors to alcohol outcomes differs by childhood maltreatment history in EA women specifically in the earliest stage of alcohol use.
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Affiliation(s)
- Carolyn E Sartor
- Department of Psychiatry, Yale University School of Medicine, 389 Whitney Avenue, New Haven, CT, 06511, USA. .,Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, Saint Louis, MO, 63110, USA.
| | - Julia D Grant
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, Saint Louis, MO, 63110, USA
| | - Lauren R Few
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, Saint Louis, MO, 63110, USA
| | - Kimberly B Werner
- George Warren Brown School of Social Work, Washington University, St. Louis, MO, USA
| | - Vivia V McCutcheon
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, Saint Louis, MO, 63110, USA
| | - Alexis E Duncan
- George Warren Brown School of Social Work, Washington University, St. Louis, MO, USA
| | - Elliot C Nelson
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, Saint Louis, MO, 63110, USA
| | - Pamela A F Madden
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, Saint Louis, MO, 63110, USA
| | - Kathleen K Bucholz
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, Saint Louis, MO, 63110, USA
| | - Andrew C Heath
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, Saint Louis, MO, 63110, USA
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, Saint Louis, MO, 63110, USA
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Maheshwari A, McCormick PJ, Sessler DI, Reich DL, You J, Mascha EJ, Castillo JG, Levin MA, Duncan AE. Prolonged concurrent hypotension and low bispectral index ('double low') are associated with mortality, serious complications, and prolonged hospitalization after cardiac surgery. Br J Anaesth 2018; 119:40-49. [PMID: 28974062 DOI: 10.1093/bja/aex095] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2017] [Indexed: 12/15/2022] Open
Abstract
Background Low bispectral index (BIS) and low mean arterial pressure (MAP) are associated with worse outcomes after surgery. We tested the hypothesis that a combination of these risk factors, a 'double low', is associated with death and major complications after cardiac surgery. Methods We used data from 8239 cardiac surgical patients from two US hospitals. The primary outcomes were 30-day mortality and a composite of in-hospital mortality and morbidity. We examined whether patients who had a case-averaged double low, defined as time-weighted average BIS and MAP (calculated over an entire case) below the sample mean but not in the reference group, had increased risk of the primary outcomes compared with patients whose BIS and/or MAP were at or higher than the sample mean. We also examined whether a prolonged cumulative duration of a concurrent double low (simultaneous low MAP and BIS) increased the risk of the primary outcomes. Results Case-averaged double low was not associated with increased risk of 30-day mortality {odds ratio [OR] 1.73 [95% confidence interval (CI) 0.94-3.18] vs reference; P =0.01} or the composite of in-hospital mortality and morbidity [OR 1.47 (95% CI 0.98-2.20); P =0.01] after correction for multiple outcomes. A prolonged concurrent double low was associated with 30-day mortality [OR 1.06 (95% CI 1.01-1.11) per 10-min increase; P =0.001] and the composite of in-hospital mortality and morbidity [OR 1.04 (95% CI 1.01-1.07), P =0.004]. Conclusions A prolonged concurrent double low, but not a case-averaged double low, was associated with higher morbidity and mortality after cardiac surgery.
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Affiliation(s)
- A Maheshwari
- Department of Outcomes Research, Cleveland Clinic, 9500 Euclid Avenue, P-77 Cleveland, OH 44195, USA.,Louis Stokes Cleveland VA Medical Centre, Cleveland, OH, USA
| | - P J McCormick
- Department of Anaesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - D I Sessler
- Department of Outcomes Research, Cleveland Clinic, 9500 Euclid Avenue, P-77 Cleveland, OH 44195, USA.,Anaesthesia Institute, Cleveland Clinic, Cleveland, OH, USA
| | - D L Reich
- Department of Anaesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J You
- Department of Outcomes Research, Cleveland Clinic, 9500 Euclid Avenue, P-77 Cleveland, OH 44195, USA.,Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - E J Mascha
- Department of Outcomes Research, Cleveland Clinic, 9500 Euclid Avenue, P-77 Cleveland, OH 44195, USA.,Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - J G Castillo
- Department of Anaesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - M A Levin
- Department of Anaesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - A E Duncan
- Department of Outcomes Research, Cleveland Clinic, 9500 Euclid Avenue, P-77 Cleveland, OH 44195, USA.,Department of Cardiothoracic Anaesthesia, Cleveland Clinic, Cleveland, OH, USA
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12
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Ziobrowski H, Brewerton TD, Duncan AE. Associations between ADHD and eating disorders in relation to comorbid psychiatric disorders in a nationally representative sample. Psychiatry Res 2018; 260:53-59. [PMID: 29172099 DOI: 10.1016/j.psychres.2017.11.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 09/23/2017] [Accepted: 11/08/2017] [Indexed: 12/11/2022]
Abstract
The objective of this study was to examine whether previously observed associations of attention-deficit/hyperactivity disorder (ADHD) with eating disorders (EDs) are at least partially attributable to other underlying psychopathology. Data came from 4719 participants aged 18-44 years in the National Comorbidity Survey Replication and the National Survey of American Life. DSM-IV diagnoses were assessed using the World Health Organization Composite International Diagnostic Interview. Multinomial logistic regression assessed associations between DSM-IV lifetime and past-12 month diagnoses of ADHD with EDs in unadjusted models and in models adjusted for demographic variables and other psychopathology. Lifetime ADHD was strongly and significantly associated with lifetime bulimia nervosa (BN), binge eating disorder (BED), and any ED in unadjusted models, but not with anorexia nervosa or subthreshold BED. After adjusting for demographic variables and psychiatric comorbidities, all associations of lifetime ADHD with EDs were substantially attenuated, and only the association of ADHD with BN remained statistically significant. Similar results were found using past-12 month diagnoses. These results suggest that previously observed associations of ADHD with EDs might be due - at least in part - to additional psychiatric disorders that are often comorbid with both ADHD and EDs.
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Affiliation(s)
- Hannah Ziobrowski
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Timothy D Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Alexis E Duncan
- George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
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13
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Sadler BE, Grant JD, Duncan AE, Sartor CE, Waldron M, Heath AC, Bucholz KK. The Influence of Paternal Separation, Paternal History of Alcohol Use Disorder Risk, and Early Substance Use on Offspring Educational Attainment by Young Adulthood. J Stud Alcohol Drugs 2017; 78:426-434. [PMID: 28499110 DOI: 10.15288/jsad.2017.78.426] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study aimed to determine the associations among paternal alcohol problems, separation, and educational attainment in European American and African American offspring and whether offspring early alcohol/tobacco/marijuana use influenced these associations. METHOD Families with offspring ages 13-19 years at intake were selected from state birth records and screened by telephone to determine high-risk or low-risk status (with/without paternal heavy drinking). Families of men with two or more driving-under-the-influence offenses were added as a very-high-risk group. Data from 340 African American and 288 European American offspring who were not enrolled in school at their last interview were analyzed. Educational attainment was modeled as less than high school, high school only (reference category), and some college or higher. Separation was defined as offspring report of not having lived continuously in the same household with their biological father from birth to age 14. Analyses were stratified by race. RESULTS In European Americans, neither family risk status nor early alcohol/tobacco/marijuana use was associated with educational outcomes. However, paternal separation significantly elevated the likelihood of not completing high school in all models (relative risk ratios [RRRs] = 6.0-8.1, p <.001). For African American offspring, likelihoods of high school noncompletion were elevated marginally for paternal separation in only one model, but significantly for early marijuana use (RRRs = 2.8-3.2, p < .05). Very-high-risk status significantly reduced the likelihood of post-high school education in an adjusted model (RRR = 0.4, p < .05). CONCLUSIONS High school noncompletion was significantly associated with paternal separation in European Americans and with early marijuana use in African American offspring. In addition, very-high-risk status reduced the likelihood of post-high school education in African American offspring only, suggesting that research with ethnically diverse samples yields important differences when examining outcomes of both separation and substance use on offspring education.
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Affiliation(s)
- Brooke E Sadler
- Washington University School of Medicine, St. Louis, Missouri
| | - Julia D Grant
- Washington University School of Medicine, St. Louis, Missouri
| | - Alexis E Duncan
- Washington University School of Medicine, St. Louis, Missouri.,George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri
| | | | - Mary Waldron
- Indiana University Bloomington, Bloomington, Indiana
| | - Andrew C Heath
- Washington University School of Medicine, St. Louis, Missouri
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14
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Duncan AE, Ziobrowski HN, Nicol G. The Prevalence of Past 12-Month and Lifetime DSM-IV Eating Disorders by BMI Category in US Men and Women. Eur Eat Disord Rev 2017; 25:165-171. [PMID: 28127825 DOI: 10.1002/erv.2503] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 12/12/2016] [Accepted: 01/05/2017] [Indexed: 01/31/2023]
Abstract
OBJECTIVE This study aims to determine whether the prevalence of lifetime and past 12-month DSM-IV eating disorders (ED) diagnoses differed by body mass index category among men and women in a general population sample. METHODS Data from the Collaborative Psychiatric Epidemiology Surveys (n = 12 337 adults) were analysed using logistic regression. Analyses were conducted separately by gender. RESULTS Lifetime ED prevalence was 2.22% in men and 4.93% in women. In both genders, the prevalence of any lifetime and past 12-month ED, binge eating disorder and recurrent binge eating was highest among obese individuals. Among obese men and women, lifetime and past 12-month ED prevalence was highest among those with class III obesity. CONCLUSION Eating disorders were most prevalent among high-weight individuals. This information is important for planning targeted public health ED and obesity prevention and intervention activities, as well as for informing the clinical care of obese individuals. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Alexis E Duncan
- George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA.,Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Hannah N Ziobrowski
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Ginger Nicol
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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15
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Heath AC, Lessov-Schlaggar CN, Lian M, Miller R, Duncan AE, Madden PAF. Research on Gene-Environment Interplay in the Era of "Big Data". J Stud Alcohol Drugs 2016; 77:681-3. [PMID: 27588523 PMCID: PMC5405704 DOI: 10.15288/jsad.2016.77.681] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Successful identification of genetic risk factors in genomewide association studies typically has depended on meta-analyses combining data from large numbers of studies involving tens or hundreds of thousands of participants. This poses a challenge for research on Gene × Environment interaction (G × E) effects, where characterization of environmental exposures is quite limited in most studies and often varies idiosyncratically between studies. Yet the importance of environmental exposures in the etiology of many disorders-and especially alcohol, tobacco, and drug use disorders-is undeniable. We discuss the potential for "big-data" approaches (e.g., aggregating data from state databases) to generate consistent measures of neighborhood environment across multiple studies, requiring only information about residential address (or ideally residential history) to make progress in G × E analyses. Big-data approaches may also help address limits to the generalizability of existing research literature, such as those that arise because of the limited numbers of severely alcohol-dependent mothers represented in prospective research studies.
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Affiliation(s)
- Andrew C. Heath
- Midwest Alcoholism Research Center,Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Christina N. Lessov-Schlaggar
- Midwest Alcoholism Research Center,Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Min Lian
- Midwest Alcoholism Research Center,Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Ruth Miller
- Midwest Alcoholism Research Center,Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Alexis E. Duncan
- Midwest Alcoholism Research Center,George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri
| | - Pamela A. F. Madden
- Midwest Alcoholism Research Center,Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
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16
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Sartor CE, Grant JD, Duncan AE, McCutcheon VV, Nelson EC, Calvert WJ, Madden PA, Heath AC, Bucholz KK. Childhood sexual abuse and two stages of cigarette smoking in African-American and European-American young women. Addict Behav 2016; 60:131-6. [PMID: 27131220 DOI: 10.1016/j.addbeh.2016.03.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 03/29/2016] [Accepted: 03/31/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of the current study was to determine whether the higher rates of childhood sexual abuse (CSA) but lower rates of cigarette smoking in African-American vs. European-American women can be explained in part by a lower magnitude of association between CSA and smoking in African-American women. METHODS Data were drawn from a same-sex female twin study of substance use (n=3521; 14.3% African-American). Cox proportional hazards regression analyses using CSA to predict smoking initiation and progression to regular smoking were conducted separately by race/ethnicity. Co-twin status on the smoking outcome was used to adjust for familial influences on smoking (which may overlap with family-level influences on CSA exposure). RESULTS After adjusting for co-twin status, CSA was associated with smoking initiation in European Americans (hazard ratio (HR)=1.43, 95% confidence intervals (CI): 1.26-1.62) and with smoking initiation ≤16 in African Americans (HR=1.70, CI: 1.26-2.29). CSA was associated with regular smoking onset ≤15 in European Americans (HR=1.63, CI: 1.21-2.18), with no change in HR after adjusting for co-twin status. In the African-American subsample, the HR for CSA was reduced to non-significance after adjusting for co-twin status (from HR=3.30, CI: 1.23-8.89 to HR=1.16, CI: 0.71-1.92 for regular smoking ≤15). CONCLUSIONS CSA is associated with moderate elevation in risk for initiating smoking among African-American and European-American women. By contrast, CSA is associated with elevated risk for (adolescent onset) regular smoking only in European-American women. Furthermore, there is significant overlap between risk conferred by CSA and familial influences on regular smoking in African-American but not European-American women.
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17
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Brewerton TD, Duncan AE. Associations between Attention Deficit Hyperactivity Disorder and Eating Disorders by Gender: Results from the National Comorbidity Survey Replication. Eur Eat Disord Rev 2016; 24:536-540. [PMID: 27480884 DOI: 10.1002/erv.2468] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 07/09/2016] [Accepted: 07/13/2016] [Indexed: 11/11/2022]
Abstract
Few studies have assessed the association between attention-deficit hyperactivity disorder (ADHD) and eating disorders (ED) separately in men and women, especially in representative samples. Using data from the National Comorbidity Survey Replication, lifetime and past 12-month prevalence of Diagnostic and Statistical Manual of Mental Disorders IV, ADHD was compared in men and women with and without diagnoses of Diagnostic and Statistical Manual of Mental Disorders IV ED and any binge eating (BE) using logistic regression models adjusted for gender and age. In both sexes, those with lifetime and past 12-month BE and binge eating disorder had significantly higher prevalence of ADHD than those without BE and binge eating disorder, respectively. Women with lifetime and past 12-month bulimia nervosa and lifetime anorexia nervosa also had significantly higher prevalence of ADHD compared with women without these diagnoses. Given that ADHD invariably began earlier than the ED, ADHD may be an important risk factor for subsequent BE and related ED, and there may be opportunities for intervention among youth with ADHD. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Timothy D Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
| | - Alexis E Duncan
- Brown School, Washington University in St. Louis, St. Louis, MO, USA.,Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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18
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Sartor CE, Jackson KM, McCutcheon VV, Duncan AE, Grant JD, Werner KB, Bucholz KK. Progression from First Drink, First Intoxication, and Regular Drinking to Alcohol Use Disorder: A Comparison of African American and European American Youth. Alcohol Clin Exp Res 2016; 40:1515-23. [PMID: 27256613 PMCID: PMC4930366 DOI: 10.1111/acer.13113] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 04/25/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Differences between African Americans (AAs) and European Americans (EAs) in the prevalence and age at onset of alcohol use and alcohol use disorder (AUD) have been documented, but distinctions in the timing of early stage transitions and contribution of various psychiatric and psychosocial risk factors to the progression from initiation to AUD have yet to be investigated. The current study characterized progression from alcohol use initiation-defined alternatively as first drink, first intoxication, and regular drinking onset-to AUD in AA and EA youth. METHODS Psychiatric interviews were administered via telephone to 1,461 participants (56% AA, 44% EA) in a high-risk family study (50.3% female, mean age = 17.6 [SD = 3.8]). Cox proportional hazards regression analyses were conducted separately for the AA and EA subsamples to predict DSM-5 AUD as a function of age at alcohol use initiation, with age at first drink, age at first intoxication, and age at regular drinking onset as the point of origin in separate models. RESULTS Across race/ethnicity, regardless of how it was measured, early alcohol use initiation predicted AUD, but hazard ratios (HRs) were lowest for first drink. Regular smoking and social anxiety disorder were significant predictors in both racial/ethnic groups, but associations with conduct disorder (all 3 models: HR range = 2.07 to 4.15) and major depressive disorder (regular drinking: HR = 4.51, confidence interval [CI]: 1.60 to 12.69 for AUD onset ≥ age 20) were specific to AAs. Posttraumatic stress disorder (HR = 5.38, CI: 1.44 to 20.08) and generalized anxiety disorder (HR = 7.35, CI: 2.31 to 23.34 for AUD onset ≤ age 17) were strongly associated with progression from regular drinking to AUD exclusively in EAs. CONCLUSIONS Early alcohol use initiation is a marker of risk for AUD in both AA and EA youth, but the contributions of various psychiatric risk factors to the development of AUD are not universal across racial/ethnic groups.
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Affiliation(s)
- Carolyn E. Sartor
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Kristina M. Jackson
- Department of Behavioral and Social Sciences, Brown School of Public Health, Brown University, Providence, RI, USA
| | - Vivia V. McCutcheon
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Alexis E. Duncan
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- George Warren Brown School of Social Work, Washington University, St. Louis, MO, USA
| | - Julia D. Grant
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Kimberly B. Werner
- George Warren Brown School of Social Work, Washington University, St. Louis, MO, USA
| | - Kathleen K. Bucholz
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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19
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Sartor CE, Agrawal A, Grant JD, Duncan AE, Madden PAF, Lynskey MT, Heath AC, Bucholz KK. Differences Between African-American and European-American Women in the Association of Childhood Sexual Abuse With Initiation of Marijuana Use and Progression to Problem Use. J Stud Alcohol Drugs 2015; 76:569-77. [PMID: 26098032 DOI: 10.15288/jsad.2015.76.569] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Childhood sexual abuse (CSA) is associated with elevated risk of early marijuana use and cannabis use disorder (CUD). Both the prevalence of CSA and the course of marijuana use differ between African Americans and European Americans. The current study aimed to determine whether these differences manifest in racial/ ethnic distinctions in the association of CSA with early and problem use of marijuana. METHOD Data were derived from female participants in a female twin study and a high-risk family study of substance use (n = 4,193, 21% African-American). Cox proportional hazard regression analyses using CSA to predict initiation of marijuana use and progression to CUD symptom(s) were conducted separately by race/ethnicity. Sibling status on the marijuana outcome was used to adjust for familial influences. RESULTS CSA was associated with both stages of marijuana use in African-American and European-American women. The association was consistent over the risk period (hazard ratio [HR] = 1.57, 95% confidence interval [CI] [1.37, 1.79] for initiation; HR = 1.51, 95% CI [1.21, 1.88] for CUD symptom onset) in European-American women. In African-American women, the HRs for initiation were 2.52 (95% CI [1.52, 4.18]) before age 15, 1.82 (95% CI [1.36, 2.44]) at ages 15-17, and nonsignificant after age 17. In the CUD symptom model, CSA predicted onset only at age 21 and older (HR = 2.17, 95% CI [1.31, 3.59]). CONCLUSIONS The association of CSA with initiation of marijuana use and progression to problem use is stable over time in European-American women, but in African-American women, it varies by developmental period. Findings suggest the importance of considering race/ethnicity in prevention efforts with this high-risk population.
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Affiliation(s)
- Carolyn E Sartor
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.,Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Julia D Grant
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Alexis E Duncan
- George Warren Brown School of Social Work, Washington University, St. Louis, Missouri
| | - Pamela A F Madden
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Michael T Lynskey
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Andrew C Heath
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Kathleen K Bucholz
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
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20
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Munn-Chernoff MA, Keel PK, Klump KL, Grant JD, Bucholz KK, Madden PAF, Heath AC, Duncan AE. Prevalence of and familial influences on purging disorder in a community sample of female twins. Int J Eat Disord 2015; 48:601-6. [PMID: 25808399 PMCID: PMC4543440 DOI: 10.1002/eat.22378] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 11/20/2014] [Accepted: 11/23/2014] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Purging disorder (PD) was recently included as an otherwise specified feeding or eating disorder (OSFED) in the DSM-5; however, limited information is available on its prevalence, and its etiology is unknown. METHOD Data from 1,790 monozygotic and 1,440 dizygotic European American female twins (age range = 18-29 years) from the Missouri Adolescent Female Twin Study were used to investigate prevalence and familial influences for PD. A structured clinical interview assessed lifetime DSM-IV criteria for eating disorders and PD. After adjustment for age, twin correlations and biometrical twin models were used to estimate familial (i.e., genetic plus shared environmental) influences on PD. RESULTS One hundred and twenty one (3.77%; 95% CI: 3.14, 4.49) women met criteria for lifetime PD. Twin correlations suggested that genetic, shared environmental, and nonshared environmental factors influenced liability to PD. Nonshared environmental factors accounted for 56% [35%, 79%] of the variance in PD. Although familial effects accounted for a significant proportion of variance (44% [21%, 65%]), it was not possible to disentangle the independent contributions of additive genetic effects (20% [0%, 65%]) and shared environmental effects (24% [0%, 57%]). DISCUSSION PD is a prevalent form of eating pathology. Familial factors are relevant to the development of PD but do not demonstrate the magnitude of heritable factors found for other eating disorders.
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Affiliation(s)
- Melissa A. Munn-Chernoff
- Department of Psychiatry and Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO
| | - Pamela K. Keel
- Department of Psychology, Florida State University, Tallahassee, FL
| | - Kelly L. Klump
- Department of Psychology, Michigan State University, East Lansing, MI
| | - Julia D. Grant
- Department of Psychiatry and Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO
| | - Kathleen K. Bucholz
- Department of Psychiatry and Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO
| | - Pamela A. F. Madden
- Department of Psychiatry and Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO
| | - Andrew C. Heath
- Department of Psychiatry and Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO
| | - Alexis E. Duncan
- Department of Psychiatry and Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO,George Warren Brown School of Social Work, Washington University, St. Louis, MO
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21
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Munn-Chernoff MA, Grant JD, Bucholz KK, Agrawal A, Lynskey MT, Madden PAF, Heath AC, Duncan AE. Bulimic Behaviors and Early Substance Use: Findings from a Cotwin-Control Study. Alcohol Clin Exp Res 2015; 39:1740-8. [PMID: 26248308 DOI: 10.1111/acer.12829] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 06/26/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Bulimic behaviors (i.e., binge eating and compensatory behaviors) and substance use frequently co-occur. However, the etiology underlying this association is poorly understood. This study evaluated the association between bulimic behaviors and early substance use, controlling for genetic and shared environmental factors. METHODS Participants were 3,540 young adult women from the Missouri Adolescent Female Twin Study. A telephone adaptation of the Semi-Structured Assessment for the Genetics of Alcoholism interview assessed DSM-IV bulimic behaviors, substance use, and other psychological characteristics. Lifetime bulimic behaviors were examined in twin pairs concordant and discordant for early substance use. Logistic regressions were adjusted for the nonindependence of twin data, zygosity, age, body mass index, early menarche (onset before age 12), and early sex (first consensual sexual intercourse before age 15). RESULTS In the entire study population, women who reported early use of alcohol or nicotine were more likely to engage in bulimic behaviors after adjusting for covariates. In 53 pairs of monozygotic twins discordant for alcohol experimentation before age 15, the twin who reported early alcohol experimentation had 3.21 (95% confidence interval = 1.54 to 6.67) times higher odds of reporting bulimic behaviors than the cotwin who did not report early alcohol experimentation, even after adjustment for covariates. CONCLUSIONS Findings suggest that early alcohol experimentation may contribute to the development of bulimic behaviors via mechanisms extending beyond shared vulnerability, including individual-specific environmental experiences or causal pathways.
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Affiliation(s)
- Melissa A Munn-Chernoff
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, Missouri
| | - Julia D Grant
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, Missouri
| | - Kathleen K Bucholz
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, Missouri
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, Missouri
| | - Michael T Lynskey
- Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, United Kingdom
| | - Pamela A F Madden
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, Missouri
| | - Andrew C Heath
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, Missouri
| | - Alexis E Duncan
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, Missouri.,George Warren Brown School of Social Work, Washington University, St. Louis, Missouri
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22
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Diemer EW, Grant JD, Munn-Chernoff MA, Patterson DA, Duncan AE. Gender Identity, Sexual Orientation, and Eating-Related Pathology in a National Sample of College Students. J Adolesc Health 2015; 57:144-9. [PMID: 25937471 PMCID: PMC4545276 DOI: 10.1016/j.jadohealth.2015.03.003] [Citation(s) in RCA: 223] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 02/28/2015] [Accepted: 03/06/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE This study examined associations of gender identity and sexual orientation with self-reported eating disorder (SR-ED) diagnosis and compensatory behaviors in transgender and cisgender college students. METHODS Data came from 289,024 students from 223 U.S. universities participating in the American College Health Association-National College Health Assessment II (median age, 20 years). Rates of past-year SR-ED diagnosis and past-month use of diet pills and vomiting or laxatives were compared among transgender students (n = 479) and cisgender sexual minority (SM) male (n = 5,977) and female (n = 9,445), unsure male (n = 1,662) and female (n = 3,395), and heterosexual male (n = 91,599) and female (n = 176,467) students using chi-square tests. Logistic regression models were used to estimate the odds of eating-related pathology outcomes after adjusting for covariates. RESULTS Rates of past-year SR-ED diagnosis and past-month use of diet pills and vomiting or laxatives were highest among transgender students and lowest among cisgender heterosexual men. Compared to cisgender heterosexual women, transgender students had greater odds of past-year SR-ED diagnosis (odds ratio [OR], 4.62; 95% confidence interval [CI], 3.41-6.26) and past-month use of diet pills (OR, 2.05; 95% CI, 1.48-2.83) and vomiting or laxatives (OR, 2.46; 95% CI, 1.83-3.30). Although cisgender SM men and unsure men and women also had elevated rates of SR-ED diagnosis than heterosexual women, the magnitudes of these associations were lower than those for transgender individuals (ORs; 1.40-1.54). CONCLUSIONS Transgender and cisgender SM young adults have elevated rates of compensatory behavior and SR-ED diagnosis. Appropriate interventions for these populations are urgently needed.
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Affiliation(s)
| | - Julia D. Grant
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63130,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO 63110
| | - Melissa A. Munn-Chernoff
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63130,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO 63110
| | - David A. Patterson
- George Warren Brown School of Social Work, Washington University, St. Louis, MO 63130
| | - Alexis E. Duncan
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63130,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO 63110,George Warren Brown School of Social Work, Washington University, St. Louis, MO 63130
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Munn-Chernoff MA, Grant JD, Agrawal A, Sartor CE, Werner KB, Bucholz KK, Madden PAF, Heath AC, Duncan AE. Genetic overlap between alcohol use disorder and bulimic behaviors in European American and African American women. Drug Alcohol Depend 2015; 153:335-40. [PMID: 26096536 PMCID: PMC4509802 DOI: 10.1016/j.drugalcdep.2015.05.043] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 05/29/2015] [Accepted: 05/30/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Despite substantial evidence that alcohol use disorder (AUD) and bulimic behaviors (i.e., binge eating and compensatory behaviors) co-occur, insufficient information exists regarding a possible shared etiology. Moreover, although numerous twin studies of European ancestry individuals have reported moderate heritability estimates for AUD and bulimic behaviors, with little evidence for shared environmental factors, research on genetic and environmental risk in African American (AA) individuals is lacking. METHODS We investigated specific and overlapping genetic and environmental influences on AUD and bulimic behaviors in 3232 European American (EA; 55.38% monozygotic) and 549 AA (42.81% monozygotic) young adult female twins from the Missouri Adolescent Female Twin Study (age range=18-29 years). A structured clinical interview assessed lifetime DSM-5 AUD (minus craving) and bulimic behaviors. Biometrical twin modeling was conducted to generate age-adjusted estimates of genetic and environmental influences on AUD, bulimic behaviors, and their comorbidity. RESULTS Estimates of genetic and environmental contributions on AUD and bulimic behaviors could be equated across EA and AA women. Additive genetic effects accounted for 59% (95% CI: 50%, 66%) and 43% (33%, 52%) of the variance in AUD and bulimic behaviors, respectively, with the remainder due to non-shared environmental effects. Shared genetic factors (rg=.33 (.18, .49)) were solely responsible for the correlation between phenotypes; the non-shared environmental correlation was not significant (re=.10 (-.05, .25)). CONCLUSIONS Findings indicate similar magnitudes of genetic and environmental effects on AUD and bulimic behaviors for EA and AA women and implicate common genetic mechanisms underlying liability to these problem behaviors.
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Affiliation(s)
| | - Julia D. Grant
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid, CB 8134, St. Louis, MO 63110, USA.
| | - Carolyn E. Sartor
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO,Department of Psychiatry, Yale University School of Medicine, West Haven, CT
| | - Kimberly B. Werner
- George Warren Brown School of Social Work, Washington University, St. Louis, MO
| | - Kathleen K. Bucholz
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Pamela A. F. Madden
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Andrew C. Heath
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Alexis E. Duncan
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO,George Warren Brown School of Social Work, Washington University, St. Louis, MO
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24
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Duncan AE, Sartor CE, Jonson-Reid M, Munn-Chernoff MA, Eschenbacher MA, Diemer EW, Nelson EC, Waldron M, Bucholz KK, Madden PA, Heath AC. Associations between body mass index, post-traumatic stress disorder, and child maltreatment in young women. Child Abuse Negl 2015; 45:154-62. [PMID: 25770346 PMCID: PMC4470860 DOI: 10.1016/j.chiabu.2015.02.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 02/03/2015] [Accepted: 02/09/2015] [Indexed: 05/16/2023]
Abstract
The objective of this study was to examine interrelationships between child maltreatment, post-traumatic stress disorder (PTSD) and body mass index (BMI) in young women. We used multinomial logistic regression models to explore the possibility that PTSD statistically mediates or moderates the association between BMI category and self-reported childhood sexual abuse (CSA), physical abuse (CPA), or neglect among 3,699 young women participating in a population-based twin study. Obese women had the highest prevalence of CSA, CPA, neglect, and PTSD (p<.001 for all). Although all three forms of child maltreatment were significantly, positively associated with overweight and obesity in unadjusted models, only CSA was significantly associated with obesity after adjusting for other forms of maltreatment and covariates (OR=2.21, 95% CI: 1.63, 3.00). CSA and neglect, but not CPA, were associated with underweight in unadjusted models; however, after adjusting for other forms of maltreatment and covariates, the associations were no longer statistically significant (OR=1.43, 95% CI: 0.90-2.28 and OR=2.16, 95% CI: 0.90-5.16 for CSA and neglect, respectively). Further adjustment for PTSD generally resulted in modest attenuation of effects across associations of child maltreatment forms with BMI categories, suggesting that PTSD may, at most, be only a weak partial mediator of these associations. Future longitudinal studies are needed to elucidate the mechanisms linking CSA and obesity and to further evaluate the role of PTSD in associations between child maltreatment and obesity.
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Affiliation(s)
- Alexis E. Duncan
- George Warren Brown School of Social Work, Washington University, St. Louis, MO
- Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Carolyn E. Sartor
- Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Melissa Jonson-Reid
- George Warren Brown School of Social Work, Washington University, St. Louis, MO
| | - Melissa A. Munn-Chernoff
- Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | | | - Elizabeth W. Diemer
- George Warren Brown School of Social Work, Washington University, St. Louis, MO
| | - Elliot C. Nelson
- Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Mary Waldron
- Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO
- School of Education, Indiana University, Bloomington, IN
| | - Kathleen K. Bucholz
- Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Pamela A.F. Madden
- Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Andrew C. Heath
- Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
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25
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Grant JD, Waldron M, Sartor CE, Scherrer JF, Duncan AE, McCutcheon VV, Haber JR, Jacob T, Heath AC, Bucholz KK. Parental Separation and Offspring Alcohol Involvement: Findings from Offspring of Alcoholic and Drug Dependent Twin Fathers. Alcohol Clin Exp Res 2015; 39:1166-73. [PMID: 26058573 DOI: 10.1111/acer.12766] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 04/25/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND We examined associations between parental separation during childhood and offspring alcohol involvement, adjusting for genetic and environmental risks specific to parental alcohol (AD) and cannabis/other illicit drug dependence (DD). METHODS The sample consisted of 1,828 offspring of male twins from the Vietnam Era Twin (VET) Registry, who completed a telephone diagnostic interview. Cox proportional hazards regression analyses were conducted predicting onset of first use, transition from first use to first AD symptom, and transition from first use to AD diagnosis from paternal and avuncular AD and DD history, parental separation, and offspring and family background characteristics. Paternal/avuncular DD/AD was based on the DSM-III-R; offspring and maternal AD were based on DSM-IV criteria. RESULTS Paternal DD/AD predicted increased offspring risk for all transitions, with genetic effects suggested on rate of transitioning to AD diagnosis. Parental separation was predictive of increased risk for early alcohol use, but a reduced rate of transition to both AD symptom onset and onset of AD. No interactions between separation and familial risk (indexed by paternal or avuncular DD/AD) were found. CONCLUSIONS Findings highlight the contribution of both parental separation and paternal substance dependence in predicting timing of offspring alcohol initiation and problems across adolescence into early adulthood.
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Affiliation(s)
- Julia D Grant
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Mary Waldron
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.,Department of Counseling and Educational Psychology, Indiana University School of Education, Bloomington, Indiana
| | - Carolyn E Sartor
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.,Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Jeffrey F Scherrer
- Department of Family and Community Medicine, Saint Louis University, St. Louis, Missouri
| | - Alexis E Duncan
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.,George Warren Brown School of Social Work, Washington University, St. Louis, Missouri
| | - Vivia V McCutcheon
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Jon Randolph Haber
- Palo Alto Department of Veterans Affairs Medical Center, Palo Alto, California
| | - Theodore Jacob
- Palo Alto Department of Veterans Affairs Medical Center, Palo Alto, California
| | - Andrew C Heath
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Kathleen K Bucholz
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
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26
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Duncan AE, Auslander WF, Bucholz KK, Hudson DL, Stein RI, White NH. Relationship between abuse and neglect in childhood and diabetes in adulthood: differential effects by sex, national longitudinal study of adolescent health. Prev Chronic Dis 2015; 12:E70. [PMID: 25950577 PMCID: PMC4436043 DOI: 10.5888/pcd12.140434] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Few studies have investigated links between child abuse and neglect and diabetes mellitus in nationally representative samples, and none have explored the role of obesity in the relationship. We sought to determine whether child abuse and neglect were associated with diabetes and if so, whether obesity mediated this relationship in a population-representative sample of young adults. METHODS We used data from 14,493 participants aged 24 to 34 years from Wave IV of the National Longitudinal Study of Adolescent Health to study associations between self-reported child abuse (sexual, physical, or emotional abuse) and neglect as children and diabetes or prediabetes in young adulthood. We conducted sex-stratified logistic regression analyses to evaluate associations in models before and after the addition of body mass index (BMI) as a covariate. RESULTS Although the prevalence of diabetes was similar for men and women (7.0% vs 6.7%), men were more likely than women to have prediabetes (36.3% vs 24.6%; omnibus P < .001). Among men, recurrent sexual abuse (≥3 lifetime incidents) was significantly associated with diabetes (OR, 3.66; 95% CI, 1.31-10.24), but not with prediabetes. There was no evidence of mediation by BMI. No forms of child abuse or neglect were associated with diabetes or prediabetes among women. CONCLUSIONS Recurrent sexual abuse is robustly associated with diabetes in young adult men, independently of other forms of child abuse or neglect and BMI. Future research should explore other potential mechanisms for this association to identify avenues for prevention of diabetes among men who have experienced sexual abuse.
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Affiliation(s)
- Alexis E Duncan
- George Warren Brown School of Social Work, Washington University, One Brookings Dr, Campus Box 1196, St Louis, MO 63130. . Dr Duncan is also affiliated with the Center for Diabetes Translational Research of Washington University and the Midwest Alcoholism Research Center and the Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Wendy F Auslander
- Washington University and Washington University School of Medicine, St Louis, Missouri
| | - Kathleen K Bucholz
- Washington University and Washington University School of Medicine, St Louis, Missouri
| | | | - Richard I Stein
- Washington University and Washington University School of Medicine, St Louis, Missouri
| | - Neil H White
- Washington University and Washington University School of Medicine, St Louis, Missouri
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27
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Munn-Chernoff MA, Grant JD, Agrawal A, Koren R, Glowinski AL, Bucholz KK, Madden PAF, Heath AC, Duncan AE. Are there common familial influences for major depressive disorder and an overeating-binge eating dimension in both European American and African American female twins? Int J Eat Disord 2015; 48:375-82. [PMID: 24659561 PMCID: PMC4278948 DOI: 10.1002/eat.22280] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 01/14/2014] [Accepted: 03/11/2014] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Although prior studies have demonstrated that depression is associated with an overeating-binge eating dimension (OE-BE) phenotypically, little research has investigated whether familial factors contribute to the co-occurrence of these phenotypes, especially in community samples with multiple racial/ethnic groups. We examined the extent to which familial (i.e., genetic and shared environmental) influences overlapped between Major Depressive Disorder (MDD) and OE-BE in a population-based sample and whether these influences were similar across racial/ethnic groups. METHOD Participants included 3,226 European American (EA) and 550 African American (AA) young adult women from the Missouri Adolescent Female Twin Study. An adaptation of the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA) was administered to assess lifetime DSM-IV MDD and OE-BE. Quantitative genetic modeling was used to estimate familial influences between both phenotypes; all models controlled for age. RESULTS The best-fitting model, which combined racial/ethnic groups, found that additive genetic influences accounted for 44% (95% CI: 34%, 53%) of the MDD variance and 40% (25%, 54%) for OE-BE, with the remaining variances due to non-shared environmental influences. Genetic overlap was substantial (rg = .61 [.39, .85]); non-shared environmental influences on MDD and OE-BE overlapped weakly (re = .26 [.09, .42]). DISCUSSION Results suggest that common familial influences underlie MDD and OE-BE, and the magnitude of familial influences contributing to the comorbidity between MDD and OE-BE is similar between EA and AA women. If racial/ethnic differences truly exist, then larger sample sizes may be needed to fully elucidate familial risk for comorbid MDD and OE-BE across these groups.
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Affiliation(s)
- Melissa A. Munn-Chernoff
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63105,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO 63105
| | - Julia D. Grant
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63105,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO 63105
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63105,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO 63105
| | | | - Anne L. Glowinski
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63105,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO 63105
| | - Kathleen K. Bucholz
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63105,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO 63105
| | - Pamela A. F. Madden
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63105,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO 63105
| | - Andrew C. Heath
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63105,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO 63105
| | - Alexis E. Duncan
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63105,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO 63105,George Warren Brown School of Social Work, Washington University, St. Louis, MO 63130
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28
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Waldron M, Doran KA, Bucholz KK, Duncan AE, Lynskey MT, Madden PAF, Sartor CE, Heath AC. Parental separation, parental alcoholism, and timing of first sexual intercourse. J Adolesc Health 2015; 56:550-6. [PMID: 25907653 PMCID: PMC4409650 DOI: 10.1016/j.jadohealth.2015.01.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 12/22/2014] [Accepted: 01/20/2015] [Indexed: 11/19/2022]
Abstract
PURPOSE We examined timing of first voluntary sexual intercourse as a joint function of parental separation during childhood and parental history of alcoholism. METHODS Data were drawn from a birth cohort of female like-sex twins (n = 569 African ancestry [AA]; n = 3,415 European or other ancestry [EA]). Cox proportional hazards regression was conducted predicting age at first sex from dummy variables coding for parental separation and parental alcoholism. Propensity score analysis was also employed to compare intact and separated families, stratified by predicted probability of separation. RESULTS Earlier sex was reported by EA twins from separated and alcoholic families, compared to EA twins from intact nonalcoholic families, with effects most pronounced through the age of 14 years. Among AA twins, effects of parental separation and parental alcoholism were largely nonsignificant. Results of propensity score analyses confirmed unique risks from parental separation in EA families, where consistent effects of parental separation were observed across predicted probability of separation. For AA families, there was poor matching on risk factors presumed to predate separation, which limited interpretability of survival-analytic findings. CONCLUSIONS In European American families, parental separation during childhood is an important predictor of early-onset sex, beyond parental alcoholism and other correlated risk factors. To characterize risk for African Americans associated with parental separation, additional research is needed where matching on confounders can be achieved.
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Affiliation(s)
- Mary Waldron
- Department of Counseling and Educational Psychology, School of Education, Bloomington, Indiana University, Indiana; Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.
| | - Kelly A Doran
- Department of Counseling and Educational Psychology, School of Education, Bloomington, Indiana University, Indiana
| | - Kathleen K Bucholz
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Alexis E Duncan
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri; George Warren Brown School of Social Work, Washington University, St. Louis, Missouri
| | - Michael T Lynskey
- Addictions Department, Institute of Psychiatry, King's College, London, United Kingdom
| | - Pamela A F Madden
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Carolyn E Sartor
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri; Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Andrew C Heath
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
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29
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Hudson DL, Purnell JQ, Duncan AE, Baker E. Subjective religiosity, church attendance, and depression in the National Survey of American Life. J Relig Health 2015; 54:584-597. [PMID: 24615302 DOI: 10.1007/s10943-014-9850-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Studies have consistently indicated that blacks report lower rates of depression than whites. This study examined the association between religion and depression and whether religion explained lower rates of depression among blacks compared to whites. Data were drawn from the National Survey of American Life, a multi-ethnic sample of African Americans, Caribbean Blacks, and non-Hispanic whites (n = 6,082). African Americans and Caribbean Blacks reported higher mean levels of subjective religiosity than whites, but there were no significant differences in levels of church attendance. African Americans (OR 0.54; CI 0.45-0.65) and Caribbean Blacks (OR 0.66; CI 0.48-0.91) reported significantly lower odds of depression than whites. Differences in subjective religiosity and church attendance did not account for the association between major depression and African American and Caribbean Black race/ethnicity relative to whites. More research is needed to examine whether there are other factors that could protect against the development of depression.
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Affiliation(s)
- Darrell L Hudson
- George Warren Brown School of Social Work and Institute for Public Health, Washington University in St. Louis, One Brookings Drive Campus, Box 1196, Saint Louis, MO, 63130, USA,
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30
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Waldron M, Vaughan EL, Bucholz KK, Lynskey MT, Sartor CE, Duncan AE, Madden PAF, Heath AC. Risks for early substance involvement associated with parental alcoholism and parental separation in an adolescent female cohort. Drug Alcohol Depend 2014; 138:130-6. [PMID: 24647368 PMCID: PMC4012919 DOI: 10.1016/j.drugalcdep.2014.02.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 02/13/2014] [Accepted: 02/13/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND We examined timing of substance involvement as a joint function of parental history of alcoholism and parental separation during childhood. METHOD Data were drawn from a large cohort of female like-sex twins [n=613 African Ancestry (AA), n=3550 European or other ancestry (EA)]. Cox proportional hazards regression was conducted predicting age at first use of alcohol, first alcohol intoxication, first use and regular use of cigarettes, and first use of cannabis and other illicit drugs from dummy variables coding for parental alcoholism and parental separation. Propensity score analysis was also conducted comparing intact and separated families by predicted probability of parental separation. RESULTS In EA families, increased risk of substance involvement was found in both alcoholic and separated families, particularly through ages 10 or 14 years, with risk to offspring from alcoholic separated families further increased. In AA families, associations with parental alcoholism and parental separation were weak and with few exceptions statistically nonsignificant. While propensity score findings confirmed unique risks observed in EA families, intact and separated AA families were poorly matched on risk-factors presumed to predate parental separation, especially parental alcoholism, requiring cautious interpretation of AA survival-analytic findings. CONCLUSION For offspring of European ancestry, parental separation predicts early substance involvement that is not explained by parental alcoholism nor associated family background characteristics. Additional research is needed to better characterize risks associated with parental separation in African American families.
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Affiliation(s)
- Mary Waldron
- School of Education, Indiana University, Bloomington, IN, USA; Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
| | - Ellen L Vaughan
- School of Education, Indiana University, Bloomington, IN, USA
| | - Kathleen K Bucholz
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Michael T Lynskey
- Addictions Department, Institute of Psychiatry, King's College, London, UK
| | - Carolyn E Sartor
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Alexis E Duncan
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; George Warren Brown School of Social Work, Washington University, St. Louis, MO, USA
| | - Pamela A F Madden
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Andrew C Heath
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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31
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Munn-Chernoff MA, Duncan AE, Grant JD, Wade TD, Agrawal A, Bucholz KK, Madden PAF, Martin NG, Heath AC. A twin study of alcohol dependence, binge eating, and compensatory behaviors. J Stud Alcohol Drugs 2014; 74:664-73. [PMID: 23948525 DOI: 10.15288/jsad.2013.74.664] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Rates of alcohol dependence are elevated in women with eating disorders who engage in binge eating or compensatory behaviors compared with women with eating disorders who do not report binge eating or compensatory behaviors and with healthy controls. Alcohol dependence, binge eating, and compensatory behaviors are heritable; however, it is unclear whether a shared genetic liability contributes to the phenotypic association among these traits, and little information exists regarding this shared liability in men. We investigated genetic and environmental correlations among alcohol dependence, binge eating, and compensatory behaviors in male and female twins. METHOD Participants included 5,993 same- and opposite-sex twins from the Australian Twin Registry who completed a modified version of the Semi-Structured Assessment for the Genetics of Alcoholism that assessed lifetime alcohol dependence and binge eating as defined in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. Compensatory behaviors were assessed via a general health questionnaire in women only. Biometrical twin models estimated genetic and environmental influences on alcohol dependence, binge eating, and compensatory behaviors. RESULTS In women, the multivariate twin model suggested that additive genetic and nonshared environmental effects influenced alcohol dependence, binge eating, and compensatory behaviors, with heritability estimates ranging from 38% to 53%. The best-fitting sex-limitation model was a common effects model that equated all genetic and nonshared environmental influences in men and women. The heritability estimates were 50% and 38% for alcohol dependence and binge eating, respectively. Overall, there were significant genetic correlations between alcohol dependence and binge eating, alcohol dependence and compensatory behaviors, and binge eating and compensatory behaviors. CONCLUSIONS These findings indicate that common genetic factors may underlie the vulnerability to alcohol dependence and the liability to binge eating and compensatory behaviors.
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Affiliation(s)
- Melissa A Munn-Chernoff
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri 63110, USA.
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32
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Waldron M, Bucholz KK, Madden PAF, Duncan AE, Sartor CE, Heath AC. Alcohol dependence and reproductive timing in African and European ancestry women: findings in a midwestern twin cohort. J Stud Alcohol Drugs 2014; 75:235-40. [PMID: 24650817 PMCID: PMC3965677 DOI: 10.15288/jsad.2014.75.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 08/29/2013] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We examined associations between reproductive onset and history of alcohol dependence (AD) in 475 African ancestry (AA) and 2,865 European or other ancestry (EA) female twins. METHOD Participants were drawn from a U.S. midwestern birth cohort study of like-sex female twin pairs born between 1975 and 1985, ages 21-32 as of last completed assessment. Cox proportional hazards regression models were estimated predicting age at first childbirth from history of AD, separately by race/ethnicity, without and with adjustment for sociodemographic characteristics, body mass index, history of other substance involvement, psychopathology, and family and childhood risks. RESULTS Among EA twins, AD predicted early childbearing through age 17 and delayed childbearing from age 25 onward; in adjusted models, AD was associated with overall delayed childbearing. Among AA twins, reproductive timing and AD were not significantly related in either unadjusted or adjusted models. CONCLUSIONS Findings for twins of European ancestry are consistent with well-documented links between early alcohol mis/use and teenage parenting as well as delays in childbearing associated with drinking-related reproductive and relationship difficulties. Extension of analyses to other racial/ethnic groups of sufficient sample size remains important.
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Affiliation(s)
- Mary Waldron
- Department of Counseling and Educational Psychology, Indiana University School of Education, Bloomington, Indiana
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Kathleen K Bucholz
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Pamela A F Madden
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Alexis E Duncan
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
- George Warren Brown School of Social Work, Washington University, St. Louis, Missouri
| | - Carolyn E Sartor
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Andrew C Heath
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
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Ridaura VK, Faith JJ, Rey FE, Cheng J, Duncan AE, Kau AL, Griffin NW, Lombard V, Henrissat B, Bain JR, Muehlbauer MJ, Ilkayeva O, Semenkovich CF, Funai K, Hayashi DK, Lyle BJ, Martini MC, Ursell LK, Clemente JC, Van Treuren W, Walters WA, Knight R, Newgard CB, Heath AC, Gordon JI. Gut microbiota from twins discordant for obesity modulate metabolism in mice. Science 2013; 341:1241214. [PMID: 24009397 DOI: 10.1126/science.1241214] [Citation(s) in RCA: 2480] [Impact Index Per Article: 225.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The role of specific gut microbes in shaping body composition remains unclear. We transplanted fecal microbiota from adult female twin pairs discordant for obesity into germ-free mice fed low-fat mouse chow, as well as diets representing different levels of saturated fat and fruit and vegetable consumption typical of the U.S. diet. Increased total body and fat mass, as well as obesity-associated metabolic phenotypes, were transmissible with uncultured fecal communities and with their corresponding fecal bacterial culture collections. Cohousing mice harboring an obese twin's microbiota (Ob) with mice containing the lean co-twin's microbiota (Ln) prevented the development of increased body mass and obesity-associated metabolic phenotypes in Ob cage mates. Rescue correlated with invasion of specific members of Bacteroidetes from the Ln microbiota into Ob microbiota and was diet-dependent. These findings reveal transmissible, rapid, and modifiable effects of diet-by-microbiota interactions.
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Affiliation(s)
- Vanessa K Ridaura
- Center for Genome Sciences and Systems Biology, Washington University School of Medicine, St. Louis, MO 63108, USA
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Sartor CE, McCutcheon VV, Nelson EC, Duncan AE, Bucholz KK, Heath AC. Investigating the association between childhood sexual abuse and alcohol use disorders in women: does it matter how we ask about sexual abuse? J Stud Alcohol Drugs 2013; 73:740-8. [PMID: 22846238 DOI: 10.15288/jsad.2012.73.740] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE The purpose of this study was to determine whether the type of questions used to assess childhood sexual abuse (CSA) introduces systematic bias into estimations of the magnitude of the association between CSA and alcohol use disorders (AUDs). METHOD The Semi-Structured Assessment for the Genetics of Alcoholism was administered by telephone to 3,787 female twins ages 18-29 years (14.6% African American, 85.4% White). Interviews included questions regarding sexual abuse experiences described in behavioral terms and a standard trauma checklist (in a separate section) with the items "rape" and "sexual molestation," with definitions provided in respondent booklets. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnoses of alcohol abuse and dependence, parental history of alcohol-related problems, and psychiatric conditions associated with AUDs were also assessed. RESULTS The majority of women who endorsed one question type also endorsed the other type. Rates of psychiatric risk factors for AUDs did not vary by pattern of CSA question endorsement. Separate Cox proportional hazards regression analyses using CSA variables derived from behavioral questions (hazard ratio [HR] = 1.67, 95% CI [1.27, 2.19]) and checklist items (HR = 1.41,95% CI [1.08, 1.84]) each revealed elevated risk for AUDs associated with CSA, and HRs did not differ significantly across models. However, a Cox proportional hazards regression analysis predicting AUD from the pattern of CSA question endorsements revealed a significantly higher risk for AUDs among women who endorsed only behavioral questions (HR = 3.26, 95% CI [1.72, 6.21]) than for all other groups. CONCLUSIONS Findings underscore the importance of querying CSA in studies of alcohol-related problems and highlight some of the limitations of assessment methods that can be integrated into studies covering a wide range of psychosocial domains.
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Affiliation(s)
- Carolyn E Sartor
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.
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Sartor CE, Waldron M, Duncan AE, Grant JD, McCutcheon VV, Nelson EC, Madden PA, Bucholz KK, Heath AC. Childhood sexual abuse and early substance use in adolescent girls: the role of familial influences. Addiction 2013; 108:993-1000. [PMID: 23316725 PMCID: PMC3628962 DOI: 10.1111/add.12115] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 09/05/2012] [Accepted: 01/04/2013] [Indexed: 11/26/2022]
Abstract
AIM To assess the extent to which the association between childhood sexual abuse (CSA) and early use of alcohol, cigarettes and cannabis in adolescent girls is mediated by risk factors that tend to cluster in families where CSA occurs. DESIGN An abridged version of the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA) was administered by telephone. PARTICIPANTS A total of 3761 female twins aged 18-29 (14.6% African American, 85.4% European American). MEASUREMENTS CSA experiences and history of substance use were queried in the SSAGA-based interviews. FINDINGS After controlling for familial influences on early substance use by including co-twin early use status in models, separate Cox proportional hazards regression analyses predicting onset of alcohol, cigarette and cannabis use revealed a significant association with CSA. The effect was observed to age 19 years for cigarettes and to age 21 years for cannabis, but was limited to age 14 years or younger for alcohol, with the most pronounced risk before age 10 [hazard ratio (HR) = 4.59; confidence interval (CI): 1.96-10.74]. CSA-associated risk for initiation of cigarette and cannabis use was also highest in the youngest age range, but the decline with age was much more gradual and the hazard ratios significantly lower (HR: 1.70; CI: 1.13-2.56 for cigarettes and HR: 2.34, CI: 1.57-3.48 for cannabis). CONCLUSIONS Childhood sexual abuse history is a distinct risk factor for use of cigarettes and cannabis, and a very strong predictor of early age at first drink.
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Affiliation(s)
- Carolyn E. Sartor
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Mary Waldron
- Indiana University School of Education, Bloomington, IN, USA
| | - Alexis E. Duncan
- George Warren Brown School of Social Work, Washington University, St. Louis, MO, USA
| | - Julia D. Grant
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Vivia V. McCutcheon
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Elliot C. Nelson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Pamela A.F. Madden
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Kathleen K. Bucholz
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Andrew C. Heath
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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Sartor CE, Agrawal A, Lynskey MT, Duncan AE, Grant JD, Nelson EC, Madden PAF, Heath AC, Bucholz KK. Cannabis or alcohol first? Differences by ethnicity and in risk for rapid progression to cannabis-related problems in women. Psychol Med 2013; 43:813-823. [PMID: 22804877 PMCID: PMC3697079 DOI: 10.1017/s0033291712001493] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Initiation of cannabis use typically follows alcohol use, but the reverse order does occur and is more common for African-Americans (AAs) than European-Americans (EAs). The aim of this study was to test for differences in the order of initiation of cannabis and alcohol use between AA and EA women and to determine whether order and ethnicity contribute independently to risk for rapid progression to cannabis-related problems. Method Data were drawn from structured psychiatric interviews of 4102 women (mean age = 21.6 years), 3787 from an all-female twin study and 315 from a high-risk family study; 18.1% self-identified as AA, 81.9% as EA. Ethnicity and order of initiation of cannabis and alcohol use were modeled as predictors of transition time from first use to onset of cannabis use disorder symptom(s) using Cox proportional hazards regression analyses. RESULTS AA women were nearly three times as likely as EA women to initiate cannabis use before alcohol use. Using cannabis before alcohol [hazard ratio (HR) 1.44, 95% confidence interval (CI) 1.08-1.93] and AA ethnicity (HR 1.59, 95% CI 1.13-2.24) were both associated with rapid progression from first use to cannabis symptom onset even after accounting for age at initiation and psychiatric risk factors. CONCLUSIONS The findings indicate that AA women are at greater risk for rapid development of cannabis-related problems than EA women and that this risk is even higher when cannabis use is initiated before alcohol use. Prevention programs should be tailored to the various patterns of cannabis use and relative contributions of risk factors to the development of cannabis-related problems in different ethnic groups.
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Affiliation(s)
- C E Sartor
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06516, USA.
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Duncan AE, Lessov-Schlaggar CN, Sartor CE, Bucholz KK. Differences in time to onset of smoking and nicotine dependence by race/ethnicity in a Midwestern sample of adolescents and young adults from a high risk family study. Drug Alcohol Depend 2012; 125:140-5. [PMID: 22564873 PMCID: PMC3700542 DOI: 10.1016/j.drugalcdep.2012.04.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 04/05/2012] [Accepted: 04/06/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The objective of this study was to determine whether race/ethnicity was associated with time to smoking initiation and time from first cigarette to onset of DSM-IV nicotine dependence (ND) after adjusting for familial and individual psychosocial risk factors. METHODS Cox proportional hazards models with time-dependent covariates were used to analyze data from 1376 offspring aged 12-33 years from 532 families at high risk for substance use problems due to paternal alcohol problems and 235 low risk families. Fifty-six percent of the sample self-identified as African-American (AA) and 44% were mainly of European descent. RESULTS Controlling for covariates, AAs began smoking at older ages (HR=0.58; 95% CI: 0.48-0.70) and had longer times between smoking initiation and onset of ND compared to non-AAs (HR=0.25, 95% CI: 0.16-0.39 for ND onset occurring <18 years and HR=0.49, 95% CI: 0.30-0.80 for ND onsets ≥ age 18). After additionally controlling for number of cigarettes smoked daily, the racial/ethnic effects for onset of ND were attenuated, but remained statistically significant for ND onset <18 (HR=0.34, 95% CI: 0.19-0.61); however, the estimate was no longer significant for later ND onset (HR=0.84, 95% CI: 0.50-1.41). CONCLUSIONS AA adolescents and young adults initiate smoking at older ages and have longer transition periods between initiation and onset of ND compared to non-AAs, even after controlling for many relevant psychiatric and psychosocial covariates; however, racial/ethnic differences in time to onset of nicotine dependence in late adolescence and young adulthood may be explained by differences in daily quantity smoked.
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Affiliation(s)
- Alexis E. Duncan
- The Brown School, Washington University, St. Louis, MO 63130,Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110,Correspondence to: Alexis E. Duncan, Ph.D., The Brown School, Washington University in St. Louis, One Brookings Drive, Box 1196, St. Louis, MO 63130, USA, 314-935-6758 (phone), 314-935-6758 (fax);
| | | | - Carolyn E. Sartor
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110,Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63130,Department of Psychiatry, Yale University School of Medicine, West Haven, CT 06516
| | - Kathleen K. Bucholz
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110,Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63130
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McNulty NP, Yatsunenko T, Hsiao A, Faith JJ, Muegge BD, Goodman AL, Henrissat B, Oozeer R, Cools-Portier S, Gobert G, Chervaux C, Knights D, Lozupone CA, Knight R, Duncan AE, Bain JR, Muehlbauer MJ, Newgard CB, Heath AC, Gordon JI. The impact of a consortium of fermented milk strains on the gut microbiome of gnotobiotic mice and monozygotic twins. Sci Transl Med 2012; 3:106ra106. [PMID: 22030749 DOI: 10.1126/scitranslmed.3002701] [Citation(s) in RCA: 373] [Impact Index Per Article: 31.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Understanding how the human gut microbiota and host are affected by probiotic bacterial strains requires carefully controlled studies in humans and in mouse models of the gut ecosystem where potentially confounding variables that are difficult to control in humans can be constrained. Therefore, we characterized the fecal microbiomes and metatranscriptomes of adult female monozygotic twin pairs through repeated sampling 4 weeks before, 7 weeks during, and 4 weeks after consumption of a commercially available fermented milk product (FMP) containing a consortium of Bifidobacterium animalis subsp. lactis, two strains of Lactobacillus delbrueckii subsp. bulgaricus, Lactococcus lactis subsp. cremoris, and Streptococcus thermophilus. In addition, gnotobiotic mice harboring a 15-species model human gut microbiota whose genomes contain 58,399 known or predicted protein-coding genes were studied before and after gavage with all five sequenced FMP strains. No significant changes in bacterial species composition or in the proportional representation of genes encoding known enzymes were observed in the feces of humans consuming the FMP. Only minimal changes in microbiota configuration were noted in mice after single or repeated gavage with the FMP consortium. However, RNA-Seq analysis of fecal samples and follow-up mass spectrometry of urinary metabolites disclosed that introducing the FMP strains into mice results in significant changes in expression of microbiome-encoded enzymes involved in numerous metabolic pathways, most prominently those related to carbohydrate metabolism. B. animalis subsp. lactis, the dominant persistent member of the FMP consortium in gnotobiotic mice, up-regulates a locus in vivo that is involved in the catabolism of xylooligosaccharides, a class of glycans widely distributed in fruits, vegetables, and other foods, underscoring the importance of these sugars to this bacterial species. The human fecal metatranscriptome exhibited significant changes, confined to the period of FMP consumption, that mirror changes in gnotobiotic mice, including those related to plant polysaccharide metabolism. These experiments illustrate a translational research pipeline for characterizing the effects of FMPs on the human gut microbiome.
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Affiliation(s)
- Nathan P McNulty
- Center for Genome Sciences and Systems Biology, Washington University School of Medicine, St. Louis, MO 63108, USA
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Grant JD, Scherrer JF, Lynskey MT, Agrawal A, Duncan AE, Haber JR, Heath AC, Bucholz KK. Associations of alcohol, nicotine, cannabis, and drug use/dependence with educational attainment: evidence from cotwin-control analyses. Alcohol Clin Exp Res 2012; 36:1412-20. [PMID: 22587016 DOI: 10.1111/j.1530-0277.2012.01752.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Accepted: 12/07/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although substance use is associated with reduced educational attainment, this association may be owing to common risk factors such as socioeconomic disadvantage. We tested whether alcohol, nicotine, and illicit drug use and dependence were associated with lifetime educational attainment after controlling for familial background characteristics. METHODS Data were from a 1987 questionnaire and a 1992 telephone diagnostic interview of 6,242 male twins (n = 3,121 pairs; mean age = 41.9 years in 1992) who served in the U.S. military during the Vietnam era and therefore, were eligible for educational benefits after military service. Reduced educational attainment (<16 years) was examined in twin pairs discordant for substance use history. Substance use and dependence risk factors assessed were early alcohol and cannabis use, daily nicotine use, lifetime cannabis use, and alcohol, nicotine, cannabis, and any illicit drug dependence. RESULTS Three significant differences were observed between at-risk twins and their cotwins: Compared to their low-risk cotwins, likelihood of completing <16 years of education was significantly increased for the following: (i) twins who used alcohol before age 18 (adjusted OR = 1.44; 95% CI: 1.02 to 2.05), (ii) twins with a lifetime alcohol dependence diagnosis (adjusted OR = 1.76; 95% CI: 1.27 to 2.44), and (iii) twins who had used nicotine daily for 30 or more days (adjusted OR = 2.54, 95% CI: 1.55 to 4.17). However, no differences in education were observed among twin pairs discordant for cannabis initiation, early cannabis use, or cannabis, nicotine, or any illicit drug dependence. CONCLUSIONS Even in a veteran population with access to military educational benefits, early alcohol use, alcohol dependence, and daily nicotine use remained significantly associated with years of education after controlling for shared familial contributions to educational attainment. The association between other substances and educational attainment was explained by familial factors common to these substance use phenotypes and adult educational attainment.
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Affiliation(s)
- Julia D Grant
- Midwest Alcoholism Research Center at Washington University, Washington University School of Medicine, St. Louis, Missouri, USA.
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Sartor CE, McCutcheon VV, Pommer NE, Nelson EC, Duncan AE, Waldron M, Bucholz KK, Madden PAF, Heath AC. Posttraumatic stress disorder and alcohol dependence in young women. J Stud Alcohol Drugs 2011; 71:810-8. [PMID: 20946737 DOI: 10.15288/jsad.2010.71.810] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The aim of the current study is to characterize the relationship between posttraumatic stress disorder (PTSD) and alcohol dependence (AD) in women, distinguishing PTSD-specific influences on AD from the contribution of co-occurring psychiatric conditions and from the influences of trauma more generally. METHOD Trauma histories and DSM-IV lifetime diagnoses, including PTSD and AD, were obtained via telephone interview from 3,768 female twins. Based on PTSD status and trauma history, participants were categorized as no trauma (43.7%), trauma without PTSD (52.6%), or trauma with PTSD (3.7%). Cox proportional hazards regression analyses were conducted using trauma/PTSD status to predict AD, first adjusting only for ethnicity and parental problem drinking, then including conduct disorder, major depressive disorder, regular smoking, and cannabis abuse. RESULTS Before accounting for psychiatric covariates, elevated rates of AD were evident in both trauma-exposed groups, but those with PTSD were at significantly greater risk for AD than those without PTSD. This distinction was no longer statistically significant when psychiatric covariates were included in the model, but both trauma-exposed groups continued to show elevated odds of developing AD compared with the no trauma group. CONCLUSIONS The elevated rates of AD in women who have experienced trauma are not accounted for in full by psychiatric conditions that commonly co-occur with AD and trauma exposure. The greater likelihood of developing AD in the subset of trauma-exposed individuals who develop PTSD may reflect higher levels of distress and/ or higher rates of psychopathology associated with traumas that lead to PTSD rather than PTSD-specific influences.
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Affiliation(s)
- Carolyn E Sartor
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
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Agrawal A, Scherrer JF, Pergadia ML, Lynskey MT, Madden PAF, Sartor CE, Grant JD, Duncan AE, Haber JR, Jacob T, Bucholz KK, Xian H. A latent class analysis of DSM-IV and Fagerström (FTND) criteria for nicotine dependence. Nicotine Tob Res 2011; 13:972-81. [PMID: 21778154 DOI: 10.1093/ntr/ntr105] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Nicotine dependence is associated with considerable morbidity and mortality. Two predominant classification systems, the Diagnostic and Statistical Manual (DSM-IV) and Fagerström Test for Nicotine Dependence (FTND), have been used to measure liability to nicotine dependence, yet few studies have attempted to simultaneously examine both sets of criteria. METHODS Using a sample of 624 regular smoking individuals who are offspring of Vietnam Era Twin fathers ascertained for an offspring of twin study, we applied latent class analysis to the 7 DSM-IV and the 6 FTND criteria to classify individuals by their nicotine dependence symptom profiles. Post-hoc across-class comparisons were conducted using a variety of smoking-related variables and aspects of psychopathology. Whether a single class identified offspring at high genetic and environmental vulnerability was also investigated. RESULTS The cross-diagnosis kappa was .30. A 4-class solution fit these data best. The classes included a low DSM-low FTND class and a high DSM-high FTND class; a moderate DSM-moderate FTND class, which was distinguished by moderate levels of smoking and intermediate levels of comorbid psychopathology; and a light smoking-moderate FTND class consisting primarily of lighter smokers with a more recent onset of regular smoking. High genetic and environmental vulnerability to nicotine dependence was noted in all classes with no statistically significant across-class differences. CONCLUSIONS In general, the DSM-IV and FTND criteria performed similarly to define a continuum of risk for nicotine dependence. The emerging class of light smokers should be further investigated to assess whether they transition to another class or remain as such.
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Affiliation(s)
- Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA.
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Kristjansson SD, Pergadia ML, Agrawal A, Lessov-Schlaggar CN, McCarthy DM, Piasecki TM, Duncan AE, Bucholz KK, Madden PAF, Sher KJ, Heath AC. Smoking outcome expectancies in young adult female smokers: individual differences and associations with nicotine dependence in a genetically informative sample. Drug Alcohol Depend 2011; 116:37-44. [PMID: 21194853 PMCID: PMC3105190 DOI: 10.1016/j.drugalcdep.2010.11.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Revised: 10/01/2010] [Accepted: 11/13/2010] [Indexed: 10/18/2022]
Abstract
Outcome expectancy is a central construct in models of addiction. Several outcome expectancies associated with smoking cigarettes have been identified, and studies suggest that individual differences in smoking expectancies are related to important aspects of tobacco use, including levels of smoking, nicotine dependence and smoking cessation. In the present study, we used a novel analytic method, exploratory structural equation modeling (ESEM), to quantify smoking expectancies from a subset of items adapted from the Smoking Consequences Questionnaire (SCQ; Brandon and Baker, 1991) and SCQ-Adult (Copeland et al., 1995). In our sample of 1262 monozygotic and dizygotic young adult, female twins who were regular smokers, we quantified six smoking expectancy factors similar to those reported in previous studies. These included Negative Affect Reduction, Boredom Reduction, Weight Control, Taste Manipulation, Craving/Addiction and Stimulation-state Enhancement. We used genetic model-fitting to examine the extent to which individual differences in the expectancies were influenced by latent genetic, shared environmental and non-shared environmental factors. We also examined the validity of the expectancy factors by examining their associations with nicotine dependence (ND) before and after adjusting for comorbid diagnoses of drug dependence and alcohol use disorder. Results of the validity analysis indicated that all of the expectancies were associated with ND after covariate adjustment. Although we lacked the statistical power to distinguish between genetic and shared environmental sources of variance, our results suggest that smoking outcome expectancies aggregate in families, but the majority of variance in these expectancies is due to environmental factors specific to the individual.
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Affiliation(s)
- Sean D. Kristjansson
- Corresponding Author: Washington University School of Medicine, Department of Psychiatry, 606 South Euclid, Box 8134, St. Louis, MO 63110, United States. Tel: +1 314 286 2213; fax: +1 314 454 0432.
| | - Michele L. Pergadia
- Washington University School of Medicine, Department of Psychiatry, 606 South Euclid, Box 8134, St. Louis, MO 63110, United States
| | - Arpana Agrawal
- Washington University School of Medicine, Department of Psychiatry, 606 South Euclid, Box 8134, St. Louis, MO 63110, United States
| | - Christina N. Lessov-Schlaggar
- Washington University School of Medicine, Department of Psychiatry, 606 South Euclid, Box 8134, St. Louis, MO 63110, United States
| | - Denis M. McCarthy
- University of Missouri-Columbia, Department of Psychological Sciences, 210 McAlester Hall, Columbia, MO, 65211, United States
| | - Thomas M. Piasecki
- University of Missouri-Columbia, Department of Psychological Sciences, 210 McAlester Hall, Columbia, MO, 65211, United States
| | - Alexis E. Duncan
- Washington University School of Medicine, Department of Psychiatry, 606 South Euclid, Box 8134, St. Louis, MO 63110, United States
| | - Kathleen K. Bucholz
- Washington University School of Medicine, Department of Psychiatry, 606 South Euclid, Box 8134, St. Louis, MO 63110, United States
| | - Pamela A. F. Madden
- Washington University School of Medicine, Department of Psychiatry, 606 South Euclid, Box 8134, St. Louis, MO 63110, United States
| | - Kenneth J. Sher
- University of Missouri-Columbia, Department of Psychological Sciences, 210 McAlester Hall, Columbia, MO, 65211, United States
| | - Andrew C. Heath
- Washington University School of Medicine, Department of Psychiatry, 606 South Euclid, Box 8134, St. Louis, MO 63110, United States
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Sartor CE, McCutcheon VV, Pommer NE, Nelson EC, Grant JD, Duncan AE, Waldron M, Bucholz KK, Madden PAF, Heath AC. Common genetic and environmental contributions to post-traumatic stress disorder and alcohol dependence in young women. Psychol Med 2011; 41:1497-1505. [PMID: 21054919 PMCID: PMC3377473 DOI: 10.1017/s0033291710002072] [Citation(s) in RCA: 162] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The few genetically informative studies to examine post-traumatic stress disorder (PTSD) and alcohol dependence (AD), all of which are based on a male veteran sample, suggest that the co-morbidity between PTSD and AD may be attributable in part to overlapping genetic influences, but this issue has yet to be addressed in females.MethodData were derived from an all-female twin sample (n=3768) ranging in age from 18 to 29 years. A trivariate genetic model that included trauma exposure as a separate phenotype was fitted to estimate genetic and environmental contributions to PTSD and the degree to which they overlap with those that contribute to AD, after accounting for potential confounding effects of heritable influences on trauma exposure. RESULTS Additive genetic influences (A) accounted for 72% of the variance in PTSD; individual-specific environmental (E) factors accounted for the remainder. An AE model also provided the best fit for AD, for which heritability was estimated to be 71%. The genetic correlation between PTSD and AD was 0.54. CONCLUSIONS The heritability estimate for PTSD in our sample is higher than estimates reported in earlier studies based almost exclusively on an all-male sample in which combat exposure was the precipitating traumatic event. However, our findings are consistent with the absence of evidence for shared environmental influences on PTSD and, most importantly, the substantial overlap in genetic influences on PTSD and AD reported in these investigations. Additional research addressing potential distinctions by gender in the relative contributions of genetic and environmental influences on PTSD is merited.
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Affiliation(s)
- C E Sartor
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA.
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Duncan AE, Agrawal A, Bucholz KK, Sartor CE, Madden PA, Heath AC. Deconstructing the architecture of alcohol abuse and dependence symptoms in a community sample of late adolescent and emerging adult women: an item response approach. Drug Alcohol Depend 2011; 116:222-7. [PMID: 21306836 PMCID: PMC3135415 DOI: 10.1016/j.drugalcdep.2011.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Revised: 12/22/2010] [Accepted: 01/07/2011] [Indexed: 11/16/2022]
Abstract
The objective of this study was to examine the underlying factorial architecture of lifetime DSM-IV alcohol use disorder (AUD) criteria in a population-based sample of adolescent and emerging adult female twins who had ever used alcohol (n=2832; aged 18-25 years), and to determine whether thresholds and factor loadings differed by age. Item response modeling was applied to DSM-IV AUD criteria. Compound criteria (e.g., persistent desire or unsuccessful attempts to quit or cut down) were included as separate items. Of the remaining 16 items, tolerance and use despite physical problems were the most and least commonly endorsed items, respectively. Underlying the items was a single factor representing liability to AUDs. Factor loadings ranged from 0.67 for blackouts to 0.90 for time spent using/recovering from effects. Some items assessing different DSM-IV criteria had very similar measurement characteristics, while others assessing the same criterion showed markedly different thresholds and factor loadings. Compared to that of women aged 21-25 years, the threshold for hazardous use was higher in women aged 18-20 years, but lower for used longer than intended and persistent desire to cut down. After accounting for threshold differences, no variations in discrimination across age groups were observed. In agreement with the extant literature, our findings indicate that the factorial structure of AUD is unidimensional, with no support for the abuse/dependence distinction. Individual components of compound criteria may differ in measurement properties; therefore pooling information from such divergent items will reduce information about the AUD construct.
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Affiliation(s)
- Alexis E. Duncan
- George Warren Brown School of Social Work, Washington University, St. Louis, MO,Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Arpana Agrawal
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Kathleen K. Bucholz
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Carolyn E. Sartor
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Pamela A.F. Madden
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Andrew C. Heath
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
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Haber JR, Bucholz KK, Jacob T, Grant JD, Scherrer JF, Sartor CE, Duncan AE, Heath A. Effect of paternal alcohol and drug dependence on offspring conduct disorder: gene-environment interplay. J Stud Alcohol Drugs 2011; 71:652-63. [PMID: 20731970 DOI: 10.15288/jsad.2010.71.652] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Not only are substance-use disorders and externalizing disorders frequently comorbid, they often co-occur in families across generations. The current study examined the role of genetic and environmental influences in the relationship between paternal histories of drug dependence or alcohol dependence and offspring conduct disorder using an offspring-of-twins design. METHOD Participants were male twins (n = 1,774) from the Vietnam Era Twin Registry, their offspring (n = 1,917), and mothers of the offspring (n = 1,202). Twins had a history of drug dependence, alcohol dependence, or neither. Based on the father's and his co-twin's drug-dependence or alcohol-dependence history and zygosity, risk groups were constructed to reflect different levels of genetic and environmental risk that were then used to predict offspring conduct disorder. RESULTS After controlling for potentially confounding variables, the offspring of men with a history of drug dependence or alcohol dependence had significantly higher rates of conduct disorder, compared with offspring of men without this history. Offspring at higher genetic risk had higher rates of conduct disorder. High-risk offspring at lower environmental risk had lower rates of conduct disorder but only in the case of paternal drug-dependence risk. Lower environmental risk did not influence rates of offspring conduct disorder when the father had an alcohol-dependence history. CONCLUSIONS Genetic risk associated with both paternal drug-dependence and paternal alcohol-dependence histories predicted offspring conduct-disorder risk, but only risk associated with paternal drug-dependence history was mitigated by having a low-risk environment. These results demonstrated a significant gene-environment interaction effect.
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Affiliation(s)
- Jon Randolph Haber
- Palo Alto Veterans Affairs Health Care System, 795 Willow Road, MC151-J, Menlo Park, California 94025-2539, USA.
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Duncan AE, Lessov-Schlaggar CN, Nelson EC, Pergadia ML, Madden PAF, Heath AC. Body mass index and regular smoking in young adult women. Addict Behav 2010; 35:983-8. [PMID: 20634004 PMCID: PMC3071024 DOI: 10.1016/j.addbeh.2010.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2009] [Revised: 05/14/2010] [Accepted: 06/14/2010] [Indexed: 11/17/2022]
Abstract
Little is known about the relationship between relative body weight and transition from experimentation to regular smoking in young adult women. In the current study, data from 2494 participants in wave 4 of the Missouri Adolescent Female Twin Study (aged 18-29years) who reported ever smoking a cigarette were analyzed using logistic regression. Body mass index (BMI) at time of interview was categorized according to CDC adult guidelines, and regular smoking was defined as having ever smoked 100 or more cigarettes and having smoked at least once a week for two months in a row. Since the OR's for the overweight and obese groups did not differ significantly from one another in any model tested, these groups were combined. Forty-five percent of women who had ever smoked had become regular smokers. Testing of interactions between potential covariates and levels of the categorical BMI variable revealed a significant interaction between overweight/obesity and childhood sexual abuse (CSA; p<0.001) associated with regular smoking. Among women reporting CSA, the association between overweight/obesity and having become a regular smoker was negative (n=374; OR=0.48, 95% CI: 0.28-0.81). Both underweight and overweight/obesity were positively associated with transition to regular smoking among women who did not report CSA (n=2076; OR=1.57, 95% CI: 1.05-2.35 and OR=1.73, 95% CI: 1.35-2.20, respectively). These results suggest that experiencing CSA alters the association between BMI and regular smoking in women who have experimented with cigarettes.
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Affiliation(s)
- Alexis E Duncan
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, United States.
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Agrawal A, Scherrer JF, Grant JD, Sartor CE, Pergadia ML, Duncan AE, Madden PAF, Haber JR, Jacob T, Bucholz KK, Xian H. The effects of maternal smoking during pregnancy on offspring outcomes. Prev Med 2010; 50:13-8. [PMID: 20026103 PMCID: PMC2813884 DOI: 10.1016/j.ypmed.2009.12.009] [Citation(s) in RCA: 118] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Revised: 12/07/2009] [Accepted: 12/08/2009] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To evaluate the possible association between maternal smoking during pregnancy and offspring outcomes of birth weight, pre-term birth, remediation, low scholastic achievement, regular smoking, attention deficit hyperactivity disorder and conduct problems while controlling for similar behaviors in parents. METHODS Using telephone interviews, data were collected, in 2001 and 2004, as a part of two United States offspring-of-twins projects. Fathers, who were twins participating in the Vietnam Era Twin Registry, their female spouse and their offspring were interviewed - information on 1,342 unique pregnancies in mothers with a history of regular smoking was utilized for these analyses. The association between maternal smoking during pregnancy and birth weight, pre-term birth, remediation, low scholastic achievement, regular smoking, attention deficit hyperactivity disorder and conduct disorder while controlling for similar behaviors in parents, was examined using regression. RESULTS Maternal smoking during pregnancy was associated with decreased birth weight, low scholastic achievement, regular smoking and attention deficit hyperactivity disorder. However, the association between maternal smoking during pregnancy and offspring attention deficit hyperactivity disorder was explained by maternal attention deficit hyperactivity disorder. Maternal smoking during pregnancy was also associated with earlier age of offspring initiation of smoking and onset of regular smoking. CONCLUSIONS Maternal smoking during pregnancy may influence certain offspring outcomes via mechanisms that are independent from genetic risk attributable to comorbid conditions. Assisting expecting mothers with their smoking cessation efforts will likely provide widespread health benefits to both mother and offspring.
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Affiliation(s)
- Arpana Agrawal
- Washington University School of Medicine, Dept. of Psychiatry, Saint Louis, MO 63110, USA.
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Scherrer JF, Grant JD, Duncan AE, Sartor CE, Haber JR, Jacob T, Bucholz KK. Subjective effects to cannabis are associated with use, abuse and dependence after adjusting for genetic and environmental influences. Drug Alcohol Depend 2009; 105:76-82. [PMID: 19628344 PMCID: PMC3633518 DOI: 10.1016/j.drugalcdep.2009.06.014] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2008] [Revised: 04/24/2009] [Accepted: 06/12/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Previous reports in adults have suggested that the effects experienced after cannabis use can be described in terms of positive and negative subtypes that are heritable and are associated with abuse and dependence. This study extends existing research by inclusion of adolescents and young adults in an offspring of twins design which makes it possible to take into account genetic and environmental risks for substance use disorder. METHODS Data were collected from 725 twin members of the Vietnam Era Twin Registry, 839 of their 12-32 year old biological offspring and 427 mothers. Offspring who had ever used cannabis (n=464) were asked the degree to which they typically experienced 13 subjective effects shortly after using cannabis. Latent class analysis (LCA) was used to derive subjective effect classes and logistic regression models were computed to test associations between subjective effect class and heavy cannabis use, abuse and dependence after adjusting for familial risk and psychopathology and sociodemographics. RESULTS The best fitting LCA model included 4 classes of responders which were characterized as 'high responders' (39%), 'positive responders' (28%), 'mixed/relaxed' (22%), and 'low responders' (11%). Compared to low responders, members of other classes were heavier users (OR range 3.0-11.8). Compared to mixed/relaxed responders and positive responders, high responders were more likely to have cannabis abuse and dependence. CONCLUSIONS Subjective reactions to cannabis use are associated with use to heavy use, abuse and dependence in adolescents and young adults. This association exists above and beyond the genetic vulnerability for problem cannabis use.
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Affiliation(s)
- Jeffrey F. Scherrer
- Research Service, St. Louis Veterans Affairs Medical Center, Research Service (151-JC), 915 North Grand Blvd, St. Louis, MO, United States,Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St. Louis, MO 63110, United States,Corresponding author at: Washington University School of Medicine, 660 South Euclid Ave, Campus Box 8134, St. Louis, MO 63110, United States. Tel.: +1 314 286 2226; fax: +1 314 286 2213. (J.F. Scherrer)
| | - Julia D. Grant
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St. Louis, MO 63110, United States
| | - Alexis E. Duncan
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St. Louis, MO 63110, United States
| | - Carolyn E. Sartor
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St. Louis, MO 63110, United States
| | - Jon R. Haber
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St. Louis, MO 63110, United States,Palo Alto Department of Veterans Affairs Medical Center, MC 151J, 795 Willow Road, Palo Alto, CA 94025, United States
| | - Theodore Jacob
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St. Louis, MO 63110, United States,Palo Alto Department of Veterans Affairs Medical Center, MC 151J, 795 Willow Road, Palo Alto, CA 94025, United States
| | - Kathleen K. Bucholz
- Research Service, St. Louis Veterans Affairs Medical Center, Research Service (151-JC), 915 North Grand Blvd, St. Louis, MO, United States,Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St. Louis, MO 63110, United States
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Duncan AE, Grant JD, Bucholz KK, Madden PAF, Heath AC. Relationship between body mass index, alcohol use, and alcohol misuse in a young adult female twin sample. J Stud Alcohol Drugs 2009; 70:458-66. [PMID: 19371498 DOI: 10.15288/jsad.2009.70.458] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE The aim of this study was to examine the relationships between body mass index (BMI) and alcohol use and misuse in young adulthood in a sample of black and white female twins. METHOD Cox proportional hazards and logistic regression models were used to examine the relationships between BMI category and first alcohol use, current weekly alcohol use, and current weekly heavy episodic drinking in 3,514 (14.06% black) young adult female twins. Analyses were conducted separately in black and white women. RESULTS After adjusting for relevant covariates, in white women obesity was protective against alcohol use (hazard ratio = 0.83; 95% confidence interval [CI]: 0.73-0.93) and against weekly drinking (odds ratio [OR] = 0.36; 95% CI: 0.24-0.53) and weekly heavy episodic drinking (OR = 0.51; 95% CI: 0.31-0.82) among ever drinkers compared with women of ideal weight. Overweight women living with their parents were less likely to be weekly drinkers (OR = 0.31; 95% CI: 0.16-0.61), whereas overweight women who were not living with their parents were less likely to be weekly heavy episodic drinkers (OR = 0.51; 95% CI: 0.31-0.82). Among black women, obesity was not associated with any of the drinking outcomes; however, black women who were overweight and who reported that the majority of their friends were not weekly drinkers had greater odds of reporting weekly drinking than those of ideal weight (OR = 2.91; 95% CI: 1.33-6.39). CONCLUSIONS Obese white women were less likely to ever use alcohol, be weekly drinkers, or be weekly heavy episodic drinkers than their ideal-weight peers. Body weight may affect drinking behavior in young women, and this effect may differ by race. Future research is needed to identify mediators and moderators of this relationship as well as to explore racial differences in the effect of body weight on drinking behavior.
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Affiliation(s)
- Alexis E Duncan
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
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Abstract
The objective of this study was to determine the genetic and environmental contributions to variation in BMI over time in European-American (EA) and African-American (AA) adolescent and young adult women. Self-reported BMI (kg/m(2)) data from 2,816 EA (1,306 twin pairs, 56.5% monozygotic (MZ)) and 404 AA (178 twin pairs, 42.7% MZ) women at baseline (T1; median age 15 years) and 3,225 EA (1,511 twin pairs, 55.3% MZ) and 539 AA (252 pairs, 43.3% MZ) women at follow-up (T2; median age 22 years) from a Midwestern US, population-based twin registry were used to construct biometrical genetic models. For EA women, the majority of the variance in BMI was attributable to additive genetic effects at both time points (82% for each), with the remaining variance attributable to nonshared environment. Genetic and nonshared environment correlations between adolescent and young adult BMI were 0.87 and 0.23, respectively. Among AA women, nonadditive genetic effects comprised 68% of the variance at T1 and 73% at T2, and were highly correlated (r(D) = 0.94). The proportions of variance attributable to nonshared environment at T1 (29%) and T2 (25%) were more modestly correlated (r(E) = 0.31). The remaining variance in AA women could be attributed to additive genetic effects. Additive vs. nonadditive genetic effects contribute differentially to BMI in AA vs. EA adolescent and young adult women. Additional research is needed to better characterize the environmental and genetic factors related to BMI in persons of different races to aid understanding of the complex determinants of body weight in individuals.
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Affiliation(s)
- Alexis E Duncan
- Midwest Alcoholism Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA.
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