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Lai D, Kuo SIC, Wetherill L, Aliev F, Zhang M, Abreu M, Schwantes-An TH, Dick D, Francis MW, Johnson EC, Kamarajan C, Kinreich S, Kuperman S, Meyers J, Nurnberger JI, Liu Y, Edenberg HJ, Porjesz B, Agrawal A, Foroud T, Schuckit M, Plawecki MH, Bucholz KK, McCutcheon VV. Associations between alcohol use disorder polygenic score and remission in participants from high-risk families and the Indiana Biobank. Alcohol Clin Exp Res (Hoboken) 2024; 48:283-294. [PMID: 38054532 PMCID: PMC10922306 DOI: 10.1111/acer.15239] [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] [Received: 08/01/2023] [Revised: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND In the United States, ~50% of individuals who meet criteria for alcohol use disorder (AUD) during their lifetimes do not remit. We previously reported that a polygenic score for AUD (PGSAUD ) was positively associated with AUD severity as measured by DSM-5 lifetime criterion count, and AUD severity was negatively associated with remission. Thus, we hypothesized that PGSAUD would be negatively associated with remission. METHODS Individuals of European (EA) and African ancestry (AA) from the Collaborative Study on the Genetics of Alcoholism (COGA) who met lifetime criteria for AUD, and two EA cohorts ascertained for studies of liver diseases and substance use disorders from the Indiana Biobank were included. In COGA, 12-month remission was defined as any period of ≥12 consecutive months without meeting AUD criteria except craving and was further categorized as abstinent and non-abstinent. In the Indiana Biobank, remission was defined based on ICD codes and could not be further distinguished as abstinent or non-abstinent. Sex and age were included as covariates. COGA analyses included additional adjustment for AUD severity, family history of remission, and AUD treatment history. RESULTS In COGA EA, PGSAUD was negatively associated with 12-month and non-abstinent remission (p ≤ 0.013, βs between -0.15 and -0.10) after adjusting for all covariates. In contrast to the COGA findings, PGSAUD was positively associated with remission (p = 0.004, β = 0.28) in the Indiana Biobank liver diseases cohort but not in the Indiana Biobank substance use disorder cohort (p = 0.17, β = 0.15). CONCLUSIONS PGSAUD was negatively associated with 12-month and non-abstinent remission in COGA EA, independent of behavioral measures of AUD severity and family history of remission. The discrepant results in COGA and the Indiana Biobank could reflect different ascertainment strategies: the Indiana Biobank participants were older and had higher rates of liver disease, suggesting that these individuals remitted due to alcohol-related health conditions that manifested in later life.
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Affiliation(s)
- Dongbing Lai
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Sally I-Chun Kuo
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ
| | - Leah Wetherill
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Fazil Aliev
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ
| | - Michael Zhang
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Marco Abreu
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Tae-Hwi Schwantes-An
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Danielle Dick
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ
| | | | - Emma C. Johnson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Chella Kamarajan
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Science University, NY
| | - Sivan Kinreich
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Science University, NY
| | - Samuel Kuperman
- Department of Psychiatry, University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, IA
| | - Jacquelyn Meyers
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Science University, NY
| | - John I Nurnberger
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
| | - Yunlong Liu
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Howard J Edenberg
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN
| | - Bernice Porjesz
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Science University, NY
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Marc Schuckit
- Department of Psychiatry, University of California, San Diego Medical School, San Diego, CA
| | - Martin H. Plawecki
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
| | - Kathleen K. Bucholz
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Vivia V. McCutcheon
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
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2
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Meyers JL, McCutcheon VV, Horne-Osipenko KA, Waters LR, Barr P, Chan G, Chorlian DB, Johnson EC, Kuo SIC, Kramer JR, Dick DM, Kuperman S, Kamarajan C, Pandey G, Singman D, de Viteri SSS, Salvatore JE, Bierut LJ, Foroud T, Goate A, Hesselbrock V, Nurnberger J, Plaweck MH, Schuckit MA, Agrawal A, Edenberg HJ, Bucholz KK, Porjesz B. COVID-19 pandemic stressors are associated with reported increases in frequency of drunkenness among individuals with a history of alcohol use disorder. Transl Psychiatry 2023; 13:311. [PMID: 37803048 PMCID: PMC10558437 DOI: 10.1038/s41398-023-02577-1] [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: 10/18/2022] [Revised: 07/25/2023] [Accepted: 07/31/2023] [Indexed: 10/08/2023] Open
Abstract
Some sources report increases in alcohol use have been observed since the start of the COVID-19 pandemic, particularly among women. Cross-sectional studies suggest that specific COVID-19-related stressful experiences (e.g., social disconnection) may be driving such increases in the general population. Few studies have explored these topics among individuals with a history of Alcohol Use Disorders (AUD), an especially vulnerable population. Drawing on recent data collected by the Collaborative Study on the Genetics of Alcoholism (COGA; COVID-19 study N = 1651, 62% women, age range: 30-91) in conjunction with AUD history data collected on the sample since 1990, we investigated associations of COVID-19 related stressors and coping activities with changes in drunkenness frequency since the start of the pandemic. Analyses were conducted for those without a history of AUD (N: 645) and three groups of participants with a history of AUD prior to the start of the pandemic: (1) those experiencing AUD symptoms (N: 606), (2) those in remission who were drinking (N: 231), and (3) those in remission who were abstinent (had not consumed alcohol for 5+ years; N: 169). Gender-stratified models were also examined. Exploratory analyses examined the moderating effects of 'problematic alcohol use' polygenic risk scores (PRS) and neural connectivity (i.e., posterior interhemispheric alpha EEG coherence) on associations between COVID-19 stressors and coping activities with changes in the frequency of drunkenness. Increases in drunkenness frequency since the start of the pandemic were higher among those with a lifetime AUD diagnosis experiencing symptoms prior to the start of the pandemic (14% reported increased drunkenness) when compared to those without a history of AUD (5% reported increased drunkenness). Among individuals in remission from AUD prior to the start of the pandemic, rates of increased drunkenness were 10% for those who were drinking pre-pandemic and 4% for those who had previously been abstinent. Across all groups, women reported nominally greater increases in drunkenness frequency when compared with men, although only women experiencing pre-pandemic AUD symptoms reported significantly greater rates of increased drunkenness since the start of the pandemic compared to men in this group (17% of women vs. 5% of men). Among those without a prior history of AUD, associations between COVID-19 risk and protective factors with increases in drunkenness frequency were not observed. Among all groups with a history of AUD (including those with AUD symptoms and those remitted from AUD), perceived stress was associated with increases in drunkenness. Among the remitted-abstinent group, essential worker status was associated with increases in drunkenness. Gender differences in these associations were observed: among women in the remitted-abstinent group, essential worker status, perceived stress, media consumption, and decreased social interactions were associated with increases in drunkenness. Among men in the remitted-drinking group, perceived stress was associated with increases in drunkenness, and increased relationship quality was associated with decreases in drunkenness. Exploratory analyses indicated that associations between family illness or death with increases in drunkenness and increased relationship quality with decreases in drunkenness were more pronounced among the remitted-drinking participants with higher PRS. Associations between family illness or death, media consumption, and economic hardships with increases in drunkenness and healthy coping with decreases in drunkenness were more pronounced among the remitted-abstinent group with lower interhemispheric alpha EEG connectivity. Our results demonstrated that only individuals with pre-pandemic AUD symptoms reported greater increases in drunkenness frequency since the start of the COVID-19 pandemic compared to those without a lifetime history of AUD. This increase was more pronounced among women than men in this group. However, COVID-19-related stressors and coping activities were associated with changes in the frequency of drunkenness among all groups of participants with a prior history of AUD, including those experiencing AUD symptoms, as well as abstinent and non-abstinent participants in remission. Perceived stress, essential worker status, media consumption, social connections (especially for women), and relationship quality (especially for men) are specific areas of focus for designing intervention and prevention strategies aimed at reducing pandemic-related alcohol misuse among this particularly vulnerable group. Interestingly, these associations were not observed for individuals without a prior history of AUD, supporting prior literature that demonstrates that widespread stressors (e.g., pandemics, terrorist attacks) disproportionately impact the mental health and alcohol use of those with a prior history of problems.
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Affiliation(s)
- Jacquelyn L Meyers
- Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, NY, USA.
| | - Vivia V McCutcheon
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Kristina A Horne-Osipenko
- Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Lawrence R Waters
- Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Peter Barr
- Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Grace Chan
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - David B Chorlian
- Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Emma C Johnson
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Sally I-Chun Kuo
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
| | - John R Kramer
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Danielle M Dick
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
| | - Samuel Kuperman
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Chella Kamarajan
- Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Gayathri Pandey
- Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Dzov Singman
- Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Stacey Subbie-Saenz de Viteri
- Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Jessica E Salvatore
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
| | - Laura J Bierut
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Tatiana Foroud
- Departments of Genetics and Genomic Sciences, Neuroscience, and Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alison Goate
- Departments of Genetics and Genomic Sciences, Neuroscience, and Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Victor Hesselbrock
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - John Nurnberger
- Department of Biochemistry and Molecular Biology and Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Martin H Plaweck
- Department of Biochemistry and Molecular Biology and Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Marc A Schuckit
- Department of Psychiatry, University of California San Diego Medical School, La Jolla, CA, USA
| | - Arpana Agrawal
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Howard J Edenberg
- Department of Biochemistry and Molecular Biology and Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Kathleen K Bucholz
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Bernice Porjesz
- Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn, NY, USA
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Miller AP, Kuo SIC, Johnson EC, Tillman R, Brislin SJ, Dick DM, Kamarajan C, Kinreich S, Kramer J, McCutcheon VV, Plawecki MH, Porjesz B, Schuckit MA, Salvatore JE, Edenberg HJ, Bucholz KK, Meyers JL, Agrawal A. Diagnostic Criteria for Identifying Individuals at High Risk of Progression From Mild or Moderate to Severe Alcohol Use Disorder. JAMA Netw Open 2023; 6:e2337192. [PMID: 37815828 PMCID: PMC10565602 DOI: 10.1001/jamanetworkopen.2023.37192] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/22/2023] [Indexed: 10/11/2023] Open
Abstract
Importance Current Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) diagnoses of substance use disorders rely on criterion count-based approaches, disregarding severity grading indexed by individual criteria. Objective To examine correlates of alcohol use disorder (AUD) across count-based severity groups (ie, mild, moderate, mild-to-moderate, severe), identify specific diagnostic criteria indicative of greater severity, and evaluate whether specific criteria within mild-to-moderate AUD differentiate across relevant correlates and manifest in greater hazards of severe AUD development. Design, Setting, and Participants This cohort study involved 2 cohorts from the family-based Collaborative Study on the Genetics of Alcoholism (COGA) with 7 sites across the United States: cross-sectional (assessed 1991-2005) and longitudinal (assessed 2004-2019). Statistical analyses were conducted from December 2022 to June 2023. Main Outcomes and Measures Sociodemographic, alcohol-related, psychiatric comorbidity, brain electroencephalography (EEG), and AUD polygenic score measures as correlates of DSM-5 AUD levels (ie, mild, moderate, severe) and criterion severity-defined mild-to-moderate AUD diagnostic groups (ie, low-risk vs high-risk mild-to-moderate). Results A total of 13 110 individuals from the cross-sectional COGA cohort (mean [SD] age, 37.8 [14.2] years) and 2818 individuals from the longitudinal COGA cohort (mean baseline [SD] age, 16.1 [3.2] years) were included. Associations with alcohol-related, psychiatric, EEG, and AUD polygenic score measures reinforced the role of increasing criterion counts as indexing severity. Yet within mild-to-moderate AUD (2-5 criteria), the presence of specific high-risk criteria (eg, withdrawal) identified a group reporting heavier drinking and greater psychiatric comorbidity even after accounting for criterion count differences. In longitudinal analyses, prior mild-to-moderate AUD characterized by endorsement of at least 1 high-risk criterion was associated with more accelerated progression to severe AUD (adjusted hazard ratio [aHR], 11.62; 95% CI, 7.54-17.92) compared with prior mild-to-moderate AUD without endorsement of high-risk criteria (aHR, 5.64; 95% CI, 3.28-9.70), independent of criterion count. Conclusions and Relevance In this cohort study of a combined 15 928 individuals, findings suggested that simple count-based AUD diagnostic approaches to estimating severe AUD vulnerability, which ignore heterogeneity among criteria, may be improved by emphasizing specific high-risk criteria. Such emphasis may allow better focus on individuals at the greatest risk and improve understanding of the development of AUD.
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Affiliation(s)
- Alex P. Miller
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Sally I-Chun Kuo
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey
| | - Emma C. Johnson
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Rebecca Tillman
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Sarah J. Brislin
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey
| | - Danielle M. Dick
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey
| | - Chella Kamarajan
- Department of Psychiatry and Behavioral Sciences, State University of New York Health Sciences University, Brooklyn
| | - Sivan Kinreich
- Department of Psychiatry and Behavioral Sciences, State University of New York Health Sciences University, Brooklyn
| | - John Kramer
- Department of Psychiatry, University of Iowa, Iowa City
| | - Vivia V. McCutcheon
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | | | - Bernice Porjesz
- Department of Psychiatry and Behavioral Sciences, State University of New York Health Sciences University, Brooklyn
| | - Marc A. Schuckit
- Department of Psychiatry, University of California San Diego Medical School, San Diego
| | - Jessica E. Salvatore
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey
| | - Howard J. Edenberg
- Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis
| | - Kathleen K. Bucholz
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Jaquelyn L. Meyers
- Department of Psychiatry and Behavioral Sciences, State University of New York Health Sciences University, Brooklyn
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
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4
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Saenz de Viteri S, Zhang J, Johnson EC, Barr PB, Edenberg HJ, Hesselbrock VM, Nurnberger JI, Pandey AK, Kamarajan C, Kinreich S, Tischfield JA, Plawecki MH, Kramer JR, Lai D, Kuperman S, Chan G, McCutcheon VV, Bucholz KK, Porjesz B, Meyers JL. Genomic risk for post-traumatic stress disorder in families densely affected with alcohol use disorders. Mol Psychiatry 2023; 28:3391-3396. [PMID: 37344610 PMCID: PMC10618091 DOI: 10.1038/s41380-023-02117-9] [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: 04/12/2022] [Revised: 05/04/2023] [Accepted: 05/11/2023] [Indexed: 06/23/2023]
Abstract
Recent genome-wide association studies (GWAS) have identified genetic markers of post-traumatic stress disorder (PTSD) in civilian and military populations. However, studies have yet to examine the genetics of PTSD while factoring in risk for alcohol dependence, which commonly co-occur. We examined genome-wide associations for DSM-IV PTSD among 4,978 trauma-exposed participants (31% with alcohol dependence, 50% female, 30% African ancestry) from the Collaborative Study on the Genetics of Alcoholism (COGA). We also examined associations of polygenic risk scores (PRS) derived from the Psychiatric Genomics Consortium (PGC)-PTSD Freeze 2 (N = 3533) and Million Veterans Program GWAS of PTSD (N = 5200) with PTSD and substance dependence in COGA, and moderating effects of sex and alcohol dependence. 7.3% of COGA participants met criteria for PTSD, with higher rates in females (10.1%) and those with alcohol dependence (12.3%). No independent loci met genome-wide significance in the PTSD meta-analysis of European (EA) and African ancestry (AA) participants. The PGC-PTSD PRS was associated with increased risk for PTSD (B = 0.126, p < 0.001), alcohol dependence (B = 0.231, p < 0.001), and cocaine dependence (B = 0.086, p < 0.01) in EA individuals. A significant interaction was observed, such that EA individuals with alcohol dependence and higher polygenic risk for PTSD were more likely to have PTSD (B = 0.090, p < 0.01) than those without alcohol dependence. These results further support the importance of examining substance dependence, specifically alcohol dependence, and PTSD together when investigating genetic influence on these disorders.
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Affiliation(s)
| | - Jian Zhang
- State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | - Emma C Johnson
- Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Peter B Barr
- State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | | | | | | | - Ashwini K Pandey
- State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | - Chella Kamarajan
- State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | - Sivan Kinreich
- State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | | | | | - John R Kramer
- University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Dongbing Lai
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Samuel Kuperman
- University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Grace Chan
- University of Connecticut Health Center, Farmington, CT, USA
- University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Vivia V McCutcheon
- Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Kathleen K Bucholz
- Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Bernice Porjesz
- State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | - Jacquelyn L Meyers
- State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
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5
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Kamarajan C, Pandey AK, Chorlian DB, Meyers JL, Kinreich S, Pandey G, Subbie-Saenz de Viteri S, Zhang J, Kuang W, Barr PB, Aliev F, Anokhin AP, Plawecki MH, Kuperman S, Almasy L, Merikangas A, Brislin SJ, Bauer L, Hesselbrock V, Chan G, Kramer J, Lai D, Hartz S, Bierut LJ, McCutcheon VV, Bucholz KK, Dick DM, Schuckit MA, Edenberg HJ, Porjesz B. Predicting Alcohol-Related Memory Problems in Older Adults: A Machine Learning Study with Multi-Domain Features. Behav Sci (Basel) 2023; 13:bs13050427. [PMID: 37232664 DOI: 10.3390/bs13050427] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 05/27/2023] Open
Abstract
Memory problems are common among older adults with a history of alcohol use disorder (AUD). Employing a machine learning framework, the current study investigates the use of multi-domain features to classify individuals with and without alcohol-induced memory problems. A group of 94 individuals (ages 50-81 years) with alcohol-induced memory problems (the memory group) were compared with a matched control group who did not have memory problems. The random forests model identified specific features from each domain that contributed to the classification of the memory group vs. the control group (AUC = 88.29%). Specifically, individuals from the memory group manifested a predominant pattern of hyperconnectivity across the default mode network regions except for some connections involving the anterior cingulate cortex, which were predominantly hypoconnected. Other significant contributing features were: (i) polygenic risk scores for AUD, (ii) alcohol consumption and related health consequences during the past five years, such as health problems, past negative experiences, withdrawal symptoms, and the largest number of drinks in a day during the past twelve months, and (iii) elevated neuroticism and increased harm avoidance, and fewer positive "uplift" life events. At the neural systems level, hyperconnectivity across the default mode network regions, including the connections across the hippocampal hub regions, in individuals with memory problems may indicate dysregulation in neural information processing. Overall, the study outlines the importance of utilizing multidomain features, consisting of resting-state brain connectivity data collected ~18 years ago, together with personality, life experiences, polygenic risk, and alcohol consumption and related consequences, to predict the alcohol-related memory problems that arise in later life.
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Affiliation(s)
- Chella Kamarajan
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry and Behavioral Science, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA
| | - Ashwini K Pandey
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry and Behavioral Science, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA
| | - David B Chorlian
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry and Behavioral Science, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA
| | - Jacquelyn L Meyers
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry and Behavioral Science, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA
| | - Sivan Kinreich
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry and Behavioral Science, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA
| | - Gayathri Pandey
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry and Behavioral Science, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA
| | - Stacey Subbie-Saenz de Viteri
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry and Behavioral Science, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA
| | - Jian Zhang
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry and Behavioral Science, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA
| | - Weipeng Kuang
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry and Behavioral Science, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA
| | - Peter B Barr
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry and Behavioral Science, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA
| | - Fazil Aliev
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ 08854, USA
| | - Andrey P Anokhin
- Department of Psychiatry, School of Medicine, Washington University, St. Louis, MO 63110, USA
| | | | - Samuel Kuperman
- Department of Psychiatry, University of Iowa, Iowa City, IA 52242, USA
| | - Laura Almasy
- The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Alison Merikangas
- The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Sarah J Brislin
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ 08854, USA
| | - Lance Bauer
- Department of Psychiatry, University of Connecticut, Farmington, CT 06030, USA
| | - Victor Hesselbrock
- Department of Psychiatry, University of Connecticut, Farmington, CT 06030, USA
| | - Grace Chan
- Department of Psychiatry, University of Iowa, Iowa City, IA 52242, USA
- Department of Psychiatry, University of Connecticut, Farmington, CT 06030, USA
| | - John Kramer
- Department of Psychiatry, University of Iowa, Iowa City, IA 52242, USA
| | - Dongbing Lai
- Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Sarah Hartz
- Department of Psychiatry, School of Medicine, Washington University, St. Louis, MO 63110, USA
| | - Laura J Bierut
- Department of Psychiatry, School of Medicine, Washington University, St. Louis, MO 63110, USA
| | - Vivia V McCutcheon
- Department of Psychiatry, School of Medicine, Washington University, St. Louis, MO 63110, USA
| | - Kathleen K Bucholz
- Department of Psychiatry, School of Medicine, Washington University, St. Louis, MO 63110, USA
| | - Danielle M Dick
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ 08854, USA
| | - Marc A Schuckit
- Department of Psychiatry, University of California, San Diego, CA 92103, USA
| | | | - Bernice Porjesz
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry and Behavioral Science, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA
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Francis MW, McCutcheon VV, Farkas KJ. Social processes during recovery: An expansion of Kelly and Hoeppner's biaxial formulation of recovery. Addict Res Theory 2023; 31:416-423. [PMID: 38283612 PMCID: PMC10812146 DOI: 10.1080/16066359.2023.2195641] [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] [Received: 04/15/2022] [Accepted: 03/22/2023] [Indexed: 01/30/2024]
Abstract
Recent conceptualizations frame addiction recovery as a complex process involving changes across behavioral, physical, psychological, and social domains. These broad conceptualizations can be difficult to apply directly to research, making detailed models of individual dimensions necessary to guide empirical work and subsequent clinical interventions. We used Kelly and Hoeppner's (2015) biaxial formulation of recovery as a basis for a detailed examination of social processes in recovery using social network approaches. We delineated how appraisal of situational risks and social network resources result in coping actions, and how repeated iterations of this process change a person's social recovery capital over time. In addition, we incorporated the experience of interpersonal trauma and structural oppression, and demonstrated how the model accommodates the complex issues often encountered during recovery. We present a measurable framework that can guide empirical testing of how social processes and social recovery capital change over time during recovery. The model presented here illuminates key factors in the recovery process that have the potential to support trauma- and social-network-informed interventions. We call for research that empirically tests this model in ways that will result in practical, trauma-informed social network interventions for people in recovery.
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Affiliation(s)
- Meredith W. Francis
- Washington University in St. Louis, Brown School of Social Work, St. Louis, MO
| | | | - Kathleen J. Farkas
- Case Western Reserve University, Jack, Joseph and Morton Mandel School of Applied Social Sciences, Cleveland, OH
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7
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Kuo SIC, Thomas NS, Aliev F, Bucholz KK, Dick DM, McCutcheon VV, Meyers JL, Chan G, Kamarajan C, Kramer JR, Hesselbrock V, Plawecki MH, Porjesz B, Tischfield J, Salvatore JE. Association of parental divorce, discord, and polygenic risk with children's alcohol initiation and lifetime risk for alcohol use disorder. Alcohol Clin Exp Res (Hoboken) 2023; 47:724-735. [PMID: 36807915 PMCID: PMC10149624 DOI: 10.1111/acer.15042] [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] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/25/2023] [Accepted: 02/14/2023] [Indexed: 02/21/2023]
Abstract
BACKGROUND Parental divorce and discord are associated with poorer alcohol-related outcomes for offspring. However, not all children exposed to these stressors develop alcohol problems. Our objective was to test gene-by-environment interaction effects whereby children's genetic risk for alcohol problems modifies the effects of parental divorce and discord to predict alcohol outcomes. METHODS The sample included European (EA; N = 5608, 47% male, Mage ~ 36 years) and African (AA; N = 1714, 46% female, Mage ~ 33 years) ancestry participants from the Collaborative Study on the Genetics of Alcoholism. Outcomes included age at initiation of regular drinking and lifetime DSM-5 alcohol use disorder (AUD). Predictors included parental divorce, parental relationship discord, and offspring alcohol problems polygenic risk scores (PRSALC ). Mixed effects Cox proportional hazard models were used to examine alcohol initiation and generalized linear mixed effects models were used to examine lifetime AUD. Tests of PRS moderation of the effects of parental divorce/relationship discord on alcohol outcomes were examined on multiplicative and additive scales. RESULTS Among EA participants, parental divorce, parental discord, and higher PRSALC were associated with earlier alcohol initiation and greater lifetime AUD risk. Among AA participants, parental divorce was associated with earlier alcohol initiation and discord was associated with earlier initiation and AUD. PRSALC was not associated with either. Parental divorce/discord and PRSALC interacted on an additive scale in the EA sample, but no interactions were found in AA participants. CONCLUSIONS Children's genetic risk for alcohol problems modifies the impact of parental divorce/discord, consistent with an additive model of diathesis-stress interaction, with some differences across ancestry.
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Affiliation(s)
- Sally I-Chun Kuo
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, New Jersey, USA
| | - Nathaniel S. Thomas
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Fazil Aliev
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, New Jersey, USA
| | - Kathleen K. Bucholz
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Danielle M. Dick
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, New Jersey, USA
| | - Vivia V. McCutcheon
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Jacquelyn L. Meyers
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Grace Chan
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Chella Kamarajan
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - John R. Kramer
- Department of Psychiatry, University of Iowa, Iowa City, Iowa, USA
| | - Victor Hesselbrock
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Martin H. Plawecki
- Department of Psychiatry, Indiana University, Indianapolis, Indiana, USA
| | - Bernice Porjesz
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Jay Tischfield
- Department of Genetics, Rutgers University, Piscataway, New Jersey, USA
| | - Jessica E. Salvatore
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, New Jersey, USA
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8
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Thomas NS, Salvatore JE, Kuo SIC, Aliev F, McCutcheon VV, Meyers JM, Bucholz KK, Brislin SJ, Chan G, Edenberg HJ, Kamarajan C, Kramer JR, Kuperman S, Pandey G, Plawecki MH, Schuckit MA, Dick DM. Genetic nurture effects for alcohol use disorder. Mol Psychiatry 2023; 28:759-766. [PMID: 36253439 PMCID: PMC10079179 DOI: 10.1038/s41380-022-01816-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 04/13/2022] [Revised: 09/19/2022] [Accepted: 09/23/2022] [Indexed: 11/09/2022]
Abstract
We tested whether aspects of the childhood/adolescent home environment mediate genetic risk for alcohol problems within families across generations. Parental relationship discord and parental divorce were the focal environments examined. The sample included participants of European ancestry (N = 4806, 51% female) and African ancestry (N = 1960, 52% female) from the high-risk Collaborative Study on the Genetics of Alcoholism. Alcohol outcomes in the child generation included lifetime criterion counts for DSM-5 Alcohol Use Disorder (AUD), lifetime maximum drinks in 24 h, age at initiation of regular drinking, and age at first alcohol intoxication. Predictors in the parent generation included relationship discord, divorce, alcohol measures parallel to those in the child generation, and polygenic scores for alcohol problems. Parental polygenic scores were partitioned into alleles that were transmitted and non-transmitted to the child. The results from structural equation models were consistent with genetic nurture effects in European ancestry families. Exposure to parental relationship discord and parental divorce mediated, in part, the transmission of genetic risk for alcohol problems from parents to children to predict earlier ages regular drinking (βindirect = -0.018 [-0.026, -0.011]) and intoxication (βindirect = -0.015 [-0.023, -0.008]), greater lifetime maximum drinks (βindirect = 0.006 [0.002, 0.01]) and more lifetime AUD criteria (βindirect = 0.011 [0.006, 0.016]). In contrast, there was no evidence that parental alleles had indirect effects on offspring alcohol outcomes via parental relationship discord or divorce in the smaller number of families of African ancestry. In conclusion, parents transmit genetic risk for alcohol problems to their children not only directly, but also indirectly via genetically influenced aspects of the home environment. Further investigation of genetic nurture in non-European samples is needed.
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Affiliation(s)
- Nathaniel S Thomas
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.
| | - Jessica E Salvatore
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA.
| | - Sally I-Chun Kuo
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
| | - Fazil Aliev
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
| | - Vivia V McCutcheon
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Jacquelyn M Meyers
- Department of Psychiatry and Behavioral Sciences, State University of New York Health Sciences University, Brooklyn, NY, USA
| | - Kathleen K Bucholz
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Sarah J Brislin
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
| | - Grace Chan
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Howard J Edenberg
- Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis, IN, USA
| | - Chella Kamarajan
- Department of Psychiatry and Behavioral Sciences, State University of New York Health Sciences University, Brooklyn, NY, USA
| | - John R Kramer
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Samuel Kuperman
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Gayathri Pandey
- Department of Psychiatry and Behavioral Sciences, State University of New York Health Sciences University, Brooklyn, NY, USA
| | | | - Marc A Schuckit
- Department of Psychiatry, University of California San Diego Medical School, San Diego, CA, USA
| | - Danielle M Dick
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
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Pandey G, Kuo SIC, Horne-Osipenko KA, Pandey AK, Kamarajan C, de Viteri SS, Kinreich S, Chorlian DB, Kuang W, Stephenson M, Kramer J, Anokhin A, Zang Y, Kuperman S, Hesselbrock V, Schuckit M, Dick D, Chan G, McCutcheon VV, Edenberg H, Bucholz KK, Meyers JL, Porjesz B. Associations of parent-adolescent closeness with P3 amplitude, frontal theta, and binge drinking among offspring with high risk for alcohol use disorder. Alcohol Clin Exp Res (Hoboken) 2023; 47:155-167. [PMID: 36680783 PMCID: PMC10910630 DOI: 10.1111/acer.14973] [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] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 10/04/2022] [Accepted: 11/03/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Parents impact their offspring's brain development, neurocognitive function, risk, and resilience for alcohol use disorder (AUD) via both genetic and socio-environmental factors. Individuals with AUD and their unaffected children manifest low parietal P3 amplitude and low frontal theta (FT) power, reflecting heritable neurocognitive deficits associated with AUD. Likewise, children who experience poor parenting tend to have atypical brain development and greater rates of alcohol problems. Conversely, positive parenting can be protective and critical for normative development of self-regulation, neurocognitive functioning and the neurobiological systems subserving them. Yet, the role of positive parenting in resiliency toward AUD is understudied and its association with neurocognitive functioning and behavioral vulnerability to AUD among high-risk offspring is less known. Using data from the Collaborative Study on the Genetics of Alcoholism prospective cohort (N = 1256, mean age [SD] = 19.25 [1.88]), we investigated the associations of closeness with mother and father during adolescence with offspring P3 amplitude, FT power, and binge drinking among high-risk offspring. METHODS Self-reported closeness with mother and father between ages 12 and 17 and binge drinking were assessed using the Semi-Structured Assessment for the Genetics of Alcoholism. P3 amplitude and FT power were assessed in response to target stimuli using a Visual Oddball Task. RESULTS Multivariate multiple regression analyses showed that closeness with father was associated with larger P3 amplitude (p = 0.002) and higher FT power (p = 0.01). Closeness with mother was associated with less binge drinking (p = 0.003). Among male offspring, closeness with father was associated with larger P3 amplitude, but among female offspring, closeness with mother was associated with less binge drinking. These associations remained statistically significant with father's and mothers' AUD symptoms, socioeconomic status, and offspring impulsivity in the model. CONCLUSIONS Among high-risk offspring, closeness with parents during adolescence may promote resilience for developing AUD and related neurocognitive deficits albeit with important sex differences.
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Affiliation(s)
- Gayathri Pandey
- Department of Psychiatry and Behavioral Sciences, State University of New York, Downstate Health Sciences University, New York, Brooklyn, USA
| | - Sally I-Chun Kuo
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, New Jersey, USA
| | - Kristina A. Horne-Osipenko
- Department of Psychiatry and Behavioral Sciences, State University of New York, Downstate Health Sciences University, New York, Brooklyn, USA
| | - Ashwini K. Pandey
- Department of Psychiatry and Behavioral Sciences, State University of New York, Downstate Health Sciences University, New York, Brooklyn, USA
| | - Chella Kamarajan
- Department of Psychiatry and Behavioral Sciences, State University of New York, Downstate Health Sciences University, New York, Brooklyn, USA
| | - Stacey Saenz de Viteri
- Department of Psychiatry and Behavioral Sciences, State University of New York, Downstate Health Sciences University, New York, Brooklyn, USA
| | - Sivan Kinreich
- Department of Psychiatry and Behavioral Sciences, State University of New York, Downstate Health Sciences University, New York, Brooklyn, USA
| | - David B. Chorlian
- Department of Psychiatry and Behavioral Sciences, State University of New York, Downstate Health Sciences University, New York, Brooklyn, USA
| | - Weipeng Kuang
- Department of Psychiatry and Behavioral Sciences, State University of New York, Downstate Health Sciences University, New York, Brooklyn, USA
| | - Mallory Stephenson
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, New Jersey, USA
| | - John Kramer
- Department of Psychiatry, University of Iowa, Iowa City, Iowa, USA
| | - Andrey Anokhin
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Yong Zang
- Department of Biostatistics, School of Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Samuel Kuperman
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Victor Hesselbrock
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Marc Schuckit
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Danielle Dick
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, New Jersey, USA
| | - Grace Chan
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Vivia V. McCutcheon
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Howard Edenberg
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Kathleen K. Bucholz
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Jacquelyn L. Meyers
- Department of Psychiatry and Behavioral Sciences, State University of New York, Downstate Health Sciences University, New York, Brooklyn, USA
| | - Bernice Porjesz
- Department of Psychiatry and Behavioral Sciences, State University of New York, Downstate Health Sciences University, New York, Brooklyn, USA
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Kuo SIC, Poore HE, Barr PB, Chirico IS, Aliev F, Bucholz KK, Chan G, Kamarajan C, Kramer JR, McCutcheon VV, Plawecki MH, Dick DM. The role of parental genotype in the intergenerational transmission of externalizing behavior: Evidence for genetic nurturance. Dev Psychopathol 2022; 34:1-11. [PMID: 36200344 PMCID: PMC10076450 DOI: 10.1017/s0954579422000700] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The purpose of this study was to examine possible pathways by which genetic risk associated with externalizing is transmitted in families. We used molecular data to disentangle the genetic and environmental pathways contributing to adolescent externalizing behavior in a sample of 1,111 adolescents (50% female; 719 European and 392 African ancestry) and their parents from the Collaborative Study on the Genetics of Alcoholism. We found evidence for genetic nurture such that parental externalizing polygenic scores were associated with adolescent externalizing behavior, over and above the effect of adolescents' own externalizing polygenic scores. Mediation analysis indicated that parental externalizing psychopathology partly explained the effect of parental genotype on children's externalizing behavior. We also found evidence for evocative gene-environment correlation, whereby adolescent externalizing polygenic scores were associated with lower parent-child communication, less parent-child closeness, and lower parental knowledge, controlling for parental genotype. These effects were observed among participants of European ancestry but not African ancestry, likely due to the limited predictive power of polygenic scores across ancestral background. These results demonstrate that in addition to genetic transmission, genes influence offspring behavior through the influence of parental genotypes on their children's environmental experiences, and the role of children's genotypes in shaping parent-child relationships.
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Affiliation(s)
- Sally I-Chun Kuo
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
| | - Holly E Poore
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
| | - Peter B Barr
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
- VA New York Harbor Healthcare System, Brooklyn, NY, USA
| | | | - Fazil Aliev
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
| | - Kathleen K Bucholz
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Grace Chan
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Chella Kamarajan
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - John R Kramer
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Vivia V McCutcheon
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Danielle M Dick
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
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11
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Thomas NS, Kuo SIC, Aliev F, McCutcheon VV, Meyers JM, Chan G, Hesselbrock V, Kamarajan C, Kinreich S, Kramer JR, Kuperman S, Lai D, Plawecki MH, Porjesz B, Schuckit MA, Dick DM, Bucholz KK, Salvatore JE. Alcohol use disorder, psychiatric comorbidities, marriage and divorce in a high-risk sample. Psychol Addict Behav 2022; 36:364-374. [PMID: 35617219 PMCID: PMC9247836 DOI: 10.1037/adb0000840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To examine associations between alcohol use disorder (AUD), its psychiatric comorbidities, and their interactions, with marital outcomes in a diverse high-risk, genetically informative sample. METHOD Participants included European ancestry (EA; n = 4,045) and African ancestry (AA; n = 1,550) individuals from the multigenerational Collaborative Study on the Genetics of Alcoholism (COGA) sample (56% female, Mage ∼ 41 years). Outcomes were lifetime marriage and divorce. Predictors included lifetime AUD, an alcohol problems polygenic score (PRS), and AUD comorbidities, including conduct or antisocial personality disorder (ASP), cannabis dependence/abuse (CAN), frequent tobacco use (TOB), and major depressive disorder (MDD). Mixed effect Cox models and generalized linear mixed effects models were fit. RESULTS Among EA participants, those with AUD and CAN were less likely to marry (hazard ratios [HRs] 0.70-0.83, ps < 0.01). Among AA participants, those with AUD and TOB were less likely to marry (HRs 0.66-0.82, ps < 0.05) and those with MDD were more likely to marry (HR = 1.34, ps < 0.01). Among EA participants, AUD, CAN, TOB, and MDD were associated with higher odds of divorce (odds ratios [ORs] 1.59-2.21, ps < 0.01). Among AA participants, no predictors were significantly associated with divorce. Significant random effects indicated genetic and environmental influences on marriage, but only environmental factors on divorce. CONCLUSIONS In a high-risk sample, AUD was associated with reduced likelihood of marriage in EA and AA individuals and increased risk of divorce in EA individuals. These associations were largely independent of comorbidities. Genetic and environmental background factors contributed to marriage, while only environmental background factors contributed to divorce. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | - Sally I-Chun Kuo
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University
| | - Fazil Aliev
- Department of Psychology, Virginia Commonwealth University
| | | | - Jacquelyn M. Meyers
- Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center
| | - Grace Chan
- Department of Psychiatry, University of Connecticut School of Medicine
| | | | - Chella Kamarajan
- Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center
| | - Sivan Kinreich
- Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center
| | | | | | - Dongbing Lai
- Department of Medical and Molecular Genetics, Indiana University
| | | | - Bernice Porjesz
- Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center
| | - Marc A. Schuckit
- Department of Psychiatry, University of California San Diego Medical School
| | - Danielle M. Dick
- Department of Psychology, Virginia Commonwealth University
- Department of Human & Molecular Genetics, Virginia Commonwealth University
| | | | - Jessica E. Salvatore
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University
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12
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Francis MW, Bourdon JL, Chan G, Dick DM, Edenberg HJ, Kamarajan C, Kinreich S, Kramer J, I-Chun Kuo S, Pandey AK, Pandey G, Smith RL, Bucholz KK, McCutcheon VV. Deriving a Measure of Social Recovery Capital From the Important People and Activities Instrument: Construction and Psychometric Properties. Alcohol Alcohol 2022; 57:322-329. [PMID: 35356964 PMCID: PMC9086804 DOI: 10.1093/alcalc/agac014] [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: 11/08/2021] [Revised: 02/07/2022] [Accepted: 02/25/2022] [Indexed: 11/14/2022] Open
Abstract
AIM This study presents a measure of Social Recovery Capital (SRC) derived from the Important People and Activities instrument (IPA). METHODS The sample comprised young adults who participated in the Collaborative Study on the Genetics of Alcoholism, a high-risk family study of alcohol use disorder (N = 2472). Exploratory and confirmatory factor analysis identified influential items and factor structure, adjusting for family relatedness. The final scale was tested for reliability and validity. RESULTS Factor analysis retained 10 items loading on three factors (Network Abstinence Behaviors, Basic Network Structure and Network Importance) that together explained 42% of the variance in SRC. The total model showed adequate fit (Comparative Fit Index = 0.95; Tucker Lewis Index = 0.93; Root Mean Square Error of Approximation = 0.06; Standardized Root Mean Squared Residual = 0.05) and acceptable reliability (α = 0.60; McDonald's ω = 0.73) and correlated with validation measures mostly in the weak to moderate range. Due to variable factor scores for reliability and validity, we only recommend using the total score. CONCLUSION The SRC-IPA is a novel measure of SRC derived from the IPA that captures social network data and has applications in research and clinical work. Secondary data analyses using the SRC-IPA in studies that collected the IPA can further demonstrate the interaction of SRC with a wide variety of clinical indicators and demographic characteristics, making it a valuable addition to other measures of SRC.
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Affiliation(s)
- Meredith W Francis
- Washington University in St. Louis, Brown School of Social Work, St. Louis, MO, USA
| | - Jessica L Bourdon
- Wellbridge Addiction Treatment and Research, Center for Addiction Science, Calverton, NY, USA
| | - Grace Chan
- University of Connecticut, Department of Psychiatry, Farmington, CT, USA
- University of Iowa, Department of Psychiatry, Iowa City, IA, USA
| | - Danielle M Dick
- Virginia Commonwealth University, Department of Psychology, Richmond, VA, USA
| | | | - Chella Kamarajan
- SUNY Downstate Health Sciences University, Department of Psychiatry, Brooklyn, NY, USA
| | - Sivan Kinreich
- SUNY Downstate Health Sciences University, Department of Psychiatry, Brooklyn, NY, USA
| | - John Kramer
- University of Iowa, Department of Psychiatry, Iowa City, IA, USA
| | - Sally I-Chun Kuo
- Virginia Commonwealth University, Department of Psychology, Richmond, VA, USA
| | - Ashwini K Pandey
- SUNY Downstate Health Sciences University, Department of Psychiatry, Brooklyn, NY, USA
| | - Gayathri Pandey
- SUNY Downstate Health Sciences University, Department of Psychiatry, Brooklyn, NY, USA
| | - Rebecca L Smith
- Virginia Commonwealth University, Department of Psychology, Richmond, VA, USA
| | - Kathleen K Bucholz
- Washington University in St. Louis, Department of Psychiatry, St. Louis, MO, USA
| | - Vivia V McCutcheon
- Washington University in St. Louis, Department of Psychiatry, St. Louis, MO, USA
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13
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Wang Y, Liu Y, Waldron M, Houston-Ludlam AN, McCutcheon VV, Lynskey MT, Madden PAF, Bucholz KK, Heath AC, Lian M. Temporal trends in smoking and nicotine dependence in relation to co-occurring substance use in the United States, 2005-2016. Drug Alcohol Depend 2021; 226:108903. [PMID: 34304125 PMCID: PMC8878578 DOI: 10.1016/j.drugalcdep.2021.108903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/18/2021] [Revised: 05/09/2021] [Accepted: 05/22/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Despite an overall decline in tobacco use in the United States, secular trends of smoking and nicotine dependence with co-occurring substance use are not well characterized. METHODS We examined self-reported tobacco and other substance use in 22,245 participants age 21-59 in the United States from six waves of the National Health and Nutrition Examination Survey (NHANES). Using Joinpoint regression, we assessed secular trends of smoking and nicotine dependence as a function of co-occurring use of alcohol, prescription opioids, marijuana/hashish, cocaine/heroin/methamphetamine, or other injection drug use. Multivariable logistic regressions were fitted to identify the potential risk factors. RESULTS During 2005-2016, the prevalence of current smoking decreased (without co-occurring substance use: 17.0 %-12.7 %; with co-occurring use of one substance: 35.3 % to 24.6 %; with co-occurring use of two or more substances: 53.8 %-42.2 %), and moderate-to-severe nicotine dependence decreased as well (8.0 %-4.2 %, 16.0 %-8.8 %, and 23.9 %-15.7 %, respectively). Smoking and nicotine dependence were more likely in those with co-occurring use of one substance (current smoking: odds ratio [OR] = 2.22, 95 % confidence interval [CI] = 2.01-2.45); nicotine dependence: OR = 1.88, 95 % CI = 1.63-2.17) and in those with co-occurring use of two or more substances (current smoking: OR = 5.25, 95 % CI = 4.63-5.95; nicotine dependence: OR = 3.24, 95 % CI = 2.72-3.87). CONCLUSIONS Co-occurring substance use was associated with smaller reductions in tobacco use, over time, and with increased odds of nicotine dependence. This suggests that co-occurring substance users should be regarded as a tobacco-related disparity group and prioritized for tobacco control interventions.
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Affiliation(s)
- Yun Wang
- Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri;,Current Institution: Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Irvine, California
| | - Ying Liu
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri;,Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri
| | - Mary Waldron
- Department of Counseling and Educational Psychology, School of Education, Indiana University, Bloomington, Indiana;,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, Missouri
| | | | - Vivia V. McCutcheon
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Michael T. Lynskey
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College, London, UK
| | - Pamela A. F. Madden
- Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri;,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, Missouri;,Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Kathleen K. Bucholz
- Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, Missouri;,Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Andrew C. Heath
- Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri;,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, Missouri;,Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Min Lian
- Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States; Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO, United States.
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14
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Cho SB, Smith RL, Bucholz K, Chan G, Edenberg HJ, Hesselbrock V, Kramer J, McCutcheon VV, Nurnberger J, Schuckit M, Zang Y, Dick DM, Salvatore JE. Using a developmental perspective to examine the moderating effects of marriage on heavy episodic drinking in a young adult sample enriched for risk. Dev Psychopathol 2021; 33:1097-1106. [PMID: 32611468 PMCID: PMC7775899 DOI: 10.1017/s0954579420000371] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Indexed: 11/06/2022]
Abstract
Many studies demonstrate that marriage protects against risky alcohol use and moderates genetic influences on alcohol outcomes; however, previous work has not considered these effects from a developmental perspective or in high-risk individuals. These represent important gaps, as it cannot be assumed that marriage has uniform effects across development or in high-risk samples. We took a longitudinal developmental approach to examine whether marital status was associated with heavy episodic drinking (HED), and whether marital status moderated polygenic influences on HED. Our sample included 937 individuals (53.25% female) from the Collaborative Study on the Genetics of Alcoholism who reported their HED and marital status biennially between the ages of 21 and 25. Polygenic risk scores (PRS) were derived from a genome-wide association study of alcohol consumption. Marital status was not associated with HED; however, we observed pathogenic gene-by-environment effects that changed across young adulthood. Among those who married young (age 21), individuals with higher PRS reported more HED; however, these effects decayed over time. The same pattern was found in supplementary analyses using parental history of alcohol use disorder as the index of genetic liability. Our findings indicate that early marriage may exacerbate risk for those with higher polygenic load.
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Affiliation(s)
- Seung Bin Cho
- Department of Psychology, Pusan National University, Busan, South Korea
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Rebecca L Smith
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Kathleen Bucholz
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | - Grace Chan
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Howard J Edenberg
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Victor Hesselbrock
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - John Kramer
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Vivia V McCutcheon
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | - John Nurnberger
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Marc Schuckit
- Department of Psychiatry, University of California-San Diego, La Jolla, CA, USA
| | - Yong Zang
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Danielle M Dick
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Jessica E Salvatore
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
- Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA
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15
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Su J, Kuo SIC, Aliev F, Chan G, Edenberg HJ, Kamarajan C, McCutcheon VV, Meyers JL, Schuckit M, Tischfield J, Dick DM. The associations between polygenic risk, sensation seeking, social support, and alcohol use in adulthood. J Abnorm Psychol 2021; 130:525-536. [PMID: 34472888 PMCID: PMC10882995 DOI: 10.1037/abn0000568] [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] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Genetic predispositions play an important role in alcohol use. Understanding the psychosocial mechanisms through which genetic risk unfolds to influence alcohol use outcomes is critical for identifying modifiable targets and developing prevention and intervention efforts. In this study, we examined the role of sensation seeking and social support from family and friends in linking genetic risk to alcohol use. We also examined the role of social support in moderating the associations between genetic risk and sensation seeking and alcohol use. Data were drawn from a sample of 2,836 European American adults from the Collaborative Study on the Genetics of Alcoholism (46% male, mean age = 35.65, standard deviation [SD] = 10.78). Results from path analysis indicated that genome-wide polygenic scores for alcohol consumption (alc-GPS) were associated with higher sensation seeking, which in turn was associated with higher levels of alcohol use. alc-GPS was also associated with higher alcohol use indirectly via lower levels of family support. In addition, high friend support attenuated the association between alc-GPS and sensation seeking and alcohol use. The pattern of associations was similar for males and females, with some differences in the associations between social support and alcohol use observed across age. Our findings highlight the important role of intermediate phenotypes and gene-environment interplay in the pathways of risk from genetic predispositions to complex alcohol use outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Jinni Su
- Department of Psychology, Arizona State University
| | | | - Fazil Aliev
- Department of Psychology, Virginia Commonwealth University
- Faculty of Business, Karabuk University, Turkey
| | - Grace Chan
- Department of Psychiatry, University of Connecticut
| | | | - Chella Kamarajan
- Department of Psychiatry, State University of New York Downstate Medical Center
| | | | - Jacquelyn L. Meyers
- Department of Psychiatry, State University of New York Downstate Medical Center
| | - Marc Schuckit
- Department of Psychiatry, University of California at San Diego
| | | | - Danielle M. Dick
- Department of Psychology, Virginia Commonwealth University
- Department of Human and Molecular Genetics, Virginia Commonwealth University
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16
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McCutcheon VV, Bucholz KK, Houston-Ludlam AN, Waldron M, Heath AC. Timing of mortality in mothers with recurrent convictions for driving under the influence of alcohol and their children, from childbirth to child age 17. Drug Alcohol Depend 2021; 221:108620. [PMID: 33639571 PMCID: PMC8772583 DOI: 10.1016/j.drugalcdep.2021.108620] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/05/2021] [Accepted: 02/09/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND We tested variation in the timing of child and maternal mortality associated with severe maternal AUD, as represented by recurrent arrests for driving under the influence of alcohol (rDUI). METHODS rDUI mothers (N = 1614) and Controls with no alcohol-related driving offenses (N = 109,928) who gave birth in Missouri from 2000 to 2004 were identified using vital records. Propensity score matching adjusted for birth record measures including delayed prenatal care, smoking during pregnancy, relationship with reproductive partner [married/unmarried, paternity acknowledged/unacknowledged], partner DUI status from driving records, and for socioeconomic characteristics of maternal residential census tract at birth derived from census data. Survival analysis was used to test months from childbirth to child or maternal death as a function of lifetime rDUI status. RESULTS Maternal rDUIs were associated with a consistently elevated probability of child mortality from birth through child age 17 after propensity score-adjustment (Hazard Ratio [HR] = 1.70, 95 % CI = 1.17-2.47). Maternal mortality was not elevated, relative to Controls, until child age 6-11 (HR = 1.58, 95 % CI = 1.05-2.35) and increased again from child age 12-17 (HR = 4.12, 95 % CI = 3.04-5.86). CONCLUSIONS Severe maternal AUD, as characterized by rDUI, increases the risk for child mortality over that of Controls through age 17. Delays in rDUI maternal mortality until child age 6 may indicate a period when maternal referral for intervention to reduce harm to child and mother is likely to be especially effective.
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Affiliation(s)
- Vivia V. McCutcheon
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Box 8134, St. Louis, MO 63110
| | - Kathleen K. Bucholz
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Box 8134, St. Louis, MO 63110
| | - Alexandra N. Houston-Ludlam
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Box 8134, St. Louis, MO 63110,Medical Scientist Training Program, Washington University School of Medicine in St. Louis, Missouri,Human and Statistical Genetics, Division of Biology and Biomedical Sciences, Washington University School of Medicine in St. Louis, Missouri
| | - Mary Waldron
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Box 8134, St. Louis, MO 63110,Department of Counseling and Educational Psychology, School of Education, Bloomington, Indiana University, Indiana
| | - Andrew C. Heath
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Box 8134, St. Louis, MO 63110
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17
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Kinreich S, McCutcheon VV, Aliev F, Meyers JL, Kamarajan C, Pandey AK, Chorlian DB, Zhang J, Kuang W, Pandey G, Viteri SSSD, Francis MW, Chan G, Bourdon JL, Dick DM, Anokhin AP, Bauer L, Hesselbrock V, Schuckit MA, Nurnberger JI, Foroud TM, Salvatore JE, Bucholz KK, Porjesz B. Predicting alcohol use disorder remission: a longitudinal multimodal multi-featured machine learning approach. Transl Psychiatry 2021; 11:166. [PMID: 33723218 PMCID: PMC7960734 DOI: 10.1038/s41398-021-01281-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 12/07/2020] [Accepted: 12/16/2020] [Indexed: 12/02/2022] Open
Abstract
Predictive models for recovering from alcohol use disorder (AUD) and identifying related predisposition biomarkers can have a tremendous impact on addiction treatment outcomes and cost reduction. Our sample (N = 1376) included individuals of European (EA) and African (AA) ancestry from the Collaborative Study on the Genetics of Alcoholism (COGA) who were initially assessed as having AUD (DSM-5) and reassessed years later as either having AUD or in remission. To predict this difference in AUD recovery status, we analyzed the initial data using multimodal, multi-features machine learning applications including EEG source-level functional brain connectivity, Polygenic Risk Scores (PRS), medications, and demographic information. Sex and ancestry age-matched stratified analyses were performed with supervised linear Support Vector Machine application and were calculated twice, once when the ancestry was defined by self-report and once defined by genetic data. Multifeatured prediction models achieved higher accuracy scores than models based on a single domain and higher scores in male models when the ancestry was based on genetic data. The AA male group model with PRS, EEG functional connectivity, marital and employment status features achieved the highest accuracy of 86.04%. Several discriminative features were identified, including collections of PRS related to neuroticism, depression, aggression, years of education, and alcohol consumption phenotypes. Other discriminated features included being married, employed, medication, lower default mode network and fusiform connectivity, and higher insula connectivity. Results highlight the importance of increasing genetic homogeneity of analyzed groups, identifying sex, and ancestry-specific features to increase prediction scores revealing biomarkers related to AUD remission.
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Affiliation(s)
- Sivan Kinreich
- Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY, USA.
| | - Vivia V McCutcheon
- Department of Psychiatry, Washington University School of Medicine in St Louis, St Louis, MO, USA
| | - Fazil Aliev
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
- Faculty of Business, Karabuk University, Karabük, Turkey
| | - Jacquelyn L Meyers
- Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Chella Kamarajan
- Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Ashwini K Pandey
- Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - David B Chorlian
- Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Jian Zhang
- Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Weipeng Kuang
- Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Gayathri Pandey
- Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | | | - Meredith W Francis
- Brown School of Social Work / Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - Grace Chan
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Jessica L Bourdon
- Department of Psychiatry, Washington University School of Medicine in St Louis, St Louis, MO, USA
| | - Danielle M Dick
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Andrey P Anokhin
- Department of Psychiatry, Washington University School of Medicine in St Louis, St Louis, MO, USA
| | - Lance Bauer
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Victor Hesselbrock
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Marc A Schuckit
- Department of Psychiatry, University of California, San Diego School of Medicine, La Jolla, CA, USA
| | - John I Nurnberger
- Departments of Psychiatry and Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tatiana M Foroud
- Department of Medical and Molecular Genetics at Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jessica E Salvatore
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Kathleen K Bucholz
- Department of Psychiatry, Washington University School of Medicine in St Louis, St Louis, MO, USA
| | - Bernice Porjesz
- Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
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18
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Bender AK, Meyers JL, di Viteri SSS, Schuckit M, Chan G, Acion L, Kamarajan C, Kramer J, Anohkin A, Kinreich S, Pandey A, Hesselbrock V, Hesselbrock M, Bucholz KK, McCutcheon VV. A latent class analysis of alcohol and posttraumatic stress symptoms among offspring of parents with and without alcohol use disorder. Addict Behav 2021; 112:106640. [PMID: 32957005 PMCID: PMC10913466 DOI: 10.1016/j.addbeh.2020.106640] [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: 02/07/2020] [Revised: 08/28/2020] [Accepted: 08/30/2020] [Indexed: 11/27/2022]
Abstract
The co-occurrence of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) is widely known, yet few studies have examined whether and how AUD symptoms co-occur with PTSD symptom clusters of hypervigilance, avoidance/numbing, and re-experiencing. The purpose of this study was to examine potential overlap between AUD and posttraumatic stress symptomatology, and to characterize the resultant latent classes in terms of demographics, drinking behaviors, parental AUD, and specific traumas experienced (physical violence, sexual violence, and non-assaultive trauma). We hypothesized that classes would be differentiated by type and severity of AUD and PTS symptoms. Drawing from a sample of white and Black participants from the Collaborative Study on the Genetics of Alcoholism (COGA), we examined young adults between the ages of 18-35 who had experienced trauma (N = 2478). A series of LCA models based on the type of trauma experienced, posttraumatic stress symptoms and problematic alcohol use were then fitted to the data. A four-class solution provided the best fit, consisting of a low symptom class (N = 1134), moderate alcohol/low PTS severity (N = 623), mild alcohol/high PTS severity (N = 544), and high symptom severity (N = 177). Higher prevalence of sexual assault was associated with membership in high PTS severity classes, and parent AUD was associated with membership in each class, particularly when the mother or both parents had the disorder. Using person-centered methods such as LCA is a commonsense approach to understanding the heterogeneity of symptoms, trauma types, and individual-level characteristics associated with trauma-exposed individuals and comorbid AUD-PTSD, and our study is one of relatively few to empirically ascertain the co-occurrence of alcohol and PTS symptoms in a high-risk family sample.
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Affiliation(s)
| | | | | | | | - Grace Chan
- University of Connecticut, United States
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19
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Houston-Ludlam AN, Waldron M, Lian M, Cahill AG, McCutcheon VV, Madden PAF, Bucholz KK, Heath AC. Marital status, partner acknowledgment of paternity, and neighborhood influences on smoking during first pregnancy: findings across race/ethnicity in linked administrative and census data. Drug Alcohol Depend 2020; 217:108273. [PMID: 32971390 PMCID: PMC8075321 DOI: 10.1016/j.drugalcdep.2020.108273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 07/24/2020] [Revised: 08/26/2020] [Accepted: 08/29/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Improving prediction of cigarette smoking during pregnancy (SDP), including differences by race/ethnicity and geography, is necessary for interventions to achieve greater and more equitable SDP reductions. METHODS Using individual-level data on singleton first births, 2010-2017 (N = 182,894), in a US state with high SDP rates, we predicted SDP risk as a function of reproductive partner relationship (marital status, paternity acknowledgement), maternal and residential census tract sociodemographics, and census tract five-year SDP rate. RESULTS SDP prevalence was 12.7% (white non-Hispanics, WNH), 6.8% (Black/African Americans, AA), 19.5% (Native American, NA), 4.7% (Hispanic, H), and 2.8% (Asian, AS). In WNH and AA, with similar trends in other groups, after adjustment for non-linear effects of maternal age and education and for census tract risk-factors, there was a consistent risk-ordering of SDP rates by reproductive partner relationship: married/with paternity acknowledged < unmarried/acknowledged < unmarried/unacknowledged < married/unacknowledged. Associations with census tract SDP rate, adjusted for maternal and census tract sociodemographics, were stronger for AA and H (OR 2.65-2.67) than for NA (OR = 1.91), WNH (OR = 1.75), or AS (NS). AA SDP was increased in tracts having a higher proportion of WNH residents and was reduced in comparison with WNH at every combination of age, education and partner relationship. CONCLUSIONS Inattention to differences by race/ethnicity may obscure SDP risk factors. Despite marked race/ethnic differences in unmarried-partner cohabitation rates, failure to acknowledge paternity emerged as an important and consistent risk-predictor. Census-tract five-year SDP rates have heterogeneous origins, but the association of AA SDP risk with increased racial heterogeneity suggests an important influence of neighbor risk behaviors.
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Affiliation(s)
- Alexandra N Houston-Ludlam
- Department of Psychiatry, Washington University School of Medicine, 660 S Euclid, CB 8134, St. Louis, MO, 63110, USA; Medical Scientist Training Program, Washington University School of Medicine, 660 S Euclid, CB 8226, St. Louis, MO, 63110, USA; Human and Statistical Genetics, Division of Biology and Biomedical Sciences, Washington University School of Medicine, 660 S Euclid, CB 8134, St. Louis, MO, 63110, USA.
| | - Mary Waldron
- Department of Psychiatry, Washington University School of Medicine, 660 S Euclid, CB 8134, St. Louis, MO, 63110, USA; School of Education, Indiana University, 201 N. Rose Ave, Bloomington, IN, 47405, USA
| | - Min Lian
- Department of Medicine, Washington University School of Medicine, 660 S Euclid, CB 8134, St. Louis, MO, 63110, USA
| | - Alison G Cahill
- Department of Women's Health, University of Texas at Austin, Dell Medical School, 1301 W 38th St Suite 705, Austin, TX, 78705, USA
| | - Vivia V McCutcheon
- Department of Psychiatry, Washington University School of Medicine, 660 S Euclid, CB 8134, St. Louis, MO, 63110, USA
| | - Pamela A F Madden
- Department of Psychiatry, Washington University School of Medicine, 660 S Euclid, CB 8134, St. Louis, MO, 63110, USA
| | - Kathleen K Bucholz
- Department of Psychiatry, Washington University School of Medicine, 660 S Euclid, CB 8134, St. Louis, MO, 63110, USA
| | - Andrew C Heath
- Department of Psychiatry, Washington University School of Medicine, 660 S Euclid, CB 8134, St. Louis, MO, 63110, USA
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20
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Xie TH, Ahuja M, McCutcheon VV, Bucholz KK. Associations between racial and socioeconomic discrimination and risk behaviors among African-American adolescents and young adults: a latent class analysis. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1479-1489. [PMID: 32417956 PMCID: PMC9036724 DOI: 10.1007/s00127-020-01884-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 06/04/2019] [Accepted: 05/02/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Discrimination is a common stressor among African Americans and may increase vulnerability to risk behaviors, such as early initiation of substance use, substance use problems, and physical aggression; however, few studies have examined different types of discrimination and their associations with patterns of risk behaviors. This study examines the relationship between experiences of racial and socioeconomic discrimination and risk behaviors in African-American adolescents and young adults. METHODS We investigated associations of two discrimination types with risk behavior patterns identified with latent class analysis in a high-risk sample of African Americans (N = 797, Mage = 17.9 years, 50.2% female). RESULTS Four distinct classes of risk behaviors were characterized by High Use and Aggression (10%), Moderate Use and Aggression (10%), High Alcohol (17%), and Low Use and Aggression (63%). Classes that exhibit general risk behaviors, including substance use and aggression, were significantly associated with racial and socioeconomic discrimination, even in the fully adjusted model. Relative to other classes, the High Use and Aggression class demonstrated an elevated likelihood of experiencing both racial and socioeconomic discrimination. CONCLUSIONS Findings support a link between racial and socioeconomic discrimination and risk behavior in African-American youth, which may be stronger for socioeconomic discrimination. Understanding the relationship between discrimination and risk behavior can inform future interventions to prevent substance misuse and conduct problems in youth. Further study is needed to elucidate the relationship between discrimination and other risk behaviors.
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Affiliation(s)
- Tiffany H. Xie
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States,Indiana University, Bloomington, IN, United States
| | - Manik Ahuja
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States,Brown School of Social Work, Washington University in St. Louis
| | - Vivia V. McCutcheon
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Kathleen K. Bucholz
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
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21
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Agrawal A, McCutcheon VV. Commentary on Hartwell et al. (2020): Alcohol use disorder treatment response-where is the variability? Addiction 2020; 115:1438-1439. [PMID: 32343448 DOI: 10.1111/add.15085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 04/06/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA
| | - Vivia V McCutcheon
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA
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22
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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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Agrawal A, Jeffries PW, Srivastava AB, McCutcheon VV, Lynskey MT, Heath AC, Nelson EC. Retrospectively assessed subjective effects of initial opioid use differ between opioid misusers with opioid use disorder (OUD) and those who never progressed to OUD: Data from a pilot and a replication sample. J Neurosci Res 2020; 100:353-361. [PMID: 32468677 DOI: 10.1002/jnr.24643] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 01/15/2020] [Revised: 04/08/2020] [Accepted: 04/25/2020] [Indexed: 01/08/2023]
Abstract
Attempts to identify opioid users with increased risk of escalating to opioid use disorder (OUD) have had limited success. Retrospectively assessed subjective effects of initial opioid misuse were compared in a pilot sample of opioid misusers (nonmedical use ≤60 times lifetime) who had never met criteria for OUD (N = 14) and heroin-addicted individuals in treatment for OUD (N = 15). Relative to opioid misusers without a lifetime OUD diagnosis, individuals with OUD reported greater euphoria and other positive emotions, activation, pruritus, and internalizing symptoms. Consistent with these findings, proxy Addiction Research Center Inventory (ARCI) Amphetamine Group, and Morphine Benzedrine Group scale mean item scores were significantly higher in those with OUD. Replication was attempted in opioid misusers with (N = 25) and without OUD (N = 25) who were assessed as part of an ongoing genetic study. We observed similar significant between-group differences in individual subjective effect items and ARCI scale mean item scores in the replication sample. We, thus confirm findings from prior reports that retrospectively assessed subjective responses to initial opioid exposure differ significantly between opioid users who do, and do not, progress to OUD. Our report extends these findings in comparisons limited to opioid misusers. Additional research will be necessary to examine prospectively whether the assessment of subjective effects after initial use has predictive utility in the identification of individuals more likely to progress to OUD.
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Affiliation(s)
- Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Paul W Jeffries
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - A Benjamin Srivastava
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY, USA
| | - Vivia V McCutcheon
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Michael T Lynskey
- National Addictions Centre Addictions Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - Andrew C Heath
- 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
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Bourdon JL, Tillman R, Francis MW, Dick DM, Stephenson M, Kamarajan C, Edenberg HJ, Kramer J, Kuperman S, Bucholz KK, McCutcheon VV. Characterization of Service Use for Alcohol Problems Across Generations and Sex in Adults With Alcohol Use Disorder. Alcohol Clin Exp Res 2020; 44:746-757. [PMID: 31984526 PMCID: PMC7069784 DOI: 10.1111/acer.14290] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 10/30/2019] [Accepted: 01/20/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND There are gaps in the literature on service use (help-seeking and treatment utilization) for alcohol problems among those with alcohol use disorder (AUD). First, policy changes and cultural shifts (e.g., insurance) related to AUD have occurred over the last few decades, making it important to study generational differences. Second, multiple studies have found that females receive fewer services than males, and exploring whether these sex differences persist across generations can inform public health and research endeavors. The current study examined service use for alcohol problems among individuals with AUD. The aims were as follows: (i) to describe service use for alcohol problems; (ii) to assess generational differences (silent [b. 1928 to 1945], boomer [b. 1946 to 1964], generation X [b. 1965 to 1980], millennial [b. 1981 to 1996]) in help-seeking and treatment utilization; and (iii) to examine sex differences across generations. METHODS Data were from affected family members of probands who participated in the Collaborative Study on the Genetics of Alcoholism (N = 4,405). First, frequencies for service use variables were calculated across generations. Pearson chi-square and ANOVA were used to test for differences in rates and types of service use across generations, taking familial clustering into account. Next, Cox survival modeling was used to assess associations of generation and sex with time to first help-seeking and first treatment for AUD, and time from first onset of AUD to first help-seeking and first treatment. Interactions between generation and sex were tested within each Cox regression. RESULTS Significant hazards were found in all 4 transitions. Overall, younger generations used services earlier than older generations, which translated into higher likelihoods of these behaviors. Regardless of generation, younger females were less likely to use services than males. CONCLUSIONS There are generational and sex differences in service use for alcohol problems among individuals with AUD. Policy and clinical implications are discussed.
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Lai D, Wetherill L, Kapoor M, Johnson EC, Schwandt M, Ramchandani VA, Goldman D, Joslyn G, Rao X, Liu Y, Farris S, Mayfield RD, Dick D, Hesselbrock V, Kramer J, McCutcheon VV, Nurnberger J, Tischfield J, Goate A, Edenberg HJ, Porjesz B, Agrawal A, Foroud T, Schuckit M. Genome-wide association studies of the self-rating of effects of ethanol (SRE). Addict Biol 2020; 25:e12800. [PMID: 31270906 PMCID: PMC6940552 DOI: 10.1111/adb.12800] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 12/18/2018] [Revised: 05/06/2019] [Accepted: 05/27/2019] [Indexed: 12/22/2022]
Abstract
The level of response (LR) to alcohol as measured with the Self-Report of the Effects of Alcohol Retrospective Questionnaire (SRE) evaluates the number of standard drinks usually required for up to four effects. The need for a higher number of drinks for effects is genetically influenced and predicts higher risks for heavy drinking and alcohol problems. We conducted genome-wide association study (GWAS) in the African-American (COGA-AA, N = 1527 from 309 families) and European-American (COGA-EA, N = 4723 from 956 families) subsamples of the Collaborative Studies on the Genetics of Alcoholism (COGA) for two SRE scores: SRE-T (average of first five times of drinking, the period of heaviest drinking, and the most recent 3 months of consumption) and SRE-5 (the first five times of drinking). We then meta-analyzed the two COGA subsamples (COGA-AA + EA). Both SRE-T and SRE-5 were modestly heritable (h2 : 21%-31%) and genetically correlated with alcohol dependence (AD) and DSM-IV AD criterion count (rg : 0.35-0.76). Genome-wide significant associations were observed (SRE-T: chromosomes 6, rs140154945, COGA-EA P = 3.30E-08 and 11, rs10647170, COGA-AA+EA P = 3.53E-09; SRE-5: chromosome13, rs4770359, COGA-AA P = 2.92E-08). Chromosome 11 was replicated in an EA dataset from the National Institute on Alcohol Abuse and Alcoholism intramural program. In silico functional analyses and RNA expression analyses suggest that the chromosome 6 locus is an eQTL for KIF25. Polygenic risk scores derived using the COGA SRE-T and SRE-5 GWAS predicted 0.47% to 2.48% of variances in AD and DSM-IV AD criterion count in independent datasets. This study highlights the genetic contribution of alcohol response phenotypes to the etiology of alcohol use disorders.
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Affiliation(s)
- Dongbing Lai
- Department of Medical and Molecular Genetics, Indiana
University School of Medicine, Indianapolis, IN
| | - Leah Wetherill
- Department of Medical and Molecular Genetics, Indiana
University School of Medicine, Indianapolis, IN
| | - Manav Kapoor
- Department of Neuroscience, Icahn School of Medicine at
Mt. Sinai, New York, NY
| | - Emma C. Johnson
- Department of Psychiatry, Washington University School of
Medicine, St. Louis, MO
| | - Melanie Schwandt
- Office of the Clinical Director, National Institute on
Alcohol Abuse & Alcoholism, Bethesda, MD
| | - Vijay A. Ramchandani
- Section on Human Psychopharmacology, Division of
Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and
Alcoholism, Bethesda, MD
| | - David Goldman
- Office of the Clinical Director, National Institute on
Alcohol Abuse & Alcoholism, Bethesda, MD
| | - Geoff Joslyn
- Ernest Gallo Clinic and Research Center, Emeryville,
CA
| | - Xi Rao
- Department of Medical and Molecular Genetics, Indiana
University School of Medicine, Indianapolis, IN
| | - Yunlong Liu
- Department of Medical and Molecular Genetics, Indiana
University School of Medicine, Indianapolis, IN
| | - Sean Farris
- Waggoner Center for Alcohol and Addiction Research, The
University of Texas at Austin, Austin, TX
| | - R. Dayne Mayfield
- Waggoner Center for Alcohol and Addiction Research, The
University of Texas at Austin, Austin, TX
| | - Danielle Dick
- Department of Psychology, Virginia Commonwealth
University, Richmond, VA
| | | | - John Kramer
- Department of Psychiatry, Roy Carver College of
Medicine, University of Iowa, Iowa City, IA
| | - Vivia V. McCutcheon
- Department of Psychiatry, Washington University School of
Medicine, St. Louis, MO
| | - John Nurnberger
- Department of Medical and Molecular Genetics, Indiana
University School of Medicine, Indianapolis, IN
- Department of Psychiatry, Indiana University School of
Medicine, Indianapolis, IN
| | - Jay Tischfield
- Department of Genetics and the Human Genetics Institute
of New Jersey, Rutgers University, Piscataway, NJ
| | - Alison Goate
- Department of Neuroscience, Icahn School of Medicine at
Mt. Sinai, New York, NY
| | - Howard J. Edenberg
- Department of Medical and Molecular Genetics, Indiana
University School of Medicine, Indianapolis, IN
- Department of Biochemistry and Molecular Biology,
Indiana University School of Medicine, Indianapolis, IN
| | - Bernice Porjesz
- Henri Begleiter Neurodynamics Lab, Department of
Psychiatry, State University of New York, Downstate Medical Center, Brooklyn,
NY
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of
Medicine, St. Louis, MO
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana
University School of Medicine, Indianapolis, IN
| | - Marc Schuckit
- Department of Psychiatry, University of California, San
Diego Medical School, San Diego, CA
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Pandey G, Seay MJ, Meyers JL, Chorlian DB, Pandey AK, Kamarajan C, Ehrenberg M, Pitti D, Kinreich S, Subbie-Saenz de Viteri S, Acion L, Anokhin A, Bauer L, Chan G, Edenberg H, Hesselbrock V, Kuperman S, McCutcheon VV, Bucholz KK, Schuckit M, Porjesz B. Density and Dichotomous Family History Measures of Alcohol Use Disorder as Predictors of Behavioral and Neural Phenotypes: A Comparative Study Across Gender and Race/Ethnicity. Alcohol Clin Exp Res 2020; 44:697-710. [PMID: 31957047 PMCID: PMC8357185 DOI: 10.1111/acer.14280] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 04/08/2019] [Accepted: 12/22/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Family history (FH) is an important risk factor for the development of alcohol use disorder (AUD). A variety of dichotomous and density measures of FH have been used to predict alcohol outcomes; yet, a systematic comparison of these FH measures is lacking. We compared 4 density and 4 commonly used dichotomous FH measures and examined variations by gender and race/ethnicity in their associations with age of onset of regular drinking, parietal P3 amplitude to visual target, and likelihood of developing AUD. METHODS Data from the Collaborative Study on the Genetics of Alcoholism (COGA) were utilized to compute the density and dichotomous measures. Only subjects and their family members with DSM-5 AUD diagnostic information obtained through direct interviews using the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA) were included in the study. Area under receiver operating characteristic curves were used to compare the diagnostic accuracy of FH measures at classifying DSM-5 AUD diagnosis. Logistic and linear regression models were used to examine associations of FH measures with alcohol outcomes. RESULTS Density measures had greater diagnostic accuracy at classifying AUD diagnosis, whereas dichotomous measures presented diagnostic accuracy closer to random chance. Both dichotomous and density measures were significantly associated with likelihood of AUD, early onset of regular drinking, and low parietal P3 amplitude, but density measures presented consistently more robust associations. Further, variations in these associations were observed such that among males (vs. females) and Whites (vs. Blacks), associations of alcohol outcomes with density (vs. dichotomous) measures were greater in magnitude. CONCLUSIONS Density (vs. dichotomous) measures seem to present more robust associations with alcohol outcomes. However, associations of dichotomous and density FH measures with different alcohol outcomes (behavioral vs. neural) varied across gender and race/ethnicity. These findings have great applicability for alcohol research examining FH of AUD.
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Affiliation(s)
- Gayathri Pandey
- From the, Department of Psychiatry and Behavioral Sciences, (GP, JLM, DBC, AKP, CK, ME, DP, S Kinreich, SS-SV, BP), Downstate Medical Center, State University of New York, Brooklyn, New York
| | - Michael J Seay
- Department of Psychology, (MJS), University of California, Los Angeles, California
| | - Jacquelyn L Meyers
- From the, Department of Psychiatry and Behavioral Sciences, (GP, JLM, DBC, AKP, CK, ME, DP, S Kinreich, SS-SV, BP), Downstate Medical Center, State University of New York, Brooklyn, New York
| | - David B Chorlian
- From the, Department of Psychiatry and Behavioral Sciences, (GP, JLM, DBC, AKP, CK, ME, DP, S Kinreich, SS-SV, BP), Downstate Medical Center, State University of New York, Brooklyn, New York
| | - Ashwini K Pandey
- From the, Department of Psychiatry and Behavioral Sciences, (GP, JLM, DBC, AKP, CK, ME, DP, S Kinreich, SS-SV, BP), Downstate Medical Center, State University of New York, Brooklyn, New York
| | - Chella Kamarajan
- From the, Department of Psychiatry and Behavioral Sciences, (GP, JLM, DBC, AKP, CK, ME, DP, S Kinreich, SS-SV, BP), Downstate Medical Center, State University of New York, Brooklyn, New York
| | - Morton Ehrenberg
- From the, Department of Psychiatry and Behavioral Sciences, (GP, JLM, DBC, AKP, CK, ME, DP, S Kinreich, SS-SV, BP), Downstate Medical Center, State University of New York, Brooklyn, New York
| | - Daniel Pitti
- From the, Department of Psychiatry and Behavioral Sciences, (GP, JLM, DBC, AKP, CK, ME, DP, S Kinreich, SS-SV, BP), Downstate Medical Center, State University of New York, Brooklyn, New York
| | - Sivan Kinreich
- From the, Department of Psychiatry and Behavioral Sciences, (GP, JLM, DBC, AKP, CK, ME, DP, S Kinreich, SS-SV, BP), Downstate Medical Center, State University of New York, Brooklyn, New York
| | - Stacey Subbie-Saenz de Viteri
- From the, Department of Psychiatry and Behavioral Sciences, (GP, JLM, DBC, AKP, CK, ME, DP, S Kinreich, SS-SV, BP), Downstate Medical Center, State University of New York, Brooklyn, New York
| | - Laura Acion
- Iowa Consortium for Substance Abuse Research and Evaluation, (LA), University of Iowa, Iowa City, Iowa
| | - Andrey Anokhin
- Department of Psychiatry, (AA, VVM, KKB), Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Lance Bauer
- Department of Psychiatry, (LB, GC, VH), University of Connecticut School of Medicine, Farmington, Connecticut
| | - Grace Chan
- Department of Psychiatry, (LB, GC, VH), University of Connecticut School of Medicine, Farmington, Connecticut
| | - Howard Edenberg
- Department of Biochemistry and Molecular Biology, (HE), Indiana University School of Medicine, Indianapolis, Indiana
| | - Victor Hesselbrock
- Department of Psychiatry, (LB, GC, VH), University of Connecticut School of Medicine, Farmington, Connecticut
| | - Samuel Kuperman
- Department of Psychiatry, (S Kuperman), University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Vivia V McCutcheon
- Department of Psychiatry, (AA, VVM, KKB), Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Kathleen K Bucholz
- Department of Psychiatry, (AA, VVM, KKB), Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Marc Schuckit
- Department of Psychiatry, (MS), University of California San Diego, La Jolla, California
| | - Bernice Porjesz
- From the, Department of Psychiatry and Behavioral Sciences, (GP, JLM, DBC, AKP, CK, ME, DP, S Kinreich, SS-SV, BP), Downstate Medical Center, State University of New York, Brooklyn, New York
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27
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Salvatore JE, Barr PB, Stephenson M, Aliev F, Kuo SIC, Su J, Agrawal A, Almasy L, Bierut L, Bucholz K, Chan G, Edenberg HJ, Johnson EC, McCutcheon VV, Meyers JL, Schuckit M, Tischfield J, Wetherill L, Dick DM. Sibling comparisons elucidate the associations between educational attainment polygenic scores and alcohol, nicotine and cannabis. Addiction 2020; 115:337-346. [PMID: 31659820 PMCID: PMC7034661 DOI: 10.1111/add.14815] [Citation(s) in RCA: 12] [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: 02/27/2019] [Revised: 05/30/2019] [Accepted: 09/02/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS The associations between low educational attainment and substance use disorders (SUDs) may be related to a common genetic vulnerability. We aimed to elucidate the associations between polygenic scores for educational attainment and clinical criterion counts for three SUDs (alcohol, nicotine and cannabis). DESIGN Polygenic association and sibling comparison methods. The latter strengthens inferences in observational research by controlling for confounding factors that differ between families. SETTING Six sites in the United States. PARTICIPANTS European ancestry participants aged 25 years and older from the Collaborative Study on the Genetics of Alcoholism (COGA). Polygenic association analyses included 5582 (54% female) participants. Sibling comparisons included 3098 (52% female) participants from 1226 sibling groups nested within the overall sample. MEASUREMENTS Outcomes included criterion counts for DSM-5 alcohol use disorder (AUDSX), Fagerström nicotine dependence (NDSX) and DSM-5 cannabis use disorder (CUDSX). We derived polygenic scores for educational attainment (EduYears-GPS) using summary statistics from a large (> 1 million) genome-wide association study of educational attainment. FINDINGS In polygenic association analyses, higher EduYears-GPS predicted lower AUDSX, NDSX and CUDSX [P < 0.01, effect sizes (R2 ) ranging from 0.30 to 1.84%]. These effects were robust in sibling comparisons, where sibling differences in EduYears-GPS predicted all three SUDs (P < 0.05, R2 0.13-0.20%). CONCLUSIONS Individuals who carry more alleles associated with educational attainment tend to meet fewer clinical criteria for alcohol, nicotine and cannabis use disorders, and these effects are robust to rigorous controls for potentially confounding factors that differ between families (e.g. socio-economic status, urban-rural residency and parental education).
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Affiliation(s)
- Jessica E. Salvatore
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth, University, Box 980126, Richmond, VA 23298
| | - Peter B. Barr
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018
| | - Mallory Stephenson
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018
| | - Fazil Aliev
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018
- Department of Business Administration, Karabuk University, 78050 Karabuk, Turkey
| | - Sally I-Chun Kuo
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018
| | - Jinni Su
- Department of Psychology, Arizona State University, Box 871104, Tempe, AZ 85287-1104
| | - Arpana Agrawal
- Department of Psychiatry, Washington University in St. Louis, 660 S. Euclid, CB 8134, St., Louis, MO 63110
| | - Laura Almasy
- Department of Genetics, University of Pennsylvania, 415 Curie Boulevard Philadelphia, PA, 19104-6145
- Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, 3615, Civic Center Blvd, ARC 1016-C, Philadelphia, PA 19104
| | - Laura Bierut
- Department of Psychiatry, Washington University in St. Louis, 660 S. Euclid, CB 8134, St., Louis, MO 63110
| | - Kathleen Bucholz
- Department of Psychiatry, Washington University in St. Louis, 660 S. Euclid, CB 8134, St., Louis, MO 63110
| | - Grace Chan
- Department of Psychiatry, University of Connecticut School of Medicine, 263 Farmington, Avenue, Farmington, CT 06030-2103
| | - Howard J. Edenberg
- Department of Biochemistry and Molecular Biology, Indiana University, 635 Barnhill Dr.,, Indianapolis, IN 46202
| | - Emma C. Johnson
- Department of Psychiatry, Washington University in St. Louis, 660 S. Euclid, CB 8134, St., Louis, MO 63110
| | - Vivia V. McCutcheon
- Department of Psychiatry, Washington University in St. Louis, 660 S. Euclid, CB 8134, St., Louis, MO 63110
| | - Jacquelyn L. Meyers
- Department of Psychiatry, SUNY Downstate Medical Center, 450 Clarkson Avenue Brooklyn, NY 11203
| | - Marc Schuckit
- Department of Psychiatry, University of California-San Diego, 9500 Gilman Drive La Jolla,, CA 92093
| | - Jay Tischfield
- Department of Genetics and the Human Genetics Institute of New Jersey, 145 Bevier Road, Piscataway, NJ 08854-8082
| | - Leah Wetherill
- Department of Medical and Molecular Genetics, Indiana University, 410 W. 10th Street, Indianapolis, IN 46202
| | - Danielle M. Dick
- Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018
- Department of Human & Molecular Genetics, Virginia Commonwealth University, Box, 980033, Richmond, VA, USA 23298
- College Behavioral and Emotional Health Institute, Virginia Commonwealth University, Box, 842018 Richmond, VA, 23284
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McCutcheon VV, Bucholz KK, Houston-Ludlam A, Heath AC. Elevated maternal and child mortality among women with multiple DUI convictions compared with socio-demographically matched controls. Addiction 2019; 114:1981-1991. [PMID: 31351443 PMCID: PMC6800795 DOI: 10.1111/add.14762] [Citation(s) in RCA: 2] [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: 09/19/2018] [Revised: 12/06/2018] [Accepted: 07/23/2019] [Indexed: 11/30/2022]
Abstract
AIMS To assess whether having multiple convictions for driving while under the influence of alcohol (MDUI) in women is a risk factor for maternal, infant and child mortality. DESIGN Retrospective cohort design using record linkage, comparing women with MDUI convictions with propensity-matched women without alcohol-related driving offences ascertained through state records, on rates of maternal, infant and child mortality. SETTING Missouri, United States. PARTICIPANTS MDUI women (n = 1658) and women with no alcohol-related driving convictions (control, n = 184 252) who gave birth from 2000 to 2004. MEASUREMENTS Data were obtained from state administrative records and US Census data. The outcomes were maternal, infant and child mortality. The input variable was presence or absence of MDUI convictions. Propensity-matching variables were maternal (smoking during pregnancy, delayed prenatal care, previous child deaths, age at birth, mother Missouri-born, education, pre-pregnancy obesity, marital status), reproductive partner (un-named partner, race/ethnicity, education, DUI status) and census tract (socio-economic advantage, urbanicity) characteristics. FINDINGS Women with MDUI convictions had higher odds of maternal, infant and child mortality than propensity-matched controls [odds ratio (OR) = 2.65, 95% confidence interval (CI) = 2.07-3.40 and OR = 1.75, 95% CI = 1.17-2.61, respectively]. CONCLUSIONS Having multiple convictions for driving under the influence of alcohol in women appears to be a risk factor for increased maternal, infant and child mortality.
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Affiliation(s)
- Vivia V. McCutcheon
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St. Louis, MO 63110
| | - Kathleen K. Bucholz
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St. Louis, MO 63110
| | - Alexandra Houston-Ludlam
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St. Louis, MO 63110
| | - Andrew C. Heath
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, St. Louis, MO 63110
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29
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Meyers JL, Salvatore JE, Aliev F, Johnson EC, McCutcheon VV, Su J, Kuo SIC, Lai D, Wetherill L, Wang JC, Chan G, Hesselbrock V, Foroud T, Bucholz KK, Edenberg HJ, Dick DM, Porjesz B, Agrawal A. Psychosocial moderation of polygenic risk for cannabis involvement: the role of trauma exposure and frequency of religious service attendance. Transl Psychiatry 2019; 9:269. [PMID: 31636251 PMCID: PMC6803671 DOI: 10.1038/s41398-019-0598-z] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 04/12/2019] [Accepted: 04/29/2019] [Indexed: 12/12/2022] Open
Abstract
Cannabis use and disorders (CUD) are influenced by multiple genetic variants of small effect and by the psychosocial environment. However, this information has not been effectively incorporated into studies of gene-environment interaction (GxE). Polygenic risk scores (PRS) that aggregate the effects of genetic variants can aid in identifying the links between genetic risk and psychosocial factors. Using data from the Pasman et al. GWAS of cannabis use (meta-analysis of data from the International Cannabis Consortium and UK Biobank), we constructed PRS in the Collaborative Study on the Genetics of Alcoholism (COGA) participants of European (N: 7591) and African (N: 3359) ancestry. The primary analyses included only individuals of European ancestry, reflecting the ancestral composition of the discovery GWAS from which the PRS was derived. Secondary analyses included the African ancestry sample. Associations of PRS with cannabis use and DSM-5 CUD symptom count (CUDsx) and interactions with trauma exposure and frequency of religious service attendance were examined. Models were adjusted for sex, birth cohort, genotype array, and ancestry. Robustness models were adjusted for cross-term interactions. Higher PRS were associated with a greater likelihood of cannabis use and with CUDsx among participants of European ancestry (p < 0.05 and p < 0.1 thresholds, respectively). PRS only influenced cannabis use among those exposed to trauma (R2: 0.011 among the trauma exposed vs. R2: 0.002 in unexposed). PRS less consistently influenced cannabis use among those who attend religious services less frequently; PRS × religious service attendance effects were attenuated when cross-term interactions with ancestry and sex were included in the model. Polygenic liability to cannabis use was related to cannabis use and, less robustly, progression to symptoms of CUD. This study provides the first evidence of PRS × trauma for cannabis use and demonstrates that ignoring important aspects of the psychosocial environment may mask genetic influences on polygenic traits.
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Affiliation(s)
- Jacquelyn L Meyers
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry, State University of New York Downstate Medical Center, Brooklyn, NY, 11203, USA.
| | | | - Fazil Aliev
- Virginia Commonwealth University, Richmond, VA, 232212, USA
| | - Emma C Johnson
- Washington University School of Medicine, St. Louis, MO, 63110, USA
| | | | - Jinni Su
- Virginia Commonwealth University, Richmond, VA, 232212, USA
| | | | - Dongbing Lai
- Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Leah Wetherill
- Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Jen C Wang
- Mount Sinai School of Medicine, New York, NY, 10029, USA
| | - Grace Chan
- University of Connecticut School of Medicine, Connecticut, CT, 06030-2103, USA
| | - Victor Hesselbrock
- University of Connecticut School of Medicine, Connecticut, CT, 06030-2103, USA
| | - Tatiana Foroud
- Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | | | | | | | - Bernice Porjesz
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry, State University of New York Downstate Medical Center, Brooklyn, NY, 11203, USA
| | - Arpana Agrawal
- Washington University School of Medicine, St. Louis, MO, 63110, USA
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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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Johnson EC, St Pierre CL, Meyers JL, Aliev F, McCutcheon VV, Lai D, Dick DM, Goate AM, Kramer J, Kuperman S, Nurnberger JI, Schuckit MA, Porjesz B, Edenberg HJ, Bucholz KK, Agrawal A. The Genetic Relationship Between Alcohol Consumption and Aspects of Problem Drinking in an Ascertained Sample. Alcohol Clin Exp Res 2019; 43:1113-1125. [PMID: 30994927 PMCID: PMC6560626 DOI: 10.1111/acer.14064] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 10/24/2018] [Accepted: 04/04/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Genomewide association studies (GWAS) have begun to identify loci related to alcohol consumption, but little is known about whether this genetic propensity overlaps with specific indices of problem drinking in ascertained samples. METHODS In 6,731 European Americans who had been exposed to alcohol, we examined whether polygenic risk scores (PRS) from a GWAS of weekly alcohol consumption in the UK Biobank predicted variance in 6 alcohol-related phenotypes: alcohol use, maximum drinks within 24 hours (MAXD), total score on the Self-Rating of the Effects of Ethanol Questionnaire (SRE-T), DSM-IV alcohol dependence (DSM4AD), DSM-5 alcohol use disorder symptom counts (DSM5AUDSX), and reduction/cessation of problematic drinking. We also examined the extent to which an single nucleotide polymorphism (rs1229984) in ADH1B, which is strongly associated with both alcohol consumption and dependence, contributed to the polygenic association with these phenotypes and whether PRS interacted with sex, age, or family history of alcoholism to predict alcohol-related outcomes. We performed mixed-effect regression analyses, with family membership and recruitment site included as random effects, as well as survival modeling of age of onset of DSM4AD. RESULTS PRS for alcohol consumption significantly predicted variance in 5 of the 6 outcomes: alcohol use (Δmarginal R2 = 1.39%, Δ area under the curve [AUC] = 0.011), DSM4AD (Δmarginal R2 = 0.56%; ΔAUC = 0.003), DSM5AUDSX (Δmarginal R2 = 0.49%), MAXD (Δmarginal R2 = 0.31%), and SRE-T (Δmarginal R2 = 0.22%). PRS were also associated with onset of DSM4AD (hazard ratio = 1.11, p = 2.08e-5). The inclusion of rs1229984 attenuated the effects of the alcohol consumption PRS, particularly for DSM4AD and DSM5AUDSX, but the PRS continued to exert an independent effect for all 5 alcohol measures (Δmarginal R2 after controlling for ADH1B = 0.14 to 1.22%). Interactions between PRS and sex, age, or family history were nonsignificant. CONCLUSIONS Genetic propensity for typical alcohol consumption was associated with alcohol use and was also associated with 4 of the additional 5 outcomes, though the variance explained in this sample was modest. Future GWAS that focus on the multifaceted nature of AUD, which goes beyond consumption, might reveal additional information regarding the polygenic underpinnings of problem drinking.
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Affiliation(s)
- Emma C Johnson
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Celine L St Pierre
- Division of Biological and Biomedical Sciences, Washington University School of Medicine, Saint Louis, Missouri
| | - Jacquelyn L Meyers
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York
| | - Fazil Aliev
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
- Department of Actuarial and Risk Management, Faculty of Business, Karabuk University, Karabük, Turkey
| | - Vivia V McCutcheon
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Dongbing Lai
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Danielle M Dick
- Department of Psychology and Human and Molecular Genetics, Virginia Commonwealth University, Richmond, Virginia
| | - Alison M Goate
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York
| | - John Kramer
- Department of Psychiatry, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Samuel Kuperman
- Department of Psychiatry, Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - John I Nurnberger
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana
| | - Marc A Schuckit
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Bernice Porjesz
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York
| | - Howard J Edenberg
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Kathleen K Bucholz
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
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Johnson EC, Tillman R, Aliev F, Meyers JL, Salvatore JE, Anokhin AP, Dick DM, Edenberg HJ, Kramer JR, Kuperman S, McCutcheon VV, Nurnberger JI, Porjesz B, Schuckit MA, Tischfield J, Bucholz KK, Agrawal A. Exploring the relationship between polygenic risk for cannabis use, peer cannabis use and the longitudinal course of cannabis involvement. Addiction 2019; 114:687-697. [PMID: 30474892 PMCID: PMC6411425 DOI: 10.1111/add.14512] [Citation(s) in RCA: 15] [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: 06/22/2018] [Revised: 08/13/2018] [Accepted: 11/16/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND AND AIMS Few studies have explored how polygenic propensity to cannabis use unfolds across development, and no studies have yet examined this question in the context of environmental contributions such as peer cannabis use. Outlining the factors that contribute to progression from cannabis initiation to problem use over time may ultimately provide insights into mechanisms for targeted interventions. We sought to examine the relationships between polygenic liability for cannabis use, cannabis use trajectories from ages 12-30 years and perceived peer cannabis use at ages 12-17 years. DESIGN Mixed-effect logistic and linear regressions were used to examine associations between polygenic risk scores, cannabis use trajectory membership and perceived peer cannabis use. SETTING United States. PARTICIPANTS From the Collaborative Study on the Genetics of Alcoholism (COGA) study, a cohort of 1167 individuals aged 12-26 years at their baseline (i.e. first) interview. MEASUREMENTS Key measurements included life-time cannabis use (yes/no), frequency of past 12-month cannabis use, maximum life-time frequency of cannabis use, cannabis use disorder (using DSM-5 criteria) and perceived peer cannabis use. Polygenic risk scores (PRS) were created using summary statistics from a large (n = 162 082) genome-wide association study (GWAS) of cannabis use. FINDINGS Three trajectories reflecting no/low (n = 844), moderate (n = 137) and high (n = 186) use were identified. PRS were significantly associated with trajectory membership [P = 0.002-0.006, maximum conditional R2 = 1.4%, odds ratios (ORs) = 1.40-1.49]. Individuals who reported that most/all of their best friends used cannabis had significantly higher PRS than those who reported that none of their friends were users [OR = 1.35, 95% confidence interval (CI) = 1.04, 1.75, P = 0.023]. Perceived peer use itself explained up to 11.3% of the variance in trajectory class membership (OR = 1.50-4.65). When peer cannabis use and the cannabis use PRS were entered into the model simultaneously, both the PRS and peer use continued to be significantly associated with class membership (P < 0.01). CONCLUSIONS Genetic propensity to cannabis use derived from heterogeneous samples appears to correlate with longitudinal increases in cannabis use frequency in young adults.
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Affiliation(s)
- Emma C Johnson
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Rebecca Tillman
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Fazil Aliev
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
- Department of Actuarial and Risk Management, Faculty of Business, Karabuk University, Turkey
| | - Jacquelyn L Meyers
- Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Jessica E Salvatore
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Andrey P Anokhin
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Danielle M Dick
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Howard J Edenberg
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - John R Kramer
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Samuel Kuperman
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Vivia V McCutcheon
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - John I Nurnberger
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Bernice Porjesz
- Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Marc A Schuckit
- Department of Psychiatry, University of California San Diego Medical School, San Diego, CA, USA
| | - Jay Tischfield
- Department of Genetics, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Kathleen K Bucholz
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
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Meyers J, McCutcheon VV, Pandey AK, Kamarajan C, Subbie S, Chorlian D, Salvatore J, Pandey G, Almasy L, Anokhin A, Bauer L, Bender A, Dick DM, Edenberg HJ, Hesselbrock V, Kramer J, Kuperman S, Agrawal A, Bucholz K, Porjesz B. Early Sexual Trauma Exposure and Neural Response Inhibition in Adolescence and Young Adults: Trajectories of Frontal Theta Oscillations During a Go/No-Go Task. J Am Acad Child Adolesc Psychiatry 2019; 58:242-255.e2. [PMID: 30738551 PMCID: PMC6537865 DOI: 10.1016/j.jaac.2018.07.905] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 12/21/2017] [Revised: 06/14/2018] [Accepted: 08/15/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Trauma, particularly when experienced early in life, can alter neurophysiologic and behavioral development, thereby increasing risk for substance use disorders and related psychopathology. However, few studies have empirically examined trauma using well-characterized developmental samples that are followed longitudinally. METHOD The association of assaultive, non-assaultive, and sexual assaultive experiences before 10 years of age with developmental trajectories of brain function during response inhibition was examined by measuring electrophysiologic theta and delta oscillations during no-go and go conditions in an equal probability go/no-go task. Data were drawn from the Collaborative Study of the Genetics of Alcoholism (COGA) prospective cohort, composed of offspring who were aged 12 through 22 years at enrollment from high-risk and comparison families, with follow-ups at 2-year intervals since 2004. In addition, other important predictors of neurophysiologic functioning (eg, substance use, impulsivity, and parental alcohol use disorders) were investigated. Moreover, associations of neurophysiologic functioning with alcohol and cannabis use disorder symptom counts and externalizing and internalizing psychopathology were examined. RESULTS Individuals exposed to sexual assaultive trauma before 10 years of age had slower rates of change in developmental trajectories of no-go frontal theta during response inhibition. Importantly, effects remained significant after accounting for exposure to other traumatic exposures, such as parental history of alcohol use disorder and participants' substance use, but not measures of impulsivity. Further, slower rates of change in no-go frontal theta adolescent and young adult development were associated with increased risk for alcohol use disorder symptoms and internalizing psychopathology, but not for cannabis use disorder symptoms or externalizing psychopathology. CONCLUSION Childhood sexual assault is associated with atypical frontal neurophysiologic development during response inhibition. This could reflect alterations in frontal lobe development, synaptic pruning, and/or cortical maturation involving neural circuits for inhibitory control. These same areas could be associated with increased risk for young adult alcohol use disorder symptoms and internalizing psychopathology. These findings support the hypothesis that changes in neurocognitive development related to early sexual trauma exposure could increase the risk for mental health and substance use problems in young adulthood.
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Affiliation(s)
- Jacquelyn Meyers
- State University of New York Downstate Medical Center, Brooklyn, NY.
| | | | | | - Chella Kamarajan
- State University of New York Downstate Medical Center, Brooklyn, NY
| | - Stacey Subbie
- State University of New York Downstate Medical Center, Brooklyn, NY
| | - David Chorlian
- State University of New York Downstate Medical Center, Brooklyn, NY
| | - Jessica Salvatore
- Virginia Commonwealth University, Richmond.,Virginia Institute of Psychiatric and Behavioral Genetics,Virginia Commonwealth University
| | - Gayathri Pandey
- State University of New York Downstate Medical Center, Brooklyn, NY
| | | | | | - Lance Bauer
- University of Connecticut School of Medicine, Farmington
| | | | | | | | | | | | | | | | | | - Bernice Porjesz
- State University of New York Downstate Medical Center, Brooklyn, NY
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Cho SB, Su J, Kuo SIC, Bucholz KK, Chan G, Edenberg HJ, McCutcheon VV, Schuckit MA, Kramer JR, Dick DM. Positive and negative reinforcement are differentially associated with alcohol consumption as a function of alcohol dependence. Psychol Addict Behav 2019; 33:58-68. [PMID: 30667237 DOI: 10.1037/adb0000436] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A multistage model of drug addiction in which individuals' motivations for use change as they develop problems is widely accepted; however, the evidence for this model comes mostly from animal work and cross-sectional studies. We used longitudinal data to test whether positive and negative reinforcement associated with alcohol consumption differed as a function of alcohol dependence (AD). Specifically, we tested whether (a) positive reinforcement is more strongly associated with alcohol consumption than is negative reinforcement among individuals without AD, (b) negative reinforcement is more strongly associated with AD than is positive reinforcement, and (c) in the presence of AD, the association between positive reinforcement and alcohol consumption becomes weaker, whereas the association with negative reinforcement becomes stronger. We included assessments between Ages 18 and 30 years from participants who indicated they ever had a drink (N = 2,556; 51.6% female) from the Collaborative Study on the Genetics of Alcoholism Prospective Study. Results from generalized estimating equations indicated that positive, but not negative, reinforcement was associated with alcohol consumption among individuals without AD. Both positive and negative reinforcement were associated with AD, but the association was stronger with negative reinforcement. Results from the multilevel growth model indicated that the association between negative reinforcement and alcohol consumption became stronger with the presence of AD, whereas the association between positive reinforcement and alcohol consumption did not differ as a function of AD. We provide empirical evidence that positive and negative reinforcement are differentially associated with alcohol consumption as a function of AD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Seung Bin Cho
- Department of Psychology, Virginia Commonwealth University
| | - Jinni Su
- Department of Psychology, Virginia Commonwealth University
| | | | | | - Grace Chan
- Department of Psychiatry, University of Connecticut
| | - Howard J Edenberg
- Department of Biochemistry and Molecular Biology, Indiana University
| | | | - Marc A Schuckit
- Department of Psychiatry, University of California at San Diego
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Werner KB, Cunningham-Williams RM, Sewell W, Agrawal A, McCutcheon VV, Waldron M, Heath AC, Bucholz KK. The Impact of Traumatic Experiences on Risky Sexual Behaviors in Black and White Young Adult Women. Womens Health Issues 2018; 28:421-429. [PMID: 29903544 PMCID: PMC6143429 DOI: 10.1016/j.whi.2018.04.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 10/05/2017] [Revised: 04/20/2018] [Accepted: 04/27/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Trauma exposure has been linked to risky sexual behavior (RSB), but few studies have examined the impact of distinct trauma types on RSB in one model or how the association with trauma and RSB may differ across race. PURPOSE The objective of the current study was to examine the contribution of trauma exposure types to RSB-substance-related RSB and partner-related RSB identified through factor analysis-in young Black and White adult women. METHODS We investigated the associations of multiple trauma types and RSB factor scores in participants from a general population sample of young adult female twins (n = 2,948). We examined the independent relationship between specific traumas and RSB, adjusting for substance use, psychopathology, and familial covariates. All pertinent constructs were coded positive only if they occurred before sexual debut. RESULTS In Black women, sexual abuse was significantly associated with substance-related and partner-related RSB, but retained significance only for partner-related RSB in a fully adjusted model. For White women, sexual abuse and physical abuse were associated with both RSB factors in the base and fully adjusted models. Witnessing injury or death was only associated with RSBs in base models. For both groups, initiating alcohol (for Black women), alcohol, or cannabis (for White women) before sexual debut (i.e., early exposure) was associated with the greatest increased odds of RSB. CONCLUSIONS Data highlight the contribution of prior sexual abuse to RSBs for both White and Black women, and of prior physical abuse to RSBs for White women. Findings have implications for intervention after physical and sexual abuse exposure to prevent RSB, and thus, potentially reduce sexually transmitted infection/human immunodeficiency virus infection and unintended pregnancy in young women.
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Affiliation(s)
- Kimberly B Werner
- Missouri Institute of Mental Health, University of Missouri, St. Louis, Missouri.
| | | | - Whitney Sewell
- George Warren Brown School of Social Work, Washington University, St. Louis, Missouri
| | - Arpana Agrawal
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Vivia V McCutcheon
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Mary Waldron
- Alcohol 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
| | - Andrew C Heath
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Kathleen K Bucholz
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
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36
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Bender AK, Bucholz KK, Heath AC, McCutcheon VV. Comparison of Characteristics of Female Drivers with Single and Multiple DUI Convictions. Alcohol Clin Exp Res 2018; 42:646-653. [PMID: 29437240 DOI: 10.1111/acer.13590] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 12/21/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Women are increasingly involved in drunk driving and fatal crashes, yet except for the screening performed in criminal justice settings, little is known about their life context, psychiatric histories, and family backgrounds. This study describes a sample of women with histories of arrest for driving under the influence of alcohol (DUI) who were interviewed outside a criminal justice setting and contrasts women with single versus multiple DUI convictions. METHODS Women with recent documented histories of DUI participated in a study of women's health behaviors. Thirty-six women with 1 DUI and 62 with 2 or more DUIs participated in a diagnostic telephone interview which assessed demographics, alcohol use and problems, psychiatric problems, treatment, and partner violence. RESULTS The sample overall had high rates of co-occurring psychiatric problems, parental alcohol problems, early sexual and physical abuse, and head injuries. Alcohol use severity and the prevalence of head injuries and partner alcohol problems were significantly higher among women with multiple DUIs than women with a single DUI. Measures reflecting life context, such as marital status, number of children, and childhood trauma, were not associated with number of DUIs. CONCLUSIONS Findings suggest that DUI recidivism in women is accounted for primarily by AUD severity and is not influenced by previous life events such as partner violence, psychiatric problems, and family context such as divorce/separation or number of children. Multiple DUIs in women may mark an alcohol severity threshold beyond which few factors account for additional risk.
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Affiliation(s)
- Annah K Bender
- College of Nursing, University of Missouri-St. Louis, St. Louis, MO
| | - Kathleen K Bucholz
- Department of Psychiatry, Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO
| | - Andrew C Heath
- Department of Psychiatry, Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO
| | - Vivia V McCutcheon
- Department of Psychiatry, Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO
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37
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McCutcheon VV, Agrawal A, Kuo SIC, Su J, Dick DM, Meyers JL, Edenberg HJ, Nurnberger JI, Kramer JR, Kuperman S, Schuckit MA, Hesselbrock VM, Brooks A, Porjesz B, Bucholz KK. Associations of parental alcohol use disorders and parental separation with offspring initiation of alcohol, cigarette and cannabis use and sexual debut in high-risk families. Addiction 2018; 113:336-345. [PMID: 28804966 PMCID: PMC5760304 DOI: 10.1111/add.14003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 03/09/2017] [Revised: 05/04/2017] [Accepted: 08/04/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND AIMS Parental alcohol use disorders (AUDs) and parental separation are associated with increased risk for early use of alcohol in offspring, but whether they increase risks for early use of other substances and for early sexual debut is under-studied. We focused on associations of parental AUDs and parental separation with substance initiation and sexual debut to (1) test the strength of the associations of parental AUDs and parental separation with time to initiation (age in years) of alcohol, tobacco and cannabis use and sexual debut and (2) compare the strength of association of parental AUD and parental separation with initiation. DESIGN Prospective adolescent and young adult cohort of a high-risk family study, the Collaborative Study on the Genetics of Alcoholism (COGA). SETTING Six sites in the United States. PARTICIPANTS A total of 3257 offspring (aged 14-33 years) first assessed in 2004 and sought for interview approximately every 2 years thereafter; 1945 (59.7%) offspring had a parent with an AUD. MEASUREMENTS Diagnostic interview data on offspring substance use and sexual debut were based on first report of these experiences. Parental life-time AUD was based on their own self-report when parents were interviewed (1991-2005) for most parents, or on offspring and other family member reports for parents who were not interviewed. Parental separation was based on offspring reports of not living with both biological parents most of the time between ages 12 and 17 years. FINDINGS Parental AUDs were associated with increased hazards for all outcomes, with cumulative hazards ranging from 1.19 to 2.71. Parental separation was also an independent and consistent predictor of early substance use and sexual debut, with hazards ranging from 1.19 to 2.34. The strength of association of parental separation with substance initiation was equal to that of having two AUD-affected parents, and its association with sexual debut was stronger than the association of parental AUD in one or both parents. CONCLUSIONS Parental alcohol use disorders (AUDs) and parental separation are independent and consistent predictors of increased risk for early alcohol, tobacco and cannabis use and sexual debut in offspring from families with a high risk of parental AUDs.
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Affiliation(s)
| | - Arpana Agrawal
- Washington University School of Medicine, St. Louis, MO, USA
| | | | - Jinni Su
- Virginia Commonwealth University, Richmond, VA, USA
| | | | | | | | | | - John R. Kramer
- University of Iowa Carver College of Medicine, Iowa City, IA USA
| | - Samuel Kuperman
- University of Iowa Carver College of Medicine, Iowa City, IA USA
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McCutcheon VV, Schuckit MA, Kramer JR, Chan G, Edenberg HJ, Smith TL, Bender AK, Hesselbrock V, Hesselbrock M, Bucholz KK. Familial association of abstinent remission from alcohol use disorder in first-degree relatives of alcohol-dependent treatment-seeking probands. Addiction 2017; 112:1909-1917. [PMID: 28556494 PMCID: PMC5633502 DOI: 10.1111/add.13890] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 10/05/2016] [Revised: 01/05/2017] [Accepted: 05/22/2017] [Indexed: 01/24/2023]
Abstract
BACKGROUND AND AIMS Studies that have included family history of alcohol use disorder (AUD) as a predictor of remission from AUD have yielded few significant results. The goals of this study were to estimate the association of persistent AUD, non-abstinent remission and abstinent remission ('AUD/remission status') in a proband with AUD/remission status in a relative and to test whether this association differed in related and unrelated proband-relative pairs. DESIGN High-risk family study of alcohol dependence. Probands were recruited from treatment settings and relatives were invited to participate. Baseline assessments occurred between 1991 and 1998 with follow-up between 1996 and 2005. Half of probands were matched with a biological 1st-degree relative with life-time AUD (related group) and half of probands were paired with an unrelated individual with life-time AUD (unrelated group). SETTING Brooklyn, New York; Indianapolis, Indiana; Iowa City, Iowa; San Diego, California; Farmington, Connecticut; and St Louis, Missouri, USA. PARTICIPANTS A total of 606 probands (25.7% female, mean age 37.7) with baseline and follow-up data and 606 of their 1st-degree relatives who had life-ime AUDs (45.8% female, mean age 36.2 years). MEASUREMENTS Persistent AUD, non-abstinent remission and abstinent remission were based on self-report interview data on most recent AUD symptoms and alcohol consumption. Dependent variable was relatives' AUD/remission status. Independent variable was probands' AUD/remission status. FINDINGS A total of 34.6% of probands and 20.6% of relatives were abstinent and 11.1% of probands and 22.8% of relatives were in non-abstinent remission. AUD/remission status was correlated significantly in related (r = 0.23, P = 0.0037) but not in unrelated pairs. A significant interaction of probands' abstinent remission with a variable representing related (versus unrelated, P = 0.003) pairs suggested a familial association for abstinent remission. In related pairs, individuals with an abstinent proband were more likely to be abstinent themselves than were individuals whose proband had persistent AUD [relative risk ratio = 3.27, 95% confidence interval (CI) = 1.56-6.85, P = 0.002]; this association was not significant in unrelated pairs. CONCLUSIONS The likelihood of abstinent remission among people with alcohol use disorder appears to be more than three times greater for individuals who are related to an abstinent proband versus those related to a proband with persistent alcohol use disorder.
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Affiliation(s)
- Vivia V. McCutcheon
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO 63110
| | - Marc A. Schuckit
- University of California, San Diego, Dept. of Psychiatry, San Diego, CA 92093
| | | | - Grace Chan
- University of Connecticut School of Medicine, Dept. of Psychiatry, Farmington, CT 06030
| | - Howard J. Edenberg
- Indiana University School of Medicine, Dept. of Biochemistry and Molecular Biology, Indianapolis, IN 46202
| | - Tom L. Smith
- University of California, San Diego, Dept. of Psychiatry, San Diego, CA 92093
| | - Annah K. Bender
- University of Missouri, College of Nursing, St. Louis, MO 63121
| | - Victor Hesselbrock
- University of Connecticut School of Medicine, Dept. of Psychiatry, Farmington, CT 06030
| | - Michie Hesselbrock
- University of Connecticut School of Medicine, Dept. of Psychiatry, Farmington, CT 06030
| | - Kathleen K. Bucholz
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO 63110
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Grant JD, Agrawal A, Werner KB, McCutcheon VV, Nelson EC, Madden PA, Bucholz KK, Heath AC, Sartor CE. Phenotypic and familial associations between childhood maltreatment and cannabis initiation and problems in young adult European-American and African-American women. Drug Alcohol Depend 2017; 179:146-152. [PMID: 28779616 PMCID: PMC5599374 DOI: 10.1016/j.drugalcdep.2017.06.038] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 06/16/2017] [Accepted: 06/19/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Childhood maltreatment is a known risk factor for cannabis initiation and problem use, but the extent to which this association is attributable to shared familial influences is unknown. We estimate the magnitude of associations between childhood maltreatment, timing of cannabis initiation, and cannabis-related problems, in European-American (EA) and African-American (AA) women, and parse the relative influence of additive genetic (A), shared environmental (C), and individual-specific environmental (E) factors on these constructs and their covariation. METHODS Data were from diagnostic telephone interviews conducted with 3786 participants (14.6% AA) in a population-based study of female twins. Logistic regression analyses and twin modeling were used to test for associations, and estimate the relative contributions of genetic and environmental influences to childhood maltreatment and cannabis outcomes and their covariation. RESULTS Maltreatment was significantly associated with increased likelihood of cannabis initiation before age 15 among EAs (OR=6.33) and AAs (OR=3.93), but with increased likelihood of later initiation among EAs only (OR=1.68). Maltreatment was associated with cannabis problems among both groups (EA OR=2.32; AA OR=2.03). Among EA women, the covariation between maltreatment and cannabis outcomes was primarily attributable to familial environment (rC=0.67-0.70); among AAs, only individual-specific environment contributed (rE=0.37-0.40). CONCLUSION Childhood maltreatment is a major contributor to early initiation of cannabis as well as progression to cannabis problems in both AA and EA women. Distinctions by race/ethnicity are not in the relative contribution of genetic factors, but rather in the type of environmental influences that contribute to stages of cannabis involvement.
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Affiliation(s)
- Julia D. Grant
- 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
| | - Kimberly B. Werner
- George Warren Brown School of Social Work, Washington University, St. Louis, MO, 63110, USA
| | - Vivia V. McCutcheon
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, Saint Louis, MO, 63110, 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
| | - Carolyn E. Sartor
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8134, Saint Louis, MO, 63110, USA,Department of Psychiatry, Yale University School of Medicine, 389 Whitney Avenue, New Haven, CT, 06511, USA
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Agrawal A, Tillman R, Grucza RA, Nelson EC, McCutcheon VV, Few L, Conner KR, Lynskey MT, Dick DM, Edenberg HJ, Hesselbrock VM, Kramer JR, Kuperman S, Nurnberger JI, Schuckit MA, Porjesz B, Bucholz KK. Reciprocal relationships between substance use and disorders and suicidal ideation and suicide attempts in the Collaborative Study of the Genetics of Alcoholism. J Affect Disord 2017; 213:96-104. [PMID: 28213124 PMCID: PMC5434702 DOI: 10.1016/j.jad.2016.12.060] [Citation(s) in RCA: 21] [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: 09/22/2016] [Revised: 11/22/2016] [Accepted: 12/21/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND Substance use and misuse and suicidal thoughts and behaviors tend to co-occur. The purpose of this study was to examine whether (a) suicidal ideation and attempt are related to onset of alcohol, nicotine and cannabis use and dependence; (b) early use of alcohol, nicotine and cannabis is associated with onset of suicidal ideation and attempt; and (c) whether these associations persist while controlling for covariates, such as family history of alcohol problems, major depression and other internalizing and externalizing disorders. METHODS The prospective cohort of the Collaborative Study of the Genetics of Alcoholism (COGA; N=3277) was used. Cross-sectional and discrete time logistic regression (i.e. survival) analyses examined associations between suicidal ideation and attempt and onset of alcohol, nicotine and cannabis use and dependence. Survival models also examined whether individual early substance use was related to onset of ideation and attempt. RESULTS Ideation was related to 0.71-0.77 odds of onset of subsequent alcohol, nicotine and cannabis use. Attempt was associated with 1.44-1.61 odds of later alcohol, nicotine and cannabis dependence, even after accounting for covariates. Evidence for early substance use being related to subsequent onset of ideation or attempt was limited. Several sex and race differences emerged. LIMITATIONS The sample was ascertained for family history of alcoholism; not all participants had been followed up allowing for censored observations; reporting bias. CONCLUSION Suicide attempts are associated with increased likelihood of onset of substance dependence.
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Affiliation(s)
- Arpana Agrawal
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA.
| | - Rebecca Tillman
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA
| | - Richard A Grucza
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA
| | - Elliot C Nelson
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA
| | - Vivia V McCutcheon
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA
| | - Lauren Few
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA
| | - Kenneth R Conner
- University of Rochester Medical Center, Dept. of Emergency Medicine, Rochester, NY, USA
| | - Michael T Lynskey
- Kings College, Institute of Psychiatry, Dept. of Addiction, London, UK
| | - Danielle M Dick
- Virginia Commonwealth University, Dept. of African-American Studies, Richmond, VA, USA
| | - Howard J Edenberg
- Indiana University, Dept. of Biochemistry and Molecular Biology, Indianapolis, IN, USA
| | | | - John R Kramer
- University of Iowa Carver College of Medicine, Dept. of Psychiatry - Div. of Psychology, Iowa City, IA, USA
| | - Samuel Kuperman
- University of Iowa Carver College of Medicine, Depts. of Psychiatry and Pediatrics, Iowa City, IA, USA
| | - John I Nurnberger
- Indiana University School of Medicine, Dept. of Psychiatry, Indianapolis, IN, USA
| | - Marc A Schuckit
- University of California San Diego, Dept. of Psychiatry, San Diego, CA, USA
| | - Bernice Porjesz
- SUNY Downstate Medical Center, Dept. of Psychiatry, Brooklyn, NY, USA
| | - Kathleen K Bucholz
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA
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Werner KB, Grant JD, McCutcheon VV, Madden PAF, Heath AC, Bucholz KK, Sartor CE. Differences in childhood physical abuse reporting and the association between CPA and alcohol use disorder in European American and African American women. Psychol Addict Behav 2017; 30:423-33. [PMID: 27322801 DOI: 10.1037/adb0000174] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The goal of the current study was to examine whether the magnitude of the association between childhood physical abuse (CPA) and alcohol use disorder (AUD) varies by type of CPA assessment and race of the respondents. Data are from the Missouri adolescent female twins study and the Missouri family study (N = 4508) where 21.2% identified as African American (AA) and 78.8% as European American (EA); mean age = 23.8. Data were collected using a structured comprehensive interview which assessed CPA experiences using behavioral questions about specific abusive behaviors and trauma checklist items. Cox proportional hazards regression analyses were conducted, adjusting for additional risk factors associated with AUD, including co-occurring psychiatric disorders (defined as time-varying) and parental alcohol misuse. Overall, CPA reporting patterns were highly correlated (tetrachoric ρ = 0.73); although, only 25.8% of women who endorsed behaviorally defined CPA also endorsed checklist items whereas 72.2% of women who endorsed checklist items also endorsed behavioral questions. Racial disparities were evident, with behaviorally defined CPA increasing the hazard for AUD in EA but not AA women. Additional racial disparities in the risk for AUD were observed: increased hazard for AUD were associated with major depressive disorder in AA, and cannabis dependence and paternal alcohol problems in EA, women. Results demonstrate the relevance of the type of CPA measure in assessing CPA in studies of alcohol-related problems-behavioral items may be more inclusive of CPA exposure and more predictive of AUD- and highlight racial distinctions of AUD etiology in women. (PsycINFO Database Record
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Affiliation(s)
- Kimberly B Werner
- George Warren Brown School of Social Work, Washington University in St. Louis
| | - Julia D Grant
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine
| | - Vivia V McCutcheon
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine
| | - Pamela A F Madden
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine
| | - Andrew C Heath
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine
| | - Kathleen K Bucholz
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine
| | - Carolyn E Sartor
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine
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Bucholz KK, McCutcheon VV, Agrawal A, Dick DM, Hesselbrock VM, Kramer JR, Kuperman S, Nurnberger JI, Salvatore JE, Schuckit MA, Bierut LJ, Foroud TM, Chan G, Hesselbrock M, Meyers JL, Edenberg HJ, Porjesz B. Comparison of Parent, Peer, Psychiatric, and Cannabis Use Influences Across Stages of Offspring Alcohol Involvement: Evidence from the COGA Prospective Study. Alcohol Clin Exp Res 2017; 41:359-368. [PMID: 28073157 PMCID: PMC5272776 DOI: 10.1111/acer.13293] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [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: 05/13/2016] [Accepted: 11/14/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND All stages of development of alcohol use disorder (AUD) have not been equally studied. While initiation of drinking has been given considerable attention, other stages have not been as thoroughly investigated. It is not clear whether the same factors are associated consistently across early and late transitions in AUD involvement. High-risk family samples that are enriched for AUD vulnerability and transitions in AUD development offer an opportunity to examine influences across multiple stages of AUD development. METHODS Data from adolescents and young adults from high-risk families were used to study 4 transitions in AUD development-time to first drink, first drink to first problem, first drink to first diagnosis, and first problem to first diagnosis. Cox modeling was used to compare associations of parental AUD, parental separation, peer substance use, offspring ever-use of cannabis, trauma exposures, and internalizing and externalizing psychopathology across transitions. RESULTS Hazards of most transitions were elevated for those who had ever used cannabis, those who attributed substance use to their peers, those with externalizing disorders, and those with parents with AUD. Many risk factors were linked to early initiation of alcohol, particularly cannabis use. Internalizing disorders were associated with later stages. Nonassaultive trauma was associated only with early initiation; assaultive trauma was not associated with any transition. CONCLUSIONS In this large, ethnically diverse sample of high-risk youth, significant influences across transitions were fairly consistent, with externalizing disorders and cannabis ever-use elevating the likelihood of each stage, and peer and parental (and especially maternal AUD) influences linked to initiation and some later stages. Finally, in light of the increasingly permissive legal and social stances toward cannabis in the United States, the marked elevations of all alcohol outcomes observed for cannabis use underscore the importance of studying the underpinnings of this relationship.
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Affiliation(s)
- Kathleen K Bucholz
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Vivia V McCutcheon
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Danielle M Dick
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | | | - John R Kramer
- University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Samuel Kuperman
- University of Iowa Carver College of Medicine, Iowa City, Iowa
| | | | - Jessica E Salvatore
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | - Marc A Schuckit
- Department of Psychiatry, University of California, San Diego, California
| | - Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | | | - Grace Chan
- Department of Psychiatry, University of Connecticut, Farmington, Connecticut
| | - Michie Hesselbrock
- Department of Psychiatry, University of Connecticut, Farmington, Connecticut
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Werner KB, Sartor CE, McCutcheon VV, Grant JD, Nelson EC, Heath AC, Bucholz KK. Association of Specific Traumatic Experiences With Alcohol Initiation and Transitions to Problem Use in European American and African American Women. Alcohol Clin Exp Res 2016; 40:2401-2408. [PMID: 27656844 DOI: 10.1111/acer.13220] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 04/06/2016] [Accepted: 08/18/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND The aims of this study were to (i) characterize racial differences in alcohol involvement and (ii) examine the risk conferred by specific trauma exposures and posttraumatic stress disorder (PTSD) for different stages of alcohol involvement in European American (EA) and African American (AA) women. METHODS Data are from the Missouri Adolescent Female Twins Study (N = 3,787, 14.6% AA; mean age at most recent interview = 24.5 [SD 2.8]). Trauma exposures (e.g., sexual abuse [SA], physical abuse [PA], witnessing another person being killed or injured, experiencing an accident, and experiencing a disaster) were modeled as time-varying predictors of alcohol initiation, transition to first alcohol use disorder (AUD) symptom, and transition to AUD diagnosis using Cox proportional hazards regression while taking into account other substance involvement, parental characteristics, and commonly co-occurring psychiatric disorders. RESULTS In EA women only, SA was associated with alcohol initiation prior to the age of 14, PA predicted transition from initiation to first AUD symptom, and PA, witnessing injury or death, and SA predicted transition to AUD diagnosis. No association was discovered between trauma exposures or PTSD for any stage of alcohol involvement in AA women. CONCLUSIONS Results reveal trauma experiences as important contributors to all stages of alcohol involvement in EA women only, with different trauma types conferring risk for each stage of alcohol involvement. PTSD was not revealed as a significant predictor of AUD in EA or AA women, suggesting trauma, independent of PTSD, directly contributes to alcohol involvement. Findings highlight the importance of considering racial differences when developing etiologic models of the association of traumatic experiences with alcohol involvement.
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Affiliation(s)
- Kimberly B Werner
- George Warren Brown School of Social Work, Washington University, St. Louis, Missouri.
| | - Carolyn E Sartor
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.,Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Vivia V McCutcheon
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Julia D Grant
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Elliot C Nelson
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Andrew C Heath
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Kathleen K Bucholz
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
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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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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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Werner KB, McCutcheon VV, Agrawal A, Sartor CE, Nelson EC, Heath AC, Bucholz KK. The association of specific traumatic experiences with cannabis initiation and transition to problem use: Differences between African-American and European-American women. Drug Alcohol Depend 2016; 162:162-9. [PMID: 27012434 PMCID: PMC4833569 DOI: 10.1016/j.drugalcdep.2016.03.003] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 02/12/2016] [Accepted: 03/04/2016] [Indexed: 01/17/2023]
Abstract
INTRODUCTION To examine the contribution of trauma exposure to cannabis initiation and transition to first cannabis use disorder (CUD) symptom in African-American (AA) and European-American (EA) emerging adults. METHODS Data are from the Missouri Adolescent Female Twins Study [(N=3787); 14.6% AA; mean age=21.7 (SD 3.8)]. Trauma exposures (e.g. sexual abuse, physical abuse, witnessing another person being killed or injured, experiencing an accident, and experiencing a disaster) were modeled as time-varying predictors of cannabis initiation and transition to CUD symptom using Cox proportional hazards regression. Other substance involvement and psychiatric disorders were considered as time-varying covariates. RESULTS Analyses revealed different trauma-related and psychiatric predictors for cannabis use supporting racially distinct etiologic models of cannabis involvement. For AA women, history of witnessing injury/death or experiencing a life-threatening accident was associated with cannabis initiation across the complete emerging adult risk period while sexual abuse predicted cannabis initiation only before 15 years old. For EA women, history of sexual or physical abuse and major depressive disorder (MDD) predicted cannabis initiation and physical abuse and MDD predicted transition from initiation to first CUD symptom. No association was discovered between trauma exposures and transition to first CUD symptom in AA women. CONCLUSIONS Results reveal trauma exposures as important contributors to cannabis initiation and to a lesser extent transition to CUD symptom, with different trauma types conferring risk for cannabis involvement in AA and EA women. Findings suggest the importance of considering racial/ethnic differences when developing etiologic models of cannabis involvement.
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Affiliation(s)
- K B Werner
- George Warren Brown School of Social Work, Washington University, St. Louis, MO, USA.
| | - V V McCutcheon
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - A Agrawal
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - C E Sartor
- Alcohol 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
| | - E C Nelson
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - A C Heath
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - K K Bucholz
- Alcohol Research Center, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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Kristjansson S, McCutcheon VV, Agrawal A, Lynskey MT, Conroy E, Statham DJ, Madden PAF, Henders AK, Todorov AA, Bucholz KK, Degenhardt L, Martin NG, Heath AC, Nelson EC. The variance shared across forms of childhood trauma is strongly associated with liability for psychiatric and substance use disorders. Brain Behav 2016; 6:e00432. [PMID: 26811803 PMCID: PMC4720689 DOI: 10.1002/brb3.432] [Citation(s) in RCA: 16] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 09/25/2015] [Accepted: 12/16/2015] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Forms of childhood trauma tend to co-occur and are associated with increased risk for psychiatric and substance use disorders. Commonly used binary measures of trauma exposure have substantial limitations. METHODS We performed multigroup confirmatory factor analysis (CFA), separately by sex, using data from the Childhood Trauma (CT) Study's sample of twins and siblings (N = 2594) to derive three first-order factors (childhood physical abuse, childhood sexual abuse, and parental partner abuse) and, as hypothesized, one higher order, childhood trauma factor (CTF) representing a measure of their common variance. RESULTS CFA produced a good-fitting model in the CT Study; we replicated the model in the Comorbidity and Trauma (CAT) Study's sample (N = 1981) of opioid-dependent cases and controls. In both samples, first-order factors are moderately correlated (indicating they measure largely unique, but related constructs) and their loadings on the CTF suggest it provides a reasonable measure of their common variance. We examined the association of CTF score with risk for psychiatric and substance use disorders in these samples and the OZ-ALC GWAS sample (N = 1538) in which CT Study factor loadings were applied. We found that CTF scores are strongly associated with liability for psychiatric and substance use disorders in all three samples; estimates of risk are extremely consistent across samples. CONCLUSIONS The CTF is a continuous, robust measure that captures the common variance across forms of childhood trauma and provides a means to estimate shared liability while avoiding multicollinearity.
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Affiliation(s)
- Sean Kristjansson
- Alcoholism Research Center Washington University School of Medicine St. Louis Missouri 63110
| | - Vivia V McCutcheon
- Alcoholism Research Center Washington University School of Medicine St. Louis Missouri 63110
| | - Arpana Agrawal
- Alcoholism Research Center Washington University School of Medicine St. Louis Missouri 63110
| | - Michael T Lynskey
- Institute of Psychiatry, Psychology, and Neuroscience King's College London UK
| | - Elizabeth Conroy
- Centre for Health Research University of Western Sydney Sydney Australia
| | - Dixie J Statham
- QIMR Berghofer Medical Research Institute Brisbane Australia
| | - Pamela A F Madden
- Alcoholism Research Center Washington University School of Medicine St. Louis Missouri 63110
| | | | - Alexandre A Todorov
- Alcoholism Research Center Washington University School of Medicine St. Louis Missouri 63110
| | - Kathleen K Bucholz
- Alcoholism Research Center Washington University School of Medicine St. Louis Missouri 63110
| | - Louisa Degenhardt
- National Drug and Alcohol Research Center University of New South Wales Sydney Australia
| | | | - Andrew C Heath
- Alcoholism Research Center Washington University School of Medicine St. Louis Missouri 63110
| | - Elliot C Nelson
- Alcoholism Research Center Washington University School of Medicine St. Louis Missouri 63110
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McCutcheon VV, Luke DA, Lessov-Schlaggar CN. Reduced Social Network Drinking is Associated with Improved Response Inhibition in Women During Early Recovery from Alcohol Use Disorders: A Pilot Study. Alcohol Clin Exp Res 2015; 40:170-7. [PMID: 26727533 DOI: 10.1111/acer.12925] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 10/05/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Social support for recovery from alcohol use disorders (AUDs) is associated with improvements in self-reported impulsive behavior in individuals treated for AUDs. We build on these findings using a behavioral task-based measure of response inhibition, a well-defined component of impulsivity, to examine the association of disinhibition with alcohol-specific social network characteristics during early recovery. METHODS Women (n = 28) were recruited from treatment for AUD within 3 to 4 weeks of their last drink and were assessed at baseline and again 3 months later. Outcome measures were level of disinhibition at baseline and change in disinhibition from baseline to follow-up, measured using a computer-based continuous performance test. The primary independent variables were level of drinking in the social network at baseline and change in network drinking from baseline to follow-up. RESULTS The sample [50% black, age M (SD) = 42.3 (9.5)] reported high rates of physical and sexual abuse before age 13 (43%), psychiatric disorder (71%), drug use disorder (78%), and previous treatment (71%). More drinking in participants' social networks was associated with greater disinhibition at baseline (β = 12.5, 95% CI = 6.3, 18.7). A reduction in network drinking from baseline to follow-up was associated with reduced disinhibition (β = -6.0, 95% CI = -11.3, -0.78) independent of IQ, recent alcohol consumption, and self-reported negative urgency. CONCLUSIONS This study extends previous findings of an association between social networks and self-reported impulsivity to a neurobehavioral phenotype, response inhibition, suggesting that abstinence-supporting social networks may play a role in cognitive change during early recovery from AUDs.
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Affiliation(s)
- Vivia V McCutcheon
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Douglas A Luke
- Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri
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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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McCutcheon VV, Lessov-Schlaggar CN, Steinley D, Bucholz KK. Social network drinking and family history contribute equally to first-onset alcohol dependence in high risk adults. Drug Alcohol Depend 2014; 141:145-8. [PMID: 24878250 PMCID: PMC4074563 DOI: 10.1016/j.drugalcdep.2014.04.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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: 12/20/2013] [Revised: 04/08/2014] [Accepted: 04/10/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Adult alcohol consumption is influenced by peer consumption, but whether peer drinking is associated with first-onset alcohol dependence (AD) in adults after age 30 is unknown. METHODS 703 adult participants in the St. Louis Epidemiologic Catchment Area Survey (ECA) with no prior history of AD, but with high risk based on previously reported drinking or family history, were re-interviewed 11 years after the last ECA assessment to detect new cases of AD (age at follow-up: M(S.D.)=42.9 (8.2)). Incident AD during the assessment interval was examined in relation to drinking patterns in the social network and history of alcohol problems in parents. RESULTS Fifteen percent of the sample had a first-onset of AD; another 19.5% never developed AD but were high-risk drinkers at follow-up. Of those who developed AD, 32.1% were remitted and 67.9% were unremitted (current AD) or unstably remitted (asymptomatic high-risk drinkers). Compared to abstinent or low-risk drinkers who did not develop AD, high-risk drinkers with no AD and unremitted/unstably remitted individuals were 4 times as likely to report moderate drinkers in their networks and remitted individuals were nearly 3 times as likely to report network members in recovery from alcohol problems. Associations of social network drinking with remitted and current AD were similar in strength to those of parental alcohol problems. CONCLUSIONS Social network drinking patterns are associated with high-risk drinking and with the development of incident AD in adults, with effects equal to that of alcohol problems in both parents.
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Affiliation(s)
- Vivia V. McCutcheon
- Washington University School of Medicine, Dept. of Psychiatry, Midwest Alcoholism Research Center, 660 S. Euclid Ave., Campus Box 8134, St. Louis, MO 63110
| | - Christina N. Lessov-Schlaggar
- Washington University School of Medicine, Dept. of Psychiatry, 660 S. Euclid Ave., Campus Box 8134, St. Louis, MO 63110
| | - Douglas Steinley
- University of Missouri, Dept. of Psychological Sciences, 210 McAlester Hall, Columbia, MO, 65211
| | - Kathleen K. Bucholz
- Washington University School of Medicine, Dept. of Psychiatry, Midwest Alcoholism Research Center, 660 S. Euclid Ave., Campus Box 8134, St. Louis, MO 63110
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