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Tam CC, Kerr WC, Cook WK, Li L. At-Risk Drinking in US Adults with Health Conditions: Differences by Gender, Race, and Ethnicity in the National Survey of Drug Use and Health, 2015-2019. J Racial Ethn Health Disparities 2024; 11:1444-1453. [PMID: 37219733 PMCID: PMC10729902 DOI: 10.1007/s40615-023-01621-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/26/2023] [Accepted: 04/30/2023] [Indexed: 05/24/2023]
Abstract
Few studies in the US address alcohol consumption patterns in adults with chronic health conditions, and little is known about race and ethnicity differences. This study examined at-risk drinking prevalence rates among US adults with hypertension, diabetes, heart condition or cancer and assessed differences by gender and, among adults aged 50 and older, by race and ethnicity. We used data from the 2015-2019 National Survey on Drug Use and Health (N = 209,183) to estimate (1) prevalence rates and (2) multivariable logistic regression models predicting odds of at-risk drinking among adults with hypertension, diabetes, heart condition, or cancer, compared to adults with none of these conditions. To examine subgroup differences, analyses were stratified by gender (ages 18-49 and ages 50 +) and by gender and race and ethnicity for adults ages 50 + . Results showed that all adults with diabetes and women ages 50 + with heart conditions in the full sample had lower odds of at-risk drinking relative to their counterparts without any of the four conditions. Men ages 50 + with hypertension had greater odds. In race and ethnicity assessments among adults ages 50 + , only non-Hispanic White (NHW) men and women with diabetes and heart conditions had lower odds, and NHW men and women and Hispanic men with hypertension had greater odds of at-risk drinking. There were differential associations of at-risk drinking with demographic and lifestyle indicators across race and ethnicity groups. These findings underscore tailored efforts in community and clinical settings to reduce at-risk drinking in subgroups with health condition diagnoses.
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Affiliation(s)
- Christina C Tam
- Alcohol Research Group, Public Health Institute, 6001 Shellmound Street, Suite 450, Emeryville, CA, 94608-1010, USA.
| | - William C Kerr
- Alcohol Research Group, Public Health Institute, 6001 Shellmound Street, Suite 450, Emeryville, CA, 94608-1010, USA
| | - Won Kim Cook
- Alcohol Research Group, Public Health Institute, 6001 Shellmound Street, Suite 450, Emeryville, CA, 94608-1010, USA
| | - Libo Li
- Alcohol Research Group, Public Health Institute, 6001 Shellmound Street, Suite 450, Emeryville, CA, 94608-1010, USA
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Lee MR, Yeung EW, Littlefield AK, Stephenson A, Kady A, Kwan T, Chassin L, Sher KJ. A life span developmental investigation of marriage and problem-drinking reduction. Dev Psychopathol 2024; 36:1-11. [PMID: 36286325 PMCID: PMC10281208 DOI: 10.1017/s0954579422000827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
While prior literature has largely focused on marriage effects during young adulthood, it is less clear whether these effects are as strong in middle adulthood. Thus, we investigated age differences in marriage effects on problem-drinking reduction. We employed parallel analyses with two independent samples (analytic-sample Ns of 577 and 441, respectively). Both are high-risk samples by design, with about 50% of participants having a parent with lifetime alcohol use disorder. Both samples have been assessed longitudinally from early young adulthood to the mid-to-late 30s. Separate parallel analyses with these two samples allowed evaluation of the reproducibility of results. Growth models of problem drinking tested marriage as a time-varying predictor and thereby assessed age differences in marriage effects. For both samples, results consistently showed marriage effects to be strongest in early young adulthood and to decrease somewhat monotonically thereafter with age, reaching very small (and nonsignificant) magnitudes by the 30s. Results may reflect that role transitions like marriage have more impact on problem drinking in earlier versus later adulthood, thereby highlighting the importance of life span developmental research for understanding problem-drinking desistance. Our findings can inform intervention strategies aimed at reducing problem drinking by jumpstarting or amplifying natural processes of adult role adaptation.
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Affiliation(s)
- Matthew R. Lee
- Department of Applied Psychology, Center of Alcohol Studies, Rutgers University, Piscataway, NJ, USA
| | - Ellen W. Yeung
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
| | | | - Audrey Stephenson
- Department of Applied Psychology, Center of Alcohol Studies, Rutgers University, Piscataway, NJ, USA
| | - Annabel Kady
- Department of Applied Psychology, Center of Alcohol Studies, Rutgers University, Piscataway, NJ, USA
| | - Thomas Kwan
- Department of Applied Psychology, Center of Alcohol Studies, Rutgers University, Piscataway, NJ, USA
| | - Laurie Chassin
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Kenneth J. Sher
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
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Liu H, Copeland M, Nowak G, Chopik WJ, Oh J. Marital Status Differences in Loneliness Among Older Americans During the COVID-19 Pandemic. POPULATION RESEARCH AND POLICY REVIEW 2023; 42:74. [PMID: 38264508 PMCID: PMC10805368 DOI: 10.1007/s11113-023-09822-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 08/14/2022] [Indexed: 01/25/2024]
Abstract
Guided by the social integration perspective, we conducted one of the first population-based studies on marital status differences in loneliness during the COVID-19 pandemic among older Americans. Analysis of data from the 2020 National Health and Aging Trends Study COVID-19 supplement (n = 2861) suggested that, compared to their married counterparts, divorced and widowed older adults reported higher levels of loneliness during the pandemic, and divorced older adults also felt lonely more often when compared to before the pandemic. These marital status differences in pandemic loneliness cannot be explained by changes in social participation (e.g., working for pay, volunteering, attending religious services, or attending clubs, classes, or other organized activities) or changes in contact frequency with family and friends (via phone calls, emails/texts/social media messages, video calls, or in-person visits). No gender difference was found in the association between marital status and loneliness during the pandemic. These results, coupled with the growth of the unmarried older population, highlight that policymakers, health care providers, and researchers should think creatively about ways to reduce the loneliness gap between married and unmarried groups to promote healthy aging for all older adults, particularly in the face of emerging pandemics that may complicate strategies to improve population health in the future.
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Affiliation(s)
- Hui Liu
- Center on Aging and the Life Course and Department of Sociology, Purdue University, MSEE Room 308B, 501 Northwestern Avenue, West Lafayette, IN 47907, USA
| | - Molly Copeland
- Department of Sociology, Michigan State University, 509 E. Circle Drive, 317 Berkey Hall, East Lansing, MI 48824, USA
| | - Gerald Nowak
- Department of Sociology, Michigan State University, 509 E. Circle Drive, 317 Berkey Hall, East Lansing, MI 48824, USA
| | - William J. Chopik
- Department of Psychology, Michigan State University, 316 Physics Rd, East Lansing, MI 48824, USA
| | - Jeewon Oh
- Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY 13244, USA
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Li W, Chen L, Hsu M, Mo D, Xia L, Min K, Jiang F, Liu T, Liu Y, Liu H, Tang YL. The association between workload, alcohol use, and alcohol misuse among psychiatrists in China. Front Psychiatry 2023; 14:1171316. [PMID: 37426098 PMCID: PMC10325676 DOI: 10.3389/fpsyt.2023.1171316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
Aim Survey alcohol use and workload among Chinese psychiatrists and explore their associations. Methods We conducted an online questionnaire among psychiatrists working in large psychiatric institutions across the country. We collected data including demographic factors, alcohol use, and workload. Alcohol use was assessed using the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C), and workload-related questions included working hours, night shifts, and caseloads. Results In total, 3,549 psychiatrists completed the survey. Nearly half (47.6%) reported alcohol use, and the percentage of alcohol use in males (74.1%) was significantly higher than in females. 8.1% exceeded the AUDIT-C cutoff scores for probable alcohol misuse (19.6%in males and 2.6%in females). AUDIT-C scores were significantly correlated with working hours per week (p = 0.017) and the number of outpatient visits per week (p = 0.006). Regressional analysis showed that alcohol use was significantly associated with the following factors: longer working hours (Working more than 44 h/week, OR = 1.315), having an administrative position (OR = 1.352), being male (OR = 6.856), being single (OR = 1.601), being divorced or widowed (OR = 1.888), smoking (OR = 2.219), working in the West (OR = 1.511) or the Northeast (OR = 2.440). Regressional analysis showed that alcohol misuse was significantly associated with the following factors: fewer night shifts (Three to four night shifts/month, OR = 1.460; No more than 2 night shifts/month, OR = 1.864), being male (OR = 4.007), working in the Northeast (OR = 1.683), smoking (OR = 2.219), frequent insomnia (OR = 1.678). Conclusion Nearly half of the psychiatrists in China reported alcohol use and 8.1% had probable AUD. Alcohol consumption is significantly associated with several workload-related factors, such as long working hours, heavy caseload, and administrative duties. Alcohol misuse was inversely associated with the number of night shifts per month. While the direction of causality is unclear, our findings may help identify vulnerable professional groups and develop more targeted interventions to improve healthcare professionals' well-being.
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Affiliation(s)
- Wenzheng Li
- Department of Psychiatry, Chao Hu Hospital of Anhui Medical University, Hefei, China
- Hefei Fourth People’s Hospital, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
| | - Long Chen
- Department of Psychiatry, Chao Hu Hospital of Anhui Medical University, Hefei, China
- Hefei Fourth People’s Hospital, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
| | - Michael Hsu
- Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Daming Mo
- Hefei Fourth People’s Hospital, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
| | - Lei Xia
- Department of Psychiatry, Chao Hu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Hefei, China
| | - Kaiyuan Min
- State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Tingfang Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huanzhong Liu
- Department of Psychiatry, Chao Hu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Hefei, China
| | - Yi-lang Tang
- Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
- Atlanta Veterans Affairs Medical Center, Decatur, GA, United States
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Marbaniang SP, Lhungdim H, Chungkham HS. Identifying the latent classes of modifiable risk behaviours among diabetic and hypertensive individuals in Northeastern India: a population-based cross-sectional study. BMJ Open 2022; 12:e053757. [PMID: 35210340 PMCID: PMC8883275 DOI: 10.1136/bmjopen-2021-053757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To identify the latent classes of modifiable risk factors among the patients with diabetes and hypertension based on the observed indicator variables: smoking, alcohol, aerated drinks, overweight or obesity, diabetes and hypertension. We hypothesised that the study population diagnosed with diabetes or hypertension is homogeneous with respect to the modifiable risk factors. DESIGN A cross-sectional study using a stratified random sampling method and a nationally representative large-scale survey. SETTING AND PARTICIPANTS Data come from the fourth round of the Indian National Family Health Survey, 2015-2016. Respondents aged 15-49 years who were diagnosed with either diabetes or hypertension or both were included. The total sample is 22 249, out of which 3284 were men and 18 965 were women. PRIMARY AND SECONDARY OUTCOME MEASURES The observed variables used as latent indicators are the following: smoking, alcohol, aerated drinks, overweight or obesity, diabetes and hypertension. The concomitant variables include age, gender, education, marital status and household wealth index. Latent class model was used to simultaneously identify the latent class and to determine the association between the concomitant variables and the latent classes. RESULTS Three latent classes were identified and labelled as class 1: 'diabetic with low-risk lifestyle' (21%), class 2: 'high-risk lifestyle' (8%) and class 3: 'hypertensive with low-risk lifestyle' (71%). Class 1 is characterised by those with a high probability of having diabetes and low probability of smoking and drinking alcohol. Class 2 is characterised by a high probability of smoking and drinking alcohol and class 3 by a high probability of having high blood pressure and low probability of smoking and drinking alcohol. CONCLUSIONS Co-occurrence of smoking and alcohol consumption was prevalent in men, while excess body weight and high blood pressure were prevalent in women. Policy and programmes in Northeastern India should focus on targeting multiple modifiable risk behaviours that co-occur within an individual.
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Affiliation(s)
- Strong P Marbaniang
- Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Hemkhothang Lhungdim
- Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Holendro Singh Chungkham
- Applied and Official Statistics Unit, Indian Statistical Institute, North-East Centre at Tezpur, Tezpur, India
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Jaguga F, Kwobah EK, Mwangi A, Patel K, Mwogi T, Kiptoo R, Atwoli L. Harmful Alcohol Use Among Healthcare Workers at the Beginning of the COVID-19 Pandemic in Kenya. Front Psychiatry 2022; 13:821610. [PMID: 35295779 PMCID: PMC8918611 DOI: 10.3389/fpsyt.2022.821610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 01/24/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Healthcare workers play a key role in responding to pandemics like the on-going COVID-19 one. Harmful alcohol use among them could result in inefficiencies in health service delivery. This is particularly concerning in sub-Saharan Africa where the health workforce is already constrained. The aim of this study is to document the burden and correlates of harmful alcohol use among healthcare workers at the beginning of the COVID-19 pandemic in Kenya with the aim of informing policy and practice. METHODS This study was a cross-sectional analysis of data obtained from a parent online survey that investigated the burden and factors associated with mental disorders among healthcare workers during the COVID-19 pandemic in Kenya. We analyzed data obtained from a sub-population of 887 participants who completed the Alcohol Use Disorder Identification Test questionnaire. We used descriptive statistics to summarize the socio-demographic characteristics of the participants and multivariate analysis to determine the factors associated with harmful alcohol use. RESULTS Three hundred and eighty nine (43.9%) participants reported harmful alcohol use. The factors significantly associated with increased odds of endorsing harmful alcohol use were: being male (AOR = 1.56; 95% CI = 1.14, 2.14; p = 0.006), being unmarried (AOR = 2.06; 95% CI = 1.48, 2.89; p < 0.001), having 11-20 years of experience as compared to having 20+ years of experience (AOR = 1.91; 95% CI = 1.18, 3.12; p = 0.009), and being a specialist (AOR = 2.78; CI = 1.64, 4.78; p = < 0.001) or doctor (AOR = 2.82; 95% CI = 1.74, 4.63; p < 0.001) as compared to being a nurse. CONCLUSIONS A high proportion of healthcare workers reported harmful alcohol use at the beginning of the COVID-19 pandemic in Kenya. Males, the unmarried, those with 11-20 years of experience in the health field, doctors and specialists, were more likely to report harmful alcohol use. These findings highlight the need to institute interventions for harmful alcohol use targeting these groups of healthcare workers in Kenya during the COVID-19 pandemic in order to optimize functioning of the available workforce.
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Affiliation(s)
- Florence Jaguga
- Department of Mental Health, Moi Teaching & Referral Hospital, Eldoret, Kenya
| | - Edith Kamaru Kwobah
- Department of Mental Health, Moi Teaching & Referral Hospital, Eldoret, Kenya
| | - Ann Mwangi
- School of Science and Aerospace Studies, Moi University, Eldoret, Kenya
| | - Kirtika Patel
- Department of Pathology, School of Medicine, Moi University, Eldoret, Kenya
| | - Thomas Mwogi
- Department of Internal Medicine, Moi Teaching & Referral Hospital, Eldoret, Kenya
| | - Robert Kiptoo
- Department of Mental Health, Moi Teaching & Referral Hospital, Eldoret, Kenya
| | - Lukoye Atwoli
- Department of Mental Health and Behavioral Sciences, School of Medicine, Moi University, Eldoret, Kenya.,Brain and Mind Institute and the Department of Internal Medicine, Medical College East Africa, Aga Khan University, Nairobi, Kenya
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7
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Ding Z, Yu D, Li H, Ding Y. Effects of marital status on overall and cancer-specific survival in laryngeal cancer patients: a population-based study. Sci Rep 2021; 11:723. [PMID: 33436991 PMCID: PMC7803965 DOI: 10.1038/s41598-020-80698-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 12/24/2020] [Indexed: 02/06/2023] Open
Abstract
Marital status has long been recognized as an important prognostic factor for many cancers, however its' prognostic effect for patients with laryngeal cancer has not been fully examined. We retrospectively analyzed 8834 laryngeal cancer patients in the Surveillance Epidemiology and End Results database from 2004 to 2010. Patients were divided into four groups: married, widowed, single, and divorced/separated. The difference in overall survival (OS) and cancer-specific survival (CSS) of the various marital subgroups were calculated using the Kaplan-Meier curve. Multivariate Cox regression analysis screened for independent prognostic factors. Propensity score matching (PSM) was also conducted to minimize selection bias. We included 8834 eligible patients (4817 married, 894 widowed, 1732 single and 1391 divorced/separated) with laryngeal cancer. The 5-year OS and CSS of married, widowed, single, and separated/divorced patients were examined. Univariate and multivariate analyses found marital status to be an independent predictor of survival. Subgroup survival analysis showed that the OS and CSS rates in widowed patients were always the lowest in the various American Joint Committee on Cancer stages, irrespective of sex. Widowed patients demonstrated worse OS and CSS in the 1:1 matched group analysis. Among patients with laryngeal cancer, widowed patients represented the highest-risk group, with the lowest OS and CSS.
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Affiliation(s)
- Zhao Ding
- Clinical Medical College, Dali University, Dali, 671000, Yunnan, China
| | - Deshun Yu
- Department of Otolaryngology, The First Affiliated Hospital of Dali University, Dali, 671000, Yunnan, China
| | - Hefeng Li
- Clinical Medical College, Dali University, Dali, 671000, Yunnan, China
| | - Yueming Ding
- Department of Otolaryngology, The First Affiliated Hospital of Dali University, Dali, 671000, Yunnan, China.
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Ünübol H, Hızlı Sayar G. Prevalence and Sociodemographic Determinants of Substance Use in Turkey. Eur Addict Res 2021; 27:447-456. [PMID: 33853069 DOI: 10.1159/000515399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 02/22/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Substance use disorder is a serious public health problem. It is essential to know who is prone to substance use in order to adopt appropriate measures. OBJECTIVES This study aims to determine the use prevalence ratios of substance use (tobacco, alcohol, cannabis, cocaine, synthetic cannabinoids, ecstasy, and others) in a large-scale sample of a general population. It also intends to examine related sociodemographic factors. METHODS This study is based on a cross-sectional survey conducted with a nationally representative sample of 24,494 individuals in face-to-face interviews conducted by a trained team of 125 clinical psychologists. RESULTS Lifetime prevalence of single substance use and polysubstance use are 4.5 and 2.6%, respectively (nicotine and alcohol excluded). Age, gender, education level, and marital status are important sociodemographic determinants for other substance use. Similarly, smoking and alcohol consumption are important determinants for other substance use. The multinomial regression analysis results showed that compared with adults aged 39 years and older, early-emerging adults (aged 18-23 years), late-emerging adults (aged 24-29 years), and young adults (aged 30-39 years) are more likely to turn to single substance use and polysubstance use. CONCLUSION Tobacco, alcohol, and other substance use are serious health concerns in Turkey. Sociodemographic status is an important determinant of several aspects of tobacco, alcohol, and other substance use and, therefore, should be examined thoroughly to be able to develop effective protective and preventive strategies.
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Affiliation(s)
- Hüseyin Ünübol
- Institute of Social Sciences, Üsküdar University, Istanbul, Turkey
| | - Gökben Hızlı Sayar
- Institute of Social Sciences/Feneryolu Health Center, Üsküdar University, Istanbul, Turkey
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Sociodemographic Correlates of Alcohol Abuse in Kassena-Nankana Municipality, Ghana. JOURNAL OF ADDICTION 2020; 2020:4375420. [PMID: 33204573 PMCID: PMC7661108 DOI: 10.1155/2020/4375420] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 10/17/2020] [Accepted: 10/23/2020] [Indexed: 11/17/2022]
Abstract
The main aim of the study was to assess the level of alcohol abuse and related factors in Kassena-Nankana Municipal of Ghana. The study was conducted using a cross-sectional survey with 397 participants, using AUDIT to assess alcohol use. Data entry and analysis was done using SPSS. Bivariate analysis was done using chi-square and multivariate analysis was done using the multinomial logistics regression model. Lifetime alcohol use among the study participants was 96.0%; out of this, 51.7% were engaged in possibly dependent drinking, 23.4% involved in harmful drinking, and 24.9% involved in moderate drinking. Males were more likely to engage in harmful drinking than moderate (AOR = 2.4, 95% CI: 1.175-4.776). Males again were more likely to engage in dependent drinking than moderate (AOR = 2.7, 95% CI: 1.489-5.068). Christians as compared to traditionalists were less likely engage in dependent drinking than moderate drinking (AOR = 0.03, 95% CI: 0.223-0.940). Those with tertiary education were less likely to engage in dependent drinking than moderate as compare to those without formal education (AOR = 0.2, 95% CI: 0.076-0.670). Also employed civil servants were more likely to engage in dependent drinking than moderate as compared to those without employment (AOR = 4.4, 95% CI: 1.187-16.646). This study revealed a high prevalence of alcohol abuse among the residents of Kassena-Nankana municipality that was predicted by gender, educational level, and religious practice; therefore, there is a need for a public campaign on the harmful effects of alcohol abuse in the municipality.
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Noguchi T, Kondo F, Nishiyama T, Otani T, Nakagawa-Senda H, Watanabe M, Imaeda N, Goto C, Hosono A, Shibata K, Kamishima H, Nogimura A, Nagaya K, Yamada T, Suzuki S. The impact of marital transitions on vegetable intake in middle-aged and older Japanese adults: a five-year longitudinal study. J Epidemiol 2020; 32:89-95. [PMID: 33071250 PMCID: PMC8761567 DOI: 10.2188/jea.je20200343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Marital transitions are associated with adverse health events, such as mortality and cardiovascular disease. Since marital transitions (eg, becoming widowed) are unavoidable life events, it is necessary to identify modifiable intermediate outcomes. Thus, we examined the association between marital transitions and vegetable intake among middle-aged and older Japanese adults. Methods This longitudinal study included Japanese adults aged 40–79 years who received an annual health checkup between 2007 and 2011 (baseline) and 5 years later (follow-up). Marital transitions were classified as whether and what type of transition occurred during the 5-year period and comprised five groups: consistently married, married to widowed, married to divorced, not married to married, and remained not married. Changes in total vegetable, green and yellow vegetable, and light-colored vegetable intake from baseline to follow-up were calculated using the Food Frequency Questionnaire. Results Data from 4,813 participants were analyzed (mean age, 59.4 years; 44.1% women). Regarding marital transitions, 3,960 participants were classified as “consistently married,” 135 as “married to widowed,” 40 as “married to divorced,” 60 as “not married to married,” and 529 as “remained not married.” Multivariable linear regression analysis revealed that compared to consistently married, married to widowed was inversely associated with the change in total vegetable intake (β = −16.64, SE = 7.68, P = 0.030) and light-colored vegetable intake (β = −11.46, SE = 4.33, P = 0.008). Conclusion Our findings suggest that being widowed could result in a reduced intake of vegetables. Hence, dietary counseling according to marital situation is necessary.
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Affiliation(s)
- Taiji Noguchi
- Department of Social Science, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology.,Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Fumi Kondo
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Takeshi Nishiyama
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Takahiro Otani
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Hiroko Nakagawa-Senda
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Miki Watanabe
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Nahomi Imaeda
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences.,Department of Nutrition Science, Faculty of Health Science, Shigakkan University
| | - Chiho Goto
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences.,Department of Health and Nutrition, Faculty of Health and Living, Nagoya Bunri University
| | - Akihiro Hosono
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences.,Atsuta Public Health Center, City of Nagoya
| | - Kiyoshi Shibata
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences.,Department of Health and Nutritional Sciences, Nagoya Keizai University
| | - Hiroyuki Kamishima
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences.,Department of Home Economics, Aichi Gakusen University
| | - Akane Nogimura
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences.,Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences
| | - Kenji Nagaya
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Tamaki Yamada
- Okazaki Public Health Center, Okazaki Medical Association
| | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
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Dash GF, Martin NG, Lynskey MT, Slutske WS. Sex differences in the relative influence of marital status and parenthood on alcohol use disorder symptoms: A multilevel discordant twin design. JOURNAL OF ABNORMAL PSYCHOLOGY 2020; 129:737-747. [PMID: 32816500 DOI: 10.1037/abn0000611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Marriage and parenthood are associated with alcohol use and use disorder (AUD), although they are confounded such that many studies struggle to identify their unique and/or causal effects. The present study utilized a genetically informed discordant twin design that strengthens the putative causal role of marital and parental status in the presentation of AUD symptoms by using each individual's cotwin as their own control while simultaneously modeling both predictors among men and women. Participants were 980 complete same-sex twin pairs from the Australian Twin Registry (Mage = 31.70 [SD = 2.48]; 71% women). Marital status, parental status, and past year AUD symptoms were assessed via semistructured interview. Three random-intercept generalized linear mixed models were fit in men and women including (a) marital status only, (b) parental status only, and (c) both marital and parental status; demographics, past year pregnancy, age of first drink, age of regular drinking, personality traits, and antisociality were included as covariates. Models tested for quasi-causal and familial effects. The sole-predictor marital status model (Model 1) provided the best fit among men, while the simultaneous-predictor marital and parental status model (Model 3) provided the best fit among women. Sole-predictor models showed familial effects of both predictors among men and quasi-causal and familial effects of both predictors among women; the simultaneous-predictor model revealed familial effects of marital status only among men and quasi-causal effects of parental status only among women. The present study elucidates important sex differences in the presentation of AUD among midlife adults in the context of notable developmental milestones. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Bellos S, Petrikis P, Malliori M, Mavreas V, Skapinakis P. Prevalence of Alcohol Use Disorders and Their Association with Sociodemographic Determinants and Depression/Anxiety Disorders in a Representative Sample of the Greek General Population. PSYCHIATRY JOURNAL 2020; 2020:4841050. [PMID: 32095485 PMCID: PMC7035575 DOI: 10.1155/2020/4841050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/24/2019] [Accepted: 11/28/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Country-level epidemiological data about alcohol-related problems is useful for planning prevention and treatment services. Heavy Alcohol Consumption (HAC) and Alcohol Use Disorder (AUD) are two syndromes of alcohol-related problems that have been recognized worldwide. Study of the epidemiological determinants of HAC and AUD in different sociocultural contexts could inform hypotheses about the etiology or the consequences of alcohol-related problems. OBJECTIVES We assessed the prevalence and associations of HAC and AUD with sociodemographic variables adjusting for common mental disorders in a representative sample of the general population of Greece (N = 4894 participants). The period of data collection just preceded the emergence of the financial crisis in Greece. RESULTS The majority of the population did not report HAC, AUD or abstinence from alcohol. HAC was reported by 12.7% (95% CI: 11.8-13.6) of the population while 3.1% (95% CI: 2.7-3.6) met criteria for AUD. Younger age, divorce, lower educational level, living in an urban area, physical health problems, and smoking were associated with a higher prevalence of both conditions. Presence of severe financial difficulties and never married family status were associated with a higher prevalence of HAC but not AUD. HAC was associated with nonspecific psychiatric morbidity while AUD was associated with more specific psychiatric disorders. Conclusion/Importance. Both alcohol-related problems are frequent in the general population and have common and distinct determinants. The comparison between the findings of our study and those of similar studies during or after the period of financial austerity in Greece, would offer the opportunity to assess the possible effects of changes in the economical context in the determinants of alcohol-related problems.
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Affiliation(s)
- Stefanos Bellos
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Petros Petrikis
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Meni Malliori
- National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Venetsanos Mavreas
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Petros Skapinakis
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
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Gitatui M, Kimani S, Muniu S, Okube O. Determinants of harmful use of alcohol among urban slum dwelling adults in Kenya. Afr Health Sci 2019; 19:2906-2925. [PMID: 32127866 PMCID: PMC7040319 DOI: 10.4314/ahs.v19i4.12] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Harmful alcohol use is a public health problem associated with negative health and socio-economic impacts. However, patterns and dynamics of alcohol use among slum-dwellers in Kenya are poorly understood. OBJECTIVE To establish determinants of harmful alcohol use among adults in an urban slum setting in Kenya. MATERIALS AND METHODS Cross-sectional study involving a consecutively selected sample (N=215) from Githurai, in Nairobi. A pre-tested questionnaire that captured data on socio-demographics, drinking patterns, type, reasons, initiator, and support system. RESULTS Of the respondents, those above 31 years, married, separated/divorced/widowed, of high education, earning above 50 USD, and from dysfunctional families consumed more alcohol. Low earners consumed (p < 0.05) unrecorded while high earners drank (p< 0.001) recorded alcohol. Adults from families with a drinking father and sibling consumed more alcohol (p=0.001). Single, low educational attainment/earners, and those in dysfunctional families (p <0.05) drank due to stress and reported alcohol-related problems. Young, unmarried, and casual laborers were introduced (p < 0.05) to alcohol by friends. CONCLUSION Socio-demographic, economic, familial, social interactions, and stress are associated with harmful alcohol use among adults from slums calling for interventions targeting these factors.
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Evans-Polce RJ, Jang BJ, Maggs JL, Patrick ME. Gender and age differences in the associations between family social roles and excessive alcohol use. Soc Sci Med 2019; 244:112664. [PMID: 31726267 DOI: 10.1016/j.socscimed.2019.112664] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 10/22/2019] [Accepted: 11/02/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Familial social roles are known to have important links with both acute and chronic excessive alcohol use. However, whether and how these links vary across adulthood and by gender is not well understood and would provide insight into populations most at risk for excessive alcohol use. METHODS This study used data from those ages 18 to 60 in the National Epidemiologic Study of Alcohol and Related Conditions-III survey (N=28,475). We examined the gender- and age-varying associations of current marital status (married vs. divorced/separated vs. never married) and parental status (parent vs. not) with acute (binge drinking) and chronic (exceeding weekly drinking guidelines) excessive alcohol use using time-varying effect modelling. RESULTS Both marital and parental statuses were inversely associated with acute and chronic excessive alcohol use at most ages, however the magnitude of these associations and gender differences in these associations varied by age. There were greater differences between adults who were married vs. never married and parents vs. not in excessive alcohol use during young adulthood as compared to later adulthood. The association of parental status with acute excessive alcohol use was stronger for women compared to men in young adulthood. CONCLUSIONS Gender and age should be considered when examining risk and protective factors, particularly in examining the role of parenthood in acute excessive alcohol use. These findings will help target populations most at risk for chronic and acute excessive alcohol use.
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Affiliation(s)
- Rebecca J Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, USA.
| | - Bohyun Joy Jang
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Jennifer L Maggs
- Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
| | - Megan E Patrick
- Institute for Translational Research in Children's Mental Health and Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
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Barr PB, Kuo SIC, Aliev F, Latvala A, Viken R, Rose RJ, Kaprio J, Salvatore JE, Dick DM. Polygenic risk for alcohol misuse is moderated by romantic partnerships. Addiction 2019; 114:1753-1762. [PMID: 31240774 PMCID: PMC7108791 DOI: 10.1111/add.14712] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/03/2019] [Accepted: 06/11/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS Previous twin research suggests relationship status can moderate underlying genetic liability towards alcohol misuse. This paper examined: (1) whether genome-wide polygenic scores (GPS) for alcohol consumption are associated with alcohol misuse; (2) whether these GPS are moderated by romantic relationships (gene-environment interaction; G × E) and (3) whether G × E results are consistent across sex. DESIGN Linear mixed-effects models were used to test associations between genome-wide polygenic scores, relationship status and alcohol use/misuse. SETTING Finnish twins born between 1983 and 1987 identified through Finland's central population registry. PARTICIPANTS An intensively studied subset of Finnish Twin Study (FinnTwin12) during the young adult phase (aged 20-26 years). The analytical sample includes those with complete interview and genetic data (n = 1201). MEASUREMENTS Key measurements included involvement in a romantic partnership, drinking frequency, intoxication frequency and DSM-IV alcohol dependence (AD) symptoms. Genome-wide polygenic scores (GPS) were created from available summary statistics from a large genome-wide association study (GWAS) of drinks per week. RESULTS GPS predicted drinking frequency [b = 0.109; 95% confidence interval (CI) = 0.050, 0.168], intoxication frequency (b = 0.111; 95% CI = 0.054, 0.168) and AD symptoms (b = 0.123; 95% CI = 0.064, 0.182). Having a romantic relationship negatively influenced the association between GPS and drinking frequency (b = -0.105; 95% CI = -0.211, -0.001), intoxication frequency (b = -0.118; 95% CI = -0.220, -0.016) and AD symptoms (b = -0.119; 95% CI = -0.229, -0.009). There was a three-way interaction between sex, relationship status and GPS for intoxication frequency (b = 0.223; 95% CI = 0.013, 0.433), such that the reduced association between GPS and intoxication frequency for those in a relationship was only apparent in males. We found no evidence of three-way interactions for drinking frequency or AD symptoms. CONCLUSIONS Being in a romantic relationship reduced the association between genetic predisposition and drinking, high-risk drinking and alcohol problems. However, for high-risk drinking the protective effect was limited to males, mapping onto earlier findings suggesting that males benefit more from romantic partnerships.
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Affiliation(s)
- Peter B. Barr
- Department of Psychology, Virginia Commonwealth University
| | | | - Fazil Aliev
- Department of Psychology, Virginia Commonwealth University,Faculty of Business, Karabuk University, Turkey
| | - Antti Latvala
- Institute for Molecular Medicine Finland, University of Helsinki, Finland,Department of Public Health, University of Helsinki, Finland
| | - Richard Viken
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Richard J. Rose
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland, University of Helsinki, Finland,Department of Public Health, University of Helsinki, Finland
| | - Jessica E. Salvatore
- Department of Psychology, Virginia Commonwealth University,Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Danielle M. Dick
- Department of Psychology, Virginia Commonwealth University,Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
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Case P, Ng Fat L, Shelton N. Exploring the characteristics of newly defined at-risk drinkers following the change to the UK low risk drinking guidelines: a retrospective analysis using Health Survey for England data. BMC Public Health 2019; 19:902. [PMID: 31286928 PMCID: PMC6615101 DOI: 10.1186/s12889-019-7240-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 06/26/2019] [Indexed: 11/21/2022] Open
Abstract
Background Alcohol guidelines enable individuals to make informed choices about drinking and assist healthcare practitioners to identify and treat at-risk drinkers. The UK Low Risk Drinking Guidelines were revised in 2016 and the weekly guideline for men was reduced from 21 to 14 units per week. This study sought to retrospectively establish 1) the number of additional at-risk male drinkers in England, 2) which demographic characteristics were associated with being an at-risk drinker under the previous versus new guidelines. Methods Average weekly alcohol consumption for men aged 16+ from the cross-sectional nationally representative Health Survey for England were used to 1) calculate annual population prevalence estimates for newly defined at-risk (> 14 to ≤21 units/week) male drinkers from 2011 to 2015 (N = 3487–3790), and 2) conduct logistic regression analyses for at-risk vs low risk male drinkers under the previous (> 21 vs ≤21 units/week) and new (> 14 vs ≤14 units/week) guidelines to assess characteristics associated with being at-risk drinkers under each guideline using 2015 data (N = 2982). Results Population prevalence estimates of newly defined at-risk drinkers ranged from 10.2% (2014 = 2,182,401 men)-11.2% (2011 = 2,322,896 men). Under the new guidelines, men aged 55–74 (OR = 1.63,95% CI = 1.25–2.12); men in managerial/professional occupations (OR = 1.64,95% CI = 1.34–2.00); current smokers (OR = 2.26,95% CI = 1.73–2.94), ex-regular smokers (OR = 2.01,95% CI = 1.63–2.47) and ex-occasional smokers (OR = 1.85,95% CI = 1.25–2.74); men from the North East (OR = 2.08,95% CI = 1.38–3.13) and North West (OR = 1.91,95% CI = 1.41–2.60) of England all had greater odds, and non-white men had reduced odds (OR = 0.53,95% CI = 0.34–0.80) of being at-risk drinkers, as they had under the previous guidelines. Under the new guidelines only: a higher percentage of at-risk drinkers aged 16–34 (32% vs 19%) attenuated the odds of men aged 35–54 being at-risk (OR = 1.18,95% CI = 0.92–1.51); a higher percentage of married at-risk drinkers (37% vs 24%) attenuated the odds of single men being at-risk (OR = 1.28,95% CI = 0.99–1.67); men from the West Midlands (OR = 1.68,95% CI = 1.17–2.42) and London (OR = 1.53,95% CI = 1.03–2.28) had greater odds of being at-risk drinkers. Conclusions The change to the Low Risk Drinking Guidelines would have resulted in more than 2 million additional male at-risk drinkers in England. Most groups with greater odds of being at-risk drinkers under the new guidelines were those already known to be drinking the most, strengthening the case for targeted screening and education. Additionally, under the new guidelines, a marked proportion of 16–35 year olds and married men were at-risk and men in the West Midlands and London had greater odds of being at-risk drinkers. These groups may benefit from specific education around the new Low Risk Drinking Guidelines.
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Affiliation(s)
- Philippa Case
- Department of Epidemiology and Public Health, UCL 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - Linda Ng Fat
- Department of Epidemiology and Public Health, UCL 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Nicola Shelton
- Department of Epidemiology and Public Health, UCL 1-19 Torrington Place, London, WC1E 7HB, UK
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Gender differences in the bidirectional relationship between alcohol consumption and sleeplessness: the Tromsø study. BMC Public Health 2019; 19:444. [PMID: 31035989 PMCID: PMC6489301 DOI: 10.1186/s12889-019-6801-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 04/11/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The degree to which the relationship between alcohol use and sleeplessness is unidirectional or reciprocal is unclear due to great variation among the results of previous studies. The aim of the present study was to investigate if the relationship between alcohol use and sleeplessness is bidirectional by exploring how the change in and stability of alcohol use were related to sleeplessness, and vice versa, how the change in and stability of sleeplessness were related to alcohol use, in a longitudinal study spanning 13 years. METHOD Data were collected from 9941 adults who participated in two waves (T1: 1994-1995, and T2: 2007-2008) of the Tromsø Study, a Norwegian general population health study. Alcohol use was measured by questions asking about the frequency of drinking, amounts of alcohol normally consumed and the frequency of binge drinking, whereas sleeplessness was measured by one item asking about the frequency of experiencing sleeplessness. Variables representing change in and stability of consumption of alcohol and sleeplessness from T1 to T2 were created. Logistic regression analyses, stratified by gender, were used to analyze the data. RESULTS Men reporting stable high (OR = 2.11, p. < .001) or increasing (OR = 1.94, p. < .01) consumption of alcohol from T1 to T2 had a significantly higher risk of reporting sleeplessness at T2. Likewise, men experiencing stable (OR = 1.84, p. < .01) or increasing (OR = 1.78, p. < .001) sleeplessness from T1 to T2 had a significantly higher risk of reporting high consumption of alcohol at T2. No significant effects were detected among women. CONCLUSION The findings indicate a bidirectional relationship between high consumption of alcohol and sleeplessness only among men. Thus, healthcare professionals ought to be informed about the health risks associated with excessive drinking and struggling with sleeplessness, especially in men.
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Miloyan B, Van Doorn G. Longitudinal association between social anxiety disorder and incident alcohol use disorder: results from two national samples of US adults. Soc Psychiatry Psychiatr Epidemiol 2019; 54:469-475. [PMID: 30054643 DOI: 10.1007/s00127-018-1569-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 07/24/2018] [Indexed: 11/26/2022]
Abstract
This study assessed the association between subclinical social fears and a 12-month diagnosis of Social Anxiety Disorder (SAD) at baseline and the risk of incident Alcohol Use Disorder (AUD) at follow-up, compared to those without subclinical social fears and a 12-month diagnosis of SAD. We performed an individual participant meta-analysis based on data from two national longitudinal surveys. Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) was conducted in 2001-2002 in a sample of 43,093 adults and Wave 2 was conducted in 2004-2005 in 34,653 of the original respondents. Wave 1 of the National Comorbidity Survey was conducted in 1990-1992 in a sample of 8098 respondents and Wave 2 was conducted in 2001-2002 in 5001 of the original respondents. Binary logistic regression analyses were performed independently in each study and then the effect estimates were combined using random-effects meta-analysis. Neither subclinical social fears nor 12-month SAD at baseline were associated with incident AUD at follow-up. These findings conflict with reports of previous studies that a diagnosis of SAD is a risk factor for AUD in adults, and suggest that subclinical social fears are not associated with differential risk of incident AUD.
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Affiliation(s)
- Beyon Miloyan
- Department of Psychology, Faculty of Health, Federation University Australia, Northways Rd., Churchill, VIC, 3842, Australia.
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA.
| | - George Van Doorn
- Department of Psychology, Faculty of Health, Federation University Australia, Northways Rd., Churchill, VIC, 3842, Australia
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Veldhuis CB, Hughes TL, Drabble L, Wilsnack SC, Riggle EDB, Rostosky SS. Relationship Status and Drinking-Related Outcomes in a Community Sample of Lesbian and Bisexual Women. JOURNAL OF SOCIAL AND PERSONAL RELATIONSHIPS 2019; 36:244-268. [PMID: 30581248 PMCID: PMC6298438 DOI: 10.1177/0265407517726183] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Although marriage tends to be protective against hazardous drinking among women in the general population, few studies have compared drinking rates, levels, or problems based on relationship status among sexual minority women (SMW; lesbian, bisexual). We examined associations between relationship status (committed relationship/cohabiting; committed/not cohabiting; single) and past-year drinking outcomes using data from a diverse sample of 696 SMW interviewed in wave 3 of the 17-year longitudinal Chicago Health and Life Experiences of Women study. The mean age of SMW in the sample was 40.01 (SD = 14.15; range 18-82). A little more than one-third (37%) of the sample was white, 36% was African American, and 23% Latina; 4% reported another or multi- race/ethnicity. Compared to SMW in committed cohabiting relationships, single SMW were significantly more likely to be heavy drinkers. SMW in committed non-cohabiting relationships were more likely to report alcohol-related problem consequences, and both single SMW and those in committed non-cohabiting relationships were more likely to report one or more symptoms of potential alcohol dependence. Findings underscore the importance of exploring relationship factors that may influence drinking and drinking-related problems among SMW.
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Affiliation(s)
- Cindy B Veldhuis
- Center for Research on Women and Gender, University of Illinois at Chicago
- College of Nursing, University of Illinois at Chicago
- School of Nursing, Columbia University
| | - Tonda L Hughes
- Center for Research on Women and Gender, University of Illinois at Chicago
- College of Nursing, University of Illinois at Chicago
- School of Nursing, Columbia University
| | | | - Sharon C Wilsnack
- Department of Psychiatry and Behavioral Science, University of North Dakota
| | - Ellen D B Riggle
- Political Science and Gender and Women's Studies, University of Kentucky
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Niedermeier M, Frühauf A, Kopp-Wilfling P, Rumpold G, Kopp M. Alcohol Consumption and Physical Activity in Austrian College Students-A Cross-Sectional Study. Subst Use Misuse 2018; 53:1581-1590. [PMID: 29381116 DOI: 10.1080/10826084.2017.1416406] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The age of college students is considered as crucial for developing health-related behaviors, e.g., alcohol consumption or a physically active lifestyle. Previous research reported a positive relationship between alcohol consumption and physical activity (PA) in college students. However, the main body of research was done in students from the United States who might differ from European students. OBJECTIVES Thus the aim of this study was to analyze the relationship between alcohol consumption and PA in a sample of Austrian college students. METHODS In a cross-sectional design, 861 Austrian students from various study fields responded to a web-based questionnaire. Self-reported alcohol consumption, PA, and relevant sociodemographic variables were assessed. Multiple regression analyses were used to study the relationship between alcohol consumption and PA. RESULTS In none of the regression models, a significant relationship between alcohol consumption and PA was found. There was a significant influence of sex, age, relationship status, education level, and study field on alcohol consumption. Male, older, and undergraduate students studying social sciences without a relationship reported higher alcohol consumption. Conclusions/Importance: The results do not support a general relationship between alcohol consumption and PA among urban Austrian college students of various study fields. Compared to other variables (e.g., sex, relationship status), PA seems to be less important in relation to the consumption of alcohol. This study challenges a global perspective on a positive relationship between alcohol consumption and PA and highlights the need for more cross-cultural investigations.
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Affiliation(s)
- Martin Niedermeier
- a Department of Sport Science , University of Innsbruck , Innsbruck , Austria
| | - Anika Frühauf
- a Department of Sport Science , University of Innsbruck , Innsbruck , Austria
| | | | - Gerhard Rumpold
- b Department of Psychiatry and Psychotherapy , Innsbruck Medical University , Innsbruck , Austria
| | - Martin Kopp
- a Department of Sport Science , University of Innsbruck , Innsbruck , Austria
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Lawana N, Booysen F. Decomposing socioeconomic inequalities in alcohol use by men living in South African urban informal settlements. BMC Public Health 2018; 18:993. [PMID: 30092760 PMCID: PMC6085648 DOI: 10.1186/s12889-018-5925-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/01/2018] [Indexed: 11/28/2022] Open
Abstract
Background The prevalence of alcohol consumption among males living in urban settlements in South Africa is high. This paper aims to measure socioeconomic inequalities in alcohol use among men residing in informal settlements and also to examine the factors associated with inequality in alcohol use among men living in informal settlements. Methods The study uses data from the 2016 Study of South African Informal Settlements. Multiple correspondence analysis is used to calculate a wealth index as a measure of socioeconomic status. The Erreygers concentration index is employed to quantify the degree of socioeconomic inequality in alcohol use and decomposition analysis is conducted to assess the factors associated with inequality in alcohol use by men of various age groups. Results There is a socioeconomic-related inequality in alcohol use in informal settlements that discriminates against poor men. Inequality is especially pronounced in the case of males aged 15–34 years and males aged 35–44 years. Wealth status makes the biggest contribution to socioeconomic inequality in alcohol use. The contribution of social determinants of health like marital status and employment status differ across age groups. Employment status contribute more to the alcohol use inequality among males aged 15–34 years while marital status contribute more to the alcohol use inequality among males aged 35–44 years. Being single substantially increases inequality in alcohol use. Conclusion Inequality in alcohol use exists among both younger and older males and discriminate against the poor. Public policies aimed at promoting public health and the prevention of unhealthy behaviours should target younger and middle-aged men from socioeconomically disadvantaged groups. We also suggest policies that target single males in informal settlements.
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Affiliation(s)
- Nozuko Lawana
- Population Health, Health Systems and Innovation, Human Sciences Research Council , 134 Pretorious Street, Pretoria, 0002, South Africa.
| | - Frederik Booysen
- Population Health, Health Systems and Innovation, Human Sciences Research Council , 134 Pretorious Street, Pretoria, 0002, South Africa.,Department of Economics, University of Free State (UFS), Bloemfontein, South Africa
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Jang BJ, Schuler MS, Evans-Polce RJ, Patrick ME. Marital Status as a Partial Mediator of the Associations Between Young Adult Substance Use and Subsequent Substance Use Disorder: Application of Causal Inference Methods. J Stud Alcohol Drugs 2018. [PMID: 30079872 DOI: 10.15288/jsad.2018.79.567] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Young adult substance use is linked with the risk of substance use disorders (SUDs) later in adulthood. Marriage may be part of this pathway because of both selection effects (early substance use reducing marriage) and socialization effects (marriage reducing later substance use and disorder). We examine whether marital status mediates the association between young adult substance use and subsequent SUDs, using causal mediation methods to strengthen inferences. METHOD Using panel data from high school seniors in 1990-1998, we examined whether the effects of two exposures (level of alcohol/marijuana use at age 19/20) on the outcomes (alcohol use disorder [AUD]/ marijuana use disorder [MUD], nondisordered use, or abstinence at age 35) were mediated by marital status at age 29/30. Propensity score weights adjusted for potential confounding regarding both the exposures and the mediator. RESULTS Moderate and heavy alcohol/marijuana use at age 19/20 were associated with higher odds of AUD/MUD and lower odds of abstinence, each relative to nondisordered use, at age 35. The association between heavy alcohol use at age 19/20 and subsequent AUD was partially mediated by being unmarried at age 29/30; the associations between moderate and heavy marijuana use at age 19/20 and subsequent marijuana abstinence were partially mediated by being unmarried at age 29/30. CONCLUSIONS Both selection and socialization effects related to marriage explain the perpetuation of substance use behaviors across adulthood. Selection effects on marriage seem to occur at different thresholds for young adult alcohol and marijuana use.
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Affiliation(s)
- Bohyun Joy Jang
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | | | | | - Megan E Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
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Josefsson K, Elovainio M, Stenholm S, Kawachi I, Kauppi M, Aalto V, Kivimäki M, Vahtera J. Relationship transitions and change in health behavior: A four-phase, twelve-year longitudinal study. Soc Sci Med 2018; 209:152-159. [PMID: 29566960 DOI: 10.1016/j.socscimed.2018.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 02/16/2018] [Accepted: 03/03/2018] [Indexed: 02/08/2023]
Abstract
RATIONALE Extensive scientific evidence shows an association between involvement in social relationships and healthy lifestyle. Prospective studies with many participants and long follow-ups are needed to study the dynamics and change in social factors within individuals over time. OBJECTIVE Our aim was to determine whether a change in relationship status (single, married, divorced, widow, cohabiting) is followed by a change in health behavior (smoking, alcohol consumption, physical activity, and body mass index). METHODS We used data from 81,925 healthy adults participating in the prospective longitudinal Finnish Public Sector Study in the period 2000-2013. We analyzed 327,700 person-observations from four data collection phases. Missing data were multiply imputed. A within-individual methodology was used to minimize the possibility of selection effects affecting the interpretation. RESULTS All four health behaviors showed associations with relationship status. The effects were very similar and in the same direction in women and men, although there were gender differences in the magnitudes of the effects. The end of a relationship was followed by a decrease in body mass index, increased odds of being a smoker, increase in physical activity, and increase in alcohol consumption (widowed men). The effects were reverse when forming a new relationship. CONCLUSION A change in relationship status is associated with a change in health behavior. The association is not explained by socioeconomic status, subjective health status, or anxiety level. People leaving or losing a relationship are at increased risk of unhealthy behavior (smoking and alcohol consumption), but at the same time they have a lower BMI and show higher physical activity compared to the time they were in a relationship. It is not clear if the cumulative health effect of these health behavior changes is positive or negative.
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Affiliation(s)
- Kim Josefsson
- National Institute for Health and Welfare, Helsinki, Finland.
| | - Marko Elovainio
- National Institute for Health and Welfare, Helsinki, Finland; University of Helsinki, Helsinki, Finland
| | | | | | - Maarit Kauppi
- Finnish Institute of Occupational Health, Turku, Finland
| | - Ville Aalto
- Finnish Institute of Occupational Health, Turku, Finland
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland; University College London, London, United Kingdom
| | - Jussi Vahtera
- University of Turku, Turku, Finland; Turku University Hospital, Turku, Finland
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Salvatore JE, Cho SB, Dick DM. Genes, Environments, and Sex Differences in Alcohol Research. J Stud Alcohol Drugs 2017; 78:494-501. [PMID: 28728631 PMCID: PMC5551654 DOI: 10.15288/jsad.2017.78.494] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 12/16/2016] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE The study of sex differences has been identified as one way to enhance scientific reproducibility, and the National Institutes of Health (NIH) have implemented a new policy to encourage the explicit examination of sex differences. Our goal here is to address sex differences in behavioral genetic research on alcohol outcomes. METHOD We review sex differences for alcohol outcomes and whether the source and magnitude of genetic influences on alcohol consumption and alcohol use disorder (AUD) are the same across sexes; describe common research designs for studying sex-specific gene-by-environment interaction (G × E) effects; and discuss the role of statistical power and theory when testing sex-specific genetic effects. RESULTS There are robust sex differences for many alcohol outcomes. The weight of evidence suggests that the source and magnitude of genetic influences on alcohol consumption and AUD are the same across sexes. Whether there are sex-specific G × E effects has received less attention to date. CONCLUSIONS The new NIH policy necessitates a systematic approach for studying sex-specific genetic effects in alcohol research. Researchers are encouraged to report power for tests of these effects and to use theory to develop testable hypotheses, especially for studies of G × E.
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Affiliation(s)
- Jessica E. Salvatore
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia
| | - Seung Bin Cho
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
- College Behavioral and Emotional Health Institute, Virginia Commonwealth University, Richmond, Virginia
| | - Danielle M. Dick
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
- College Behavioral and Emotional Health Institute, Virginia Commonwealth University, Richmond, Virginia
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, Virginia
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Kendler KS, Larsson Lönn S, Salvatore J, Sundquist J, Sundquist K. Divorce and the Onset of Alcohol Use Disorder: A Swedish Population-Based Longitudinal Cohort and Co-Relative Study. Am J Psychiatry 2017; 174:451-458. [PMID: 28103713 PMCID: PMC5411284 DOI: 10.1176/appi.ajp.2016.16050589] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this study was to clarify the magnitude and nature of the relationship between divorce and risk for alcohol use disorder (AUD). METHOD In a population-based Swedish sample of married individuals (N=942,366), the authors examined the association between divorce or widowhood and risk for first registration for AUD. AUD was assessed using medical, criminal, and pharmacy registries. RESULTS Divorce was strongly associated with risk for first AUD onset in both men (hazard ratio=5.98, 95% CI=5.65-6.33) and women (hazard ratio=7.29, 95% CI=6.72-7.91). The hazard ratio was estimated for AUD onset given divorce among discordant monozygotic twins to equal 3.45 and 3.62 in men and women, respectively. Divorce was also associated with an AUD recurrence in those with AUD registrations before marriage. Furthermore, widowhood increased risk for AUD in men (hazard ratio=3.85, 95% CI=2.81-5.28) and women (hazard ratio=4.10, 95% CI=2.98-5.64). Among divorced individuals, remarriage was associated with a large decline in AUD in both sexes (men: hazard ratio=0.56, 95% CI=0.52-0.64; women: hazard ratio=0.61, 95% CI=0.55-0.69). Divorce produced a greater increase in first AUD onset in those with a family history of AUD or with prior externalizing behaviors. CONCLUSIONS Spousal loss through divorce or bereavement is associated with a large enduring increased AUD risk. This association likely reflects both causal and noncausal processes. That the AUD status of the spouse alters this association highlights the importance of spouse characteristics for the behavioral health consequences of spousal loss. The pronounced elevation in AUD risk following divorce or widowhood, and the protective effect of remarriage against subsequent AUD, speaks to the profound impact of marriage on problematic alcohol use.
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Affiliation(s)
- Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychiatry, Virginia Commonwealth University, Richmond VA, USA,Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Sara Larsson Lönn
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Jessica Salvatore
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychology, Virginia Commonwealth University, Richmond VA, USA
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
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Shi X, Zhang TT, Hu WP, Ji QH. Marital status and survival of patients with oral cavity squamous cell carcinoma: a population-based study. Oncotarget 2017; 8:28526-28543. [PMID: 28415710 PMCID: PMC5438670 DOI: 10.18632/oncotarget.16095] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 02/28/2017] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The relationship between marital status and oral cavity squamous cell carcinoma (OCSCC) survival has not been explored. The objective of our study was to evaluate the impact of marital status on OCSCC survival and investigate the potential mechanisms. RESULTS Married patients had better 5-year cancer-specific survival (CSS) (66.7% vs 54.9%) and 5-year overall survival (OS) (56.0% vs 41.1%). In multivariate Cox regression models, unmarried patients also showed higher mortality risk for both CSS (Hazard Ratio [HR]: 1.260, 95% confidence interval (CI): 1.187-1.339, P < 0.001) and OS (HR: 1.328, 95% CI: 1.266-1.392, P < 0.001). Multivariate logistic regression showed married patients were more likely to be diagnosed at earlier stage (P < 0.001) and receive surgery (P < 0.001). Married patients still demonstrated better prognosis in the 1:1 matched group analysis (CSS: 62.9% vs 60.8%, OS: 52.3% vs 46.5%). MATERIALS AND METHODS 11022 eligible OCSCC patients were identified from Surveillance, Epidemiology, and End Results (SEER) database, including 5902 married and 5120 unmarried individuals. Kaplan-Meier analysis, Log-rank test and Cox proportional hazards regression model were used to analyze survival and mortality risk. Influence of marital status on stage, age at diagnosis and selection of treatment was determined by binomial and multinomial logistic regression. Propensity score matching method was adopted to perform a 1:1 matched cohort. CONCLUSIONS Marriage has an independently protective effect on OCSCC survival. Earlier diagnosis and more sufficient treatment are possible explanations. Besides, even after 1:1 matching, survival advantage of married group still exists, indicating that spousal support from other aspects may also play an important role.
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Affiliation(s)
- Xiao Shi
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ting-ting Zhang
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wei-ping Hu
- Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qing-hai Ji
- Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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Salvatore JE, Lönn SL, Sundquist J, Lichtenstein P, Sundquist K, Kendler KS. Alcohol use disorder and divorce: evidence for a genetic correlation in a population-based Swedish sample. Addiction 2017; 112:586-593. [PMID: 27981669 PMCID: PMC5339032 DOI: 10.1111/add.13719] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 08/08/2016] [Accepted: 12/05/2016] [Indexed: 11/29/2022]
Abstract
AIMS We tested the association between alcohol use disorder (AUD) and divorce; estimated the genetic and environmental influences on divorce; estimated how much genetic and environmental influences accounted for covariance between AUD and divorce; and estimated latent genetic and environmental correlations between AUD and divorce. We tested sex differences in these effects. DESIGN We identified twin and sibling pairs with AUD and divorce information in Swedish national registers. We described the association between AUD and divorce using tetrachorics and used twin and sibling models to estimate genetic and environmental influences on divorce, on the covariance between AUD and divorce and the latent genetic and environmental correlations between AUD and divorce. SETTING Sweden. PARTICIPANTS A total of 670 836 individuals (53% male) born 1940-1965. MEASUREMENTS Life-time measures of AUD and divorce. FINDINGS AUD and divorce were related strongly (males: rtet = +0.44, 95% CI = 0.43, 0.45; females rtet = +0.37, 95% CI = 0.36, 0.38). Genetic factors accounted for a modest proportion of the variance in divorce (males: 21.3%, 95% CI = 7.6, 28.5; females: 31.0%, 95% CI = 18.8, 37.1). Genetic factors accounted for most of the covariance between AUD and divorce (males: 52.0%, 95% CI = 48.8, 67.9; females: 53.74%, 95% CI = 17.6, 54.5), followed by non-shared environmental factors (males: 45.0%, 95% CI = 37.5, 54.9; females: 41.6%, 95% CI = 40.3, 60.2). Shared environmental factors accounted for a negligible proportion of the covariance (males: 3.0%, 95% CI = -3.0, 13.5; females: 4.75%, 95% CI = 0.0, 6.6). The AUD-divorce genetic correlations were high (males: rA = +0.76, 95% CI = 0.53, 0.90; females +0.52, 95% CI = 0.24, 0.67). The non-shared environmental correlations were modest (males: rE = +0.32, 95% CI = 0.31, 0.40; females: +0.27, 95% CI = 0.27, 0.36). CONCLUSIONS Divorce and alcohol use disorder are correlated strongly in the Swedish population, and the heritability of divorce is consistent with previous studies. Covariation between AUD and divorce results from overlapping genetic and non-shared environmental factors. Latent genetic and non-shared environmental correlations for alcohol use disorder and divorce are high and moderate.
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Affiliation(s)
- Jessica E. Salvatore
- Department of Psychology, Virginia Commonwealth University,Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University
| | - Sara Larsson Lönn
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet
| | | | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University,Department of Psychiatry, Virginia Commonwealth University,Department of Human and Molecular Genetics, Virginia Commonwealth University
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28
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Harmful drinking after job loss: a stronger association during the post-2008 economic crisis? Int J Public Health 2017; 62:563-572. [PMID: 28229184 PMCID: PMC5429894 DOI: 10.1007/s00038-016-0936-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 09/04/2016] [Accepted: 12/16/2016] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVES This study investigated, among the Dutch working population, whether job loss during the post-2008 economic crisis is associated with harmful drinking and whether this association is stronger than before the crisis. METHODS Repeated cross-sectional data from the Dutch Health Interview Survey 2004-2013 were used to define episodic drinking (≥6 glasses on 1 day ≥1/week) and chronic drinking (≥14 glasses/week for women and ≥21 for men). These data were linked to longitudinal data from tax registries, to measure the experience and duration of job loss during a 5-year working history. RESULTS Before the crisis, job loss experience and duration were not associated with harmful drinking. During the crisis, job loss for more than 6 months was associated with episodic drinking [OR 1.40 (95% CI 1.01; 1.94)], while current job loss was associated with chronic drinking [OR 1.43 (95% CI 1.03; 1.98)]. These associations were most clear in men and different between the pre-crisis and crisis period (p interaction = 0.023 and 0.035, respectively). CONCLUSIONS The results suggest that economic crises strengthen the potential impact of job loss on harmful drinking, predominately among men.
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29
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Otoo FE, Gyebi B, Wireko-Gyebi S. Associated factors of alcohol and alcoholism among tertiary students. JOURNAL OF SUBSTANCE USE 2017. [DOI: 10.3109/14659891.2016.1140236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Felix Elvis Otoo
- Department of Hospitality and Tourism Management, Christ Apostolic University College, Kumasi, Ghana
| | - Barbara Gyebi
- Department of Hospitality and Tourism Management, Christ Apostolic University College, Kumasi, Ghana
| | - Sampson Wireko-Gyebi
- Department of Hospitality and Tourism Management, Christ Apostolic University College, Kumasi, Ghana
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30
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Dupre ME. Race, Marital History, and Risks for Stroke in US Older Adults. SOCIAL FORCES; A SCIENTIFIC MEDIUM OF SOCIAL STUDY AND INTERPRETATION 2016; 95:439-468. [PMID: 29187763 PMCID: PMC5703199 DOI: 10.1093/sf/sow040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Stroke is among the leading causes of disability and death in the United States, and racial differences are greater for stroke than for all other major chronic diseases. Considering the equally sizeable racial disparities in marital life and associated risks across adulthood, the current study hypothesizes that black-white differences in marital history play an important role in the large racial inequalities in the incidence of stroke. The major objective are to (i) demonstrate how marital history is associated with the incidence of stroke, (ii) examine how marital factors mediate and/or moderate racial disparities in stroke, and (iii) examine the factors that may explain the associations. Using retrospective and prospective data from the Health and Retirement Study (n = 23,289), the results show that non-Hispanic (NH) blacks have significantly higher rates of marital instability, greater numbers of health-risk factors, and substantially higher rates of stroke compared with NH whites. Contrary to the cumulative disadvantage hypothesis, findings from discrete-time-hazard models show that the effects of marital history are more pronounced for NH whites than for NH blacks. Risks for stroke were significantly higher in NH whites who were currently divorced, remarried, and widowed, as well as in those with a history of divorce or widowhood, compared with NH whites who were continuously married. In NH blacks, risks for stroke were elevated only in those who had either never married or had been widowed-with no significant risks attributable to divorce. The potential mechanisms underlying the associations are assessed, and the implications of the findings are discussed.
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31
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Dinescu D, Turkheimer E, Beam CR, Horn EE, Duncan G, Emery RE. Is marriage a buzzkill? A twin study of marital status and alcohol consumption. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2016; 30:698-707. [PMID: 27336180 PMCID: PMC5014643 DOI: 10.1037/fam0000221] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Married adults have consistently been found to drink less than their single or divorced counterparts. This correlation may not be causal, however, as people nonrandomly "select" into marriage and into alcohol use. The current study uses a sample of 2,425 same-sex twin pairs (1,703 MZ; 722 DZ) to control for genetic and shared environmental selection, thereby eliminating a great many third variable, alternative explanations to the hypothesis that marriage causes less drinking. Married twins were compared with their single, divorced, and cohabiting cotwins on drinking frequency and quantity. Married cotwins consumed fewer alcoholic beverages than their single or divorced cotwins, and drank less frequently than their single cotwins. Alcohol use patterns did not differ among married and cohabiting twins. These findings provide strong evidence that intimate relationships cause a decline in alcohol consumption. (PsycINFO Database Record
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Affiliation(s)
- Diana Dinescu
- Department of Psychology, University of Virginia, 102 Gilmer Hall, Charlottesville, VA, 22904
| | - Eric Turkheimer
- Department of Psychology, University of Virginia, 102 Gilmer Hall, Charlottesville, VA, 22904
| | - Christopher R. Beam
- Department of Psychology & Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089
| | - Erin E. Horn
- Department of Psychology, University of Virginia, 102 Gilmer Hall, Charlottesville, VA, 22904
| | - Glen Duncan
- Elson S. Floyd College of Medicine, Nutrition & Exercise Physiology Program, Washington State University – Health Sciences Spokane, Spokane, WA 99210
| | - Robert E. Emery
- Department of Psychology, University of Virginia, 102 Gilmer Hall, Charlottesville, VA, 22904
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32
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Jin JJ, Wang W, Dai FX, Long ZW, Cai H, Liu XW, Zhou Y, Huang H, Wang YN. Marital status and survival in patients with gastric cancer. Cancer Med 2016; 5:1821-9. [PMID: 27264020 PMCID: PMC4898975 DOI: 10.1002/cam4.758] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 03/30/2016] [Accepted: 04/04/2016] [Indexed: 12/30/2022] Open
Abstract
The objective of this study is to examine the impact of marital status on incidence of metastasis at diagnosis, receipt of surgery, and cause‐specific survival (CSS) in patients with gastric cancer (GC). Research data is extracted from The Surveillance, Epidemiology, and End Results (SEER) database, and 18,196 patients diagnosed with GC from 2004 to 2010 are involved. Effects of marital status on incidence of metastasis at diagnosis, receipt of surgery, and CSS are determined using multivariable logistic regression and multivariable Cox regression models, as appropriate. Single GC patients have a higher incidence of metastasis at diagnosis than married patients, while the differences between divorced/separated patients or widowed patients and married patients are not significant. Among those without distant metastasis, single patients, divorced/separated patients, and widowed patients are much less likely to accept surgery compared with married patients. Finally, in the whole group of 18,196 GC patients, single patients, divorced/separated patients, and widowed patients have shorter CSS compared with married patients, even in each of the TNM stage. Marriage had a protective effect against undertreatment and cause‐specific mortality (CSM) in GC. Spousal support may contribute to higher rate of surgery receipt and better survival in patients with GC.
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Affiliation(s)
- Jie-Jie Jin
- Department of Gastric Cancer and Soft Tissue Sarcoma, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Wei Wang
- Department of Hepatobiliary Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, 226001, China
| | - Fa-Xiang Dai
- Department of Hepatobiliary Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, 226001, China
| | - Zi-Wen Long
- Department of Gastric Cancer and Soft Tissue Sarcoma, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Hong Cai
- Department of Gastric Cancer and Soft Tissue Sarcoma, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Xiao-Wen Liu
- Department of Gastric Cancer and Soft Tissue Sarcoma, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Ye Zhou
- Department of Gastric Cancer and Soft Tissue Sarcoma, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Hua Huang
- Department of Gastric Cancer and Soft Tissue Sarcoma, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Ya-Nong Wang
- Department of Gastric Cancer and Soft Tissue Sarcoma, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
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Reczek C, Pudrovska T, Carr D, Thomeer MB, Umberson D. Marital Histories and Heavy Alcohol Use among Older Adults. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2016; 57:77-96. [PMID: 26957135 PMCID: PMC4785832 DOI: 10.1177/0022146515628028] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
We develop a gendered marital biography approach-which emphasizes the accumulating gendered experiences of singlehood, marriage, marital dissolution, and remarriage-to examine the relationship between marital statuses and transitions and heavy alcohol use. We test this approach using individual-level (n = 10,457) and couple-level (n = 2,170) longitudinal data from the Health and Retirement Study, and individual-level (n = 46) and couple-level (n = 42) in-depth interview data. Quantitative results show that marriage, including remarriage, reduces men's but increases women's drinking relative to being never married and previously married, whereas divorce increases men's but decrease women's drinking, with some variation by age. Our qualitative findings reveal that social control and convergence processes underlie quantitative results. We call attention to how men's and women's heavy drinking trajectories stop, start, and change direction as individuals move through their distinctive marital biography.
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Ilhan MN, Arikan Z, Kotan Z, Tunçoğlu T, Pinarci M, Taşdemir A, Ay B, Koçak N. Prevalence and Socio-Demographic Determinants of Tobacco, Alcohol, Substance Use and Drug Misuse in General Population in Turkey. Noro Psikiyatr Ars 2016; 53:205-212. [PMID: 28373796 DOI: 10.5152/npa.2015.10050] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Accepted: 06/11/2015] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The aim of the current study is to determine prevalence ratios of tobacco, alcohol, substance use and drug misuse in a large scale sample of general population and recognize related socio-demographic factors. METHODS The study was based on a cross-sectional survey conducted with a nationally representative sample of 8045 individuals with face-to-face, in-house interviews implemented by a trained team of interviewers. RESULTS Life-time prevalences of tobacco, alcohol, substance use and drug misuse are 51.8%, 28.3%, 2.8% and 10.5% respectively. Age, gender, education level and marital status are important socio-demographic determinants for tobacco, alcohol use and drug misuse. Income level is an important determinant for alcohol and substance use. CONCLUSION Tobacco, alcohol, substance use and drug misuse are significant health concerns in Turkey. Socio-demographic status is an important determinant of several aspects of tobacco, alcohol, substance use and drug misuse and should therefore be evaluated carefully to develop effective protective and preventive strategies.
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Affiliation(s)
- Mustafa Necmi Ilhan
- Department of Public Health, Gazi University School of Medicine, Ankara, Turkey
| | - Zehra Arikan
- Department of Psychiatry, Gazi University School of Medicine, Ankara, Turkey
| | - Zeynep Kotan
- Clinic of Psychiatry, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Tolga Tunçoğlu
- Department of Anti-Smuggling and Organized Crime, Republic of Turkey Ministry of Interior Turkish National Police, Ankara, Turkey
| | - Mustafa Pinarci
- Department of Anti-Smuggling and Organized Crime, Republic of Turkey Ministry of Interior Turkish National Police, Ankara, Turkey
| | - Ahmet Taşdemir
- Department of Anti-Smuggling and Organized Crime, Republic of Turkey Ministry of Interior Turkish National Police, Ankara, Turkey
| | - Bülent Ay
- Department of Anti-Smuggling and Organized Crime, Republic of Turkey Ministry of Interior Turkish National Police, Ankara, Turkey
| | - Nadir Koçak
- Department of Anti-Smuggling and Organized Crime, Republic of Turkey Ministry of Interior Turkish National Police, Ankara, Turkey
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Pavarin RM, Caputo F, Zoli G, Domenicali M, Bernardi M, Gambini D. Mortality risk in a cohort of Italian alcoholic individuals treated for alcohol dependence. Drug Alcohol Rev 2015; 36:186-191. [PMID: 26643015 DOI: 10.1111/dar.12366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 10/21/2015] [Accepted: 10/26/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS The aim of this study was to investigate the mortality risk and to explore the presence of subjects more at risk of dying in a cohort of alcoholic individuals treated for alcohol dependence over a lengthy follow-up period. DESIGN AND METHODS A total of 2363 subjects attending 10 centres for addiction treatment for alcohol dependence were recruited. RESULTS During the 17 year follow-up period, 14.7% of the entire cohort died. Total standardised mortality rates (SMR) were higher in women (SMR = 5.94) as compared with men (SMR = 4.65). Higher SMRs were found for several diseases, for traumatic episodes (SMR = 6.65) and in younger patients (18-44 age group) (SMR = 8.16). Alcoholic women showed a higher survival rate as compared with men. In addition, a higher risk of death for men and unemployed subjects, with a progressive increase of risk in line with the increase of the age of admission to treatment, and with a progressive decrease of risk after 1 year from the beginning of the treatment, was also found. DISCUSSION AND CONCLUSIONS This study confirms that mortality risk in alcoholic individuals in treatment is higher in comparison with the general population. Moreover, alcoholics men, unemployed, >40 years at time of admission and during the first year of treatment are more at risk to die. Thus, much more attention to patients with these characteristics should be planned by the professional staff working in centres for addiction treatment. [ Pavarin R M, Caputo F, Zoli G, Domenicali M, Bernardi M, Gambini D. Mortality risk in a cohort of Italian alcoholic individuals treated for alcohol dependence Drug Alcohol Rev 2017;36:186-191].
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Affiliation(s)
| | - Fabio Caputo
- Department of Internal Medicine, SS Annunziata Hospital, Cento, Ferrara, Italy.,Department of Medical and Surgical Sciences, 'G. Fontana' Centre for the Study and Multidisciplinary Treatment of Alcohol Addiction, University of Bologna, Bologna, Italy
| | - Giorgio Zoli
- Department of Internal Medicine, SS Annunziata Hospital, Cento, Ferrara, Italy
| | - Marco Domenicali
- Department of Medical and Surgical Sciences, 'G. Fontana' Centre for the Study and Multidisciplinary Treatment of Alcohol Addiction, University of Bologna, Bologna, Italy
| | - Mauro Bernardi
- Department of Medical and Surgical Sciences, 'G. Fontana' Centre for the Study and Multidisciplinary Treatment of Alcohol Addiction, University of Bologna, Bologna, Italy
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Lakew Y, Benedict S, Haile D. Social determinants of HIV infection, hotspot areas and subpopulation groups in Ethiopia: evidence from the National Demographic and Health Survey in 2011. BMJ Open 2015; 5:e008669. [PMID: 26589427 PMCID: PMC4663400 DOI: 10.1136/bmjopen-2015-008669] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE This study identifies social determinants of HIV infection, hotspot areas and subpopulation groups in Ethiopia. DESIGN The study used data from the 2011 Ethiopian Demographic and Health Survey (EDHS). Sample blood tests from the finger pricks collected on filter paper cards were labelled with a barcode unique to each respondent. Spatial scan statistics and geographic information system tools were used to map hotspot areas of HIV prevalence. Bivariate and multivariable logistic regression models were used to identify social determinants of HIV infection. POPULATION A total of 30,625 adults (16,515 women and 14,110 men) were included from 11 administrative states of Ethiopia. MAIN OUTCOME MEASURES Laboratory-confirmed HIV serostatus is the main outcome variable. RESULTS HIV prevalence reached 10-21% in the central, eastern and western geographic clusters of Ethiopia. Multivariable analysis showed that individuals who were in the middle, richer and richest wealth quintiles had increased odds of having HIV over those in the poorest quintile. Adults who had primary, secondary and higher educational levels had higher odds of being HIV positive than non-educated individuals. The odds of having HIV were higher among adults who had multiple lifetime sexual partners than those with a single partner. An increasing odds of HIV infection were observed among adults in the age groups of 25-29, 30-34, 35-39 and 40-45 years compared with adults in the age group of 45-49 years. Merchants had higher odds of being HIV positive than those who were not employed. The odds of having HIV were higher among urban residents and females than among rural residents and males, respectively. CONCLUSIONS This study found statistically significant HIV concentrations in administrative zones of central, eastern and western Ethiopia. Geospatial monitoring and targeting of prevention strategies for specific population groups is recommended.
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Affiliation(s)
- Yihunie Lakew
- Ethiopian Public Health Association, Addis Ababa, Ethiopia
| | - Susan Benedict
- The University of Texas Health Science Center at Houston, School of Nursing, Houston, Texas, USA
| | - Demewoz Haile
- Department of Reproductive Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara Region, Ethiopia
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Thandi G, Sundin J, Ng-Knight T, Jones M, Hull L, Jones N, Greenberg N, Rona RJ, Wessely S, Fear NT. Alcohol misuse in the United Kingdom Armed Forces: A longitudinal study. Drug Alcohol Depend 2015; 156:78-83. [PMID: 26409753 DOI: 10.1016/j.drugalcdep.2015.08.033] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 08/22/2015] [Accepted: 08/24/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVES We assessed changes in Alcohol Use Disorders Identification Test (AUDIT) scores over time. We investigated the impact of life events and changes in mental health status on AUDIT scores over time in UK military personnel. METHODS A random representative sample of regular UK military personnel who had been serving in 2003 were surveyed in 2004-2006 (phase 1) and again in 2007-2009 (phase 2). The impact of changes in symptoms of psychological distress, probable post-traumatic stress disorder (PTSD), marital status, serving status, rank, deployment to Iraq/Afghanistan and smoking was assessed between phases. RESULTS We found a statistically significant but small decrease in AUDIT scores between phases 1 and 2 (mean change=-1.01, 95% confidence interval=-1.14, -0.88). Participants reported a decrease in AUDIT scores if they experienced remission in psychological distress (adjusted mean -2.21, 95% CI -2.58, -1.84) and probable PTSD (adjusted mean -3.59, 95% CI -4.41, -2.78), if they stopped smoking (adjusted mean -1.41, 95% CI -1.83, -0.98) and were in a new relationship (adjusted mean -2.77, 95% CI -3.15, -2.38). On the other hand, reporting new onset or persistent symptoms of probable PTSD (adjusted mean 1.34, 95% CI 0.71, 1.98) or a relationship breakdown (adjusted mean 0.53, 95% CI 0.07, 0.99) at phase 2 were associated with an increase in AUDIT scores. CONCLUSIONS The overall level of hazardous alcohol consumption remains high in the UK military. Changes in AUDIT scores were linked to mental health and life events but not with deployment to Iraq or Afghanistan.
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Affiliation(s)
- Gursimran Thandi
- Academic Department of Military Mental Health, King's College London, London, UK; King's Centre for Military Health Research, King's College London, London, UK.
| | - Josefin Sundin
- Academic Department of Military Mental Health, King's College London, London, UK
| | - Terry Ng-Knight
- Academic Department of Military Mental Health, King's College London, London, UK
| | - Margaret Jones
- King's Centre for Military Health Research, King's College London, London, UK
| | - Lisa Hull
- King's Centre for Military Health Research, King's College London, London, UK
| | - Norman Jones
- Academic Department of Military Mental Health, King's College London, London, UK
| | - Neil Greenberg
- Academic Department of Military Mental Health, King's College London, London, UK
| | - Roberto J Rona
- King's Centre for Military Health Research, King's College London, London, UK
| | - Simon Wessely
- King's Centre for Military Health Research, King's College London, London, UK
| | - Nicola T Fear
- King's Centre for Military Health Research, King's College London, London, UK
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Kelley ML, Brancu M, Robbins AT, D'Lima GM, Strauss JL, Curry JF, Fairbank JA, Runnals J. Drug use and childhood-, military- and post-military trauma exposure among women and men veterans. Drug Alcohol Depend 2015; 152:201-8. [PMID: 25957156 DOI: 10.1016/j.drugalcdep.2015.03.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 03/26/2015] [Accepted: 03/31/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND The current study was undertaken to examine whether posttraumatic stress symptoms (PTSS) and depressive symptoms mediated the association between trauma exposure (combat-related trauma and non-combat traumas occurring before, during, and after military service), and drug abuse symptoms use among male and female veterans. METHODS Participants were 2304 (1851 male, 453 female) veterans who took part in a multi-site research study conducted through the Department of Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center (VISN 6 MIRECC). Path analytic models were used to determine the association between problematic past-year drug use and combat-related and non-combat trauma experienced before, during, or after the military and whether current post-traumatic stress symptoms or depressive symptoms mediated these associations. RESULTS For both male and female veterans, depressive symptoms significantly mediated the effects of pre- and post-military trauma on drug abuse symptoms. CONCLUSION Mental health providers who work with trauma-exposed Iraq and Afghanistan era veterans should assess for drug use, depressive symptoms, and life-span trauma (i.e., not only combat-related traumas) as part of a thorough trauma-based assessment for both men and women.
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Affiliation(s)
- Michelle L Kelley
- Department of Psychology, Old Dominion University, 5115 Hampton Boulevard, Norfolk, VA 23529, USA.
| | - Mira Brancu
- Mid-Atlantic Region VA Mental Illness Research, Education and Clinical Center (MIRECC), Durham, NC 27705, USA; Durham VA Medical Center, Durham, NC 27705, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA.
| | - Allison T Robbins
- Virginia Consortium Program in Clinical Psychology, Norfolk, VA 23504, USA.
| | - Gabrielle M D'Lima
- Department of Psychology, Old Dominion University, 5115 Hampton Boulevard, Norfolk, VA 23529, USA.
| | - Jennifer L Strauss
- Mid-Atlantic Region VA Mental Illness Research, Education and Clinical Center (MIRECC), Durham, NC 27705, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA; Mental Health Services, Department of Veterans Affairs, Washington, DC 20420, USA.
| | - John F Curry
- Mid-Atlantic Region VA Mental Illness Research, Education and Clinical Center (MIRECC), Durham, NC 27705, USA; Durham VA Medical Center, Durham, NC 27705, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA.
| | - John A Fairbank
- Mid-Atlantic Region VA Mental Illness Research, Education and Clinical Center (MIRECC), Durham, NC 27705, USA; Durham VA Medical Center, Durham, NC 27705, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA.
| | - Jennifer Runnals
- Mid-Atlantic Region VA Mental Illness Research, Education and Clinical Center (MIRECC), Durham, NC 27705, USA; Durham VA Medical Center, Durham, NC 27705, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA.
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Salvatore JE, Kendler KS, Dick DM. Romantic relationship status and alcohol use and problems across the first year of college. J Stud Alcohol Drugs 2015; 75:580-9. [PMID: 24988257 DOI: 10.15288/jsad.2014.75.580] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We examined the associations between romantic relationship status and alcohol use and problems in a large sample of first-year college students. METHOD Participants (n = 2,056) came from a longitudinal study of college students who answered questions about relationship status (single, in an exclusive relationship, or dating several people), alcohol use, and alcohol problems at two time points across their first year. RESULTS After we controlled for a number of covariates (parental alcohol problems, high school conduct problems, peer deviance, and extraversion), we found that dating several people was associated with higher alcohol use and problems, compared with being single or being in an exclusive relationship, at the follow-up assessment only, with modest effect sizes. Being in an exclusive relationship was not associated with lower alcohol use or problems compared with being single. Relationship dissolution was associated with a modest longitudinal increase in alcohol problems. CONCLUSIONS It is important to consider alternative relationship statuses (e.g., dating several people) for understanding the association of romantic status with alcohol use and problems in college-aged samples. Involvement in an exclusive romantic relationship (vs. being single) in this age group is not associated with the behavioral health benefits documented in older-adult samples. College students dating several people may be at risk for high levels of alcohol use or problems and may benefit from targeted interventions. Those who have recently experienced a breakup also may be at risk for increases in alcohol problems, although the clinical relevance of this finding should be tempered by the small observed effect size.
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Affiliation(s)
- Jessica E Salvatore
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia
| | - Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia
| | - Danielle M Dick
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia
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Kriegbaum M, Christensen U, Andersen PK, Osler M, Lund R. Does the association between broken partnership and first time myocardial infarction vary with time after break-up? Int J Epidemiol 2014; 42:1811-9. [PMID: 24415614 DOI: 10.1093/ije/dyt190] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Marriage is associated with lower risk of coronary heart disease, but it is unknown if the association depends on time since break-up with a partner. In this study we included both married and unmarried couples to study if the association between broken partnership (BP) and first time incident myocardial infarction (MI) changes with time since BP. METHODS Register study of the entire Danish population: the population was restricted to those aged 30 to 65 years with follow-up for incident MI between 1985 and 2006 with an annual record on each individual; in total 43 million records. The register data were used to identify MI events. Poisson regression was used to study associations between time since BP and MI adjusted for socio-demographic confounders and hospital admissions. Analyses were stratified by sex. RESULTS Compared with unexposed (no BP), the incidence rate ratio (IRR) of MI in men with BP in the same year was 0.97 [95% confidence interval (CI) 0.90-1.05], year before BP was 1.25 (95% CI 1.17-1.34), 2-3 years after BP was 1.12 (95% CI 1.06-1.18), 4-8 years after BP was 1.09 (95% CI 1.05-1.14) and 9+ years since BP was 1.09 (95% CI 1.05-1.12). In women, the IRR same year as BP was 1.45 (95% CI 1.26-1.66), the year after BP was 1.30 (95% CI 1.14-1.50), 2-3 years after BP was 1.26 (95% CI 1.13-1.39), 4-8 years after BP was 1.17 (95% CI 1.08-1.26) and 9+ years since BP was 1.24 (95% CI 1.17-1.32). CONCLUSIONS We found both a short-term elevated risk of first time MI following BP and a weaker long-term elevated risk, in both men and women.
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Affiliation(s)
- Margit Kriegbaum
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark and Glostrup University Hospital, Copenhagen, Denmark
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Family structure, marital discord and offspring's psychopathology in early adulthood: a prospective study. Eur Child Adolesc Psychiatry 2013; 22:693-700. [PMID: 23949103 DOI: 10.1007/s00787-013-0464-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Accepted: 06/24/2012] [Indexed: 10/26/2022]
Abstract
With marital breakdown and discord relatively common, we examined whether family structure and the quality of marital relationship have a long-term impact on offspring's psychopathology in early adulthood. This study aimed to examine the association of family structure and marital discord in the family with a wide range of offspring's mental health and problem behaviours at 21 years. Data were from the Mater-University of Queensland Study of Pregnancy, a population based birth cohort study, which commenced in Brisbane, Australia in 1981. Mothers and children were followed up at birth, 6 months and 5, 14 and 21 years after the initial interview. Marital status and marital quality were assessed at the 14 year follow-up. Young Adult Self-Report sub-scales of mental health and problem behaviours were measured at the 21-year follow-up. Type of family structure and the quality of marital relationship (at the 14-year follow-up) predicted offspring's psychopathology at 21 years. When a selected group of confounding factors were included in the multivariate analyses, children who lived with a step-father, un-partnered mother, or in families where parents had conflict in marital relationship reported higher symptoms of psychopathology at 21 years. The association between marital problems and young adult psychopathology does not appear to be confounded by a wide range of confounding variables. Further research is needed to explore the mechanism of these associations to develop preventive programmes.
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Aizer AA, Chen MH, McCarthy EP, Mendu ML, Koo S, Wilhite TJ, Graham PL, Choueiri TK, Hoffman KE, Martin NE, Hu JC, Nguyen PL. Marital status and survival in patients with cancer. J Clin Oncol 2013; 31:3869-76. [PMID: 24062405 DOI: 10.1200/jco.2013.49.6489] [Citation(s) in RCA: 703] [Impact Index Per Article: 63.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To examine the impact of marital status on stage at diagnosis, use of definitive therapy, and cancer-specific mortality among each of the 10 leading causes of cancer-related death in the United States. METHODS We used the Surveillance, Epidemiology and End Results program to identify 1,260,898 patients diagnosed in 2004 through 2008 with lung, colorectal, breast, pancreatic, prostate, liver/intrahepatic bile duct, non-Hodgkin lymphoma, head/neck, ovarian, or esophageal cancer. We used multivariable logistic and Cox regression to analyze the 734,889 patients who had clinical and follow-up information available. RESULTS Married patients were less likely to present with metastatic disease (adjusted odds ratio [OR], 0.83; 95% CI, 0.82 to 0.84; P < .001), more likely to receive definitive therapy (adjusted OR, 1.53; 95% CI, 1.51 to 1.56; P < .001), and less likely to die as a result of their cancer after adjusting for demographics, stage, and treatment (adjusted hazard ratio, 0.80; 95% CI, 0.79 to 0.81; P < .001) than unmarried patients. These associations remained significant when each individual cancer was analyzed (P < .05 for all end points for each malignancy). The benefit associated with marriage was greater in males than females for all outcome measures analyzed (P < .001 in all cases). For prostate, breast, colorectal, esophageal, and head/neck cancers, the survival benefit associated with marriage was larger than the published survival benefit of chemotherapy. CONCLUSION Even after adjusting for known confounders, unmarried patients are at significantly higher risk of presentation with metastatic cancer, undertreatment, and death resulting from their cancer. This study highlights the potentially significant impact that social support can have on cancer detection, treatment, and survival.
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Affiliation(s)
- Ayal A Aizer
- Ayal A. Aizer, Harvard Radiation Oncology Program; Ellen P. McCarthy, Beth Israel Deaconess Medical Center; Mallika L. Mendu, Sophia Koo, Powell L. Graham, Neil E. Martin, and Paul L. Nguyen, Dana-Farber/Brigham and Women's Cancer Center; Tyler J. Wilhite, Harvard Medical School, Boston, MA; Ming-Hui Chen, University of Connecticut, Storrs, CT; Karen E. Hoffman, The University of Texas MD Anderson Cancer Center, Houston, TX; and Jim C. Hu, University of California at Los Angeles, Los Angeles, CA
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Rognmo K, Torvik FA, Idstad M, Tambs K. More mental health problems after divorce in couples with high pre-divorce alcohol consumption than in other divorced couples: results from the HUNT-study. BMC Public Health 2013; 13:852. [PMID: 24040831 PMCID: PMC3848599 DOI: 10.1186/1471-2458-13-852] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 09/11/2013] [Indexed: 12/02/2022] Open
Abstract
Background Divorce is associated with mental health problems, and heavy drinking is related to higher risk of divorce. Less is known about the effects of divorce in couples where one or both drinks heavily. There are, however, reasons to expect different consequences of divorce in heavy risk using couples compared to other couples. Spouses of abusers may experience the divorce as a relief, whereas abusers may find it extra difficult to be left single. The aim of the study is to compare the effect of divorce on mental health in heavy drinking couples to the effect in couples who drink less. Methods Registry data were matched with data from the Nord-Trøndelag Health Study (HUNT 1 (T1) and 2 (T2)), enabling longitudinal analyses of approximately 11,000 couples. Interaction terms between 1) alcohol use on T1 and divorce between T1 and T2 (11 year time lag), and 2) alcohol use on T1 and time since divorce at T2 for all divorced couples were tested to examine changes in mental health between T1 and T2 for a) spouses of high-risk compared to low-risk users, and b) high-risk compared to low-risk users themselves. Data were analyzed using multivariate analysis of variance. Results There was a general effect of divorce on change in mental health between T1 and T2. We observed a significantly stronger worsening in mental health in female high-risk users and their spouses than in divorced low-risk users and their spouses. The results also suggest that the strain after divorce lasts longer in women with a high alcohol consumption and their spouses. Conclusions Divorce seems to affect couples where one or both drink heavily more than couples with a low consumption. Also there was some evidence of a slower healing of mental health problems after divorce in alcohol exposed couples than in other couples. The results only reached significance for female high consumers and their spouses, but due to limited statistical power, safe conclusions about gender specific effects cannot be drawn.
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Affiliation(s)
- Kamilla Rognmo
- Norwegian Institute of Public Health, Division of Mental Health, PO BOX 4404 NydalenN-0403, Oslo, Norway.
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Kreager DA, Felson RB, Warner C, Wenger MR. Women's Education, Marital Violence, and Divorce: A Social Exchange Perspective. JOURNAL OF MARRIAGE AND THE FAMILY 2013; 75:565-581. [PMID: 24357879 PMCID: PMC3864686 DOI: 10.1111/jomf.12018] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Drawing on social exchange theories, the authors hypothesized that educated women are more likely than uneducated women to leave violent marriages and suggested that this pattern offsets the negative education - divorce association commonly found in the United States. They tested these hypotheses using 2 waves of young adult data on 914 married women from the National Longitudinal Study of Adolescent Health. The evidence suggests that the negative relationship between women's education and divorce is weaker when marriages involve abuse than when they do not. The authors observed a similar pattern when they examined the association of women's proportional earnings and divorce, controlling for education. Supplementary analyses suggested that marital satisfaction explains some of the association among women's resources, victimization, and divorce but that marital violence continues to be a significant moderator of the education - divorce association. In sum, education appears to benefit women by both maintaining stable marriages and dissolving violent ones.
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Affiliation(s)
- Derek A Kreager
- Department of Sociology and Crime, Law, and Justice, Pennsylvania State University, 211 Oswald Tower, University Park, PA 16802 ( )
| | - Richard B Felson
- Department of Sociology and Crime, Law, and Justice, Pennsylvania State University, 211 Oswald Tower, University Park, PA 16802
| | - Cody Warner
- Department of Sociology and Crime, Law, and Justice, Pennsylvania State University, 211 Oswald Tower, University Park, PA 16802
| | - Marin R Wenger
- Department of Sociology and Crime, Law, and Justice, Pennsylvania State University, 211 Oswald Tower, University Park, PA 16802
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Rogers RG, Krueger PM, Miech R, Lawrence EM, Kemp R. NONDRINKER MORTALITY RISK IN THE UNITED STATES. POPULATION RESEARCH AND POLICY REVIEW 2013; 32:325-352. [PMID: 25045194 PMCID: PMC4100719 DOI: 10.1007/s11113-013-9268-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The literature has shown that people who do not drink alcohol are at greater risk for death than light to moderate drinkers, yet the reasons for this remain largely unexplained. We examine whether variation in people's reasons for nondrinking explains the increased mortality. Our data come from the 1988-2006 National Health Interview Survey Linked Mortality File (N= 41,076 individuals age 21 and above, of whom 10,421 died over the follow-up period). The results indicate that nondrinkers include several different groups that have unique mortality risks. Among abstainers and light drinkers the risk of mortality is the same as light drinkers for a subgroup who report that they do not drink because of their family upbringing, and moral/religious reasons. In contrast, the risk of mortality is higher than light drinkers for former drinkers who cite health problems or who report problematic drinking behaviors. Our findings address a notable gap in the literature and may inform social policies to reduce or prevent alcohol abuse, increase health, and lengthen life.
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Affiliation(s)
- Richard G. Rogers
- Department of Sociology and Population Program, IBS, University of Colorado Boulder
| | - Patrick M. Krueger
- Departments of Health and Behavioral Sciences and Sociology, University of Colorado Denver
| | - Richard Miech
- Department of Health and Behavioral Sciences, University of Colorado Denver
| | | | - Robert Kemp
- Department of Sociology and Population Program, IBS, University of Colorado Boulder
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Jager J, Schulenberg JE, O'Malley PM, Bachman JG. Historical variation in drug use trajectories across the transition to adulthood: the trend toward lower intercepts and steeper, ascending slopes. Dev Psychopathol 2013; 25:527-43. [PMID: 23627961 PMCID: PMC3641689 DOI: 10.1017/s0954579412001228] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study examines historical variation in individual trajectories of heavy drinking and marijuana use from age 18 to 22. Unlike most studies that have examined cohort differences in drug use, it focuses on differences in both level of use and rates of change (growth). Nearly 39,000 youths from the high school classes of 1976-2004 were surveyed at biennial intervals between the ages of 18 and 22 as part of the national Monitoring the Future study. Between 1976 and 2004, adolescent heavy drinking decreased substantially. However, because the age 18-22 heavy drinking growth rate increased threefold for males and sixfold for females during this period, heavy drinking among 21- to 22-year-olds remained largely stable. The growth rate for marijuana use was more stable across cohorts, and historical declines in use were sizable across the entire 18-22 age band. Generally, historical variation in use was unrelated to college status and living arrangements as well as to historical changes in the distribution of young adult social roles. Findings suggest that historical fluctuations in use were less the result of proximal young adult factors and more the result of historical variation in distal adolescent factors, the effect of which diminished with age, especially for heavy drinking.
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Affiliation(s)
- Justin Jager
- Eunice Kennedy Shriver National Institute for Child Health and Human Development, Bethesda, MD 20892, USA.
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Berg N, Kiviruusu O, Karvonen S, Kestilä L, Lintonen T, Rahkonen O, Huurre T. A 26-year follow-up study of heavy drinking trajectories from adolescence to mid-adulthood and adult disadvantage. Alcohol Alcohol 2013; 48:452-7. [PMID: 23531717 DOI: 10.1093/alcalc/agt026] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
AIMS The aim of the study was to identify heavy drinking trajectories from age 16 to 42 years and to examine their associations with health, social, employment and economic disadvantage in mid-adulthood. METHODS Finnish cohort study's participants who were 16 years old in 1983 were followed up at age 22, 32 and 42 (n = 1334). Heavy drinking was assessed at every study phase and based on these measurements trajectories of heavy drinking were identified. The trajectory groups were then examined as predictors of disadvantage at age 42. RESULTS Five distinct heavy drinking trajectories were identified: moderate (35%), steady low (22%), decreasing (9%), increasing (11%) and steady high (23%). Frequencies of the trajectory groups differed by gender. Using the moderate trajectory as a reference category, women in the steady high trajectory had an increased risk of experiencing almost all disadvantages at age 42. In men, increasing and steady high groups had an increased risk for experiencing health and economic disadvantage. CONCLUSION Steady high female drinkers and steady high and increasing male drinkers had the highest risk for disadvantage in mid-adulthood. By identifying heavy drinking trajectories from adolescence to mid-adulthood we can better predict long-term consequences of heavy alcohol use and plan prevention and intervention programmes.
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Affiliation(s)
- Noora Berg
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland.
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48
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Waldron M, Bucholz KK, Lynskey MT, Madden PAF, Heath AC. Alcoholism and timing of separation in parents: findings in a midwestern birth cohort. J Stud Alcohol Drugs 2013; 74:337-48. [PMID: 23384382 PMCID: PMC3568171 DOI: 10.15288/jsad.2013.74.337] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We examined history of alcoholism and occurrence and timing of separation in parents of a female twin cohort. METHOD Parental separation (never-together; never-married cohabitants who separated; married who separated) was predicted from maternal and paternal alcoholism in 326 African ancestry (AA) and 1,849 European/ other ancestry (EA) families. Broad (single-informant, reported in abstract) and narrow (self-report or two-informant) measures of alcoholism were compared. RESULTS Parental separation was more common in families with parental alcoholism: By the time twins were 18 years of age, parents had separated in only 24% of EA families in which neither parent was alcoholic, contrasted with 58% of families in which only the father was (father-only), 61% of families in which only the mother was (mother-only), and 75% in which both parents were alcoholic (two-parent); corresponding AA percentages were 59%, 71%, 82%, and 86%, respectively. Maternal alcoholism was more common in EA nevertogether couples (mother-only: odds ratio [OR] = 5.95; two parent: OR = 3.69). In ever-together couples, alcoholism in either parent predicted elevated risk of separation, with half of EA relationships ending in separation within 12 years of twins' birth for father-only families, 9 years for mother-only families, and 4 years for both parents alcoholic; corresponding median survival times for AA couples were 9, 4, and 2 years, respectively. EA maternal alcoholism was especially strongly associated with separation in the early postnatal years (mother-only: birth-5 years, hazard ratio [HR] = 4.43; 6 years on, HR = 2.52; two-parent: HRs = 5.76, 3.68, respectively). CONCLUSIONS Parental separation is a childhood environmental exposure that is more common in children of alcoholics, with timing of separation highly dependent on alcoholic parent gender.
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Affiliation(s)
- Mary Waldron
- School of Education, Indiana University, Bloomington, Indiana 47405, USA.
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49
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Torvik FA, Røysamb E, Gustavson K, Idstad M, Tambs K. Discordant and Concordant Alcohol Use in Spouses as Predictors of Marital Dissolution in the General Population: Results from the Hunt Study. Alcohol Clin Exp Res 2013; 37:877-84. [DOI: 10.1111/acer.12029] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Accepted: 09/18/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Fartein A. Torvik
- Division of Mental Health ; Norwegian Institute of Public Health; Oslo; Norway
| | | | - Kristin Gustavson
- Division of Mental Health ; Norwegian Institute of Public Health; Oslo; Norway
| | - Mariann Idstad
- Division of Mental Health ; Norwegian Institute of Public Health; Oslo; Norway
| | - Kristian Tambs
- Division of Mental Health ; Norwegian Institute of Public Health; Oslo; Norway
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50
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Horn EE, Xu Y, Beam CR, Turkheimer E, Emery RE. Accounting for the physical and mental health benefits of entry into marriage: a genetically informed study of selection and causation. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2013; 27:30-41. [PMID: 23088795 PMCID: PMC3645280 DOI: 10.1037/a0029803] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Married adults show better psychological adjustment and physical health than their separated/divorced or never-married counterparts. However, this apparent "marriage benefit" may be due to social selection, social causation, or both processes. Genetically informed research designs offer critical advantages for helping to disentangle selection from causation by controlling for measured and unmeasured genetic and shared environmental selection. Using young-adult twin and sibling pairs from the National Longitudinal Study of Adolescent Health (Harris, 2009), we conducted genetically informed analyses of the association between entry into marriage, cohabitation, or singlehood and multiple indices of psychological and physical health. The relation between physical health and marriage was completely explained by nonrandom selection. For internalizing behaviors, selection did not fully explain the benefits of marriage or cohabitation relative to being single, whereas for externalizing symptoms, marriage predicted benefits over cohabitation. The genetically informed approach provides perhaps the strongest nonexperimental evidence that these observed effects are causal.
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Affiliation(s)
- Erin E Horn
- Department of Psychology, University of Virginia, Charlottesville, VA 22904, USA.
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