Barbara W. Lex

Panel III: Behavioral risk factors related to chronic diseases in ethnic minorities.

This article reviews the evidence on 5 risk behaviors: cigarette smoking, dietary intake, being overweight, limited exercise, and alcohol consumption among African Americans, Asian/Pacific Islanders, Latinos, and Native Americans. Although there is little basis for believing that these high-risk behaviors are any less significant as contributors to chronic disease risk in any ethnic group, the limited information available, especially for Asian/Pacific Islanders and Native Americans, indicates that there may be significant within- and between-group differences in the prevalence of these behaviors. Therefore, some of the ethnic group differences in morbidity and mortality for chronic diseases are partly attributable to differences in behavioral risk profiles. Limited basic health behavior information on most ethnic minority groups delay the development of effective health promotion interventions.

Alcohol use and premenstrual symptoms in social drinkers

The relationship between premenstrual dysphoria and alcohol acquisition and use patterns was studied in 14 women over 35 days on a clinical research ward. A 7-day drug-free baseline was followed by 21 days of alcohol availability and a post-alcohol drug-free period of 7 days. Women could earn alcohol or 50 cents for 30 min of performance on a simple operant task. The Premenstrual Assessment Form (PAF) was administered during baseline and at the premenstruum. Menstrual cycle phase was associated with changes in alcohol use by 8 of the 14 women. Five women drank more during the premenstruum and scored higher on 12 of 18 PAF factors than women whose drinking remained the same (N=6) or decreased (N=3). Women who increased drinking had significantly higher PAF scores on impaired social functioning, hostility/anger and hysteroid features (P<0.05, 0.01). Women who drank less during the premenstruum reported more pain and physical discomfort, whereas women who drank about the same amount were relatively asymptomatic. PAF profiles reported at the premenstruum and baseline PAF profiles based on recall of the preceding three menstrual cycles were concordant in 13 of the 14 women (P<0.001–0.0001). These data suggest that womens perceptions of premenstrual symptomatology are stable through time.

Prolactin and cortisol levels following acute alcohol challenges in women with and without a family history of alcoholism.

In a pilot study 5 matched pairs of female social drinkers received both 0.56 g/kg alcohol and placebo in a double-blind crossover design. Family history positive (FHP) women had biological fathers who met criteria for alcohol dependence, and FHN women had no relatives who met these criteria. FHP and FHN women had BALs about 70 mg/dl 60 min after alcohol. FHP subjects had significantly lower prolactin levels 40, 60 and 80 min following alcohol, but higher cortisol levels 130 and 150 min following alcohol. No significant differences in hormone levels occurred after placebo.

Effects of acute marijuana smoking on pulse rate and mood states in women.

The effects of marijuana cigarette (1.8% THC) smoking on pulse rate and mood were studied under double-blind placebo-controlled conditions in 28 adult female volunteers during the follicular, luteal, and ovulatory phases of the menstrual cycle. Statistically significant increases in pulse rate, subjective levels of intoxication, and the POMS confusion factor occurred after marijuana smoking. However, no statistically significant differences for any measure were observed following marijuana smoking as a function of menstrual cycle phase. Subjects with a past history of intermittent marijuana use (five or less times weekly) had significantly higher pulse rates, subjective levels of intoxication, and POMS confusion factor scores than did subjects with a past history of regular (six or more times weekly) marijuana use. Persistence of marijuana-induced changes in pulse rate, intoxication, and confusion were also of longer duration for subjects with a past history of intermittent marijuana smoking. The influence of past history of marijuana use on marijuana-induced alterations in pulse rate, intoxication, and mood for females appears to be similar to males. These similarities are not attenuated as a function of the menstrualcycle phase of females.

Divided attention task performance and subjective effects following alcohol and placebo: differences between women with and without a family history of alcoholism

Women with (FHP) and without (FHN) family histories of alcoholism received either 0.56 g/kg alcohol or an isocaloric placebo in a repeated measures group design. Subjects performed a divided attention task and gave subjective ratings of 12 alcohol effects over a 3-h interval. After comparable doses of alcohol, 7 FHP and 10 FHN women had comparable ascending (blood alcohol levels) BALs. BALs peaked earlier for FHP women and then steadily declined. FHP women had a concomitant increase in visual search response times 30 min after alcohol. In contrast, scores on a simultaneously presented compensatory tracking task were virtually identical for the 7 FHP and 10 FHN women after alcohol and for the 8 FHP and 10 FHN women after placebo. After alcohol the FHP and FHN women had 7 out of 12 significantly different subjective ratings of alcohol responses. FHP women had lower subjective responses to alcohol and lower BALs, but their subjective responses were more strongly correlated with BALs. Our findings for women studied in a group design confirm the lower magnitude of subjective responses reported for pair-matched FHP men following comparable doses of alcohol in within-subjects and between-subjects designs in other laboratories.

Marihuana use across the menstrual cycle

Thirty women completed marihuana use diaries and Form T of the Moos Menstrual Distress Questionnaire (MDQ) every day for three consecutive menstrual cycles. A 99.1% response rate was obtained: 2715 of a possible 2741 diaries were returned. Women reported smoking an average of 1.4 (+/- 2.0) marihuana cigarettes per day (range for individuals: 7.3 [+/- 3.8] to 0.2 [+/- 0.4]). There was no significant covariance between daily marihuana smoking and menstrual cycle phase. The psychological MDQ factors reflecting negative affect, difficulty in concentration, behavior change and arousal also did not vary with menstrual cycle phase. The physiological MDQ factors of pain, autonomic reactions and water retention were significantly increased during the premenstrual and/or menstrual phases of the cycle. MDQ scores during the premenstruum and menstruation were generally very low. These data indicate that in the absence of severe premenstrual dysphoria, changes in drug use are not systematically related to phase of the menstrual cycle.

Alcohol, Marijuana, and Mood States in Young Women

Potential predictors of 8 Profile of Mood States (POMS) factor scores were examined for 30 young women (mean age = 26.4 years). Prospective data were obtained from diary questionnaires and POMS ratings submitted daily during 3 consecutive menstrual cycles. Behavioral and social variables (heavy versus light marijuana smoking, consumption of both marijuana and alcohol on a given day, stress, and sexual activity) were stronger mood factor predictors than temporal or biological variables (weekends or menstrual cycle phase). Heavy marijuana users consistently reported higher negative moods and lower positive moods than light marijuana users.

A microanalysis of ethanol-induced disruption of body sway and psychomotor performance in women.

Measures of body sway, psychomotor performance and subjective reports of intoxication were obtained from 20 women after consuming either ethanol (0.56 g/kg) or placebo. Simple motor tasks were unaffected by the relatively low ethanol dose. Performance on the Digit Symbol Substitution Test (DSST) was affected only during the ascending portion of the blood ethanol curve while stance stability was disrupted during peak and descending blood ethanol levels. A microanalysis of the dynamic changes of ethanol-induced body sway was conducted and the results plotted in three-dimensional space. These data revealed that disruption of stance stability was more pronounced in the sagittal plane than in the lateral plane and that subjects swayed to the rear and the right side. The results of this study suggest that such data analysis techniques provide extremely sensitive measures of body sway resulting from consuming a moderate dose of ethanol.

Platelet Adenylate Cyclase and Monoamine Oxidase in Women with Alcoholism or a Family History of Alcoholism

&NA; Purpose. Characteristic changes of platelet membrane monoamine oxidase and adenylate cyclase activities have been described in men with alcoholism. We studied the occurrence of these changes in abstinent alcoholic women and in nonalcoholic female control subjects with and without family histories of alcoholism. Methods. Blood samples were collected from 23 female alcoholics and 39 nonalcoholic female social drinkers. Platelet membrane assays were performed for monoamine oxidase and adenylate cyclase activities. Results. Alcoholic women had lower basal adenylate cyclase (p < 0.01) and adenylate cyclase activities stimulated by cesium fluoride (p < 0.001), by the guanine nucleotide analog 5‐guanylylimidodiphosphate (p < 0.02), and by prostaglandin E1 (p < 0.01). Female control subjects with family histories of alcoholism also had lower basal adenylate cyclase (p < 0.01) and adenylate cyclase activities enhanced by incubation with cesium fluoride (p < 0.005) and 5′‐guanylylimidodiphosphate (p < 0.001). Monoamine oxidase activity levels measured with (p < 0.001) and without ethanol (p < 0.01) were higher for alcoholic women. No significant differences were found between female control subjects with and without family histories of alcoholism for monoamine oxidase in the absence or presence of ethanol. Discussion. In vitro platelet adenylate cyclase activity may facilitate a diagnosis of alcoholism in women and may be a biologic indicator of vulnerability in the offspring of alcoholics.

Putative type II alcoholism characteristics in female third DUI offenders in Massachusetts: a pilot study.

Women who come to the attention of the courts may exhibit heritable Type II alcoholism. Accumulating evidence indicates that more women report having alcoholic parents, that onset of womens alcohol problems before age 25 predicts greater severity of alcohol problems, that women most frequently acknowledge driving while intoxicated (DUI) as an alcohol-related problem, and that the percent of female arrests for DUI has increased. Alcoholic men have been classified as Type I (onset after age 25 and environmentally influenced) or Type II (onset before age 25 with impulsivity and criminal activity) alcoholics. Alcoholism in daughters of Type I fathers is said to occur after age 25 and to be shaped by environmental conditions, but it has been argued that daughters of Type II alcoholic fathers express their family histories in somatization. We report results from a pilot study that found putative Type II alcoholism characteristics, including early age of onset and inability to curtail drinking, in a sample of 12 incarcerated female third DUI offenders.