Michie N. Hesselbrock

Gender comparison of antisocial personality disorder and depression in alcoholism.

This study compared male and female alcoholics in terms of family history of alcoholism, Antisocial Personality (ASP), and depression on the course, consequences, and 1-year treatment outcome. The sample included 266 subjects (197 men and 69 women) who were hospitalized for treatment of alcoholism from three facilities in the greater Hartford area. Female alcoholics reported higher rates of alcoholism among their fathers than men across all diagnostic categories. Both male and female alcoholics who were diagnosed as having ASP reported higher alcoholism among their fathers than those with depression or no other diagnoses. Male alcoholics reported a longer duration of alcohol abuse and a higher number of lifetime alcohol-related problems than women. Subjects with ASP reported more childhood behavior problems, higher levels of alcohol consumption, and more affective and physical disturbances in the month prior to hospitalization whereas no gender differences were found on those variables. ASP alcoholics reported poorer 1-year treatment outcomes than non-ASP alcoholics. Males who were diagnosed as having depression tended to relapse, although the diagnosis of depression tended to modify the rate of relapse among women. The rate of depression was higher among women than men at the 1-year follow-up.

Antisocial Behavior, Psychopathology and Problem Drinking in the Natural History of Alcoholism

It is well known that alcoholism often occurs in persons having an antisocial personality. Conversely, the behavior of persons with alcoholism often appears to be antisocial in nature. Thus, the differentiation of alcoholism from antisocial personality can be quite difficult and lead to diagnostic confusion [27]. While these two disorders are similar in some respects, and may sometimes occur together, their natural histories probably differ.

Development and vulnerability factors in adolescent alcohol use.

This article provides an overview of the characteristics of adolescent alcohol use, normative and subgroup variations in drinking behavior, and the important factors associated with an increased risk for developing alcohol problems in later adolescence and young adulthood. Parental or family histories of alcoholism, temperament traits, conduct problems, cognitive functioning, alcohol expectancies, and peer and other social relations are identified as factors influencing an adolescents susceptibility for initiating a variety of alcohol use behaviors. The deviance prone model, proposed by Sher in 1991, is presented as an important tool for testing possible relationships among the various risk factors and their sequencing that leads to early adolescent alcohol use and drug initiation. It is also possible to extend the model to allow for an examination of the complex interplay of risk factors that lead to the development of alcohol use problems in late adolescence and young adults.

Ethnicity and Psychiatric Comorbidity Among Alcohol-Dependent Persons Who Receive Inpatient Treatment: African Americans, Alaska Natives, Caucasians, and Hispanics

This study examined ethnic and gender differences of psychiatric comorbidity among alcohol dependent men and women from four ethnic groups: Alaska Native, Caucasians, African Americans, and Hispanics. The data were obtained through individual standardized interview; DSM-III-R diagnoses were obtained via a computer algorithm. The subjects included 1177 Caucasians, 361 African Americans, 93 Hispanics and 486 Alaska Natives. Significant ethnic differences were found in relation to age of onset of alcohol and multiple substance dependence and psychiatric comorbidity. Ethnic differences were also noted with regard to the health care utilization.

The nature of alcoholism in patients with different family histories for alcoholism

1. The course and consequences of alcohol abuse were examined in male and female patients being treated for alcoholism. 2. Demographic characteristics, family history for alcoholism, psychopathology, drinking history and social and physical consequences of alcohol abuse were assessed. 3. Probands with alcoholism on both the maternal and paternal sides of their pedigree experience greater psychosocial and physical consequences of alcohol abuse than other alcoholic patients. 4. Sex of the proband and type of family pedigree for alcoholism were found not to be interactive but to contribute separate additive effects.

Minimal Brain Dysfunction and Neuropsychological Test Performance in Offspring of Alcoholics

Previous studies have indicated that alcoholics report a high frequency of problem behaviors in childhood. Additionally, certain neuropsychological deficits are often evident. Both childhood problem behavior and antecedent neuropsychological deficits have been suggested as risk factors for the later development of alcoholism. However, neither set of variables nor their interrelationship have been previously investigated in a sample at high risk for the development of alcoholism. In this study, unaffected offspring of an alcoholic parent and unaffected offspring of nonalcoholic parents were examined. Although attention deficit disorder/hyperactivity and conduct disorder prior to age twelve predicted the onset of drinking, the frequency of childhood behaviors was similar in both groups. Further, the neuropsychological performances of the high-risk and low-risk samples were also similar and within normal limits. The theoretical and methodological implications of these findings for future research are discussed.

Polygenic Risk for Externalizing Disorders Gene-by-Development and Gene-by-Environment Effects in Adolescents and Young Adults

In this project, we aimed to bring large-scale gene-identification findings into a developmental psychopathology framework. Using a family-based sample, we tested whether polygenic scores for externalizing disorders—based on single nucleotide polymorphism weights derived from genome-wide association study results in adults (n = 1,249)—predicted externalizing disorders, subclinical externalizing behavior, and impulsivity-related traits among adolescents (n = 248) and young adults (n = 207) and whether parenting and peer factors in adolescence moderated polygenic risk to predict externalizing disorders. Polygenic scores predicted externalizing disorders in adolescents and young adults, even after we controlled for parental externalizing-disorder history. Polygenic scores also predicted subclinical externalizing behavior and impulsivity traits in the adolescents and young adults. Adolescent parental monitoring and peer substance use moderated polygenic scores to predict externalizing disorders. This illustrates how state-of-the-science genetics can be integrated with psychological science to identify how genetic risk contributes to the development of psychopathology.

Alcohol problems in young adults transitioning from adolescence to adulthood: The association with race and gender

Race and gender may be important considerations for recognizing alcohol related problems in Black and White young adults. This study examined the prevalence and age of onset of individual alcohol problems and alcohol problem severity across race and gender subgroups from a longitudinal study of a community sample of adolescents followed into young adulthood (N=166; 23-29 yrs. old who were drinkers). All alcohol problems examined first occurred when subjects were in their late teens and early 20s. Drinking in hazardous situations, blackouts, and tolerance were the most common reported alcohol problems. In race and gender comparisons, more males than females experienced alcohol problems. Blacks generally had a later age of onset of alcohol problems. Multivariate regressions showed greater alcohol problem severity in males compared to females, but no significant differences between Blacks and Whites. Education, family environment and earlier alcohol use behaviors and expectancies were reliable predictors of alcohol problem severity in young adulthood. White males were at particular risk for experiencing more severe alcohol problems. Findings may inform the design of more targeted interventions for alcohol problems in different populations.

Sex differences in how a low sensitivity to alcohol relates to later heavy drinking

INTRODUCTION AND AIMS A low level of response (LR), or low sensitivity, to alcohol is a genetically influenced characteristic that predicts future heavy drinking and alcohol problems. While previous analyses of how LR relates to heavier drinking reported the process is similar in males and females, some potential sex differences have been identified. This difference is further explored in these analyses. DESIGN AND METHODS Prospective structural equation models (SEMs) were evaluated for 183 young adult females and 162 males, none of Asian background, from the Collaborative Study on the Genetics of Alcoholism. Invariance analyses and SEM evaluations by sex were used to compare across females and males for these primarily Caucasian (75%), non-Asian young (mean age 19) subjects. RESULTS The prospective SEM for the full set of 345 subjects had good fit characteristics and explained 37% of the variance. While the initial invariance analyses identified few sex differences, comparisons of correlations and direct evaluations of path coefficients across males and females indicated that only females showed a link between a low LR and future alcohol problems that was partially mediated by more positive alcohol expectancies and drinking to cope. These sex differences were reflected in the different structures of the SEM results for female versus male subjects. DISCUSSION AND CONCLUSIONS These prospective results indicate that there might be some important sex differences regarding how a lower LR relates to alcohol outcomes that should be considered in protocols focusing on preventing the impact of LR on future drinking problems.

Multiple Substance Dependence and Course of Alcoholism among Alaska Native Men and Women

Alcohol dependence among Native Americans and Alaska Natives is twice that found in the general population. Alaska Natives are 7 times more likely to die of alcohol-related problems. This study investigated differences in the course and consequences of alcoholism and co-occurring polysubstance dependence in a sample of 582 alcohol-dependent Alaska Natives undergoing inpatient lifetime treatment in Anchorage between 1994 and 1999. Mean age was 33.9 years. Information on lifetime psychiatric symptoms and disorders was collected by using the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA), a research diagnostic interview. Results indicate that in addition to alcohol dependence, the majority of subjects were dependent on other substances. Marijuana dependence was most common, followed by dependence on cocaine and opiates. Compared with subjects not dependent on any other drugs, subjects with co-occurring alcohol and opiate dependence showed significant differences in relation to age of first regular drink, intoxication, tolerance and withdrawal symptoms, number of medical problems, and number of psychological problems. More research and specific clinical interventions are needed for alcohol- and opiate-dependent Alaska Natives. Findings indicate the need for prevention and interventions in alcohol and illicit drug abuse in this population at an early age.