摘要:

Alcohol use and related problems were studied from the senior year in high school to the first autumn in college for 366 heavy drinking students. Four risk factors‐subject sex, family history of drinking problems, prior conduct problems, and type of college residence‐were evaluated as predictors of: (1) differential changes in drinking rates, (2) differential changes in alcohol‐related problems, and (3) alcohol dependence symptoms during the first college term. Results suggest that both dispositional and environmental factors are associated with changes in drinking rates and the existence of dependence symptoms. Increases in the frequency of drinking were specifically and strongly associated with residence in a fraternity (men) or sorority (women). Three risk factors were associated with increased quantity of drinking: male gender, residence in a fraternity or sorority, and a history of conduct problems. Prior conduct problems were also consistently associated with dependence symptoms during the first term in college. A family history of alcohol problems was not consistently related to changes in use rates or problems, although some analyses suggest interactive effects. Early interventions on college campuses should target individuals using additive risk pro

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1995.tb01472.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Moderate alcohol intakes decreases the risk of gallstones; in contrast, the prevalence of gallstones is increased in patients with alcoholic cirrhosis. The aims of this prospective study were to assess the prevalence of cholethiasis among drinkers according to the histological severity of liver disease, and to estimate the importance of serum apolipoproteins AI and apolipoprotein All as risk factors for gallstones. Among the 320 drinkers included, 53 patients had cholelithiasis. The prevalence increased (p<0,0001) from 5% in patients with normal liver (1 of 22) and 6% in patients with steatosis only (3 of 47) to 13% in patients with fibrosis (7 of 54), reaching 27% among patients with biopsy‐proven cirrhosis (28 of 103). Among patients with clinically obvious cirrhosis on whom biopsy was not performed mainly because of the severity of liver disease, the prevalence of cholelithiasis reached a maximum of 46% (6 of 13).Among drinkers with nonsevere liver disease, patients with cholelithiasis were older (59 ± 9 years, mean ± SD vs. 45 ± 11,p= 0.003) with lower apolipoprotein AI (118 ± 37 vs. 163 ± 45mg/dl;p= 0.002) and apolipoprotein All (30 ± 12 vs. 53 ± 20 mg/dl;p= 0.0002) in comparison with patients without cholelithiasis. These differences persisted after considering by multiple logistic regression analysis, sex, and ideal body weight. Alcohol consumption during the last 5 years was lower in patients with cholelithiasis (83 g/day) in comparison with patients without cholelithiasis (142 g/day;p= 0.04).Among drinkers with severe liver disease, patients with cholelithiasis were slightly older (56 ± 13 vs. 52 ± 12 years;p= 0.07) and were more often female (46% vs. 29%;p= 0.06). Unconjugated serum bilirubin was also slightly higher (30 ± 43 vs. 19 ± 40 μmol/liter;p= 0.08).In conclusion, alcohol intake could protect drinkers against cholesterol gallstones as long as apolipoprotein Al and apolipoprotein All secretions are increased. In contrast, heavy ethanol‐induced fibrosis in the liver results in decreased apolipoprotein Al and apolipoprotein All secretions and thus, may promote the occurrence of cholesterol gallstones. These relationships could explain the paradox of decrease gallstones prevalence among moderate drinkers and the high prevalence among alcoh

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1995.tb01473.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

An epidemiological study of alcohol use disorders was conducted on population samples from four aboriginal groups in Taiwan (a total of 993 subjects). The survey involved ethnographic observation and a semistructured psychiatric interview. The interview covered a detailed symptom profile that allowed diagnoses to be made according to different diagnostic criteria. The lifetime prevalences of alcoholism according to the ICD‐10 (research criteria) and the DSM‐III‐R criteria were found to be 42.2–54.7% and 44.2–55.5%, respectively, much higher than the rates found in an earlier study (0.11–0.16%) conducted 40 years ago. Men in all groups were found to have higher prevalences, a lower mean age at onset, and a longer mean duration (except in one group) of alcoholism than women. Differences in the distribution of sociodemographic correlates (age, sex, marital status, education, and ethnicity) of ICD‐10 harmful use of alcohol and alcohol dependence were examined by case‐control analysis with logistic regression. The lifetime prevalences of alcohol use disorders were higher than in recent epidemiological surveys conducted elsewhere. Possible biological and sociocultural explanations for the high prevalence of alcoholism among the study population

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1995.tb01474.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

It has been suggested that a crucial dimension of alcohol “craving” includes the concept of both obsessive thoughts about alcohol use and compulsive behaviors toward drinking. An interview‐based rating scale, the Yale‐Brown Obsessive Compulsive Scale‐heavy drinkers (YBOCS‐hd), has been found useful in quantifying this concept in alcohol‐dependent individuals. A self‐rating scale, the Obsessive Compulsive Drinking Scale (OCDS) has been developed by us as a modification of the YBOCS‐hd. The YBOCS‐hd showed excellent interrater reliability in our hands. The correlation between the YBOCS‐hd and the OCDS total scores obtained on 60 alcohol‐dependent individuals was 0.83. The test‐retest correlation for the OCDS total score was 0.96, and the obsessive and compulsive sub‐scales test‐retest correlations were 0.94 and 0.86, respectively. The internal consistency of the items in the OCDS was high (0.86) and did not improve significantly with removal of individual items. The shared variance between the OCDS scores and alcohol consumption during the period of evaluation was only = 20%, indicating that the dimension measured by the scale was somewhat independent of actual drinking. As such, it might act as an independent measure of the “state of illness” for alcohol‐dependent individuals.When used during a prospective 12‐week treatment research study, initial results indicate that the OCDS seems to validly measure a dimension of alcohol dependence, because it decreased from baseline during alcohol reduction and increased in relationship to relapse drinking. The ease of administration (5 min), reliability, and concurrent validity of the OCDS makes it particularly suitable as a screening and outcome measurement tool for various types of clin

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1995.tb01475.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Female college students (n= 49) from a small southwestern United States university participated in the 9‐month study. Data collected included the assessment of drinking habits and other related substance use habits and serum levels of carbohydrate‐deficient transferrin (COT). Each subject provided an interview and blood sample on three occasions at 90‐day intervals. Appended to the interview were a series of questions regarding stage of menstrual cycle and the diagnoses of certain diseases. The CDT values obtained were consistent with those obtained in other studies. Moderate‐drinking subjects had significantly higher CDT values than did the abstainers and light drinkers. Females using oral contraceptives had significantly higher CDT values than those who were not taking oral contraceptives. Finally, although CDT values varied over time, they did not appear to vary as a function of menstrual cycl

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1995.tb01476.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1995.tb01477.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Magnetic resonance imaging was used to quantify the volume of the hippocampus in 47 men with chronic alcoholism and 72 healthy male control subjects. The subjects ranged in age from 21 to 70 years, thus permitting a test of whether older alcoholics suffer greater brain tissue volume reduction than do younger ones. Comparison brain regions included temporal lobe gray matter, white matter, and cerebrospinal fluid, as well as measures of the lateral ventricles, third ventricle, and temporal horns. The results of this cross‐sectional study showed that the anterior, but not the posterior, portions of the hippocampus in both hemispheres were significantly smaller in the alcoholic than the healthy control group. Furthermore, the bilateral anterior hippocampal volume loss was greater in older than younger alcoholics. Despite the hippocampal volume deficit, these alcoholics did not demonstrate an explicit memory impairment; furthermore, memory test scores did not correlate significantly with hippocampal volumes. In the alcoholics, the age‐related volume loss, which was over and above that expected in normal aging, was also evident in the temporal cortex and white matter. Likewise, alcoholic ventricular enlargement was age‐related. Analysis of covariance revealed that the anterior hippocampal deficit persisted after accounting for the temporal lobe gray matter volume deficit. Multiple regression analysis revealed that the age‐related brain volume abnormalities observed in the alcoholics could not be attributed to duration of alcoholism or total lifetime consumption of

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1995.tb01478.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The objective of this study was to determine the relations between the hallmark circulatory finding of decompensated cirrhosis, a reduced systemic vascular resistance (SVR), and the indices of hepatic decompensation, the accumulation of ascites, and the concentrations of various vasoactive substances.At a university‐affiliated teaching hospital, eighteen hospitalized patients with cirrhosis and 18 age‐ and sex‐matched healthy subjects were used. This was a case‐control study.Measurements included cardiac dimensions and indices derived from echocardiograms and Doppler studies, abdominal ultrasound estimates of ascites, indices of hepatic function, and various serum (S) and urinary (U) substances.Results showed that cirrhotics had increased left atrial and left ventricular dimensions, left ventricular mass, heart rate, cardiac output (CO), transvalvular velocities, and a decreased SVR. SVR was related to hepatic dysfunction, as reflected by an abnormal prothrombin time ratio (r= ‐0.64,p= 0.006), and also related to overall severity of liver disease as estimated by the Child‐Pugh score (r= ‐0.53, p = 0.044). Although cirrhotics with ascites generally had a reduced SVR, estimates of ascites were directly related to SVR (r = 0.57, p = 0.03) and inversely related to CO (r= ‐0.53,p= 0.04). Concentrations of S and U digoxin‐like immunoreactive substance (DLIS) were also increased, but the concentrations of S glucagon and estradiol were not elevated. The accumulations of S and U DLIS, S glucagon, and S estradiol were all related to hepatic dysfunction. S estradiol was also related to SVR (r =‐0.55,p= 0.04), but this was only evident with S estradiol expressed as a logarithm and did not emerge as significant on a multivariate analysis.The reduced SVR observed in decompensated cirrhosis is related to various indices of hepatic dysfunction. Certain substances that accumulate in cirrhosis (such as DLIS, glucagon, and estradiol) do not explain the vasodilatation observed. Although ascites in decompensated cirrhosis generally signifies a vasodilated state, a reduced SVR may be found even before ascites is clinically evident, and tense ascites may actually o

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1995.tb01479.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

This study tested the combined predictive ability of blood alcohol concentration (BAC), subjective intoxication, and aggressive personality traits on physical aggression in males and females in Highland Low‐provocation conditions. Sixty intoxicated White social drinkers (30 males and 30 females) competed against a fictitious opponent on a modified version of the Taylor aggression paradigm in which subjects both received and delivered electric shocks to their opponents in provoking and nonprovoking conditions. Provocation conditions (High and Low) were defined by the intensity of the shocks the subjects received. Aggression was operationalized as the intensity of the shocks selected by the subjects. Results indicated that, for males in the High‐provocation condition, aggressive personality traits, subjective intoxication, and BAC were effective predictors of physical aggression. However, in the Low‐provocation condition, only aggressive personality traits and BAC predicted aggression. None of the variables were effective predictors of aggression for intoxicated fe

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1995.tb01480.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Studies with animal models of alcohol‐related birth defects (ARBDs) suggest that reductions in circulating thyroid hormones, including thyroxine (T4), may be a persistent postnatal effect of fetal alcohol exposure. The few clinical reports of children with fetal alcohol syndrome (FAS) that address thyroid system function generally reported that FAS children have thyroid hormone levels within normal limits. For the current study, data bases from the Fetal Alcohol Research Center and the Michigan Department of Public Health Newborn Screening Program were assessed to correlate measures of maternal drug use during pregnancy and infant outcome (gestational age at birth, birthweight, “fetal growth”), with infant whole‐blood T4levels. Multiple regression analyses accounted for demographic factors, infant age at testing, and variation in the T4assay. As expected, alcohol intake and smoking each had a substantial negative impact on birthweight, gestational age at birth, and fetal growth, assessed as birthweight corrected for gestational age. Infant T4levels were positively related to birthweight and gestational age and were more strongly related to fetal growth. Infant T4levels were not influenced significantly by either maternal smoking or alcohol consumption. Smoking‐ and alcohol‐related reductions in birthweight, gestational age, or fetal growth were not associated significantly with variations in infant T4. Interesting questions remain regarding species differences and the influences of maternal alcohol consumption on T4metabolism as a mechanism for ARBDs. However, the current data do not support the hypothesis that maternal alcohol consumption, or smoking, during pregnancy leads to compromised thyroid system function in newborn humans. Therefore, newborn screens for T4are not likely to be effective in helping to detect infants with A

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1995.tb01481.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY