Solitary drinking: a risk factor for alcohol-related problems?

This paper investigates whether solitary drinking is a risk factor for alcohol-related problems using data from a general population of drinkers in Montre 'al, Canada. Three indicators of solitary drinking were used: (1) having had a drink alone; (2) frequency of solitary drinking; and (3) having had five drinks or more in a solitary setting. Among the 2015 respondent drinkers of a telephone survey, 31% reported drinking alone, of whom 27% did so more than once a week, and 17% had had five drinks or more alone at least once. Problems with family or social relationships, physical health, work, budget, physical security and happiness or view of life, self-reported as being alcohol-related, were measured by seven binary items. Strong positive associations were found at the univariate level between overall alcohol-related problems and both solitary drinking and having had five or more drinks alone, whereas frequency of solitary drinking had no effect. Only the relationship with having five or more drinks alone remained statistically significant in logistic regressions controlling for potential confounders. No evidence was found that solitary drinking per se is a risk factor for alcohol-related problems unless large quantities of alcohol are involved.     

The alcohol-related problems survey: identifying hazardous and harmful drinking in older primary care patients

OBJECTIVES: Older adults can incur problems at low levels of alcohol consumption because of age-related physiological changes, declining health and functional status, and medication use. We have developed and tested a screening measure specifically for older people, the Alcohol-Related Problems Survey (ARPS), to identify older adults with these risks. DESIGN: Survey. SETTING: Academic and community primary care clinics. PARTICIPANTS: Five hundred forty-nine current drinkers aged 65 and older, mostly white with high school or more education. MEASURES: Alcohol use was classified as harmful, hazardous, or nonhazardous depending upon consumption alone or combined with selected comorbidities and medication use. Harmful drinking (including alcohol abuse or dependence) means the presence of problems (e.g., hypertension, adverse drug events, legal problems) due to drinking. Hazardous drinking means risks for problems are likely. Nonhazardous drinking poses no known risks for problems. RESULTS: Eleven percent of subjects were harmful drinkers and 35% were hazardous drinkers. Harmful drinking was more common in men than women and in persons younger than 75 than those aged 75 and older. Similar proportions of men and women and younger and older age groups were hazardous drinkers. Most harmful drinkers were identified by their use of alcohol with their comorbidity, whereas most hazardous drinkers were identified by their use of alcohol with medications. Test-retest reliability was substantial (kappa = 0.65). CONCLUSION: Physicians are urged to screen for alcohol-related problems in older persons. The ARPS reliably identifies harmful, hazardous, and nonhazardous drinking in older adults resulting most often from the interaction between alcohol and disease and medication use.     

The roles of alcohol-related self-statements in social drinking

Recent literature showed that expectancies or cognitions have been proposed as a major factor in influencing the amount of alcohol an individual consumes and the behavioral consequences following consumption. However, how alcohol expectancies influence alcohol consumption is unclear; this paper reports two studies of the relationship. Study I examined the relationship between alcohol consumption and alcohol-related positive and negative self-statements in 110 social drinkers. The results showed that, in a nondrinking situation, the alcohol expectancies and variables measuring consumption and alcohol-related problems were correlated. Also, subjects who perceived their "alcoholic sets" as negative consumed more than those who perceived theirs as positive. Study II investigated changes in self-statement responding in 8 light and 8 heavy drinkers in a "normal" pub drinking situation. The results showed that alcohol-dependent self-statements in the light drinkers were relatively stable across time and between drinking and nondrinking environments. However, the alcohol-dependent self-statements of heavy drinkers became more negative during the drinking session. Furthermore, the degree and nature of such changes appeared to be related to alcohol-associated problems and consumption.     

The Japanese society of alcohol-related problems

This paper presents an outline of the Japanese Society of Alcohol-Related Problems. The precursor of the Society was the Japan Alcoholism Treatment Research Group, inaugurated in 1979, by merging two local research groups in the Tokyo and Osaka areas, both of which were exclusive gatherings of psychiatrists associated with alcoholism clinics. The Research Group developed into the Society in 1992, as the number of participants including those from other medical professions increased yearly, and the subjects of the group widened to include all addictive behaviours. In reflecting the process of establishment, it is unique in many aspects as a scientific society. The Society is not a science-orientated body for presentation of new research findings. The main programme of the annual meeting is therefore a set of symposia in which members participate and discuss clinical and/or social problems arising from dependency on alcohol or drugs. Perhaps because of its content, the annual meeting is attended each year by the largest number of participants among all the societies in Japan concerned with alcohol and drugs. For the next several years, the Society's activities will be directed at (1) establishment of guidelines for early identification of and intervention in alcohol-related problems; (2) expansion of its membership to include those in related fields of medicine and non-medical professions; (3) improvement of the system of journal publication; and (4) creation of a system for timely adequate response to social problems associated with drugs and alcohol.     

Preventive strategies for alcohol-related problems

Preventive strategies for alcohol-related problems need to be in keeping with their socio-political context. Prohibition is inappropriate except where it has widespread support within the culture. Preventive strategies focus on the population and/or high risk groups and behaviours. Primary prevention can be achieved by control policies, education and provision of alternatives. Fiscal measures are of proven value. Legislative approaches influence availability and context of drinking, such as drinking and driving. Advertising control, server training and server liability are further approaches. Encouraging the provision of alternative beverages and promoting alcohol-free environments is a further approach which should be seen as pan of an integrated community response. Secondary prevention linked with early recognition of hazardous drinking at primary level is of known efficacy and would form part of a coordinated strategy.     

Alcohol consumption and alcohol-related problems: Chinese experience from six area samples, 1994

Aims. To understand the drinking frequency, mean yearly volume of consumption and drinking-related problems in individuals living in six areas in China. Design and measurements. By two-stage sampling, 23 513 community household residents (15-65 years old) were assessed with data collected by trained psychiatrists using structured questionnaires and DSM-III-R criteria. Findings. The male, female and total drinking rates were 84.1%, 29.3% and 59.5%, respectively. More than half of male drinkers and 90.0% of female drinkers used alcohol once a week or less. More than 16.1% of male drinkers and 2.5% of female drinkers drank once a day or more. The males reported a greater amount of alcohol consumed per session. The mean yearly volume of consumption of pure alcohol per year for all sample was 3.60 l; males consumed 18.6 times more alcohol than females. The rate of alcohol-related problems was higher in males than females. The male, female and total alcohol dependence point prevalence rates were 6.632%, 0.104% and 3.428%, respectively. Six-month incidence rates of acute intoxication were 5.162%, 0.017% and 2.637%, respectively. Conclusion. Drinking problems in China will continue to be a public health problem in the next century.     

The importance of drinking frequency in evaluating individuals' drinking patterns: implications for the development of national drinking guidelines

Aims   This paper examines the relationship between frequency of drinking, usual daily consumption and frequency of binge drinking, taking into consideration possible age and gender differences.
Participants and design   Subjects were 10 466 current drinkers (5743 women and 4723 men) aged between 18 and 76 years, who participated in the GENACIS Canada (GENder Alcohol and Culture: an International Study) study.
Setting   Canada.
Measurements   The independent variable was the annual drinking frequency. The dependent variables were the usual daily quantity consumed, annual, monthly and weekly frequency of binge drinking (five drinks or more on one occasion).
Findings   Logistic regressions show (i) that those who drink less than once a week are less likely than weekly drinkers to take more than two drinks when they do drink; (ii) that the usual daily quantity consumed by weekly drinkers is not related to their frequency of drinking; but that (iii) the risk and frequency of binge drinking increase with the frequency of drinking.
Conclusions   Given that risk and frequency of binge drinking among Canadians increases with their frequency of drinking, any public recommendation to drink moderately should be made with great caution.     

Prevalence and determinants of alcohol-related problems.

In this study, we sought to determine what factors, in addition to alcohol consumption, were the best predictors of social and physical alcohol-related problems. Variables examined as possible predictors of problems included circumstances under which people drink, feelings of alienation, and religious affiliation. Data for this study were collected continually from 1984 to 1989 using a random telephone survey of 2094 New York State residents aged 18 or older; the study sample was comprised of the 1076 who had consumed alcohol in the previous 30 days. Stepwise regression analyses examined the main effects of all possible predictors of problems while controlling for alcohol consumption. Forced-entry regressions examined interaction effects of problem predictors while controlling for basic demographics. Drinking with breakfast, smoking marijuana, and drinking in bars alone were all significant predictors of more problems. This suggests that problems are associated with an aberrant lifestyle (i.e., different from a typical lifestyle), although it makes no assumption about motivations. Further investigation of this subject area is warranted to ascertain which population subgroups are the most vulnerable to alcohol-related problems and to guide the design of prevention programs.     

Lability and impulsivity synergistically increase risk for alcohol-related problems

This study examined two aspects of affect dysregulation as risk factors for alcohol-related problems. From a sample of 592 undergraduates, 442 alcohol users were examined on measures of impulsivity, lability, alcohol use, and alcohol-related problems. As expected, affect lability and impulsivity significantly increased risk for alcohol problems even after controlling for gender and lifetime-use frequency. Impulsivity was further examined as a vulnerability factor, potentially enhancing the relations between use frequency and problems and affect lability and problems. Impulsivity did not moderate the use frequency-problems relationship. However, the relationship between affect lability and problems was greatest among participants with higher degrees of impulsivity. The results demonstrate that individual differences in affect dysregulation are associated with alcohol-related problems in young adults.     

Social anxiety and drinking refusal self-efficacy moderate the relationship between drinking game participation and alcohol-related consequences

Background: Participation in drinking games is associated with excessive drinking and alcohol risks. Despite the growing literature documenting the ubiquity and consequences of drinking games, limited research has examined the influence of psychosocial factors on the experience of negative consequences as the result of drinking game participation. Objectives: The current event-level study examined the relationships among drinking game participation, social anxiety, drinking refusal self-efficacy (DRSE) and alcohol-related consequences in a sample of college students. Methods: Participants (n?=?976) reported on their most recent drinking occasion in the past month in which they did not preparty. Results: After controlling for sex, age, and typical drinking, higher levels of social anxiety, lower levels of DRSE, and playing drinking games predicted greater alcohol-related consequences. Moreover, two-way interactions (Social Anxiety?×?Drinking Games, DRSE?×?Drinking Games) demonstrated that social anxiety and DRSE each moderated the relationship between drinking game participation and alcohol-related consequences. Participation in drinking games resulted in more alcohol problems for students with high social anxiety, but not low social anxiety. Students with low DRSE experienced high levels of consequences regardless of whether they participated in drinking games; however, drinking game participation was associated with more consequences for students confident in their ability to resist drinking. Conclusion: Findings highlight the important role that social anxiety and DRSE play in drinking game-related risk, and hence provide valuable implications for screening at-risk students and designing targeted harm reduction interventions that address social anxiety and drink refusal in the context of drinking games.     

Shop steward handling of alcohol-related problems

Using direct observations and extensive field interviewing over a 4-year period, this paper examines practices and beliefs of shop stewards in their effects on drinking patterns and consequences. It also includes response frequencies from a random sample survey questionnaire (n = 984) that are consistent with the qualitative analysis of steward behavior. Several themes are extracted which position steward handling of alcohol-related cases as intervening between disciplinary measures of supervisors and consequences of work-related drinking of union employees.     

A systematic review of work-place interventions for alcohol-related problems

Aims   The aims of this study were to (1) gauge any improvement in methodological quality of work-place interventions addressing alcohol problems; and (2) to determine which interventions most effectively reduce work-place-related alcohol problems.
Methods   A literature search was undertaken of the data bases, Ovid Medline, PsychINFO, Web of Science, Scopus, HSELINE, OSHLINE and NIOSHTIC-2 for papers published between January 1995 and September 2007 (inclusive). Search terms varied, depending on the database. Papers were included for analysis if they reported on interventions conducted at work-places with the aim of reducing alcohol problems. Methodological adequacy of the studies was assessed using a method derived from the Cochrane Collaboration guidelines.
Results   Ten papers reporting on work-place alcohol interventions were located. Only four studies employed randomized controlled trials (RCT), but all these had methodological problems. Weaknesses in all studies related to representativeness of samples, consent and participation rates, blinding, post-test time-frames, contamination and reliability, and validity of measures used. All except one study reported statistically significant differences in measures such as reduced alcohol consumption, binge drinking and alcohol problems.
Conclusions   The literature review revealed few methodologically adequate studies of work-place alcohol interventions. Study designs, types of interventions, measures employed and types of work-places varied considerably, making comparison of results difficult. However, it appears from the evidence that brief interventions, interventions contained within health and life-style checks, psychosocial skills training and peer referral have potential to produce beneficial results.     

The role of female occupation in severity of alcohol-related problems

This study investigated whether occupational class is related to the severity of problems associated with alcohol abuse in females. Sixty-six female alcoholic inpatients at a private psychiatric hospital were studied. Of these women, 31 were workers (working at the time of admission), 18 were unemployed workers (unemployed at admission but had worked most of their adult lives), and the remaining 17 were homemakers. Problem severity was assessed for 66 alcoholic women using the Addiction Severity Index (ASI), a standardized clinical interview. A questionnaire assessing the degree of occupational stress experienced was also administered. Employment problem severity ratings from the ASI differed significantly across the three occupation subgroups [F(2,63) = 10.99, p less than .05]; the unemployed workers reported more severe employment problems than did either the workers [t(63) = 3.07, p less than .05] or homemakers [t(63) = 4.77, p less than .05]. There were no significant differences between the three groups on the other five ASI dimensions. A cluster analysis on ASI severity ratings revealed a trend for workers to have family and psychological problems in addition to alcoholism. This seems not to have had an impact on wanting a job change; significantly more homemakers (z = 4.77, p less than .05) and unemployed workers (z = 4.56, p less than .05) than workers wanted a job change.     

G ender differences in alcohol-related problem s: controlling for drinking behaviour

A bstract A im s. Two hypotheses were tested to explain a high prevalence of alcohol-related problems among women relative to their low prevalence of excessive drinking: (1) At a given level of drinking, women may report more problems of any type than do men. (2) At a given level of drinking, the number of problems or the severity of the reported problems may be lower among women than among men. D esign. General population survey. Setting. Rotterdam, The Netherlands. Participants. 3537 Dutch respondents within the age range 16-69 years . M easurem ents. Alcohol-related problems were measured in five problem areas: psychological dependence, symptomatic drinking, social problems, health problems/accidents and frequent drunkenness/ hangovers. A problem index was formed by adding up the scores in the five separate problem areas. Alcohol use was measured by the Quantity-Frequency-Variability index. Findings. For the same level of drinking, women were as likely as men to report alcohol-related problems except that women light drinkers were actually less likely to report problems than men. Men tended to have a greater accumulation of different types of problems within drinking categories than women. Overall problem severity, however, did not differ between men and women. The apparent excess prevalence of alcohol problems in women relative to drinking level appears to be due to presence of problems even among light drinkers and a greater preponderance of light drinkers in women than men. C onclusions. The first hypothesis was rejected; drinking levels being the same, the level of alcohol problems is the same or even lower for women than for men. As hypothesized, men tend to have a greater accumulation of different kinds of problems than women. However, the severity of the reported problems does not differ between men and women.     

Negative affect, alcohol expectancies and alcohol-related problems

Using data from the first epidemiological study of mainland Puerto Rican drinking, the authors explore the relationships between negative affect, alcohol expectancies and drinking problems. Results revealed that the co-occurrence of depressed mood and drinking problems was strongly moderated by alcohol expectancies. More specifically, the co-occurrence was strongest among those Puerto Ricans who most expected alcohol to elevate their mood. Findings are discussed in terms of their explication of the co-morbidity of depressive symptomatology and alcohol abuse.     

The role of alcohol-related expectancies in the prediction of drinking behaviour in a simulated social interaction

This study investigated the relationship between socially-relevant alcohol-related beliefs and drinking behaviour in a laboratory-based study. Ninety male subjects were told they would be videotaped while completing the Simulated Social Interaction Test; they were then assigned to one of three conditions. In the first, alcohol consumption prior to the interaction was optional, in the second, a standard dose was administered, and in the third, no alcohol was offered. The outcome measures included drinking behaviour and rated level of social skill. In the optional condition, beliefs that alcohol would reduce anxiety in social situations and enhance social competence predicted amount consumed. The decision to continue drinking after the compulsory dose was predicted by anxiety level. In the no alcohol condition, rated social skill was negatively correlated with the beliefs that alcohol reduces tension and reduces fear of negative evaluation. Results are discussed with reference to social learning approaches to understanding drinking behaviour.