Alcohol involvement and marital quality in the early years of marriage: a longitudinal growth curve analysis

BACKGROUND: Previous research suggests that becoming married is associated with declines in drinking. The current study examines two potential influences on newly married husbands' and wives' drinking trajectories, the impact of the partner's drinking and the quality of the marriage. METHODS: Couples (n=592) were assessed at the time of their first marriage, at the first anniversary, and at the second anniversary. Husbands and wives completed separate, self-administered questionnaires at home. Latent growth curve analysis was used to examine husbands' and wives' alcohol use and marital quality trajectories and to test the bi-directional relationships between alcohol involvement and marital quality both within and between couple members. RESULTS: Husbands' and wives' alcohol involvement and marital quality declined over time and there was significant individual variability in these changes over time. Although we failed to find any longitudinal influence of greater alcohol involvement on declines in marital quality or vice versa, individuals' marital quality and alcohol involvement were correlated at the time of marriage and individuals' changes in drinking were significantly associated with changes in their reported marital satisfaction. There were also significant correlations observed between one partner's alcohol involvement slope and the spouse's marital quality slope, indicating that steeper declines in husbands' and wives' drinking were associated with less steep declines in their partner's marital quality. CONCLUSIONS: There is clearly an association between husbands' and wives' alcohol use and marital quality. However, given the absence of longitudinal effects, we cannot discern the temporal precedence of this association. Additional research is needed to more fully understand this complex relationship.     

Spousal characteristics as predictors of well-being in older couples.

This study examined the relations between spousal variables and the psychological well-being of husbands and wives in older couples to determine if spousal characteristics were more important determinants of well-being for wives than for husbands. One hundred-twenty older married men and women completed standardized self-report measures and a short interview. The variables investigated included education, verbal intelligence, personality, physical health, marital adjustment, psychological well-being, as well as response bias to marital defensiveness. Spousal variables significantly predicted wives' well-being (R2 = 29%) with the three most influential predictor variables being the husbands' perception of the marriage, positive dimension of well-being and physical health. In contrast, spousal variables did not significantly predict husbands' well-being. The study supported the hypothesis of differential responsiveness of men and women to spousal variables and highlighted the importance of marital adjustment for the psychological well-being of older wives.     

The role of substance use in young adult divorce

AIM: To test the relationships between various forms of substance use during marriage and subsequent divorce among US young adults. DESIGN: Three waves of survey data collected at approximately ages 18, 23 and 29 years were used. Using multivariate logistic regression and controlling for factors present at the two early waves, we tested for prospective relationships between substance use at the second assessment and divorce by the third. PARTICIPANTS: A longitudinal panel following adolescents on the west coast of the United States into young adulthood. The analytic subsample consisted of the 454 individuals currently married at the age 23 survey. MEASUREMENTS: Predictors were past-year frequency of alcohol intoxication, marijuana use and cigarette use, as well as any hard drug use in the past year. Covariates included substance use prior to marriage, demographic and socio-economic factors, marital discord and religiosity. FINDINGS: Controlling for other factors, more frequent alcohol intoxication during marriage was an independent predictor of later divorce. Frequency of marijuana use had a significant bivariate relationship with divorce that was not significant in the multivariate model. CONCLUSION: These data are consistent with the notion that alcohol intoxication is related causally to divorce among young adults.     

Substance use trends among active duty military personnel: findings from the United States Department of Defense Health Related Behavior Surveys, 1980-2005

AIMS: This study was designed to assess trends in cigarette, illicit drug, and heavy alcohol use among active-duty military personnel from 1980 to 2005 and to examine the influence of socio-demographic changes within the military on patterns of substance use. DESIGN: Substance use prevalence rates were estimated from cross-sectional data obtained from nine self-report surveys administered to more than 150 000 active-duty service members world-wide over a 25-year period. Direct standardization was used to adjust for socio-demographic changes. MEASUREMENTS: Measures included self-reported cigarette use, illicit drug use and heavy alcohol use in the 30 days prior to the survey. Heavy alcohol use was defined as drinking five or more drinks per typical drinking occasion at least once a week in the past 30 days. FINDINGS: Cigarette and illicit drug use among military personnel declined sharply and significantly from 1980 to 1998. Heavy alcohol use decreased in the mid-1980s but was stable from 1988 to 1998. Both cigarette smoking and heavy alcohol use increased significantly between 1998 and 2002 and remained at those levels in 2005. Illicit drug use remained low. Logistic regression analyses indicated that trends were influenced by other factors besides socio-demographic changes across survey years. CONCLUSIONS: The military has made notable progress in decreasing cigarette smoking and illicit drug use, but has made less progress in reducing heavy alcohol use. Additional emphasis should be placed on understanding recent increases in substance use and on planning effective interventions and prevention programs to reduce use in this high-risk population.     

Alcohol and the continuation of early marital aggression

BACKGROUND: Husband alcohol use has frequently been found to be related to husband-to-wife marital violence. Research has demonstrated a prospective link between husband alcohol use before marriage and husband-to-wife aggression in the first year of marriage. The present study examined the relationships of husband violence, marital conflict, and couple's alcohol use in the first year of marriage to husband-to-wife marital violence in the second and third years of marriage. METHODS: Newlywed couples were recruited at the time of marriage and were interviewed regarding alcohol use and experience with violence before marriage, 1 year after marriage, and 3 years after marriage. RESULTS: Year 1 violence was predictive of subsequent marital violence. Husband and wife drinking patterns in the first year of marriage interacted to predict violence in later years. The most violence in subsequent years occurred in couples where the husband was a heavy drinker and the wife was not. Husbands who were violent in year 1 were more likely to be violent in later years. When no violence occurred in the first year, frequent use of verbal aggression in year 1 was predictive of violence in subsequent years. CONCLUSIONS: The predictive value of husband drinking patterns for subsequent violence extends beyond the transition to marriage. The fact that husband and wife alcohol use interacted to predict future aggression suggests that the relationship between husband alcohol use and marital violence is not spurious nor the result of conflict and violence promoting alcohol use. The findings may reflect multiple instances of acute intoxication and/or alcohol-related stress and conflict within the relationship, both of which may increase the likelihood of aggression.     

Hypothalamic–pituitary–adrenal axis and smoking and drinking onset among adolescents: the longitudinal cohort TRacking Adolescents' Individual Lives Survey (TRAILS)

Aims   We examined within a prospective longitudinal study whether cortisol levels were associated with smoking or drinking behaviours, taking parental substance use into account.
Design   The influence of parental substance use on cortisol levels of their adolescent offspring at age 10–12 years was examined. Next, cortisol levels of adolescents who initiated smoking or drinking at the first data collection (age 10–12) were compared to non-users. Finally, we examined whether cortisol levels could predict new onset and frequency of smoking and drinking 2 years later.
Setting and participants   First and second assessment data of the TRacking Adolescents' Individual Lives Survey (TRAILS) were used, including 1768 Dutch adolescents aged 10–12 years, who were followed-up across a period of 2 years.
Measurements   Cortisol was measured in saliva samples at awakening, 30 minutes later, and at 8 p.m. at age 10–12. Self-reported substance use at age 10–12 and 13–14, and parental self-reported substance use were used.
Findings   Only maternal substance use was related to slightly lower adolescent cortisol levels at 8 p.m. Both maternal and paternal substance use were associated with adolescent smoking and drinking at age 13–14, although fathers' use only predicted the amount used and not the chance of ever use. Finally, higher cortisol levels were related moderately to current smoking and future frequency of smoking, but not to alcohol use.
Conclusions   In a general population, parental heavy substance use does not seem to affect cortisol levels consistently in their offspring. We found some evidence for higher, instead of lower, hypothalamic–pituitary–adrenal axis activity as a predictor of smoking in early adolescence.     

Spouse Concordance for Alcohol Dependence and Heavy Drinking: Evidence from a Community Sample

Using data from a community sample of 586 married couples, levels of spouse concordance for lifetime and current alcohol dependence and heavy drinking were estimated. In addition, marital quality ratings in concordant and discordant couples were compared. Spouse concordance was significant for lifetime alcohol dependence and for both lifetime and current heavy drinking. Marital quality varied as a function of current heavy drinking and alcohol dependence such that members of couples in which neither spouse drank heavily reported better marital quality than other couples. Furthermore, although marital quality did not differ significantly between concordant and discordant couples, couples concordant for current heavy drinking consistently reported poorer marital quality than other couples.     

Prevalence of alcohol use disorders and associated factors: a population-based study using AUDIT in southern Brazil

Aims   To assess the prevalence of potential alcohol use disorders and associated factors using the Alcohol Use Disorders Identification Test (AUDIT).
Design   Cross-sectional study.
Setting   A town in southern Brazil.
Participants   A representative sample of 1260 people aged 15 and over.
Measurements   Demographic, socioeconomic, smoking habit and mental health data were collected. Logistic regression was used in the multivariate analysis, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.
Findings   Overall prevalence of alcohol use disorder was 7.9%, with 14.5% prevalence among men and 2.4% among women. The risk of alcohol misuse increased across social class ( P linear trend = 0.03) and compared with the highest classes (A and B), groups C through E had ORs of 1.48, 1.51 and 2.36, respectively. Males had an OR of 6.89 (CI 3.61–13.16) compared with women. A linear trend was found ( P  = 0.001) between smoking categories, and smokers (OR 3.27; CI 1.91–5.58) and ex-smokers (OR 1.30; CI 0.56–2.98) were at higher risk than non-smokers. Those with minor psychiatric disorders had a 2.48 OR (CI 1.35–4.56) of presenting a positive test.
Conclusions   The AUDIT detected a high prevalence of potential alcohol use disorders in the population sampled. Those identified are potential targets for preventive measures implemented through health policies.     

The Mexican migration to the United States and substance use in northern Mexico

Aims   To examine the impact of migration to the United States on substance use and substance use disorders in three urban areas of northern Mexico.
Design   Cross-sectional survey of immigration-related experiences and life-time and past-year alcohol and drug use, in a representative sample of respondents aged 12–65 years.
Setting   Interviews were conducted in the cities of Tijuana, Ciudad Juarez and Monterrey during 2005. Respondents were classified into three groups: (i) 'return migrants', (ii) 'relatives of migrants' and (iii) 'others in the general population'.
Findings   A total of 1630 completed interviews were obtained for a response rate of 70.5%. 'Return migrants' were more likely to have used alcohol, marijuana or cocaine at least once in their life-time and in the last 12 months, more likely to develop a substance use disorder and more likely to have a 12-month substance use disorder compared with 'others in the general population'. Among 'return migrants', longer length of time in the United States and type of work performed as an immigrant were related to higher prevalence of substance use. Among 'relatives of migrants', migration experiences were not associated with increased prevalence of substance use compared with 'others in the general population'.
Conclusion   This study found a link between migration to the United States and the transformation of substance use norms and pathology in Mexico. Future research on pre-migration involvement in substance use and data on the timing of events among return migrants is needed. Public health measures are likely to require cross-border coordination of research and service development.     

Probabilities of alcohol high-risk drinking,abuse or dependence estimated on grounds of tobacco smoking and nicotine dependence

Aims  To estimate probabilities of alcohol high-risk drinking, alcohol abuse and alcohol dependence on grounds of smoking-behaviour related variables and single nicotine dependence criteria.
Design  Cross-sectional population-based study.
Setting  Adult population of a region in north Germany.
Participants  Cigarette smokers ( n  = 2437) among a random sample of 4075 females and males aged 18–64, drawn in 1996.
Measurement  Smoking, nicotine dependence according to the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM-IV) and the Fagerström Test for Nicotine Dependence (FTND); increasing alcohol-related harm (ARH): high-risk drinking, DSM-IV alcohol abuse, remitted and current alcohol dependence diagnosed by the Composite International Diagnostic Interview (CIDI).
Findings  Having smoked 30 cigarettes or more per day, onset of smoking at the age of 17 or younger, nicotine dependence and single nicotine dependence criteria revealed odds ratios higher than 4.0 for alcohol dependence. For alcohol dependence, a logistic regression model showed an increased odds ratios for male gender, smoking for 25 years or more, no attempt to quit or cut down, continuation of smoking despite problems, craving for nicotine, withdrawal experience 1 day or longer, smoking first cigarette in the morning 5 minutes or less after waking. The probability of increasing ARH was more likely in males, smokers for 25 years or more, no attempt to quit or cut down, continuation of smoking despite problems and smoking first cigarette in the morning 5 minutes or less after waking.
Conclusions  Gender and single nicotine dependence criteria show particularly high probabilities of alcohol dependence and increasing ARH. Interventions need to take these connections into account.     

Stress and substance use among military women and men.

This paper examines the relationship between perceived stress (at work, in family or personal life, and from being a woman in the military) and substance use (heavy drinking, illicit drug use, cigarette smoking) among active-duty military women and men. Data were drawn from over 16,000 respondents to the 1995 Department of Defense Survey of Health Related Behaviors Among Military Personnel. Findings indicated substantial substance use and perceived high stress in the armed forces. Further, the relation between substance use and stress varied by gender. Military women reported substantially lower rates of heavy drinking than men, but had similar rates of illicit drug use and cigarette smoking. Both military women and men were more likely to describe their military duties as more stressful than their family or personal lives; for women, the stress associated with being a woman in the military was second to stress at work. Stress at work or in the family was an important predictor of substance use among military men, but not among military women. For military women, stress associated with being a woman in the military was predictive of illicit drug use and cigarette use. These findings suggest that more effective stress management strategies may need to be implemented for military men to reduce the link between stress and heavy alcohol use, illicit drug use, and smoking.     

Stress and Substance Use Among Military Women and Men

This paper examines the relationship between perceived stress (at work, in family or personal life, and from being a woman in the military) and substance use (heavy drinking, illicit drug use, cigarette smoking) among active-duty military women and men. Data were drawn from over 16,000 respondents to the 1995 Department of Defense Survey of Health Related Behaviors Among Military Personnel. Findings indicated substantial substance use and perceived high stress in the armed forces. Further, the relation between substance use and stress varied by gender. Military women reported substantially lower rates of heavy drinking than men, but had similar rates of illicit drug use and cigarette smoking. Both military women and men were more likely to describe their military duties as more stressful than their family or personal lives; for women, the stress associated with being a woman in the military was second to stress at work. Stress at work or in the family was an important predictor of substance use among military men, but not among military women. For military women, stress associated with being a woman in the military was predictive of illicit drug use and cigarette use. These findings suggest that more effective stress management strategies may need to be implemented for military men to reduce the link between stress and heavy alcohol use, illicit drug use, and smoking.     

Impact of husbands' involuntary job loss on wives' mental health,among older adults

OBJECTIVES: This study estimates the consequences of older husbands' involuntary job loss for their wives' mental health. METHODS: Using longitudinal data from the 1992, 1994, and 1996 waves of the Health and Retirement Study, multivariate regression models were estimated to measure the impact of older husbands' involuntary job loss on wives' mental health. We created two longitudinal data sets of two waves each to use in our analysis. The first data set, or period, combined Waves 1 and 2 of the Health and Retirement Study and described the 1992-1994 experience of spouse pairs in our sample. It included the wives of 55 husbands who experienced involuntary job loss between these survey dates and a comparison group of wives of 730 continuously employed husbands. The second data set described the 1994-1996 experience of couples. In particular, it included the wives of an additional 38 husbands who were displaced from their jobs between Waves 2 and 3, and a comparison group of wives of 425 husbands who were continuously employed from 1994 to 1996. RESULTS: Husbands' involuntary job loss did not have a statistically significant effect on wives' mental health. We found no evidence that changes in husbands' depressive symptoms modified the effect of his job loss on wives' mental health. In the first period only, the effect of husbands' job loss on wives' mental health was more pronounced for wives who were more financially satisfied at baseline. DISCUSSION: There is limited evidence among this cohort that husbands' job loss increases wives' subsequent depressive symptoms. However, the effect of husbands' job loss on wives' mental health appears to be magnified when wives report being financially satisfied pre-job loss. This suggests that, for subgroups of older couples, mental health services specifically targeted at displaced men should also be made available to wives.     

Health behavior and cardiovascular risk factors in females in relation to their marital status

This is an overview of the literature analysing the international level of knowledge about the influence of marital status on the prevalence of cigarette smoking, hypertension, hyperlipoproteinemia, obesity, alcohol consumption and type-A-behavior of women. An accumulation of the more behavior-dependent risk factors cigarette smoking and alcohol consumption was found by divorced and of the obesity by never married women. Widowed women scarcely differ from women in other marital status groups in their risk factor profile. The risk factors hypertension and hyperlipoproteinemia hardly correlate with the marital status. The overcome-behavior by loading is discussed as one possible cause of the found correlations. That's why family and social support has got a preventive consequence.     

The impact of depressive symptoms on alcohol and cigarette consumption following treatment for alcohol and nicotine dependence

Background:  Although depression is common among alcohol and tobacco dependent patients, its impact on treatment outcomes is not well established. The purpose of this study was to examine the impact of depressive symptoms on abstinence from tobacco and alcohol after treatment for alcohol dependence and nicotine dependence.
Methods:  The Timing of Alcohol and Smoking Cessation Study (TASC) randomized adults receiving intensive alcohol dependence treatment, who were also smokers, to concurrent or delayed smoking cessation treatment. The sample consisted of 462 adults who completed depression and substance use (alcohol and smoking) assessments at treatment entry and 6, 12, and 18 months posttreatment. Longitudinal regression models were used to examine the relationships between depression and subsequent abstinence from alcohol and tobacco after baseline characteristics, including alcohol and smoking histories, were considered.
Results:  Depressive symptoms were prospectively related to nonabstinence from alcohol. Depressive symptoms at the previous assessment increased the odds of drinking at the subsequent time point by a factor of 1.67 (95% CI 1.14, 2.43), p  < 0.01. Depressive symptoms were not significantly related to subsequent abstinence from cigarettes.
Conclusions:  Depression is an important negative predictor of the ability to maintain abstinence from alcohol within the context of intensive alcoholism and smoking treatment. It may be important to include depression-specific interventions for alcohol and tobacco dependent individuals to facilitate successful drinking treatment outcomes.     

More Canadian students drink but American students drink more: comparing college alcohol use in two countries

Aims  To compare alcohol use among US and Canadian college students.
Design  Results of the 1999 College Alcohol Study and the 1998 Canadian Campus Survey are compared.
Setting  One hundred and nineteen nationally representative US 4-year colleges and universities in 40 states and 16 nationally representative Canadian 4-year universities.
Participants  Randomly selected students under 25 years (12 344 US and 6729 Canadian).
Measurements  Self-reports of alcohol use and heavy alcohol use.
Findings  The prevalence of life-time and past year alcohol use is significantly higher among Canadian students than US students (92% versus 86%, 87% versus 81%). The prevalence of heavy alcohol use (typically consuming five or more drinks in a row for males/four or more for females) among past-year and past-week drinkers is significantly higher among US students than Canadian students (41% versus 35%, 54% versus 42%). In both countries younger students and students living at home with their parents are less likely to be heavy drinkers; students who report first drunkenness before the age of 16 are more likely to be heavy drinkers in college.
Conclusion  Programs aimed at students' heavy alcohol use should target freshman at entry or earlier. Since students living with their parents are less likely to be heavy drinkers, parents may play a potentially important role in prevention efforts. The patterns of drinking in both countries may be influenced by the legal minimum drinking age. However, the relationship is complex and must be viewed in the context of other variables such as chronological age.     

Genetic and non-genetic influences on the development of co-occurring alcohol problem use and internalizing symptomatology in adolescence: a review

Aims   Alcohol problem use during adolescence has been linked to a variety of adverse consequences, including cigarette and illicit drug use, delinquency, adverse effects on pubertal brain development and increased risk of morbidity and mortality. In addition, heavy alcohol-drinking adolescents are at increased risk of comorbid psychopathology, including internalizing symptomatology (especially depression and anxiety). A range of genetic and non-genetic factors have been implicated in both alcohol problem use as well as internalizing symptomatology. However, to what extent shared risk factors contribute to their comorbidity in adolescence is poorly understood.
Design   We conducted a systematic review on Medline, PsycINFO, Embase and Web of Science to identify epidemiological and molecular genetic studies published between November 1997 and November 2007 that examined risk factors that may be shared in common between alcohol problem use and internalizing symptomatology in adolescence.
Findings   Externalizing disorders, family alcohol problems and stress, as well as the serotonin transporter ( 5-HTT ) S-allele, the monoamine oxidase A ( MAOA ) low-activity alleles and the dopamine D2 receptor ( DDR2 ) Taq A1 allele have been associated most frequently with both traits. An increasing number of papers are focusing upon the role of gene–gene (epistasis) and gene–environment interactions in the development of comorbid alcohol problem use and internalizing symptomatology.
Conclusions   Further research in adolescents is warranted; the increasing availability of large longitudinal genetically informative studies will provide the evidence base from which effective prevention and intervention strategies for comorbid alcohol problems and internalizing symptomatology can be developed.     

Alcohol-Related Disorders in Beijing, China: Prevalence, Socio-Demographic Correlates, and Unmet Need for Treatment

Background:  The study aimed to determine the prevalence of alcohol use, episodic heavy drinking, and alcohol dependence and their socio-demographic correlates in Beijing, China.
Methods:  A total of 5,926 subjects were randomly selected in Beijing and interviewed using the Composite International Diagnostic Interview (CIDI 1.0). Data on basic socio-demographic and current major medical conditions were also collected.
Results:  The 12-month prevalence of alcohol use and episodic heavy drinking were 32.5 and 13.8%, respectively. The 12-month and lifetime prevalence of alcohol dependence were 1.7 and 4.3%, respectively. Age above 24 years, male sex, being married and employed, low education level (junior high school, primary school or illiterate), rural residence, and having comorbid psychiatric disorders were all significantly associated with a higher likelihood of alcohol-related disorders. Only 2.4% of the subjects with alcohol dependence were receiving treatment, and a mere 1.4% had sought treatment from mental health professionals.
Conclusions:  Nationwide surveys are urgently needed to further explore the prevalence of alcohol-related disorders in China.