BACKGROUND: Rates of alcohol disorders peak in late adolescence and decrease substantially into the mid-20s. Our aim was to identify risk factors that predict alcohol problems that persist into the mid-20s. METHOD: Data are from the prospective, population-based Great Smoky Mountains Study (GSMS; n=1420), which followed children through late adolescence and into young adulthood. Alcohol persisters were defined as subjects with an alcohol disorder (abuse or dependence) in late adolescence (ages 19 and 21 years) that continued to meet criteria for an alcohol disorder at the mid-20s assessment. RESULTS: The 3-month prevalence of having an alcohol disorder (abuse or dependence) decreased markedly from late adolescence into the mid-20s. A third of late adolescents with an alcohol disorder continued to meet criteria for an alcohol disorder in young adulthood (37 of 144 who met criteria in late adolescence). Risk factors for persister status included multiple alcohol abuse criteria during late adolescence but no alcohol dependence criteria. Risk factors for persister status also included associated features of alcohol dependence such as craving alcohol and drinking to unconsciousness. Persister status was also associated with depression, cannabis dependence and illicit substance use, but not with other psychiatric disorders. More than 90% of late adolescents with three or more of the risk factors identified met criteria for a young adult alcohol disorder. CONCLUSIONS: Symptoms of alcohol abuse, not dependence, best predict long-term persistence of alcohol problems. The set of risk factors identified may be a useful screen for selective and indicated prevention efforts.
BACKGROUND: Rates of alcohol disorders peak in late adolescence and decrease substantially into the mid-20s. Our aim was to identify risk factors that predict alcohol problems that persist into the mid-20s. METHOD: Data are from the prospective, population-based Great Smoky Mountains Study (GSMS; n=1420), which followed children through late adolescence and into young adulthood. Alcohol persisters were defined as subjects with an alcohol disorder (abuse or dependence) in late adolescence (ages 19 and 21 years) that continued to meet criteria for an alcohol disorder at the mid-20s assessment. RESULTS: The 3-month prevalence of having an alcohol disorder (abuse or dependence) decreased markedly from late adolescence into the mid-20s. A third of late adolescents with an alcohol disorder continued to meet criteria for an alcohol disorder in young adulthood (37 of 144 who met criteria in late adolescence). Risk factors for persister status included multiple alcohol abuse criteria during late adolescence but no alcohol dependence criteria. Risk factors for persister status also included associated features of alcohol dependence such as craving alcohol and drinking to unconsciousness. Persister status was also associated with depression, cannabis dependence and illicit substance use, but not with other psychiatric disorders. More than 90% of late adolescents with three or more of the risk factors identified met criteria for a young adult alcohol disorder. CONCLUSIONS: Symptoms of alcohol abuse, not dependence, best predict long-term persistence of alcohol problems. The set of risk factors identified may be a useful screen for selective and indicated prevention efforts.
Authors: Jane Metrik; Rachel L Gunn; Kristina M Jackson; Alexander W Sokolovsky; Brian Borsari Journal: Alcohol Clin Exp Res Date: 2018-05-08 Impact factor: 3.455
Authors: Rachel L Gunn; Angela K Stevens; Lauren Micalizzi; Kristina M Jackson; Brian Borsari; Jane Metrik Journal: Exp Clin Psychopharmacol Date: 2020-03-05 Impact factor: 3.157
Authors: Christian Hopfer; Stacy Salomonsen-Sautel; Susan Mikulich-Gilbertson; Sung-Joon Min; Matt McQueen; Thomas Crowley; Susan Young; Robin Corley; Joseph Sakai; Christian Thurstone; Analice Hoffenberg; Christie Hartman; John Hewitt Journal: J Am Acad Child Adolesc Psychiatry Date: 2013-04-04 Impact factor: 8.829
Authors: Ali M Yurasek; Jennifer E Merrill; Jane Metrik; Mary Beth Miller; Anne C Fernandez; Brian Borsari Journal: J Subst Abuse Treat Date: 2017-05-31
Authors: M H Meier; W Hall; A Caspi; D W Belsky; M Cerdá; H L Harrington; R Houts; R Poulton; T E Moffitt Journal: Psychol Med Date: 2015-12-01 Impact factor: 7.723