Wendy Swift1,2, Tim Slade1,2, Natacha Carragher1,2,3, Carolyn Coffey4, Louisa Degenhardt1,4,5,6, Wayne Hall7,8, George Patton4,9. 1. National Drug and Alcohol Research Centre, The University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia. 2. National Health & Medical Research Council (NHMRC) Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Australia, Sydney, New South Wales, Australia. 3. Office of Medical Education, UNSW Australia, Sydney, New South Wales, Australia. 4. Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia. 5. School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia. 6. Department of Global Health, School of Public Health, University of Washington, Seattle, Washington, United States. 7. Centre for Youth Substance Abuse Research, University of Queensland, St. Lucia, Queensland, Australia. 8. Institute of Psychiatry, King's College London, London, England. 9. Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia.
Abstract
OBJECTIVE: There is little research examining alcohol use disorder (AUD) symptoms (based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5]) in young adulthood. We assessed symptom structure at 24 years using latent class analysis (LCA), examining relationships between class membership and (a) concurrent alcohol use and DSM-5 AUD severity and (b) adolescent risk factors. METHOD: A stratified, random sample of 1,943 adolescents ages 14-15 years was recruited from 44 secondary schools in Victoria, Australia, and interviewed during adolescence and young adulthood. We report findings on drinkers who completed the AUD module (N = 1,268; 51% male). RESULTS: Data clearly fit a three-class, dimensional model, comprising "mild symptoms" (63.2%), "moderate symptoms" (32.2%), and "severe symptoms" (4.6%) classes. Class membership was validated by concurrent drinking patterns and in reasonable agreement with DSM-5 AUD severity categories. Relative to mild symptoms class membership, moderate symptoms class membership increased odds of adolescent alcohol problems (odds ratio [OR] = 2.0, 95% CI [1.2, 3.5]) and persisting anxiety/depression symptoms (OR = 1.9, 95% CI [1.2, 3.1]). Daily smoking (OR = 2.6, 95% CI [1.1, 5.9]), persisting anxiety/ depression symptoms (OR = 2.5, 95% CI [1.3, 5.0]), and antisocial behavior (OR = 3.2, 95% CI [1.5, 6.8]) increased odds of severe symptoms class membership. Adolescent daily smoking (OR = 0.3, 95% CI [0.11, 0.81]) and antisocial behavior (OR = 0.3, 95% CI [0.14, 0.64]) were less likely among members of the moderate symptoms class, relative to the severe symptoms class. CONCLUSIONS: We found support for a dimensional AUD typology like that in DSM-5. Young adults with more severe AUD symptoms had a different adolescent risk profile than those in the low and moderate classes. These findings provide a focus for preventive intervention in adolescence to limit the severity of AUDs in young adulthood.
OBJECTIVE: There is little research examining alcohol use disorder (AUD) symptoms (based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5]) in young adulthood. We assessed symptom structure at 24 years using latent class analysis (LCA), examining relationships between class membership and (a) concurrent alcohol use and DSM-5 AUD severity and (b) adolescent risk factors. METHOD: A stratified, random sample of 1,943 adolescents ages 14-15 years was recruited from 44 secondary schools in Victoria, Australia, and interviewed during adolescence and young adulthood. We report findings on drinkers who completed the AUD module (N = 1,268; 51% male). RESULTS: Data clearly fit a three-class, dimensional model, comprising "mild symptoms" (63.2%), "moderate symptoms" (32.2%), and "severe symptoms" (4.6%) classes. Class membership was validated by concurrent drinking patterns and in reasonable agreement with DSM-5 AUD severity categories. Relative to mild symptoms class membership, moderate symptoms class membership increased odds of adolescent alcohol problems (odds ratio [OR] = 2.0, 95% CI [1.2, 3.5]) and persisting anxiety/depression symptoms (OR = 1.9, 95% CI [1.2, 3.1]). Daily smoking (OR = 2.6, 95% CI [1.1, 5.9]), persisting anxiety/ depression symptoms (OR = 2.5, 95% CI [1.3, 5.0]), and antisocial behavior (OR = 3.2, 95% CI [1.5, 6.8]) increased odds of severe symptoms class membership. Adolescent daily smoking (OR = 0.3, 95% CI [0.11, 0.81]) and antisocial behavior (OR = 0.3, 95% CI [0.14, 0.64]) were less likely among members of the moderate symptoms class, relative to the severe symptoms class. CONCLUSIONS: We found support for a dimensional AUD typology like that in DSM-5. Young adults with more severe AUD symptoms had a different adolescent risk profile than those in the low and moderate classes. These findings provide a focus for preventive intervention in adolescence to limit the severity of AUDs in young adulthood.
Authors: Rosa M Crum; Kerry M Green; Elizabeth A Stuart; Lareina N La Flair; Marc Kealhofer; Andrea S Young; Noa Krawczyk; Kayla N Tormohlen; Carla L Storr; Anika A H Alvanzo; Ramin Mojtabai; Lauren R Pacek; Bernadette A Cullen; Beth A Reboussin Journal: Drug Alcohol Depend Date: 2018-04-10 Impact factor: 4.492
Authors: Alejandro Pérez-Milena; Manuel de Dios Redondo-Olmedilla; María Luz Martínez-Fernández; Idoia Jiménez-Pulido; Inmaculada Mesa-Gallardo; Francisco Javier Leal-Helmling Journal: Aten Primaria Date: 2017-05-10 Impact factor: 1.137