Temporal progression of alcohol dependence symptoms in the U.S. household population: results from the National Comorbidity Survey.

General population data are presented on patterns and predictors of temporal progression of alcohol dependence symptoms in the general population. The data come from the National Comorbidity Survey, a nationally representative general population survey of respondents ages 15-54. Lifetime symptom classes were estimated with latent class analysis (LCA). A 4-class LCA solution, including a 1st asymptomatic class and 3 progressively more serious symptomatic classes, was found to fit the data. Probability of initial symptom onset among drinkers was found to be highest in the 10-24 age range, to be higher among men than women, and to have increased dramatically in the past 4 decades. Age, gender, and cohort effects were less powerful in predicting symptom progression. A narrowing of the gender difference over time was due largely to a convergence in initial symptom onset among men and women ages 10-24. These results suggest that a rise in initial problems was more important than an increase in the transition from problems to dependence in accounting for the growing prevalence of alcohol dependence during the post-World War II years in the United States.