Researchers from the Departments of Psychiatry (PTM, RAD, MNP) and Child Study Center (MNP) at Yale University’s School of Medicine examined data from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) to assess the prevalence of multiple psychiatric disorders—including alcohol abuse, nicotine dependence, mania, schizoid personality disorder, panic disorder—in both male and female children. Lead researcher Peter Morgan and his team studied 23,006 males and 17,368 females who grew up with and without an alcohol abusing mother or father, and measured the occurrence of disorders based on gender and maternal or paternal alcoholism.

As a result, researchers found a higher prevalence of psychiatric disorders in children of alcoholic parents than children without a history of familial alcohol abuse, regardless of their gender and the gender of the alcoholic parent. However, the gender of the alcohol abusing parent and their child created differing increases in the pervasiveness of specific disorders. For example, sons of alcoholic fathers were associated with an increased risk of mania, but sons of alcoholic mothers were at higher risk of panic disorder. Female offspring showed the greatest disparity among psychiatric risks. Daughters of alcoholic fathers were associated with an increased risk of alcohol abuse, but daughters of alcoholic mothers were associated with increased risk of nicotine dependence, alcohol abuse, mania, and schizoid personality disorder. Female children of alcohol abusing mothers were at the greatest risk of adulthood psychiatric illness than any other child-parent ratio.

Alcohol use disorders may directly affect the health, behavior, and productivity of the individual experiencing it, but ultimately alcoholism is a family disease. Not only does the alcoholic’s behavior affect their relationships with family members, causing various behavioral and developmental problems, but their dependencies have shown to cause specific effects on their offspring’s psychopathology that otherwise could have been prevented. During adolescence, children of alcoholic parents are susceptible to the negative effects of a parent’s drinking problem, and as adults these children face the greatest risk of essentially every type of chronic mental illness. Based on the finding from this new study, specialized intervention and prevention strategies can be implemented that target the psychiatric disorders that are specific to gender-related influences between parents and their offspring. The greater occurrence of multiple psychiatric disorders among daughters of alcoholic mothers, for example, can help families, medical professionals, and policymakers identify individuals that are at highest risk and encourage preventative strategies to aid these families.

The Yale’s research team’s study is available online and in the October 2010 print issue of Alcoholism: Clinical & Experimental Research.

Sources: Morgan, Peter T., Rani A. Desai, and Marc N. Potenza. October, 2010. Gender-Related Influences of Parental Alcoholism on the Prevalence of Psychiatric Illnesses: Analysis of the National Epidemiologic Survey on Alcohol and Related Conditions. Alcoholism: Clinical & Experimental Research. Published online July 20, 2010. DOI: 10.1111/j.1530-0277.2010.01263.x.

HealthDay News, Mom’s Alcoholism Especially Tough on Daughter’s Mental Health, July 20, 2010

The researchers surveyed 1,910 people with alcohol-related problems, and 14.7 percent used clergy services. Most of those who used clergy services also used professional services, and only .5 percent used clergy services just for their problems with alcohol.

Examining the use of clergy services among people who sought treatment for alcohol abuse and comparing the characteristics of the people who used clergy services with those of people who used other types of services to seek help, the researchers found that many people who used clergy services were Black, between the ages of 35 and 54, had a history of alcohol dependence, and suffered from depression or personality disorders They also found that people who were alcohol dependent were more likely to have used clergy services for alcohol-related problems than people who weren’t alcohol dependent or didn’t abuse alcohol.

Amy Bohnert, Ph.D., M.H.S., lead author of the study and assistant professor of psychiatry at the University of Michigan, said their findings suggest that people who can be classified as alcohol abusers tend to have problems with the legal system, work, and social situations, and may be more likely to be placed in treatment through social services or the courts.

Brian Perron, assistant professor of social work at the University of Michigan, said that rabbits, priests, ministers, and other clergy members are in an ideal position to help addicts because they are involved in their communities and see their congregants on a regular basis, which allows them to notice changes in behavior. Clergy are also often highly regarded by their community, especially in African American communities. Congregates also tend to feel that they can talk to clergy members in confidence.

Source: Science Daily, Individuals Confess Alcohol Abuse to Clergy, July 14, 2010

Prior addiction research has shown that many negative childhood experiences–such as neglect, physical abuse, sexual abuse, and the presence of mental illness or substance abuse in the household–compound an individual’s risk of psychological disorders as an adolescent or adult. Although several studies have demonstrated much higher rates of alcohol consumption among American and European young adults than those in Africa, not much data has been presented on the propensity of African adolescent alcohol abuse and other behavioral disorders related to early developmental influences. Even though African teenagers have lower alcohol consumption rates, they are still at high risk of contracting diseases or disorders attributable to drunkenness and risky behavior.

This latest study by researchers at the African Population and Health Research Center in Nairobi, Kenya examined the prevalence of alcohol abuse among sub-Saharan teenagers and their associations with specific influences of childhood maltreatment. Lead researcher Dr. Caroline Kabiru and her team surveyed a total of 9,189 teenagers ages 12 to 19 on their levels of drunkenness as well as the presence of various risk factors including insecure food supplies in the household, physical abuse, sexual abuse, and living with a family member who had a drinking problem. Participants in the study were from Burkina Faso, Ghana, Malawi, or Uganda. Researchers controlled such factors as the teenager’s country, place of residence, gender of the teenager’s head of household, living arrangements, and personal elements including the teenager’s gender, age, religiosity, school status, and marital status during their analysis.

As a result, researchers found that approximately 9% of the adolescents reported drunkenness within the past 12 months. Overall, the presence of any of the childhood risk factors measured was attributed to increased levels of drunkenness among adolescents. For males, those who had experienced physical abuse or lived with a problem drinker prior to the age of 10 were most likely to have reported drunkenness. For females, having a family history of alcoholism, being sexually abused, or experiencing physical abuse during childhood increased their likelihood to report problem drinking. 

The association between early childhood adverse events and future problem drinking was more prominent in female adolescents. Females were also more likely than males to be coerced into sex, and even more females were coerced into other acts of sexual nature during childhood. For both genders, adolescents who had experienced more than one adverse event during childhood had graded increases in risk of future drunkenness. In general, males were more likely than females to be currently enrolled in school and to live with both biological parents. Although only 6% of all respondents had ever been married, females were much more likely than males to be married.

The researchers point to their findings as evidence for the need of early intervention and treatment strategies for children who undergo abuse, trauma, or neglect in order to prevent problem alcohol use in later life.

According to a recent Science Daily release, there is an association between sleep problems and alcohol abuse. For those teens who have difficulty sleeping, this can predict the onset of a problem with alcohol abuse when they are healthy adults or a relapse in abstinent alcoholics.

Puberty doesn’t tend to help the situation, either. A new study out of the University Nijmegen examines the associations among pubertal development, sleep problems and alcohol use in early adolescence. The study found that puberty is related to sleep problems and later bedtimes, which are in turn associated with the use of alcohol.

Sara Pieters, a doctoral student and corresponding author for the study, noted that the timing of puberty has been found to predict adolescent use of alcohol. Adolescents who mature early are more likely to drink.

Carmen Van Der Zwaluw, a doctoral student in neuropsychology at the University Nijmegen added that adolescents who experience problems with sleep have a tendency to use more alcohol than those without difficulties with sleep.

The results of this study indicated that puberty had a direct relationship with sleep problems and more evening-type tendencies, including later bedtimes, which positively related to early adolescent alcohol use. This tended to be true regardless of gender, underlying psychopathology and educational level.

Researchers advise clinicians to apply better screening for sleep problems when adolescents seem to have other psychological or behavioral problems. Parents should monitor adolescent sleep and keep in mind the effect it has on the overall healthy lifestyle.
 

Issued by the National Highway Traffic Safety Administration, the report was published in 1995. At that time, only 9 percent of drivers across the nation were Hispanic – but overall, 21 percent of arrests for driving under the influence were Hispanic drivers. Furthermore, Hispanic drivers were part of automobile accidents more often than black or Caucasian populations. While car crashes represented the third primary cause of fatalities across the entire Hispanic population, they were also the second most common cause of death among Hispanics aged 24-44 years old and the primary cause of fatalities for those in the younger category of 17 to 24 years old.

More than 100 agencies submitted study data collected by phone surveys and focus groups, substance abuse experts, social workers, clerical workers and police or law enforcement staff. Information from Community leaders was also included. Regions of the U.S. with higher Hispanic populations were the focus, including southwestern, western and eastern areas. Segments of the population were categorized, such as Guatemalan, Mexican, Puerto Rican and Salvadoran.

Social pressures to be “machismo” may be connected to higher rates of accidents and fatalities, reflected in activities such as speeding, drag racing, using alcohol and drugs together or attempting to drive while under the influence. Illiteracy may also be a factor, with study results suggesting some Latinos were unable to read traffic signs or purposely ignored them. The alarming trend to act macho may also be generational, with fathers reported to frequently purchase fast cars for their sons.

Other research statistics show that many Hispanics arrested for drunk driving may be illegal aliens; many others have been arrested previously for driving while intoxicated. Experts say the problem reflects generational alcoholism, a prolific situation among some segments of the Latino population.

In response to these dangerous study outcomes, the National Highway Traffic Safety Administration has enhanced its driver education programs for Latinos. Favorable results have surfaced, including fewer infant deaths when mothers were more educated about the dangers of holding babies on their laps while driving. It is not yet known if deaths or injuries across the U.S. have been reduced since the report was published.

Overall, the Hispanic population represents the fastest growing segment of the U.S. population, making the study findings extremely important in considering steps to help save lives and prevent injuries. Study results could also influence immigration and deportation laws.
 

The Centers for Disease Control and Prevention (CDC) examined the frequency of binge drinking in relation to individuals’ perceptions of their own health, and found that binge drinkers are 13 to 23 percent more likely to report suboptimal health.

The study, which will be published in the August issue of Alcoholism: Clinical & Experimental Research, examined 200,587 adult drinkers who participated in the 2008 Behavioral Risk Factor Surveillance System (BRFSS), which asked participants to rate their health as excellent, very good, good, fair, or poor.

The researchers then estimated the prevalence of binge drinking and heavy drinking, along with the frequency of binge drinking during a 30-day period. Binge drinking was defined as four or more drinks per drinking session for women and five or more for men. They then divided the self-reports into two categories: optimal health (excellent, very good, or good) and suboptimal (fair or poor).

James Tasi, corresponding author for the study and an epidemiologist at the CDC, said that self-related health is a single question that has been used by many health surveys to measure perception of health, and is a strong predictor of eventual morbidity and mortality.

Robert D. Brewer, the CDC’s alcohol program leader, said that binge drinking is a dangerous pattern that can result in a variety of health and social problems, from potentially fatal car accidents to violence and risky sexual behavior. He added that adult binge drinkers usually have eight drinks per episode, which is far more than the four or five drinks that define binge drinking. Despite this, most binge drinkers are not dependent on alcohol.

According to Tsai, about 35 million adults reported binge drinking in 2008, and more than 40 percent reported binge drinking four or more times over a 30-day period. The new study found that frequent binge drinkers are significantly more likely to perceive their health as suboptimal.

Brewer said these results are important because people who report lower self-related health are more at risk for being hospitalized than those who report higher self-related health. In addition, the study adds to the scientific evidence that binge drinking is dangerous and can lead to hospitalization and death.

Tsai added that these results underscore the importance of screening for problematic drinking in healthcare settings.

Source: Science Daily, Binge Drinkers Report Sub-Optimal Health Status More Often Than Non-Binge Drinkers, June 7, 2010. 

A new study says that the risks do not stop in the adolescent years. Recent research suggests that there may be a link between adolescent alcohol consumption and breast health in adulthood among young women.

The study, led by Catherine S. Berkey, ScDa, examined the relationship between adolescent alcohol consumption and the risk of benign breast disease in young women. The study used consumption information gathered in real time, and looked at the relationship between the drinking levels and biopsy-confirmed benign breast disease.

The researchers utilized the Growing Up Today Study, which is a prospective study of US girls. At the start of the study, the girls were aged 9 to 15 years. They were given annual questionnaires from 1996 to 2001, and then follow-up questionnaires were issued in 2003, 2005, and 2007.

The 2003 questionnaire included questions about the alcoholic beverage consumption of the girls, who were then aged from 16 to 23 years. The 2005 and 2007 surveys showed that 6,899 women, aged between 18 and 27 years, reported whether they had been diagnosed with benign breast disease.

147 of the women reported that they had been diagnosed with benign breast disease, and 67 of those cases were confirmed with a biopsy. 6,752 women reported that they had never been diagnosed with a benign breast disease.

The results of the study show that there was an association between the amount of alcohol consumed during adolescence and the occurrence of benign breast disease in adulthood. Adolescent girls who had consumed alcohol on a regular basis 6 or 7 days a week were at higher risk than those who abstained from drinking, or who rarely drank.

The results of the study indicate that higher amounts of alcohol consumed during adolescence may be associated with a higher risk of developing a benign breast disease in early adulthood.

Adolescents should be counseled to consider many different aspects of alcohol consumption choices, and this study indicates that breast health may soon be a part of the discussion of the consequences of consuming alcohol at a young age.
 

Scientists are constantly striving to understand the different brain responses to alcohol. One area that has recently been examined is how preference conditioning influences healthy individuals while intoxicated. Iris M. Balodis led a group of researchers from the Department of Psychology at Queen’s University in Kingston, Ontario in Canada.

The researchers examined the Conditioned Pattern Preference task in individuals under the influence of alcohol. The research team had previously studied the effects of alcohol on CPP, and had not discovered a relationship between CPP and alcohol. However, the authors wanted to better understand the relationship if there was prior drug use that may impact the conditioning scores.

To test the impact of prior drug use on the relationship between CPP and alcohol, the researchers looked at self-reported alcohol use and preference conditioning in the CPP task. The participants were asked to count the cues that appeared in difference locations on the computer monitor. This was done to measure working memory.

The participants, 69 female and 23 male undergraduate students, also completed the Alcohol Use Disorders Identification Test and the Rutgers Alcohol Problem Index to measure their levels of drinking.

The results of the study show that there was an association between self-reported binge drinking and preference conditioning. Individuals who scored higher on the alcohol use disorder scales tended to have an increased preference for reward-paired cues. The study also found that hazardous drinking did not cause any impairment in working memory when completing the CPP task.

The findings of this study show support for evidence that a history of drug use may sensitize neural pathways that mediate conditioned reward. It may also indicate a neurocognitive disposition connecting substance misuse and interpretations of reward-paired stimuli.
The study found that the relationship between binge drinking and conditioned reward did not impact any cognitive functions. Working memory, for example, was not impacted by the association between binge drinking and conditioned reward.
The findings of this study will be an important step to understanding the way that the brain functions under the influence of alcohol. While working memory and other cognitive functions were not impacted, there is now a better understanding of how the brain responds to conditioning after an individual consumes large amounts of alcohol.
 

One form of treatment that has not been widely applied to alcohol use disorder is intervention with medicine. A recent study by Amanda J. Abraham and Paul M. Roman examined the early adoption of naltrexone as an injectable drug for alcohol use disorder. The study looked at the private-treatment sector to see how injectable naltrexone was being administered.

The study began with the understanding that the substance abuse treatment facilities in the United States have not been enthusiastic about using medications for alcohol use disorders.

The objectives of the study were focused on understanding how the characteristics of injectable naltrexone shape decisions whether the use the medication at the organizational level and on identifying predictors of adoption and barriers that discourage adoption.

The study looked at 345 privately-funded U.S. substance abuse treatment programs. The data was obtained from a nationally representative sample of programs, and the researchers used the data to examine use of injectable naltrexone.

The results of the study show that 16 percent of the programs examined were early adopters of injectable naltrexone as a treatment for alcohol use disorder. The researchers used multivariate logistic regression models to determine that there are certain factors that predict adoption of injectable naltrexone: the percentage of patients paying with private insurance and organizational size.

The strongest predictor of adoption, however, is innovation compatibility. Innovation compatibility is measured by how the program utilizes other types of pharmacotherapies for alcohol use disorder.

There are also several predictors of treatment facilities not using the medicine as a treatment for alcohol use disorder. Factors such as cost, lack of access to prescribing physicians and lack of knowledge about injectable naltrexone can all be circumstances that affect the use of the medication.

70 percent of the patients that receive the medication continue its use for at least two months, which is evidence that injectable naltrexone addresses the patient compliance barrier.

The use of injectable naltrexone gives treatment facilities another tool to assist individuals who are struggling with alcohol use disorder. Its adoption into more treatment facilities may provide those for whom other treatment strategies have not worked another option in healing.
 

Unresolved anger is often considered a trigger for unhealthy decisions related to alcohol, and often dealing with the root of the anger can help AA participants lead healthier lives. But if anger is not addressed, it may lead to a continuing struggle for alcoholics.

Anger is often understood as a trigger for relapse in alcoholics. AA literature indicates that addressing anger issues is critical for recovery, but it has not been fully investigated scientifically. A recent study led by John F. Kelly examined whether AA’s success is due in part to reducing anger.

The researchers used lagged, controlled hierarchical linear modeling analyses to determine whether AA participation mobilized changes in anger. The impact of such changes on AA-related benefit was also examined.

The study involved 1,706 alcohol-dependent adults who were receiving treatment in a clinical trial setting. The participants were assessed at baseline and at 3, 6, 9, 12, and 15 months.

The results of the study show that there were significantly higher levels of anger among those in the AA program when compared with the general population (98th percentile). The anger levels of the participants decreased over the 15-month study period but remained high when compared with general levels (89th percentile).

Participation in AA was positively associated with better alcohol choices, and higher levels of anger were associated with heavier drinking. However, attendance at AA meetings was not related to anger reduction.

The results of the study suggest that anger is not a mediator for alcohol abuse, but there was a strong connection between AA’s focus on anger and the findings of the study. Anger does appear to be a strong predictor for relapse and heavy alcohol consumption.

Though there may have been factors relating to methodology that contributed to the findings showing no association between AA and anger, the findings do indicate that AA participation alone does not specifically alleviate the suffering and alcohol-related risks associated with anger.

Understanding anger issues and how they contribute to alcohol abuse is important for organizations like AA to help alcoholics reduce their struggle with relapse. While this study indicates that anger is not significantly reduced due to AA participation, program organizers may be able to utilize the new research to make anger management in AA more effective for alcoholics.