These data suggest that effective environmental prevention efforts at reducing underage drinking may be an important strategy to lower the prevalence of alcohol dependence in this high-risk population.
Cannabis is the most widely used illicit drug in the United States, yet the role of genetics in individual symptoms associated with cannabis use disorders has not been evaluated. The purpose of the present set of analyses was to describe the symptomatology and estimate the heritability of DSM-IV criteria/ symptoms of cannabis dependence in a large sample of families. Participants were 2524 adults, participating in the University of California San Francisco (UCSF) Family Study of alcoholism. Seventy percent of the sample had ever used cannabis and 13.9% met DSM-IV criteria for cannabis dependence. Younger age at first cannabis use was found to be significantly associated with a shortened survival to becoming cannabis dependent. Although a greater percentage of men met criteria for cannabis dependence, women were found to demonstrate "telescoping" as indexed by a shorter survival time from initial use to dependence as compared to men. A cannabis withdrawal syndrome was identified in users, the primary symptoms of which were nervousness, appetite change, and sleep disturbance. Cannabis use (h 2 = 0.31) and dependence (h 2 = 0.20), age at first use, individual DSM-IV criteria for dependence, and cannabis-use associated symptoms of depression, trouble concentrating and paranoia were all found to be heritable. These findings suggest that within this population that cannabis use and dependence, as well as individual cannabis dependence symptoms have a significant heritable component, that cannabis dependence is more likely to occur when use Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. ContributorsThe submitted manuscript has been read and approved by all authors and all authors concur with the submitted manuscript. Kirk Wilhelmsen and Cassandra Vieten designed the study and wrote the protocol. Phillip Lau, Gina Stouffer and Ian Gizer conducted the statistical analysis. David Gilder did all best final diagnoses of research participants. Cindy Ehlers wrote the first draft of the manuscript and all authors contributed to and have approved the final manuscript. In addition, the authors acknowledge that they have exercised due care in ensuring the integrity of the work, and none of the original material contained in the manuscript has been submitted for consideration nor will any of it be published elsewhere except in abstract form in connection with scientific meetings. Conflict of Interest
Study Objectives: Epidemiological studies have found that insufficient sleep (< 7 h/night) is more common among American Indians/Alaska Natives (AI/AN). In this study we sought to identify specific demographic, clinical, and cultural factors that may be associated with reduced sleep quality in an American Indian community sample. Methods: Information on demography along with personal medical, psychiatric, and drinking history was obtained using the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA). Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Results:The adult participants (n = 386, 54% women) had a mean ± standard deviation age of 31.35 ± 14.4 y. Higher degrees of AI ancestry, but not cultural identification, being older than 30 y, and having a high school diploma all were factors predictive of having a short sleep duration (< 6 h). The global score on the PSQI was significantly higher in those participants with a lifetime diagnosis of substance use disorders, anxiety disorders, and affective disorders. Alcohol use disorders and affective disorders were significant predictors of sleep latency whereas anxiety and affective disorders were correlated with waking more often in the night/early morning. Nicotine dependence was associated with having trouble breathing, and alcohol use disorders and anxiety disorders with bad dreams. Conclusions: Alcohol use disorders are associated with poorer quality of sleep in this population and substance use disorders were associated with different aspects of sleep than anxiety and depressive disorders. These findings add to the understanding of the interactions between sleep and substance use, anxiety, and affective disorders in an understudied and underserved population. Keywords: alcohol dependence, American Indians, anxiety disorders, BMI, drug dependence, major depressive disorders, PSQI, sleep Citation: Ehlers CL, Wills DN, Lau P, Gilder DA. Sleep quality in an adult American Indian community sample. J Clin Sleep Med. 2017;13(3):385-391. I NTRO DUCTI O NOver the past decade there has been a growing body of literature that has explored the potential overlap between health disparities research and sleep medicine.1 A number of epidemiological studies have reported poorer quality sleep and a higher prevalence of short and/or long sleep in non-White adults, particularly from lower socioeconomic status groups, in comparison with White adults. [2][3][4][5] This research has provided crucial information on disparities in such factors as selfreported sleep duration, daytime sleepiness, and symptoms of sleep disordered breathing across ethnic groups, geographical location, and socioeconomic status. However, the underlying racial/ethnic specific factors that may lead to these disparities in sleep health are less well understood.6 It has been suggested that studies using a multilevel approach that includes examination of factors such as level of acculturation, comorbid medical and psychiatric conditions, neighborhood conditions, and cultural ...
Objective-This study identified factors associated with remission from DSM-III-R alcohol dependence in an American Indian community group.Method-Participants were assessed using the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA).Results-Five hundred and eighty participants were assessed for alcohol use and alcohol use symptoms; 254 participants were found to have alcohol dependence. The rate of remission in this sample was 59%. Thirty-four percent of remitters and 39% of non-remitters had received treatment for alcohol problems. Remission from alcohol dependence was associated with being female, older, and married; an earlier age of onset of alcohol dependence; and self-reported depression symptoms from drinking. Absence of remission was associated with continuing to drink despite knowing one had medical problems from drinking and self-reported anxiety symptoms from drinking.Conclusion-Attention to factors associated with remission from alcohol dependence may be important in designing more effective treatment and prevention programs in this high risk population.
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