Cross‐sectional and prospective associations of drinking characteristics with scores from the Self‐Report of the Effects of Alcohol questionnaire and findings from alcohol challenges

Abstract

Background: Data from 2 generations of participants in the San Diego Prospective Study (SDPS) were used to compare cross-sectional and prospective relationships of 5 measures of the low level of response (low LR) to alcohol to 2 key alcohol-related outcomes. Methods:The analyses used data from 373 SDPS male probands and 158 male and female offspring of these individuals to evaluate relationships of 5 LR measures to the prior 5-year maximum drinks per occasion and the number of 11 DSM-IV alcohol use disorder (AUD) criteria experienced. Probands' LR measures included responses to alcohol challenges administered 15 years previously, and ratings for both generations included measures of the number of standard drinks during four periods: the first five times of drinking (SRE-5), the prior three drinking months (SRE-3), the period of heaviest drinking (SRE-H), and a total average across all time frames (SRE-T). Analyses included zero-order correlations, correlations using covariates, and hierarchical multiple regression analyses.Results: All 5 LR measures were correlated with aspects of maximum drinks and the number of AUD criteria, but the most robust results were seen for SRE-3 and maximum drinks. Correlations were less consistent for SRE-5, a measure more closely related to outcomes in the offspring. Hierarchical regression analyses supported most of these conclusions and showed that alcohol challenge-based LRs added significant information regarding maximum drinks even when evaluated with SRE values. The close correlation between SRE-H and SRE-T argues against the need for studies to include both measures. The patterns of results were similar irrespective of whether covariates were included.Conclusions: There were significant correlations of maximum drinks and the number of AUD criteria with findings from prior alcohol challenges and all SRE scores.Challenges and SRE reports are related but not identical LR measures. All SRE scores, including SRE-5, offered useful information regarding subsequent drinking behavior.

AUD Risk, Diagnoses, and Course in a Prospective Study Across Two Generations: Implications for Prevention

“…Long-term prospective studies such as SDPS with its follow-up component provide an opportunity to evaluate problems from a unique perspective compared to other investigations. 31 , 43 , 46 , 47 Such studies are challenging to carry out when funding requires renewal every 3 to 5 years, and they require great effort to ensure consistent participation over time. Thus, such investigations are costly and the number of subjects in the protocol are often limited to several hundred individuals or less, but the data that can be produced by these efforts are unique.…”

“…The retrospective LR measure is not identical to the alcohol challenge in which specific changes in alcohol responses are observed at rising, peak, and falling alcohol blood levels. 18 , 23 However, laboratory measures of subjective feelings gathered at about the same time as the self-report questionnaire correlated with the SRE at >.3, and SRE ratings overlapped about 60% with alcohol-challenge results in predicting drinking quantities. 28 , 33 …”

“…Beginning with the 15-year follow-up of SDPS families, the investigators also began to record environmental and attitudinal characteristics that might partially mediate the impact of low LR on heavy drinking and alcohol problems. 31 , 37 , 38 These mediators included:…”

“…Testing has supported the hypothetical model in Figure 1 regarding how a low LR, which occurs more frequently in individuals with a family history of AUD, increases the risk for heavy drinking and alcohol problems both directly and indirectly through these potential mediators. 31 , 37 , 42 The findings suggested that as much as half of the impact of low LR on adverse alcohol outcomes occurs indirectly, through associating with heavier-drinking peers, expectations that getting drunk is rewarding and desirable, and using alcohol to cope with stress. These findings raised the possibility that for individuals with low LR, interventions that decrease the impact of these three mediators on heavier drinking might reduce the risk for higher maximum drinks and alcohol problems later.…”

“… A low LR to alcohol, which is often associated with a family history of alcohol use disorder (FHalc), increases the risk for heavy drinking and alcohol problems (HD & Probs) both directly and indirectly, through association with heavier-drinking peers (Peer), expectations that heavy drinking is desirable (Expect), and use of alcohol to cope with stress (Cope). 31 , 37 , 42 Source: Adapted from Schuckit et al (2004). 19 Reprinted with permission.…”