Family cohesion and pride, drinking and alcohol use disorder in Puerto Rico

Abstract

Background The extended multigenerational family is a core value of Hispanic culture. Family cohesion/pride can have protective effects on drinking and drug use related behavior among Hispanics. Objectives To examine the association between family cohesion/pride, drinking, binge drinking, and DSM-5 alcohol use disorder in Puerto Rico. Methods Data are from a household random sample of 1510 individuals 18-64 years of age of San Juan, Puerto Rico. Results Bivariate analyses showed that family cohesion/pride was not associated with the average number of drinks consumed per week, but was associated with binge drinking among men. Family cohesion/pride was also associated with DSM-5 alcohol use disorder. Results of the multivariate analyses were consistent with these bivariate results for DSM-5 AUD. Respondents with low (OR=2.2, 95CL=1.21-3.98; p<.01) and medium (OR=1.88; 95CL=1.12-3.14; p<.01) family cohesion/pride were more likely than those with high family cohesion/pride to have a positive diagnosis of DSM-5 alcohol use disorder. More liberal drinking norms and positive attitudes towards drinking were also strong predictors of the average number of drinks consumed per week. More liberal drinking norms also predicted binge drinking, and DSM-5 AUD. Conclusions Higher family cohesion/pride may have a protective effect against DSM-5 alcohol use disorder. This may have practical implications for clinical and prevention programs. As long as high cohesion is not enabling drinking, these programs can enhance and support family cohesion/pride to help clients in treatment and recovery and prevent drinking problems.

DSM‐5 Alcohol Use Disorder Severity in Puerto Rico: Prevalence, Criteria Profile, and Correlates

“…They are therefore not differentially related to severity levels and represent factors that affect overall risk for AUD. All these characteristics increased the odds of AUD at a statistically significant level, as reported previously in the literature for Puerto Rico (Caetano et al, 2016c; Caetano et al, 2016a) and the U.S. mainland (Keyes et al, 2009; Li et al, 2007; Caetano et al, 2011).…”

“…In contrast, the AOR for medium family cohesion/support is smaller and varied only slightly across AUD severity levels. This protective effect of high levels of family cohesion/support is not unexpected given the importance of family life in Latin cultures (Sabogal et al, 1987); it has been previously reported by several authors (Ayón et al, 2010; Coohey, 2001), including previous analyses of this data set (Caetano et al, 2016a). In discussing these results, it is also important to consider the cross-sectional nature of the data, and the fact that some of the associations in Table 3 may be reciprocal.…”

“…Cronbach’s alpha in the data set under analysis is .87. A higher score on these items has been previously found to be associated with a higher volume of drinking and heavier drinking in Puerto Rico (Caetano et al, 2016a)…”

“…The results confirmed a gender-invariant unidimensional model for the DSM-5 AUD criteria (Caetano et al, 2016d). Two other papers examined sociodemographic correlates of DSM-5 AUD but not for lifetime data and not for AUD severity levels (Caetano et al, 2016a; Caetano et al, 2016c).…”

Socioeconomic risk factors for fatal opioid overdoses in the United States: Findings from the Mortality Disparities in American Communities Study (MDAC)

“…Explanations may include NDI artifacts related to nativity [41], less intensive marketing, or access to opioids among non-citizens. [2] Health affirming values placed on social mobility and family cohesion within traditional [42,43] or immigrant communities [44] may also mitigate economic stressors that contribute to depression and substance abuse. [42,43,44] Cultivating networks of support and resilience within communities affected by the opioid epidemic could help to prevent fatal overdoses in the United States.…”