终生酒精使用障碍的控制障碍和药理学标准对饮酒和问题之间关系的影响

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2025-10-06 DOI:10.1016/j.drugalcdep.2025.112910

Paul J. Gruenewald , Raul Caetano , Christina Mair

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引用次数: 0

摘要

在以社区为基础的酒精使用者研究中，终生酒精使用障碍（AUD）标准对更多饮酒和问题的贡献很少被考虑。然而，理论和实证研究表明，饮酒与问题之间的关系可能在报告与AUD相关的控制受损（ic）或药理学(p)标准的饮酒者中有很大不同。在这项研究中，我们测量了大量这些标准的存在对饮酒和问题之间的剂量-反应关系的影响程度。方法对2044名每月至少饮酒两次的“常规”饮酒者进行调查，评估受访者的社会人口学特征、冲动性、饮酒动机、感觉寻求、饮酒模式、终身AUD标准（综合国际诊断访谈）以及过去28天内18个饮酒问题的发生情况。使用异方差Tobit回归模型来衡量两种控制受损指标（饮酒控制受损、无法停止饮酒）和三种药理学标准（渴望、耐受性、戒断）对饮酒与问题之间剂量-反应关系的影响。结果经常饮酒者中存在剂量-反应效应（Χ2=53.2, df=1, p < 0.001）。终生icpAUD标准的数量越多，剂量反应越低（Χ2=6.59, df=1, p = 0.010）， 28天饮酒问题的数量越多（Χ2=127.8, df=1, p < 0.001）。大量非线性效应与饮酒与28天问题有关，饮酒者的终生icpAUD标准数量较多。结论与终生AUD相关的控制障碍措施和药理学症状标准改变了剂量-反应关系，并大大增加了28天饮酒问题。因此，评估终身AUD标准对于社区研究中酒精问题的病因学评估至关重要。

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Impacts of impaired control and pharmacological criteria for lifetime alcohol use disorder on relationships between drinking and problems

Background

The contribution of criteria for lifetime alcohol use disorder (AUD) to greater drinking and problems is infrequently considered in community-based studies of alcohol users. However, theoretical and empirical work indicate that relationships between drinking and problems may be quite different among drinkers reporting impaired control (ic) or pharmacological (p) criteria related to AUD (icpAUD). In this study we measured the extent to which the presence of greater number of these criteria affected dose-response relationships between drinking and problems.

Methods

A survey of 2044 “regular” drinkers reporting use at least twice a month over the previous year assessed respondents’ sociodemographic characteristics, impulsivity, drinking motives, sensation seeking, drinking patterns, lifetime AUD criteria (Composite International Diagnostic Interview) and the occurrence of 18 drinking problems over the previous 28 days. Heteroskedastic Tobit regression models were used to measure impacts of two measures of impaired control (impaired control over drinking, inability to stop drinking) and three pharmacological criteria (craving, tolerance, withdrawal) on dose-response relationships between drinking and problems.

Results

A dose-response effect was observed among regular drinkers with no criteria (Χ²=53.2, df=1, p < 0.001). Greater number of lifetime icpAUD criteria was related to reduced dose-response (Χ²=6.59, df=1, p = 0.010) and much greater numbers of 28-day drinking problems (Χ²=127.8, df=1, p < 0.001). Substantive nonlinear effects related drinking to 28-day problems across drinkers with greater numbers of lifetime icpAUD criteria.

Conclusions

Measures of impaired control and pharmacological symptom criteria related to lifetime AUD alter dose-response relationships and greatly increase 28-day drinking problems. Therefore, assessments of lifetime AUD criteria are critical to etiological assessments of alcohol problems in community-based studies.

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来源期刊

Drug and alcohol dependence 医学-精神病学

CiteScore

7.40

自引率

7.10%

发文量

409

审稿时长

41 days

期刊介绍： Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.