Treatment of Older Women With Alcohol Problems: Meeting the Challenge for a Special Population

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65642/1/j.1530-0277.2000.tb02092.x.pd

Young-adult children of alcoholic parents: protective effects of positive family functioning

The occurrence of alcoholism is clustered within families, but the detrimental effect of a positive family history may vary with the degree of family impairment involved. In this study we assessed the effects of family history and family environment on alcohol misuse. From ongoing studies we recruited parents who had a child aged 18–30, 20 with a DSM-III-R alcohol dependence diagnosis, 20 without. The child then completed a multidimensional assessment. The young-adult participants included 20 men and 20 women (mean age=24.8). Differences by family history were restricted to substance abuse behaviors. While a high level of alcohol problems occurred in both groups, those with an alcohol-dependent parent were more likely to be heavy drinkers and showed more symptoms of alcohol dependence. Overall psychological adjustment did not differ between the groups, however. Alcohol misuse measures did correlate moderately with symptoms of poor emotional health. The most important correlates of alcohol misuse measures in this study were exposure to parental alcoholism, abusive punishment, and psychological symptoms, with some separation of effects in the two subgroups. Psychological symptoms had a stronger relationship with misuse in subjects with social-drinking parents, while abuse was more associated in the group with an alcohol-dependent parent. These results confirm the importance of environmental interactions with familial risk. A biological vulnerability from an alcohol-dependent parent was not sufficient or necessary for the participants in this study to develop alcohol dependence as a young adult, although there was an increased risk. There appear to be strong protective effects of positive family relationships on the potential negative effects of a family history of alcoholism.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73415/1/j.1360-0443.1992.tb02681.x.pd

Role of Alcohol in Late-Life Suicide

Suicide is among the leading causes of death in the United States, ranking 10th to 12th annually, depending on the year. Rates of suicide increase markedly among Americans over age 75, especially among white men. After age 85, rates are >5-fold higher in this group than in the general population. The relationship between alcohol use and later-life suicide is complex and currently ill defined. Substance use disorders, particularly alcohol abuse and dependence, are the second most common category of axis I disorders associated with completed suicide among adults aged 65 and older, following only depression. The co-occurrence of alcohol use disorders and depression heightens suicide risk. Most studies that have evaluated the effects of alcohol in geriatric suicide have focused on older adults who met DSM criteria for abuse and/or dependence. However, the majority of older adults who are experiencing problems related to their alcohol use do not meet alcohol abuse/dependence criteria. Therefore, the role of at-risk and problem alcohol use in geriatric suicide may be underestimated. Drinking among elders elevates suicide risk through interactions with other factors that are more prevalent in this age group, such as depressive symptoms, medical illness, negatively perceived health status, and low social support. This article reviews the literature related to alcohol use and suicide among older adults. Clinical and research recommendations for addressing this problem are also presented.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65936/1/j.1530-0277.2004.tb03603.x.pd

Prevalence and Severity of Alcohol and Cannabis Use Across the Urban‐Rural Continuum in the Michigan National Guard

PurposeThe National Guard provides critical support both domestically and abroad with soldiers dispersed throughout America and spanning the urban‐rural continuum. To determine if location‐specific interventions may be needed, we compared the prevalence and severity of cannabis and alcohol use among National Guard members across localities.MethodsMichigan National Guard members were enrolled (N = 2,746) during drill weekends as part of a larger randomized behavioral trial. Cannabis (ASSIST; prevalence = 5%) and alcohol use (AUDIT; prevalence = 82%) were compared using hurdle regression models across locality status after adjusting for covariates.FindingsPrevalence of cannabis and alcohol use was predicted by locality (adjusted odds ratio [AOR] = 0.913, 95% CI: 0.838‐0.986, P = .029; AOR = 0.963, 95% CI: 0.929‐0.998, P = .038, respectively), with more use in urban localities. Neither severity of cannabis nor alcohol use was predicted by locality status.ConclusionsPrevalence of cannabis and alcohol use in the National Guard is differentially elevated across localities with higher prevalence in more central, densely populated areas. Findings may inform future work considering accessibility and utilization of prevention and treatment services for Guard members across the urban‐rural continuum.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154619/1/jrh12412.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154619/2/jrh12412_am.pd

Injury Type, Injury Severity, and Repeat Occurrence of Alcohol-Related Trauma in Adolescents

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66113/1/j.1530-0277.1994.tb00011.x.pd

Symptoms and correlates of anabolic-androgenic steroid dependence

Forty-nine male weight lifters, all users of anabolic-androgenic steroids (AASs), completed an anonymous, self-administered questionnaire to investigate addictive patterns of use. At least one DSM-III-R symptom of dependence was reported by 94% of the sample. Three or more symptoms, consistent with a diagnosis of dependence, were reported by 57%. Dependent users (n=28) could be distinguished from non-dependent users (n=21) by their use of larger doses, more cycles of use, more dissatisfaction with body size, and more aggressive symptoms. Multiple regression analysis revealed that dosage and dissatisfaction with body size were the best predictors of dependent use. Patterns of other substances used, although not predictive of AAS dependence, revealed very low cigarette use and at the same time high alcohol consumption. These data support the notion that AASs are addicting, and suggest that dissatisfaction with body size may lead to dependent patterns of use. The implications for both prevention and treatment are discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73678/1/j.1360-0443.1991.tb03101.x.pd

No End in Sight: Benzodiazepine Use in Older Adults in the United States

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135540/1/jgs14379_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/135540/2/jgs14379.pd

Associations between body mass index and suicide in the veterans affairs health system

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/102714/1/oby20422.pd

The prevalence and correlates of eating disorders in adult emergency department patients

ObjectiveThis study describes the prevalence of eating disorders among adult patients who present to the emergency department for medical care and examines the relationship between eating disorders, depression, and substance use disorders.MethodEmergency department patients aged 21-65-years (n = 1,795) completed a computerized questionnaire that included validated screening tools for eating disorders, risky drinking behavior, other substance use, and depression. Analyses were conducted comparing individuals who screened positive for an eating disorder with those who did not based on demographics (gender, age, race, income, education), body mass index (BMI), risky drinking behavior, other substance use, and depression.ResultsNearly 16% (15.9%) of all patients screened positive for an eating disorder regardless of their reason for presenting to the emergency department. Patients who screened positive for an eating disorder were significantly more likely to have a BMI->-30 (odds ratio [OR] = 2.68, confidence interval [CI] = 1.98, 3.62, p-<-.001), to also screen positive for depression (OR = 3.19, CI = 2.28, 4.47, p-<-.001) and to be female (OR = 2.37, CI = 1.76, 3.19, p-<-.001). No differences in the prevalence of positive screens for eating disorders were seen across age or racial groups, level of education or income, or for any of the included substance use variables.DiscussionEating disorders are common among adult emergency department patients and are associated with high rates of comorbid depression and higher BMI. Given the significant morbidity and mortality associated with eating disorders, targeted screening may be warranted in the emergency department setting.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152020/1/eat23140_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/152020/2/eat23140.pd

FORMS OF COCAINE AND PSYCHIATRIC SYMPTOMS

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/27431/1/0000469.pd