title: Shifts in problem drinking during a life transition: adaptation to medical school training.
abstract: This study addresses the course of alcohol-related problems in future physicians from the perspectives of occupational stress versus selection and life-span developmental frameworks. A cohort of medical students was surveyed at medical school entrance and during the early fall of the second training year. Self-report questionnaires assessed: alcohol-related problems (using a modified time-linked version of the MAST), pretraining psychosocial and psychopathological characteristics and experiences (symptomatic distress, motivations for drinking, personality attributes/deficits, familial history of problem drinking, family disruption and earlier parental bonding) and medical-training characteristics (perceived stressors and levels of social support). On the basis of MAST scores, respondents manifested the following drinking patterns: consistent nonproblem drinking (67.4%), problem exit or remission during medical training (19.4%), problem entrance or onset during medical training (6.3%) and problem chronicity involving problems before and during medical training (6.9%). Female students were overrepresented in the consistent nonproblem group. The major predictors of Time 2 problem onset and chronicity as opposed to problem remission involved pretraining factors: familial history of alcohol problems, Time 1 symptomatic distress and escape motives for drinking. Future reports will depict the prevalence and etiology of problem drinking manifested during the clinical portion of medical training.
authors.affiliation: Department of Psychiatry, University of Illinois, Chicago 60612.
authors.forename: J A
authors.initials: JA
authors.lastname: Richman
authors.forename: J A
authors.initials: JA
authors.lastname: Flaherty
authors.forename: C
authors.initials: C
authors.lastname: Pyskoty
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology*; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology; D016241:Child of Impaired Parents / Q000523:psychology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005783:Gender Identity; D006801:Humans; D015994:Incidence; D008016:Life Change Events; D016015:Logistic Models; D008297:Male; D010553:Personality Development; D012931:Social Environment; D013337:Students, Medical / Q000523:psychology*; D014481:United States / Q000453:epidemiology