title: An empirical classification of drinking patterns among alcoholics: binge, episodic, sporadic, and steady.
abstract: Steady (daily, continuous) versus nonsteady (binge, episodic, bout, intermittent) drinking pattern have been influential Jellinek's (1960) formulation of delta and gamma drinkers, and are used as variables in various typological systems and drinker profiles. However, definitions of drinking patterns vary widely across studies, and most studies rely on one self-report item to establish a subject's pattern. To systematize and empirically test drinking-pattern schemas, we developed detailed definitions of binge, episodic, sporadic, and steady drinking patterns. A computer algorithm was written in SAS to classify 94 male alcoholics participating in outpatient conjoint therapy, using 6-month pretreatment drinking data from the Timeline Followback Interview. The final classification was: 3 (3%) binge, 33 (35%) episodic, 12 (13%) sporadic, and 40 (43%) steady drinkers. Six (6%) were unclassifiable (due to too few drinking days or too many interruptions to the pattern) by the computer. Episodic, sporadic, and steady drinkers did not differ in demographics, alcohol-related consequences, global psychological distress, or marital satisfaction. Steady drinking was associated with later onset of drinking problems (> 25), while episodic and sporadic drinking were associated with earlier onset. These results are contrary to current use of "binge drinking" as a variable associated with Type 1 alcoholism. Predictive validity analyses indicated that steady drinkers continued to drink more frequently than episodic and sporadic drinkers during treatment and 6 months posttreatment. Also, preliminary data indicate that pretreatment drinking pattern may be predictive of similar within-treatment urge-to-drink patterns. Implications for research and treatment are discussed.
authors.affiliation: Center of Alcohol Studies, Rutgers, State University of New Jersey, Piscataway 08855-0969, USA.
authors.forename: E E
authors.initials: EE
authors.lastname: Epstein
authors.forename: C W
authors.initials: CW
authors.lastname: Kahler
authors.forename: B S
authors.initials: BS
authors.lastname: McCrady
authors.forename: K D
authors.initials: KD
authors.lastname: Lewis
authors.forename: S
authors.initials: S
authors.lastname: Lewis
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000523:psychology*; D000436:Alcoholics Anonymous; D000437:Alcoholism / Q000145:classification* / Q000175:diagnosis / Q000534:rehabilitation; D000465:Algorithms; D000553:Ambulatory Care; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008388:Marital Therapy; D008875:Middle Aged; D010555:Personality Inventory; D011446:Prospective Studies