The Type A-Type B classification in a community sample of problem drinkers: structural and predictive validity.
OBJECTIVE
The Type A-Type B multidimensional classification model has been useful for identifying a subgroup of alcohol dependent drinkers with more severe psychosocial problems and a poor prognosis. Evidence suggests its dimensions may be useful for identifying problem drinkers in the general population at risk for developing alcohol dependence. To date, the model has not yet been investigated for this purpose. The present study investigated the Type A/Type B distinction in a community sample of problem drinkers as well as its predictive validity among problem drinkers with no history of alcohol dependence.


METHODS
Households from a geographically delimited area in the United States were designated via random digit dialing and randomly designated members were screened for eligibility. A total of 876 participants met eligibility criteria and completed a structured interview (AUDADIS) on alcohol and other health related behaviors at baseline and at 1-year follow-up. A k-means cluster analysis was performed to identify subgroups of problem drinkers.


RESULTS
A two-cluster solution adequately fit the data and identified two main subgroups of problem drinkers consistent with a Type A-Type B distinction. The group differences held among those with and without a history of alcohol dependence and the subset of Type B drinkers with no history of alcohol dependence were approximately five times (beta = 1.56, p< or =0.01) more likely to have an initial onset of dependence than Type A drinkers at 1-year follow-up. In contrast, a DSM-IV alcohol abuse diagnosis at baseline did not predict 1-year onset of dependence.


CONCLUSIONS
The Type A-Type B model is useful for identifying untreated problem drinkers at risk for developing alcohol dependence. This model may facilitate the development of more targeted prevention efforts.
Carpenter
Kenneth M
KM
Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, NY 10032, USA. carpent@pi.cpmc.columbia.edu
Liu
Xinhua
X
Hasin
Deborah S
DS
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D000437:Alcoholism / Q000145:classification* / Q000453:epidemiology; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009515:New Jersey / Q000453:epidemiology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D012307:Risk Factors