Drinking trajectories from adolescence to the mid-forties among alcohol dependent males.
OBJECTIVE
Identifying differing developmental trajectories of alcohol behavior is fundamental in building theories of alcoholism etiology and course. The purpose of this study was to identify differences in developmental pathways of alcoholism from onset of drinking into middle adulthood.


METHODS
Alcohol-related behaviors and psychiatric status were assessed in 330 men from the Vietnam Era Twin Registry having a lifetime diagnosis of alcohol dependence (AD). Using a modified version of Skinner's Lifetime Drinking History, distinct drinking phases were identified that differed in terms of quantity, frequency and context of drinking. Person-year data were created to indicate whether AD criteria were or were not met for each year between drinking onset and age 41.


RESULTS
Using Latent Growth Mixture Modeling, a four-class model was identified: Severe Chronic Alcoholics; Severe Non-Chronic Alcoholics (SNCA); Late Onset Alcoholics; and Young Adult Alcoholics. Counterparts for three trajectories could be found in the larger alcoholism literature, whereas the fourth type (SNCA) has not been described, notwithstanding its seeming importance and prevalence.


CONCLUSIONS
Present findings support the existence of different alcoholism trajectories and provide a more complete understanding of the variability of alcohol dependence over time. Findings build on the larger alcoholism literature identifying alcoholic subgroups and provide important information regarding alcoholism trajectories and associated features. Future studies are needed with regard to better understanding of the psychosocial influences related to the different alcoholism trajectories, as well as characterizing the different trajectories as individuals transition into older age.
Jacob
Theodore
T
Department of Veterans Affairs, Palo Alto Health Care System, 795 Willow Road 151-J, Menlo Park, California 94025, USA. tjacob@pgsp.edu
Bucholz
Kathleen K
KK
Sartor
Carolyn E
CE
Howell
Donelle N
DN
Wood
Phillip K
PK
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000437:Alcoholism / Q000453:epidemiology*; D003710:Demography; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014427:Twins