title: A literature overview of the relationship between life-events and alcohol use in the general population.
abstract: OBJECTIVE
  A critical review of the evidence of effects of stressful life-events on alcohol use in the general population, with a particular focus on study design.
  
  
  METHODS
  A literature search in Medline was conducted, covering the period from 1990 to 2005, to identify articles in which the relationship between life-events and alcohol use in the general population (i.e. non-problem drinking population) was investigated. Samples with a limited age range (e.g. college students) were excluded. Twelve studies with a cross-sectional design, and four articles with a longitudinal design were included in this review.
  
  
  RESULTS
  Four cross-sectional studies found evidence that experiencing life-events is related to higher alcohol use, three other studies, however, found no such association. The relationship between specific life-events and alcohol use in the five remaining cross-sectional studies is less clear-cut. Being a victim of crime was associated with higher alcohol use, but divorce and financial problems were related to both higher and lower alcohol use. Health-related life-events were found to be associated with lower alcohol use. In studies with a longitudinal design, it was found that health-related life-events and financial problems caused a decrease in alcohol use, and life-events related to spouse, friends and relatives, and retiring led to an increase in alcohol use.
  
  
  CONCLUSIONS
  Evidence points towards a relationship between the occurrence of life-events and alcohol use in the general population. The direction of the effect is, however, not unequivocal. When life-events are operationalized or categorized separately they are not only related to an increased alcohol use but also to a decreased alcohol use. Specification of the model to be tested, including buffering factors such as gender, social support, coping resources, as well as baseline consumption, is important for a correct estimation of the effect of negative life-events.
authors.affiliation: Addiction Research Institute, Erasmus University Rotterdam, Rotterdam, the Netherlands. mveenstra@zw.unimaas.nl
authors.forename: Marja Y
authors.initials: MY
authors.lastname: Veenstra
authors.forename: Paul H H M
authors.initials: PH
authors.lastname: Lemmens
authors.forename: Ingrid H M
authors.initials: IH
authors.lastname: Friesema
authors.forename: Henk F L
authors.initials: HF
authors.lastname: Garretsen
authors.forename: J André
authors.initials: JA
authors.lastname: Knottnerus
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Zwietering
mesh_terms: D000223:Adaptation, Psychological; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000706:statistics & numerical data; D006801:Humans; D008016:Life Change Events; D012737:Sex Factors; D012944:Social Support; D013223:Statistics as Topic