title: Trajectories of alcohol use over time among adults with alcohol dependence.
abstract: This study sought to identify trajectories of drinking behavior change over time in a sample of adults with current alcohol use disorder (AUD). We conducted secondary analyses of seven waves of data from a prospective longitudinal study of 364 adults (mean age=44.0 years, SD=12.8 years) who met criteria for DSM-IV alcohol dependence (AD), 74.4% of whom were entering alcohol treatment. Participants were followed for 2 1/2 to 3 years with in-person interviews every 6 months. Results from latent class growth analyses of drinks per drinking day over 3 years indicated five trajectory classes: 1) Moderate Baseline→Slow Decline; 2) Heavy Baseline→Stable Abstinent; 3) Heavy Baseline→Slow Decline; 4) Heaviest Baseline→Steep Decline, and 5) Heaviest Baseline→Stable Heavy. Findings are consistent with previous research and suggest that these trajectory classes might represent longitudinal phenotypes of alcohol involvement across diverse samples. Treatment modality, Alcoholics Anonymous involvement, and purpose in life were associated with diverse trajectories of drinking behavior among adults with AD. AA involvement was associated with higher odds of membership in trajectory classes that showed declines in drinking from baseline, and having higher purpose in life predicted lower odds of membership in the Heaviest Baseline→Stable Heavy class. AA involvement predicts different pathways of recovery characterized by stable abstinence, steep declines, and/or slower declines in drinking over time. Higher purpose in life may protect against chronic heavy drinking by strengthening motivations to pursue goals that are unrelated to substance use.
authors.affiliation: Addiction Research Center, Department of Psychiatry University of Michigan, Rachel Upjohn Building, Ann Arbor, MI 48109-2700, United States. Electronic address: jcranfor@med.umich.edu.
authors.forename: James A
authors.initials: JA
authors.lastname: Cranford
authors.affiliation: School of Social Work, University of Minnesota, St. Paul, MN 55108, United States.
authors.forename: Amy R
authors.initials: AR
authors.lastname: Krentzman
authors.affiliation: School of Social Work, University of Georgia Athens, GA 30602, United States.
authors.forename: Orion
authors.initials: O
authors.lastname: Mowbray
authors.affiliation: Addiction Research Center, Department of Psychiatry University of Michigan, Rachel Upjohn Building, Ann Arbor, MI 48109-2700, United States.
authors.forename: Elizabeth A R
authors.initials: EA
authors.lastname: Robinson
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D000434:Alcoholic Beverages / Q000706:statistics & numerical data; D000436:Alcoholics Anonymous; D000437:Alcoholism / Q000453:epidemiology* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D008824:Michigan / Q000453:epidemiology; D011446:Prospective Studies; D012959:Socioeconomic Factors
keywords: Alcoholics Anonymous; Drinking behavior change; Purpose in life; Recovery from alcohol dependence