title: Associations between exposure to stressful life events and alcohol use disorder in a longitudinal birth cohort studied to age 30.
abstract: BACKGROUND
  To examine associations between measures of stressful life events exposure and alcohol abuse/dependence (AAD) from ages 18 to 30 using data from a longitudinal birth cohort (n=987 to 1011).
  
  
  METHODS
  Outcome measures included DSM-IV (American Psychiatric Association, 1994) AAD symptoms and AAD, at ages 20-21, 24-25, and 29-30 years. Exposure to a range of stressful life events was measured during the periods 18-21, 21-25, and 25-30 years using items adapted from the social readjustment rating scale (Holmes and Rahe, 1967). Data were analysed using Generalised Estimating Equation models, adjusted for non-observed sources of confounding using conditional fixed effects regression. Further analyses examined: gender×life events exposure interactions, structural equation modelling of possible reciprocal causal pathways linking stressful life events and AAD symptoms, and an alternative conceptualization of the stressful life events measure.
  
  
  RESULTS
  After adjustment, those with the highest exposure to stressful life events had rates of AAD symptoms that were 2.24 (p<.0001) times higher, and odds of AAD that were 2.24 times higher(p<.01), than those at the lowest level of exposure. Associations between life events exposure and AAD symptoms were stronger for females than for males (p<.05), with results consistent using a count measure of stressful life events. Structural equation modelling showed that the best-fitting model was one in which life events influenced AAD symptoms.
  
  
  CONCLUSIONS
  The results suggest that there were persistent linkages between stressful life events and AAD, providing support for a stress-reduction model of alcohol consumption.
authors.affiliation: Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch School of Medicine and Health Sciences, PO Box 4345, Christchurch 8140, New Zealand. Electronic address: joseph.boden@otago.ac.nz.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Boden
authors.affiliation: Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch School of Medicine and Health Sciences, PO Box 4345, Christchurch 8140, New Zealand.
authors.forename: David M
authors.initials: DM
authors.lastname: Fergusson
authors.affiliation: Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch School of Medicine and Health Sciences, PO Box 4345, Christchurch 8140, New Zealand.
authors.forename: L John
authors.initials: LJ
authors.lastname: Horwood
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology; D000437:Alcoholism / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D005260:Female; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult
keywords: Alcohol; Life stress; Longitudinal study