An assessment of the demographic and clinical correlates of the dimensions of alcohol use behaviour.

AIMS: To identify population-based clinical and demographic correlates of alcohol use dimensions. METHODS: Using data from a population-based sample of Great Britain (n = 7849), structural equation modelling (SEM) was used to identify associations between demographic and clinical variables and two competing dimensional models of the Alcohol Use Disorders Identification Test (AUDIT). RESULTS: A two-factor SEM fit best. In this model, Factor 1, alcohol consumption, was associated with male sex, younger age, lower educational attainment, generalized anxiety disorder (GAD) and suicide attempts. Factor 2, alcohol-related problems, was associated with the demographic variables (to a lesser extent) and to a wider range of clinical variables, including depressive episode, GAD, mixed anxiety and depressive disorder, obsessive compulsive disorder, phobia, suicidal thoughts and suicide attempts. The one-factor SEM was associated with demographic and all assessed clinical correlates; however, this model did not fit the data well. CONCLUSIONS: Two main conclusions justify the two-factor approach to alcohol use classification. First, the model fit was considerably superior and, second, the dimensions of alcohol consumption and alcohol-related problems vary considerably in their associations with measures of demographic and clinical risk. A one-factor representation of alcohol use, for instance, would fail to recognize that measures of affective/anxiety disorders are more consistently related to alcohol-related problems than to alcohol consumption. It is suggested therefore that to fully understand the complexity of alcohol use behaviour and its associated risk, future research should acknowledge the basic underlying dimensional structure of the construct.

Patterns of alcohol consumption and related behaviour in Great Britain: a latent class analysis of the alcohol use disorder identification test (AUDIT).

AIMS: Attempts have been made to develop typologies to classify different types of alcoholism. However, limited research has focused on classifications to describe general patterns of alcohol use in general population samples. METHODS: Latent class analysis was used to create empirically derived behaviour clusters of alcohol consumption and related problems from the Alcohol Use Disorder Identification Test (AUDIT) based on data from a large stratified multi-stage random sample of the population of Great Britain. Multinomial logistic regression was performed to describe these resultant classes using both demographic variables and mental health outcomes. RESULTS: Six classes best described responses in the sample data. Three were heavy consumption groups, one with multiple negative consequences, one experiencing alcohol-related injury and social pressures to cut down and an additional class with memory loss. There was one moderate class with few negative consequences, and finally two mild consumption groups, one with alcohol-related injury and social pressure to cut down and one with no associated problems. CONCLUSIONS: Alcohol use in Great Britain can be hypothesized as reflecting six distinct classes, four of which follow a continuum of increased consumption leading to increased dependence and related problems and two that do not. Differences between alcohol use classes are apparent with reduced risk of depressive episode in moderate classes and an increased risk of anxiety disorders for the highest consumers of alcohol.

The factor structure and concurrent validity of the alcohol use disorder identification test based on a nationally representative UK sample.

AIMS: To assess the psychometric structure and construct validity of the alcohol use disorder identification test (AUDIT) in a Great Britain population sample. METHODS: A stratified multi-stage random sample of 7849 participants completed the AUDIT as part of a computer assisted interview. Confirmatory factor analyses were conducted testing one to three factor models. The factors in these models were correlated with demographic variables and scores relating to perceived wellbeing, verbal IQ, and neurotic and psychosis symptoms to assess construct validity of the factor solutions. RESULTS: A two factor solution was deemed to appropriately fit the data, measuring alcohol consumption and alcohol related problems. Correlations between the two factors on demographic, wellbeing, neurosis and psychosis symptomology were significantly different. CONCLUSIONS: The two factor solution suggests an advantage to investigating factor specific cut off scores for both consumption and alcohol related problems given their difference in predictive validity on both health and demographic variables.

Patterns of polydrug use in Great Britain: findings from a national household population survey.

BACKGROUND: Polydrug use potentially increases the likelihood of harm. As little is known about polydrug use patterns in the general population, it is difficult to determine patterns associated with highest likelihood. METHODS: Latent class analysis was performed on nine illicit substance groups indicating past year use of cannabis, cocaine, amphetamines, ecstasy, LSD, mushrooms, amyl nitrate, tranquillisers and heroin or crack. Analyses were based on data from a large multi-stage probability sample of the population of Great Britain (n=8538) collected in 2000. Multinomial logistic regression was performed highlighting associations between classes, and demographic and mental health variables. RESULTS: A three class solution best described patterns of polydrug use; wide range, moderate range, and no polydrug use. For males and young people, there was a significantly increased chance of being in the wide and moderate range polydrug use groups compared to the no polydrug use class. Hazardous drinking was more likely in the wide and moderate polydrug classes with odds ratios of 9.99 and 2.38 (respectively) compared to the no polydrug use class. Current smokers were more likely to be wide and moderate range polydrug users compared to the no polydrug use class with odds ratios of 4.53 and 5.85 respectively. A range of mental health variables were also related to class membership. CONCLUSIONS: Polydrug use in Great Britain can be expressed as three distinct classes. Hazardous alcohol use and tobacco use were strongly associated with illicit polydrug use, polydrug use appeared to be significantly associated with mental health, particularly lifetime suicide attempts.

Alternative factor models and heritability of the Short Leyton Obsessional Inventory-Children's Version.

An alternative models framework was used to test three confirmatory factor analytic models for the Short Leyton Obsessional Inventory-Children's Version (Short LOI-CV) in a general population sample of 517 young adolescent twins (11-16 years). A one-factor model as implicit in current classification systems of Obsessive-Compulsive Disorder (OCD), a two-factor obsessions and compulsions model, and a multidimensional model corresponding to the three proposed subscales of the Short LOI-CV (labelled Obsessions/Incompleteness, Numbers/Luck and Cleanliness) were considered. The three-factor model was the only model to provide an adequate explanation of the data. Twin analyses suggested significant quantitative sex differences in heritability for both the Obsessions/Incompleteness and Numbers/Luck dimensions with these being significantly heritable in males only (heritability of 60% and 65% respectively). The correlation between the additive genetic effects for these two dimensions in males was 0.95 suggesting they largely share the same genetic risk factors.