Discrepant substance use and marital functioning in newlywed couples.

The configuration of partners' drinking patterns may be most critical to marital functioning. Implications of discrepant husband and wife smoking, drinking, and drug use for relationship quality at the transition to marriage were examined. Participants were 642 couples entering into their 1st marriage. Separate, self-administered questionnaires were completed at home by each partner. Both husbands and wives in couples in which only 1 partner drank heavily or used drugs reported significantly lower marital quality than other spouses. Husband Use x Wife Use interactions were not significant for cigarette use, alcohol use, or regular drinking. Discrepancies in more deviant substance use behaviors may be most relevant to marital functioning.

Alcohol use in the year before marriage: alcohol expectancies and peer drinking as proximal influences on husband and wife alcohol involvement.

BACKGROUND: Models of adolescent alcohol involvement that include individual difference, family, and peer risk factors indicate a significant association between the drinking of adolescents and that of their peers. Peer drinking influences, however, have not been investigated extensively in integrative models of adult drinking. The purpose of this study was to test a model of adult drinking that incorporated the potentially important risk factor of partner drinking and in which proximal risk factors (peer drinking, alcohol expectancies) were hypothesized to be strongly associated with adult alcohol use and to mediate relationships between more distal risk factors and drinking. METHODS: Couples (n = 389) were assessed at the time of their first marriage. Separate, self-administered questionnaires were completed at home by both husbands and wives. Distal risk factors included family history of alcoholism, antisocial behavior, and depressive symptomatology. Substantive relationships were tested in a model that included spousal associations with respect to distal risk factors, proximal risk factors, and drinking. RESULTS: Findings demonstrate the unique association of alcohol expectancies and peer drinking with adult alcohol use. Of particular relevance is the significance of the social network as a correlate of adult drinking. A peer network characterized by a higher level of alcohol involvement was strongly associated with heavier drinking among both men and women. This relationship was independent of sociodemographic and individual difference factors, alcohol expectancies, and partner's drinking. Results also demonstrate the similarity between husband and wife drinking, an association that cannot be attributed to assorting with respect to the other risk factors. CONCLUSIONS: The social network continues to significantly impact drinking behavior in adulthood. The relevancy of peer and partner drinking influences to adult alcohol involvement suggests that the immediate social environment may have a prominent role in the continuity/discontinuity of heavy or problem drinking during the transition to marriage.

Peer networks among heavy, regular and infrequent drinkers prior to marriage.

OBJECTIVE: Research has consistently demonstrated that, among adolescents, the characteristics of one's peers are important predictors of substance abuse. The impact of the peer network on adult drinking, however, has received considerably less attention. The purpose of the present study was to examine social network characteristics that are associated with heavy drinking in adulthood prior to marriage. METHOD: Couples were recruited at the time of their first marriage. Husbands and wives were each given identical questionnaire packets to complete at home, independently, as well as a postage-paid envelope for packet return. A broad range of constructs was assessed; included were personality characteristics, relationship functioning, drinking behavior and social network characteristics. Complete data were obtained from 471 husbands and 471 wives. RESULTS: The social networks of heavy-drinking men, compared to men drinking regularly or infrequently, were younger, more likely to be male and unmarried and consisted of friends rather than family or others. For both men and women, "drinking buddies" accounted for nearly 75% of the heavy drinkers' peer networks. The overall ratings of support and conflict created by peers did not differ according to drinking group, for either men or women. CONCLUSIONS: Prior to marriage, the social networks of heavy drinkers differ considerably from the networks of regular or infrequent drinkers with regard to the drinking patterns of their peers. An important finding was that heavy drinkers appear to experience a similar level of emotional, financial and practical support from their peer network compared to regular or infrequent drinkers.

A longitudinal model of social contact, social support, depression, and alcohol use.

The longitudinal relations among contact with one's social network (social contact), perceived social support, depression, and alcohol use were examined. An integrative model was developed from affect regulation theory and theories of social support and dysfunctional drinking. Data were obtained from a random sample of 1,192 adults. The 3-wave panel model was tested using structural equation modeling analysis. Results revealed that (a) social contact was positively related to perceived social support; (b) perceived social support was, in turn, negatively related to depression; and (c) depression was, in turn, positively related to alcohol use for 1 of 2 longitudinal lags. There was partial support for the feedback hypothesis that increased alcohol use leads to decreased contact with family and friends. Although the results generally supported the authors' hypotheses, the significant coefficients in the model were generally small in size.

Mothers' alcohol and other drug problems and their punitiveness toward their children.

OBJECTIVE: The relationship between mothers' alcohol or other drug (AOD) problems and their punitiveness toward their children is examined in this study. METHOD: Women (N = 170) were recruited from five different sources, including clinical interventions and the community. Women's punitiveness toward their children was assessed by three different maternal self-report measures: Conflict Tactics Scale, Parental Punitiveness Scale and Child Abuse Potential Inventory. Women's histories of AOD problems, violent victimization and hostility were assessed using standardized assessment tools. RESULTS: Women were categorized by their AOD problems as follows: current problem (22.4%), past only problem (44.7%) or no problems (32.9%). Results indicate that mothers with current or past AOD problems are more punitive toward their children, controlling for potentially confounding demographic factors. Mothers' histories of partner violence and parental violence also predicted higher levels of mother-to-child punitiveness. However, histories of childhood sexual abuse predicted lower levels of mothers' punitiveness. Hostility served as a predictor of mothers' punitiveness and moderated some of the relationships between their AOD problems and their punitiveness. CONCLUSIONS: Findings suggest that women with AOD problems are more likely to be punitive toward their children, but other factors may also contribute to this risk. Treatment and prevention interventions need to be developed to decrease the risk of violent victimization among children whose mothers have alcohol and other drug problems.

Gender differences in the relation between depressive symptoms and alcohol problems: a longitudinal perspective.

Longitudinal relations between depressive symptoms and alcohol problems have been examined infrequently in community-based studies, and gender-specific findings to date appear to be inconclusive. Study hypotheses were that depressive symptoms predicted subsequent alcohol problems for females, whereas alcohol problems predicted subsequent depressive symptoms for males. The authors examined these relations in a random sample of household adults (aged 19 years or more) from Erie County, New York, assessed in 1986, 1989, and 1993 (n = 1,306). Measures of alcohol problems (in the previous year) incorporated an alcohol abuse/dependence diagnosis and a heavy alcohol use index. The Center for Epidemiologic Studies Depression Scale was used to assess depressive symptoms over a 1-month time frame. Comprehensive logistic regression models incorporated prior depressive symptoms, prior alcohol problems and sociodemographic variables (age, race, education, marital status, employment, total family income, and number of children living at home). For females, depressive symptoms predicted subsequent alcohol problems over 3 years (odds ratio = 3.04, 95% confidence interval 1.35-6.80, p < 0.01) and 4 years (odds ratio = 2.42, 95% confidence interval 1.14-5.12, p < 0.05), but not for 7 years. There was no evidence to support the hypothesis for males. This study clarifies and extends prior investigations of relations between these two prevalent mental health problems in a community-based sample.

Detecting risk drinking during pregnancy: a comparison of four screening questionnaires.

OBJECTIVES: This study investigated the efficacy of screening for risk drinking during pregnancy with two brief questionnaires, TWEAK and T-ACE. Both include an assessment of tolerance based on the number of drinks women report they can hold. METHODS: Subjects were disadvantaged African-American obstetric patients in Detroit, Mich. Traditional alcoholism screens (Michigan Alcohol Screening Test [MAST], CAGE) and the tolerance question were administered (n = 2717); TWEAK and T-ACE were constructed from tolerance and embedded MAST and CAGE items. In a separate sample (n = 1420), only the T-ACE was administered. Periconceptional risk drinking was the gold standard. Screen evaluations were based on receiver-operating characteristic analyses. RESULTS: At the cutpoint of 2, sensitivity/specificity for embedded screens were 91/77 for TWEAK and 88/79 for T-ACE; comparable values for T-ACE alone were 67/86. TWEAK and T-ACE screened more effectively than CAGE or MAST. CONCLUSIONS: Embedded versions of TWEAK and T-ACE were both highly sensitive to periconceptional risk drinking in this population. Administering T-ACE alone reduced its sensitivity; this suggests that MAST and CAGE administration improves its performance.

Drinking to regulate positive and negative emotions: a motivational model of alcohol use.

The present study proposed and tested a motivational model of alcohol use in which people are hypothesized to use alcohol to regulate both positive and negative emotions. Two central premises underpin this model: (a) that enhancement and coping motives for alcohol use are proximal determinants of alcohol use and abuse through which the influence of expectancies, emotions, and other individual differences are mediated and (b) that enhancement and coping motives represent phenomenologically distinct behaviors having both unique antecedents and consequences. This model was tested in 2 random samples (1 of adults, 1 of adolescents) using a combination of moderated regression and path analysis corrected for measurement error. Results revealed strong support for the hypothesized model in both samples and indicate the importance of distinguishing psychological motives for alcohol use.

Correlates of alcohol-related problems in African-American and white gynecologic patients.

The purpose of this study was to assess racial differences in the risk of alcohol-related problems associated with alcohol consumption, regular psychoactive drug use, a family history of alcohol-related problems, sociodemographic factors (age and education), and social roles (work, marital, and parental) among nonabstaining African-American and White gynecologic outpatients. In addition, work, marital, and parental roles were investigated to determine whether they mediated or explained racial differences observed in relationships between these factors and alcohol-related problems. Respondents were 630 African-American women and 769 White women aged 13-77 who were systematically sampled from three obstetric/gynecologic clinics and two private practices in Erie County, New York. Hierarchical multiple regression analysis was used to test the significance of main effects of these factors on alcohol-related problems, to test the interactive effects of race with each factor, and to test the interactive effects of social roles with alcohol consumption, the only factor for which a racial difference was observed in its relationship with alcohol-related problems. Overall, results indicated that correlates of alcohol-related problems were similar for African-American and White women. Higher risk of alcohol-related problems was associated with lower levels of education and lack of work and parental roles. In addition, married women who drank heavily were at higher risk of alcohol-related women who drank heavily were at higher risk of alcohol-related problems than unmarried women who drank heavily.(ABSTRACT TRUNCATED AT 250 WORDS)

Screening for pregnancy risk-drinking.

The efficacy of alcohol screening questionnaires, the TWEAK, T-ACE, NET, MAST, and CAGE, in detecting periconceptional risk-drinking, > or = 1 oz absolute alcohol/day, was investigated in 4743 African-American women attending an inner-city prenatal clinic who had reported ever drinking. Sensitivity, specificity, positive predictive value, efficiency, follow-up rates, and receiver operating characteristics of the questionnaires were examined to compare the overall effectiveness of the questionnaires and their performance at cut-points defining positive scores ranging from 1 to 3. Relatively little difference between TWEAK, T-ACE, and MAST was seen in the receiver operating characteristic accuracy indices; NET and CAGE lagged behind. Sensitivity/specificity scores for the two questionnaires most sensitive at cut-point 1 were TWEAK (87/72) and T-ACE (83/75). At cut-point 2, sensitivity was optimized with respect to specificity; TWEAK (79/83) was significantly more sensitive than T-ACE (70/85; p = 0.002). At cut-point 3, the two most sensitive tests were MAST (61/92) and TWEAK (59/94). In general, measures of merit were not greatly affected by the time between conception and the administration of the screens. Screening was most sensitive for women interviewed during the first 15 weeks of pregnancy; risk-drinkers tended to delay entry into prenatal care, increasing positive predictive values associated with screening later in pregnancy. This study confirms the utility, when screening for risk-drinking during pregnancy, of brief questionnaires that assess alcohol intake indirectly by asking women about their tolerance to alcohol's effects, psychological consequences of drinking, and significant others' concern about their drinking. It validates T-ACE and provides preliminary data indicating that TWEAK may outperform T-ACE.

Stress and alcohol use: moderating effects of gender, coping, and alcohol expectancies.

A stressor vulnerability model of stress-induced drinking was tested in a stratified random sample of 1,316 Black and White adult drinkers. Stressors were highly predictive of both alcohol use and drinking problems among men who relied on avoidant forms of emotion coping or held strong positive expectancies for alcohol's effects and accounted for more than 35% of the variance in alcohol use among the subgroup of men who were high in both vulnerability factors. In contrast, stressors were negatively related among men who were low in both and were unrelated among women regardless of their coping or expectancies. These findings suggest that tension reduction theories of alcohol use are overly broad and that individual characteristics must be considered to account for stress-related effects on alcohol use and abuse.

Sociodemographic correlates of alcohol consumption among African-American and white women.

Correlates of abstention and heavier drinking were examined among 654 African-American and 474 white women, aged 19-70+, from a representative sample of households in Erie County, New York. Discriminant function analysis was employed to investigate the relationship between alcohol consumption and race, age, church attendance, family history of alcohol problems, household density, marriage, socioeconomic status (SES), employment and parity. Abstention was compared with drinking, and light/moderate drinking was compared with heavier drinking in the total sample and within each race. Compared to drinkers, abstainers were older, more religious, more likely to be African-American, or to be of lower SES. Racial differences in the correlates of abstention were found with respect to church attendance (positive association in African-Americans only), SES (negative association in African-Americans only), and household density (positive association in whites only). Compared to light/moderate drinkers, heavier drinking women were younger, less religious, more likely to be white, to have a positive family history, or to live in less crowded households. Racial differences in the correlates of heavier drinking were found with respect to church attendance (negative association in African-Americans only), parity (positive association in African-Americans only), and marital status (more heavier drinking among unmarried white women). Racial differences in the correlates of alcohol consumption document the need for further examination of the culture-specific determinants of women's drinking patterns.

Measures of maternal alcohol use as predictors of development in early childhood.

The effect of prenatal alcohol exposure on growth, dysmorphology, and cognitive development at 6 years was examined in children whose mothers had completed a self-administered questionnaire during pregnancy. Drinking patterns prior to pregnancy recognition and indications of problem drinking (IPD) were assessed. Heavier alcohol intake was associated with slower growth in height and head circumference and increased dysmorphology, as evidenced by facial features associated with fetal alcohol syndrome (FAS) and the prevalence of probable/possible fetal alcohol effects (FAE). Indications of problem drinking predicted facial features associated with FAS and cognitive deficits (i.e., lower WPPSI Verbal IQ scores and lower scores on a test of receptive language function, the Token Test). Effects of alcohol consumption on head circumference and of indications of problem drinking on Verbal IQ and Token Test scores remained significant, even after excluding children born to mothers having drinkers (over seven drinks a day) and children with probable/possible FAE. Verbal IQ was an average of 7.1 points (95% confidence interval = 0.01, 14.25) lower among children born to mothers having more than one indication of problem drinking than it was among those born to women having fewer indications; Token Test scores were 4.3 points lower (95% confidence interval = 1.38, 7.24). Although the confidence intervals for these estimates are broad in this small, heterogeneous sample, their magnitude, if confirmed, is significant given that the population standard deviation for Verbal IQ is 15, and that for the Token Test is 5.

Excitatory amino acid antagonists induce a phencyclidine-like catalepsy in pigeons: structure-activity studies.

The excitatory amino acid antagonists D,L-2-amino-5-phosphonovalerate (D,L-AP5), its isomers D-(-)-AP5 and L-(+)-AP5, D,L-2-amino-4-phosphonobutyrate (AP4), D,L-2-amino-7-phosphonoheptanoate (AP7), beta-D-aspartylaminomethylphosphonic acid (ASP-AMP), cis-2,3-piperidinedicarboxylic acid (cis-PDA), and gamma-D-glutamylaminomethylsulphonic acid (GAMS) were tested for their ability to produce a phencyclidine (PCP)-like catalepsy in pigeons when administered intracerebroventricularly. Each of the antagonists produced catalepsy, although L-AP5, and the non-selective antagonists GAMS and cis-PDA, produced the effect only at toxic doses. The rank order of potency to produce catalepsy was AP7 greater than D-AP5 greater than D,L-AP5 greater than cis-PDA greater than ASP-AMP greater than AP4 greater than L-AP5 greater than GAMS; there was a strong positive correlation between this rank order of potency in vivo and the potency order of these compounds in vitro as NMDA antagonists. The antagonists did not displace significant amounts of [3H]N-[1-(2-thienyl)cyclohexyl]piperidine (a congener of phencyclidine) from its recognition site in the brain of pigeon. Thus, the PCP-like catalepsy that is produced by the excitatory neurotransmission at NMDA-preferring receptors that are distinct from, but related to, PCP receptors. The results strongly support the hypothesis that a reduction of neurotransmission at excitatory synapses, utilizing NMDA-preferring receptors, may underlie catalepsy in pigeons induced by PCP.

Methadone, pentobarbital, pimozide and ethanol-intake.

For 28 days, water-deprived rats were given a daily, 1-hr opportunity to take a sweetened ethanol solution (ES) or water. Across days under this regimen, rats gained weight normally and increased intake of ES until they were taking considerable amounts. Across the next 13 days of the regimen, selected groups were given, before the opportunity to drink, one of five doses of methadone (from 0.5 to 8.0 mg/kg), pentobarbital (from 5 to 30 mg/kg), or their vehicles. Large doses of both agents increased intakes, with methadone (1 and 2 mg/kg) increasing only ES-intake. Subsequently, while the daily regimen continued, rats were given pimozide (0.2, 0.4, or 0.6 mg/kg) at either 1 or 4 hr before the opportunity to drink. Pimozide did not reduce ES-intake. Next, they were given a dose of pentobarbital (5.0 mg/kg) with challenge doses of naloxone (0.3, 1.0, 3.0 mg/kg). Naloxone dose-relatedly antagonized pentobarbital's potential to increase intakes.

Phencyclidine-like catalepsy induced by the excitatory amino acid antagonist DL-2-amino-5-phosphonovalerate.

This study presents experimental evidence for the mediation of a behavioral effect of phencyclidine-like drugs by inhibition of neurotransmission at excitatory synapses utilizing N-methyl-aspartate (NMA) receptors by showing that DL-2-amino-5-phosphonovalerate, a selective NMA antagonist, produces phencyclidine-like catalepsy in pigeons. This finding suggests the possibility that other behavioral actions of phencyclidine-like substances may be mediated in a similar fashion.