Mortality in male alcoholics after ten to fourteen years.

OBJECTIVE: Alcoholics frequently die prematurely. The purpose of this study was to determine: (1) whether subjects in a sample of 360 male alcoholics, followed over a period of 10-14 years, died prematurely: (2) if so, from what causes; and (3) whether such deaths are predictable from characteristics present at initial assessment. METHOD: Subjects were male veterans (N = 360) with a diagnosis of alcoholism admitted to an inpatient substance abuse treatment program at the Kansas City Veterans Affairs (VA) Medical Center during 1980-1984 who consented to participate in intake evaluations and subsequent follow-ups at 1 year and 10-14 years later. Of the 357 (99.2%) men located at the 10-14 year follow-up, 96 (26.6%) were confirmed as deceased, 255 survivors agreed to be reassessed and 6 subjects refused reassessment. Information regarding cause of death was obtained from death certificates, VA records and other sources. RESULTS: At intake, the subsequently deceased men were older, had less education, lower psychosocial functioning, more medical problems and greater psychiatric severity. Their overall death rate was 2.5 times greater than that of a reference group of men. Men in the 35-44 year age group were 5.5 times as likely to die. A statistical model utilizing measures of alcohol dependence to predict mortality from intake to 10-14 year follow-up indicated that alcoholics who limited drinking were half as likely to die whereas those who engaged in morning drinking were 2.5 times more likely to die. CONCLUSIONS: Alcoholic men, especially those in the group aged 35 to 44 years, have a significantly higher risk of premature death than a reference group of men. Men who engaged in morning drinking and could not limit drinking appeared to be at higher risk of mortality 10 years later.

The pathophysiology of otitic hydrocephalus.

The pathophysiology of otitic hydrocephalus remains controversial. It has been argued that involvement of the superior sagittal sinus, by, at least, a mural thrombus is a necessary component of this disease. We present a case of otitic hydrocephalus where on magnetic resonance imaging (MRI) normal luminal and mural flow within the superior sagittal sinus is demonstrated. The presence of thrombus in the lateral venous sinus alone appears sufficient in this case to impede venous drainage of the intracranial contents into the neck and produce a rise in the cerebral venous pressure and a subsequent increase in the CSF pressure. The presence of a superior sagittal sinus mural thrombus is not required.

Violence in the marital dyad as a predictor of violence in the peer relationships of older adolescents/young adults.

This study used self-report of older adolescent/young adult children from a general college population to examine if violent parental conflict tactics predict the use of similarly violent tactics in the same-sex and opposite-sex peer relationships of offspring. Conflict Tactics Scale date from 256 subjects indicate that parental violence within the marital dyad is predictive of violence in both same-sex and opposite-sex peer relationships. Surprisingly high frequencies of violence were reported within parents' marriages and by subjects in their current peer relationships. Implications of these findings are discussed.

The false consensus bias as applied to psychologically disturbed adolescents.

In order to examine whether the false consensus bias applied to psychologically disturbed adolescents, outpatients at a rural mental health center who described themselves as very depressed or suicidal, and nondisturbed teenagers (who had no history of psychological treatment and were not at that time seeking psychological treatment), were asked to read a newspaper article about either a child's suicidal or viral illness death. Both groups of adolescents, like adults in previous research, viewed the suicidal child and the surviving family more negatively than they did the child and survivors of a viral illness death. Further, consistent with the false consensus hypothesis, adolescent clients viewed either child as more psychologically disturbed than did nonclients. Also, clients, as compared to nonclients, viewed both parents as more psychologically disturbed prior to either child's death. Results somewhat support the hypothesis of a false consensus bias which operates for depressed, suicidal adolescents when they view the tragedy of a child's death, but not when they are making recommendations about psychological help for the surviving family. Results are interpreted as suggesting that adolescent outpatients either view therapy as not particularly beneficial or as not particularly appropriate for bereaved individuals.

Violent tactics in family conflict relative to familial and economic factors.

A study was conducted to examine the social, economic, and family process factors which may be associated with families' use of violent tactics in conflict within an homogeneous population in the Appalachian region of southwestern Virginia. The primary hypothesis stated that economic conditions as set by the employment status of parents would be a significant factor in predicting use of violence in the resolution of family conflict. The study employed a questionnaire modeled after that used in a national study of family violence conducted by Straus, Gelles, and Steinmetz in 1980 with additional items developed to assess regional family processes and economic conditions. 114 boys and 161 girls ranging in age from 15 to 17 yr. participated. Statistical analysis confirmed the major hypothesis: in families where the father was unemployed, there was greater than expected frequency of reported violent interactions. Additional findings included associations between previous generation's abuse and use of violent interactions as well as sex of subject and use of violent interactions.

Factors distinguishing samples of lesbian and heterosexual women.

This study utilized non-clinical samples of women and examined historical, familial, sexual, and attitudinal variables to assess differences between groups endorsing heterosexual or homosexual orientations. Drawing from social learning theory, researchers expected the lesbian group to report more negative childhood sexual experiences with males, more positive childhood sexual experiences with females, more accepting parental attitudes toward sexuality and sexual experimentation, and more distant relationships with parents. Results indicate that, rather than childhood sexual experiences distinguishing groups, respondents' current attitudes are significant between-group discriminators. These findings are consistent with the recent body of literature that suggests that sexual orientation cannot be explained in terms of early sexual trauma or negative heterosexual experiences.

Gender role and risk patterns for eating disorders in men and women.

The relationship between gender role and at-risk patterns for eating dysfunction was examined in this study of 206 men and women. The Bem Sex Role Inventory (Bem, 1974) and the Eating Disorders Inventory (EDI; Garner, Olmsted, & Polivy, 1983) were the measures used. In accordance with the psychocultural model, it was expected that gender role and gender would interact across the risk factors. An interaction between gender and gender role was found across factors associated with eating disorders: different gender role identities contributed differentially to specific risk factors. The data contribute to a growing body of literature that suggests that the relationship between gender role and eating dysfunction is complex and requires multidimensional conceptualizations.

Comorbid psychiatric diagnosis and long-term drinking outcome.

This longitudinal study of alcoholics investigated which psychiatric comorbidities among alcoholics would predict very long-term drinking outcome. Previous research has yielded inconsistent findings. We hypothesized that antisocial personality characteristics alone among psychiatric comorbidities would show an association with poorer drinking outcome. The use of multiple measures of psychopathology, a relatively large sample size, and an absence of systematic treatment matching to particular patient groups were all aspects of the current study which allowed for a comprehensive examination of this issue. The study used single and multivariate correlational analyses. The setting was an inpatient Veterans Administration alcohol dependence treatment unit and follow-up clinic. Participants were 255 adult male veterans diagnosed with alcohol dependence. The predictors were the Symptom Checklist 90 (SCL), Minnesota Multiphasic Personality Inventory (MMPI), and Psychiatric Diagnostic Interview (PDI). The outcome measure was the Clinician Rating of Drinking Scale (CRDS). The study showed that antisocial personality characteristics alone were consistently associated with a worse long-term drinking outcome. However, despite the consistent presence of a statistical association between antisocial personality characteristics and a poorer long-term drinking outcome, the small size of the relationship is a very important issue which is discussed in detail.

Prediction of drinking outcomes for male alcoholics after 10 to 14 years.

This study reports on the long-term outcomes of 360 men who were hospitalized for alcoholism during 1980 to 1984 and followed at 12 months and again 10 to 14 years later. At the 10/14-year follow-up, 96 (26.7%) men were confirmed as deceased; 255 (70.8%) men participated in the assessment/interview battery completed during baseline hospitalization. The battery consisted of psychosocial, alcohol-related, and psychiatric measures. Two distinct but highly correlated outcome measures were selected: a clinical rating scale and a factor score. Overall, predictors from baseline and 12-month follow-up included age at intake hospitalization, alcoholism severity, social stability, drinking days, and antisocial personality disorder. Approximately 37% of the assessed survivors were either totally abstinent or drinking nonabusively throughout the 10/14-year follow-up, whereas another 37% continued to drink abusively. Men who abstained or reduced alcohol intake reported better physical health at follow-up than those who continued to drink. Although our findings did not directly link alcoholism to death, they strongly indicate that chronic alcohol abuse may lead to premature death.