Search

Background The aims of this study were to (i) characterize racial differences in alcohol involvement and (ii) examine the risk conferred by specific trauma exposures and posttraumatic stress disorder (PTSD) for different stages of alcohol involvement in European American ( EA) and African American ( AA) women. Methods Data are from the Missouri Adolescent Female Twins Study ( N = 3,787, 14.6% AA; mean age at most recent interview = 24.5 [ SD 2.8]). Trauma exposures (e.g., sexual abuse [ SA], physical abuse [ PA], witnessing another person being killed or injured, experiencing an accident, and experiencing a disaster) were modeled as time-varying predictors of alcohol initiation, transition to first alcohol use disorder ( AUD) symptom, and transition to AUD diagnosis using Cox proportional hazards regression while taking into account other substance involvement, parental characteristics, and commonly co-occurring psychiatric disorders. Results In EA women only, SA was associated with alcohol initiation prior to the age of 14, PA predicted transition from initiation to first AUD symptom, and PA, witnessing injury or death, and SA predicted transition to AUD diagnosis. No association was discovered between trauma exposures or PTSD for any stage of alcohol involvement in AA women. Conclusions Results reveal trauma experiences as important contributors to all stages of alcohol involvement in EA women only, with different trauma types conferring risk for each stage of alcohol involvement. PTSD was not revealed as a significant predictor of AUD in EA or AA women, suggesting trauma, independent of PTSD, directly contributes to alcohol involvement. Findings highlight the importance of considering racial differences when developing etiologic models of the association of traumatic experiences with alcohol involvement. [ABSTRACT FROM AUTHOR]

Background: Differences between African Americans (AAs) and European Americans (EAs) in the prevalence and age at onset of alcohol use and alcohol use disorder (AUD) have been documented, but distinctions in the timing of early stage transitions and contribution of various psychiatric and psychosocial risk factors to the progression from initiation toAUD have yet to be investigated. The current study characterized progression from alcohol use initiation--defined alternatively as first drink, first intoxication, and regular drinking onset--to AUD in AA and EA youth. Methods: Psychiatric interviews were administered via telephone to 1,461 participants (56% AA, 44% EA) in a high-risk family study (50.3% female, mean age = 17.6 [SD = 3.8]). Cox proportional hazards regression analyses were conducted separately for the AA and EA subsamples to predict DSM- 5 AUD as a function of age at alcohol use initiation, with age at first drink, age at first intoxication, and age at regular drinking onset as the point of origin in separate models. Results: Across race/ethnicity, regardless of how it was measured, early alcohol use initiation predicted AUD, but hazard ratios (HRs) were lowest for first drink. Regular smoking and social anxiety disorder were significant predictors in both racial/ethnic groups, but associations with conduct disorder (all 3 models: HR range = 2.07 to 4.15) and major depressive disorder (regular drinking: HR = 4.51, confidence interval [CI]: 1.60 to 12.69 for AUD onset ≥ age 20) were specific to AAs. Posttraumatic stress disorder (HR = 5.38, CI: 1.44 to 20.08) and generalized anxiety disorder (HR = 7.35, CI: 2.31 to 23.34 for AUD onset ≤ age 17) were strongly associated with progression from regular drinking to AUD exclusively in EAs. Conclusions: Early alcohol use initiation is a marker of risk for AUD in both AA and EA youth, but the contributions of various psychiatric risk factors to the development of AUD are not universal across racial/ethnic groups. [ABSTRACT FROM AUTHOR]