Characteristics of women with alcohol use disorders who benefit from intensive motivational interviewing.

BACKGROUND: Women with alcohol disorders have more severe problems related to their drinking than men. They have higher mortality from alcohol-related accidents and enter treatment with more serious medical, psychiatric, and social consequences.Objective: This study assessed the effects of Intensive Motivational Interviewing (IMI), a new, 9-session counseling intervention for women with drinking problems.Methods: A randomized clinical trial was conducted with 215 women. Most were white (83%), college educated (61%), and older (mean age 51). Half received IMI and half a standard single session of MI (SMI) along with an attention control (nutritional education).Results: Generalized estimating equations models showed women who were heavy drinkers at baseline in the IMI condition reduced heavy drinking more than those in the SMI condition at 2-, 6-, and 12-month follow-up. Analyses of disaggregated subgroups showed IMI was most effective for women with low psychiatric severity, more severe physical and impulse control consequences associated with drinking, and higher motivation. However, formal 3-way interaction models (condition by moderator by time) showed significant effects primarily at 2 months.Conclusions: Improvements associated with IMI were limited to heavy drinking and varied among subgroups of women. Studies of women with more diverse characteristics are needed.

Heavy Drinking among Women Receiving Intensive Motivational Interviewing: 6-Month Outcomes.

Compared to men, women with alcohol use disorders experience more severe consequences related to drinking. Intensive Motivational Interviewing (IMI) is a new 9-session version of Motivational Interviewing (MI) designed for women with alcohol use disorders. The current study reports outcomes from a randomized clinical trial of IMI compared to a single session of MI. Data were collected at baseline, 2-month, and 6-month follow-up. In addition to a standard "intent-to-treat" (ITT) analysis, we conducted disaggregated subgroup analyses of women who were heavy drinkers and a "per protocol" (PP) analysis of women in the IMI condition who attended 7-9 sessions (80% of the IMI sample). Women in both study conditions made large reductions in drinking between baseline and 2 months that were maintained at 6 months. Generalized estimating equation (GEE) models using the full sample (N = 215) did not show time by condition differences, but heavy drinkers(n = 153) receiving IMI showed significantly larger reductions in drinking at 2- and 6-month follow-up than the comparison condition. Assessment of heavy drinkers using the PP sample showed larger between condition differences favoring IMI at both follow-up time points. Results support the efficacy of IMI in terms of reducing drinking, particularly among women who are heavy drinkers.

Alcohol's Secondhand Harms in the United States: New Data on Prevalence and Risk Factors.

OBJECTIVE: This study examined a range of indicators of alcohol's harm to others (AHTO) among U.S. adults and assessed sociodemographic and alcohol-related risk factors for AHTO. METHOD: The data came from 8,750 adult men and women in two parallel 2015 U.S. national surveys conducted in English and Spanish. Both surveys used computer-assisted telephone interviews and two-stage, stratified, list-assisted, random samples of adults ages 18 and older. RESULTS: One in five adults experienced at least one of ten 12-month harms because of someone else's drinking. The prevalence of specific harm types and characteristics differed by gender. Women were more likely to report harm due to drinking by a spouse/partner or family member, whereas men were more likely to report harm due to a stranger's drinking. Being female also predicted family/financial harms. Younger age increased risk for all AHTO types, except physical aggression. Being of Black/other ethnicity, being separated/widowed/divorced, and having a college education without a degree each predicted physical aggression harm. The harmed individual's own heavy drinking and having a heavy drinker in the household increased risk for all AHTO types. The risk for physical aggression due to someone else's drinking was particularly elevated for heavy drinking women. CONCLUSIONS: Secondhand effects of alcohol in the United States are substantial and affected by sociodemographics, the harmed individual's own drinking, and the presence of a heavy drinker in the household. Broad-based and targeted public health measures that consider AHTO risk factors are needed to reduce alcohol's secondhand harms.

Intensive Motivational Interviewing for Heavy Drinking among Women.

OBJECTIVES: Women suffer more severe consequences related to heavy drinking than men. Relative to men, women who are heavy drinkers experience higher severity of medical, psychiatric, and social problems, even when they have fewer years drinking. Currently there are few gender-specific, evidence-based interventions for heavy drinking among women. METHODS: A randomized clinical trial was conducted with 215 women with alcohol problems. Half were randomly assigned to receive a 9-session, "Intensive Motivational Interviewing" (IMI) intervention (N=107) and half were randomly assigned to a standard single session of MI (SMI) along with 8 sessions of nutritional education (N=108) to achieve time equivalence. Both conditions received weekly outpatient group counseling. Follow-up interviews were conducted at 2 months. Primary outcomes included percent drinking days (PDD), percent heavy drinking days (PHDD, 4+ drinks), and the Addiction Severity Index (ASI) Alcohol scale. Longitudinal changes were assessed using generalized estimating equations (GEE). RESULTS: The sample was predominantly white (83.3%), college educated (61.4%), and married (53.5%). The mean age was 50.9 (sd = 11.3). Relative to baseline, both study conditions showed significant reductions in PDD, PHDD, and ASI alcohol severity (p<.001). Among heavy drinkers, defined as women drinking 14+ days to the point of intoxication over the past 30 days at baseline (N=153), those assigned to IMI (n=67) showed larger reductions in PDD (p<.01) and PHDD (p<.05) at 2-months compared to women receiving SMI. CONCLUSIONS: Findings support the efficacy of IMI for heavy drinking among women. Additional studies are needed that assess drinking over longer time periods.

Randomized Trial of an Innovative Electronic Screening and Brief Intervention for Reducing Drinking Among Women of Childbearing Age.

OBJECTIVES: To evaluate the efficacy of an innovative, self-administered, electronic Screening and Brief Intervention (e-SBI) in English and Spanish, "DrinkWise," for reducing drinking among nonpregnant women of childbearing age. METHODS: A parallel design, phase 1 trial included 185 nonpregnant women reporting risky drinking (8 or more drinks in a week or 3 or more drinks in a day) who were recruited from 2 publicly funded Nutritional Assistance for Women, Infants and Children (WIC) program sites in the United States from 2016 to 2017. Participants were 18 to 44 years in age, 75% of Hispanic ethnicity, 44% Spanish speakers, 30% had not completed high school, and 15% were currently breastfeeding. Participants were randomized to receive (intervention condition, n = 99) or not receive (control condition, no intervention, n = 86) DrinkWise and followed at 3 and 6 months. RESULTS: Women receiving DrinkWise had greater reductions in the odds of self-reported weekly alcohol use (odds ratio [OR] = 0.22, SE = 0.12, P < 0.01) and heavy alcohol use (OR = 0.23, SE = 0.14, P < 0.05) at 6-month follow-up than controls, with no group differences at 3-month follow-up. Compared with heavy drinking controls, heavy drinkers receiving DrinkWise showed a trend (P = 0.06) for greater reductions in drink (pour) size from 3- to 6-month follow-up. CONCLUSIONS: DrinkWise may be efficacious in reducing drinking among low-income women of childbearing age and provides a low-cost tool for increasing access to recommended SBI among childbearing-age women. Studies should continue to build DrinkWise's evidence base. TRIAL REGISTRATION: ClinicalTrials.gov, https://clinicaltrials.gov/ct2/show/NCT02337361.

Development of Intensive Motivational Interviewing (IMI) and Modifications for Treating Women with Alcohol Use Disorders.

Women have greater vulnerability to alcohol problems than men. They become intoxicated after drinking half as much as men, develop cirrhosis of the liver more rapidly, and have a greater risk of dying from alcohol-related accidents. Despite more serious consequences related to their drinking, treatment for women with alcohol use disorders has been understudied relative to treatment for men. Intensive motivational interviewing (IMI) is a recent psychotherapeutic intervention for substance abuse problems that draws on the principles of brief motivational interviewing (1-2 session). However, the intervention includes 9 sessions designed to enable therapists to have maximum flexibility to facilitate factors known to be important for women with substance use disorders, such as active facilitation of client-therapist collaboration, empowerment, and affirmation of strengths. This paper reviews the development of IMI, initial favorable findings for women with co-occurring methamphetamine and alcohol problems, and the design of an ongoing longitudinal study assessing the effects of MI for women with alcohol problems over a 12-month time period. Relational Theory is used as a conceptual framework for understanding IMI for women. The theory emphasizes understanding, building, and modifying interpersonal relationships as a central goal. From this perspective, self-efficacy, self-esteem, and reduction in drinking are enhanced through interpersonal connections with others. Plans for additional study of IMI are described along with suggestions for therapists.

Alcohol's Harm to Children: Findings from the 2015 United States National Alcohol's Harm to Others Survey.

OBJECTIVES: To examine the prevalence and severity of alcohol's harm to children in the US and the relationship of the harmer to the child, and to examine caregivers' sociodemographic characteristics, alcohol use, and exposure to harm due to a drinking spouse/partner or other family member as risk factors for alcohol's harm to children. STUDY DESIGN: We report data on 764 caregivers (defined as persons with parental responsibility for at least 1 child aged ≤17 years) from the 2015 National Alcohol's Harm to Others Survey, a dual-frame national sample of US adults. RESULTS: Overall 7.4% of caregivers reported alcohol's harm to children in the past year. Risk factors for alcohol's harm to children included the caregiver's own experience of alcohol's harm from a spouse/partner or other family member. Caregivers with a heavy drinker in the household were significantly more likely to report harm to children. A caregiver's own heavy drinking was not a significant risk factor for children in his or her care. CONCLUSIONS: Alcohol places a substantial burden on children in the US. Although a caregiver's own drinking can harm children, other drinkers also increase the risk of alcohol's harm to children. Screening caregivers to determine whether there is a heavy drinker in the household may help reduce alcohol's harm in the family without stigmatizing caregivers, who themselves may not be heavy drinkers.

Changes in psychiatric symptoms among persons with methamphetamine dependence predicts changes in severity of drug problems but not frequency of use.

BACKGROUND: Few studies have examined how changes in psychiatric symptoms over time are associated with changes in drug use and severity of drug problems. No studies have examined these relationships among methamphetamine (MA)-dependent persons receiving motivational interviewing within the context of standard outpatient treatment. METHODS: Two hundred seventeen individuals with MA dependence were randomly assigned to a standard single session of motivational interviewing (MI) or an intensive 9-session model of MI. Both groups received standard outpatient group treatment. The Addiction Severity Index (ASI) and timeline follow-back (TLFB) for MA use were administered at treatment entry and 2-, 4-, and 6-month follow-ups. RESULTS: Changes in ASI psychiatric severity between baseline and 2 months predicted changes in ASI drug severity during the same time period, but not changes on measures of MA use. Item analysis of the ASI drug scale showed that psychiatric severity predicted how troubled or bothered participants were by their drug us, how important they felt it was for them to get treatment, and the number of days they experienced drug problems. However, it did not predict the number days they used drugs in the past 30 days. These associations did not differ between study conditions, and they persisted when psychiatric severity and outcomes were compared across 4- and 6-month time periods. CONCLUSIONS: Results are among the first to track how changes in psychiatric severity over time are associated with changes in MA use and severity of drug problems. Treatment efforts targeting reduction of psychiatric symptoms among MA-dependent persons might be helpful in reducing the level of distress and problems associated with MA use but not how often it is used. There is a need for additional research describing the circumstances under which the experiences and perceptions of drug-related problems diverge from frequency of consumption.

Evaluating Shortened Versions of the AUDIT as Screeners for Alcohol Use Problems in a General Population Study.

BACKGROUND: Efficient alcohol screening measures are important to prevent or treat alcohol use disorders (AUDs). OBJECTIVES: We studied different versions of the Alcohol Use Disorders Identification Test (AUDIT) comparing their performance to the full AUDIT and an AUD measure as screeners for alcohol use problems in Goa, India. METHODS: Data from a general population study on 743 male drinkers aged 18-49 years are reported. Drinkers completed the AUDIT and an AUD measure. We created shorter versions of the AUDIT by (a) collapsing AUDIT item responses into three and two categories and (b) deleting two items with the lowest factor loadings. Each version was evaluated using factor, reliability and validity, and differential item functioning (DIF) analysis by age, education, standard of living index (SLI), and area of residence. RESULTS: A single factor solution was found for each version with lower factor loadings for items on guilt and concern. There were no significant differences among the different AUDIT versions in predicting AUD. No significant DIF was found by education, SLI or area of residence. DIF was observed for the alcohol frequency item by age. CONCLUSIONS/IMPORTANCE: The AUDIT may be used with dichotomized response options without loss of predictive validity. A shortened eight-item dichotomized scale can adequately screen for AUDs in Goa when brevity is of paramount importance, although with lower predictive validity. Although the frequency item was endorsed more by older men, there is no evidence that the AUDIT items perform differently in other groups of male drinkers in Goa.

Readiness to Change and to Accept Help and Drinking Outcomes in Young Adults of Mexican Origin.

OBJECTIVE: The purpose of this study was to assess whether readiness to change drinking (RCD) and readiness to accept help (RAH) improve short- and longer term drinking outcomes. METHOD: Data from a randomized controlled trial of screening and brief intervention (SBI) conducted in a U.S. emergency department at the U.S.-Mexico border are reported. A total of 620 at-risk and dependent Mexican-origin drinkers (56% male), ages 18-30, received either an assessment only or intervention (SBI). Drinking outcomes included drinking days per week, average and maximum drinks per drinking day, heavy drinking (5+ drinks) days per week, and negative consequences. Random effects longitudinal models predicted baseline, 3-month, and 12-month drinking outcomes from baseline RCD and RAH. Models tested if (a) outcomes were significantly reduced at follow-ups and (b) differential reduction occurred by RCD, RAH, and post-intervention changes in readiness among those receiving SBI. RESULTS: For both study groups, outcomes improved from baseline to each follow-up across RCD and RAH status. RCD was not associated with differential improvement in outcomes for either group. In the SBI group, those RAH reported larger reductions at 3 months in average and maximum quantity than those not RAH but did not differ from those not RAH at 12-month outcomes. Among the SBI group, changing from not ready to ready (RTC or RAH) post-intervention was not associated with greater reductions in drinking compared with remaining not ready or ready post-intervention. CONCLUSIONS: Baseline RCD is not associated with drinking outcomes. Baseline RAH may facilitate greater reductions in drinking for those receiving SBI and should be further examined as a possible mediator of SBI effects for young adults of Mexican origin.

Feasibility and acceptability of a novel, computerized screening and brief intervention (SBI) for alcohol and sweetened beverage use in pregnancy.

BACKGROUND: Recommended screening and brief intervention (SBI) for alcohol use during pregnancy is impeded by high patient loads and limited resources in public health settings. We evaluated the feasibility, acceptability and validity of a new self-administered, single-session, bilingual, computerized Screening and Brief Intervention (SBI) program for alcohol and sugar sweetened beverage (SSB) use in pregnancy. METHODS: We developed and tested the computerized SBI program at a public health clinic with 290 pregnant women. Feasibility, acceptability, and validity measures were included in the program which had several modules, including those on demographics, health and beverage use. Time to complete the program and user experience items were used to determine program feasibility and acceptability. Validity analyses compared proportions of prenatal alcohol use identified by the program versus in-person screening by clinic staff. RESULTS: Most program users (87%, n = 251) completed the entire program; 91% (n = 263) completed the key screening and brief intervention modules. Most users also completed the program in ten to fifteen minutes. Program users reported that the program was easy to use (97%), they learned something new (88%), and that they would share what they learned with others (83%) and with their doctors or clinic staff (76%). Program acceptability did not differ by age, education, or type of beverage intervention received. The program identified alcohol use in pregnancy among 21% of users, a higher rate than the 13% (p < .01) found via screening by clinic staff. CONCLUSIONS: Computerized Screening and Brief Intervention for alcohol and SSB use in public health clinics is feasible and acceptable to English and Spanish speaking pregnant women and can efficiently identify prenatal alcohol use.

Randomized trial of intensive motivational interviewing for methamphetamine dependence.

An intensive, 9-session motivational interviewing (IMI) intervention was assessed using a randomized clinical trial of 217 methamphetamine (MA) dependent individuals. Intensive motivational interviewing (IMI) was compared with a single standard session of MI (SMI) combined with eight nutrition education sessions. Interventions were delivered weekly over 2 months. All study participants also received standard outpatient group treatment three times per week. Both study groups showed significant decreases in MA use and Addiction Severity Index drug scores, but there were no significant differences between the two groups. However, reductions in Addiction Severity Index psychiatric severity scores and days of psychiatric problems during the past 30 days were found for clients in the IMI group but not the SMI group. SMI may be equally beneficial to IMI in reducing MA use and problem severity, but IMI may help alleviate co-occurring psychiatric problems that are unaffected by shorter MI interventions. Additional studies are needed to assess the problems, populations, and contexts for which IMI is effective.

Adolescent drinking onset and its adult consequences among men: a population based study from India.

BACKGROUND: Few population-based studies from low-income and middle-income countries have addressed adolescent drinking onset and its association with adult alcohol-related adverse outcomes. The aims of this study were to: (1) estimate the rate of adolescent drinking onset and its trend over time among men (2) describe demographic and socioeconomic factors associated with adolescent drinking onset; and (3) examine the association between adolescent drinking onset and adverse outcomes in later life, including hazardous or harmful alcohol use, heavy episodic drinking, alcohol dependence, injuries and psychological distress. METHODS: Population-based survey of men (n=1899) from rural and urban communities in northern Goa, India. Analysis addressed age of drinking onset among those who reported ever drinking in their lifetime, and drinking patterns and consequences among current drinkers. RESULTS: Adolescent drinking onset showed an increasing trend over time (p<0.001), from 19.5% for those born between 1956 and 1960 to 74.3% for those born between 1981 and 1985. Urban residence, Christian religion and low standard of living were associated with adolescent drinking onset. Adolescent drinking onset was associated with psychological distress (OR 2.82; 95% CI 1.41 to 5.63), alcohol dependence (OR 2.56; 95% CI 1.79 to 3.68), lifetime history of alcohol related injuries (OR 3.07; 95% CI 1.16 to 8.14), alcohol related injuries during the past year (OR 3.04; 95% CI 1.35 to 6.81), and a Alcohol Use Disorder Identification Test score ≥8 indicating hazardous or harmful alcohol use (OR 1.9; 95% CI 1.17 to 3.08) in adulthood. CONCLUSIONS: This study among men in Goa, India suggests a substantial increase in adolescent drinking onset in more recent birth cohorts. Consistent with other countries, adolescent drinking onset increased the likelihood of lifetime alcohol dependence, hazardous or harmful alcohol use, alcohol related injuries and psychological distress. These findings highlight the need for policies and programmes to delay drinking onset in India.

Test-retest reliability and validity of life-course alcohol consumption measures: the 2005 National Alcohol Survey follow-up.

BACKGROUND: Few studies assess reliability and validity of lifetime alcohol measures. We undertook extended test-retest analyses of retrospective lifetime drinking measures and of incremental predictive ability of lifetime heavy drinking (days 5+ drinks) in teens, 20s, and 30s for current (12-month) alcohol use disorders (AUDs). METHODS: A subset (31.4%; 962 men, 1,220 women) of the 2005 U.S. National Alcohol Survey (NAS; N11) completed a follow-up survey (N11T) by phone or mail (mean delay of 2.7 years). Both surveys assessed lifetime drinking. RESULTS: In N11T, drinking status was reported consistently by 94.7% of N11 current drinkers, 85.5% of ex-drinkers, and 74.4% of lifetime abstainers (93.5% overall). Cumulative number of prior heavy drinking days (teens through 30s) were moderately consistent (Pearson's ρ = 0.6, p < 0.001, n = 1,636). Reliability was lower for younger respondents under 30 and higher for Whites versus Blacks and Hispanics (ρ = 0.68 vs. ρ = 0.56 vs. ρ = 0.56, both p = 0.01), but did not differ by gender. Heavy drinking days in teens correlated 0.63 (p < 0.001) for those aged 20 or older, higher for women than men and for Whites versus ethnic minorities. Heavy drinking days in the 20s and 30s reported by those 30 and older and 40 and older correlated at 0.63 and 0.67, respectively, being higher for Whites. Age of drinking onset and of lifetime maximum quantity reports were also consistent (0.65, 0.73), higher for women versus men, for those older than 29 versus younger, and for Whites versus Blacks and Hispanics. In N11, controlling for gender, age, ethnicity, and current 5+ frequency, cumulative prior 5+ days (teens to age 39) predicted current alcohol-related consequences and dependence (both p = 0.003). CONCLUSIONS: Measurements of earlier heavy drinking are feasible, efficient, and reasonably reliable, albeit with some individual imprecision. Prior drinking data improve prediction of current AUDs, adjusting for demographics and current drinking.

Risks of alcohol use disorders related to drinking patterns in the U.S. general population.

OBJECTIVE: The purpose of this study was to examine the relations between drinking (mean quantity and heavy drinking patterns) and alcohol use disorders (AUDs) in the U.S. general population. METHOD: Data from three telephone National Alcohol Surveys (in 2000, 2005, and 2010) were pooled, with separate analyses for men and women restricted to current drinkers (ns = 5,922 men, 6,270 women). Predictors were 12-month volume (mean drinks per day), rates of heavy drinking (5+/4+ drinks in a day for men/women), and very heavy drinking (8+, 12+, and 24+ drinks in a day). Outcomes were negative alcohol-related consequences constituting abuse (1+ of 4 DSM-IV-based domains assessed by 13 items) and alcohol dependence (symptoms in 3+ of 7 DSM-IV-based domains), together taken to indicate an AUD. Segmentation analyses were used to model risks of problem outcomes from drinking patterns separately by gender. RESULTS: In the general population, men and women who consumed ≤1 drink/day on average with no heavy drinking days did not incur substantial risks of an AUD (<10%). Men who drank from 1 to 2 drinks/day on average but never 5+ incurred a 16% risk of reporting an AUD (3.5% alcohol dependence). At higher volumes, men and women who indicated higher rates of drinking larger amounts per day and/or involving 8+ and 12+ drinks/day (and even 24+ drinks/day for men) showed much higher risks of experiencing AUDs. CONCLUSIONS: The findings provide quantitative guidance for primary care practitioners who wish to make population-based recommendations to patients who might benefit by reducing both overall intake and amounts per occasion in an effort to lower their risks of developing AUDs.

Patterns of alcohol use, their correlates, and impact in male drinkers: a population-based survey from Goa, India.

PURPOSE: Associations between low socio-economic class and alcohol use disorders are relatively well established in developed countries; however, there is comparably little research in India and other developing countries on the associations between socio-economic class, drinking patterns, and alcohol-related problems. We sought to assess drinking patterns and adverse outcomes among male drinkers and examine whether the association between drinking patterns and adverse outcomes differ by socioeconomic class. METHODS: Population survey of 732 male drinkers screened from 1,899 men, aged 18 to 49 years, randomly selected from rural and urban communities in northern Goa, India. RESULTS: Usual quantity of alcohol consumed by 14.8% (rural 16.8%; urban 13.6%) current drinkers is at high-risk level. About 28.6% (rural 31%; urban 27.2%) and 33.7% (rural 30.5%; urban 35.5%) of current drinkers reported monthly or more frequent heavy episodic drinking and drunkenness, respectively. Lower education and lower standard of living (SLI) were associated with higher usual quantity of alcohol consumption. More frequent heavy episodic drinking was associated with older age, being separated, lower education, and lower standard of living; weekly or more frequent drunkenness was associated only with rural residence. All three risky drinking patterns were associated with common mental disorders, sexual risk, intimate partner violence, acute alcohol-related consequences, and alcohol dependence. Significant interactions between SLI and risky alcohol use patterns suggested an increased risk of intimate partner violence among men with risky drinking and lower SLI. CONCLUSIONS: Risky drinking patterns are common among male drinkers in Goa and associated with lower socio-economic class. A range of adverse health and social outcomes were associated with risky drinking across all socio-economic classes. Alcohol policy should target risky drinking patterns, particularly among poorer men, to reduce the health and social burden of alcohol use in India.

Lifetime victimization and past year alcohol use in a U.S. population sample of men and women drinkers.

BACKGROUND: Research on alcohol use among victims of physical and sexual violence has focused mostly on women and alcohol use disorders. It is also limited by the relative lack of consideration of victimization over the lifetime and of population data on both men and women. We critically examined associations between lifetime victimization and diverse past year alcohol use patterns and problems and whether these associations differ for men and women. METHODS: Population data from the 2005 U.S. National Alcohol Survey (NAS11, n=6919) are reported for 4256 adult men and women drinkers. Logistic regressions assessed associations between physical only or any sexual victimization experienced over the lifetime and past year heavy episodic drinking, drinking to intoxication, alcohol-related consequences and any alcohol use disorder. Models controlled for demographics and parental history of alcohol abuse and examined interactions of gender with victimization. RESULTS: Associations between victimization experienced over the lifetime and all past year alcohol measures were significant for both men and women. These associations did not differ by type of lifetime victimization (physical only vs any sexual). The association of physical only victimization with drinking to intoxication was stronger for victimized vs non-victimized women compared to victimized vs non-victimized men. This gender difference ceased to be significant when specific victimization characteristics were controlled for. CONCLUSIONS: Lifetime victimization is associated with increased risk for diverse alcohol use problems for both men and women. All prevention and treatment programs should screen men and women for lifetime victimization and diverse alcohol use problems.

Gender Differences in Psychiatric Symptoms among Methamphetamine Dependent Residents in Sober Living Houses.

OBJECTIVES: Although psychiatric symptoms among methamphetamine (MA) dependent individuals have been studied in treatment programs, they have not been examined in services designed to support sustained recovery in the community (e.g. sober living houses). In addition, some disorders more common among women, such as somatoform and bulimia, have been understudied among MA dependent individuals. This study aimed to examine psychiatric symptom differences between MA dependent men and women who we entering sober living houses (SLHs). METHODS: Two hundred forty five individuals were interviewed within one week of entering SLHs. Instruments included a DSM IV based measure for MA dependence, a psychiatric screen (the Psychiatric Diagnostic Screening Questionnaire), demographics, recent substance use and recent use of services. RESULTS: Of the 245 participants, 103 men and 25 women met criteria for MA dependence. Womenwith MA dependence reported more psychiatric symptoms than men. They also trended toward reporting more psychiatric symptoms than non-MA dependent women. For men, psychiatric symptoms did not vary between those with and without MA dependence. Some understudied disorders (e.g., somatoform) had large proportions of women meeting the screening criteria. CONCLUSIONS: Additional research is needed on understudied psychiatric disorders that are common among MA dependent women. SLH's should consider ways to address psychiatric symptoms among MA dependent individuals, especially women. Strategies could include increasing linkages with professional mental health services as well as developing peer oriented strategies for managing symptoms.

Child physical and sexual abuse: a comprehensive look at alcohol consumption patterns, consequences, and dependence from the National Alcohol Survey.

BACKGROUND: Previous research has documented a relationship between child sexual abuse and alcohol dependence. This paper extends that work by providing a comprehensive description of past year and lifetime alcohol consumption patterns, consequences, and dependence among women reporting either physical and sexual abuse in a national sample. METHODS: This study used survey data from 3,680 women who participated in the 2005 U.S. National Alcohol Survey. Information on physical and sexual child abuse and its characteristics were assessed in relation to 8 past year and lifetime alcohol consumption measures. RESULTS: Child physical or sexual abuse was significantly associated with past year and lifetime alcohol consumption measures. In multivariate analyses, controlling for age, marital status, employment status, education, ethnicity, and parental alcoholism or problem drinking, women reporting child sexual abuse vs. no abuse were more likely to report past year heavy episodic drinking (OR(adj) = 1.7; 95% CI 1.0 to 2.9), alcohol dependence (OR(adj) = 7.2; 95% CI 3.2 to 16.5), and alcohol consequences (OR(adj) = 3.6; 95% CI 1.8 to 7.3). Sexual abuse (vs. no abuse) was associated with a greater number of past year drinks (124 vs. 74 drinks, respectively, p = 0.002). Sexual child abuse was also associated with lifetime alcohol-related consequences (OR(adj) = 3.5; 95% CI 2.6 to 4.8) and dependence (OR(adj) = 3.7; 95% CI 2.6 to 5.3). Physical child abuse was associated with 4 of 8 alcohol measures in multivariate models. Both physical and sexual child abuse were associated with getting into fights, health, legal, work, and family alcohol-related consequences. Alcohol-related consequences and dependence were more common for women reporting sexual abuse compared to physical abuse, 2 or more physical abuse perpetrators, nonparental and nonfamily physical abuse perpetrators, and women reporting injury related to the abuse. CONCLUSION: Both child physical and sexual abuse were associated with many alcohol outcomes in adult women, even when controlling for parental alcohol problems. The study results point to the need to screen for and treat underlying issues related to child abuse, particularly in an alcohol treatment setting.