Jacob Theodore, Bucholz Kathleen K, Sartor Carolyn E, Howell Donelle N, Wood Phillip K
Department of Veterans Affairs, Palo Alto Health Care System, 795 Willow Road 151-J, Menlo Park, California 94025, USA.
J Stud Alcohol. 2005 Nov;66(6):745-55. doi: 10.15288/jsa.2005.66.745.
Identifying differing developmental trajectories of alcohol behavior is fundamental in building theories of alcoholism etiology and course. The purpose of this study was to identify differences in developmental pathways of alcoholism from onset of drinking into middle adulthood.
Alcohol-related behaviors and psychiatric status were assessed in 330 men from the Vietnam Era Twin Registry having a lifetime diagnosis of alcohol dependence (AD). Using a modified version of Skinner's Lifetime Drinking History, distinct drinking phases were identified that differed in terms of quantity, frequency and context of drinking. Person-year data were created to indicate whether AD criteria were or were not met for each year between drinking onset and age 41.
Using Latent Growth Mixture Modeling, a four-class model was identified: Severe Chronic Alcoholics; Severe Non-Chronic Alcoholics (SNCA); Late Onset Alcoholics; and Young Adult Alcoholics. Counterparts for three trajectories could be found in the larger alcoholism literature, whereas the fourth type (SNCA) has not been described, notwithstanding its seeming importance and prevalence.
Present findings support the existence of different alcoholism trajectories and provide a more complete understanding of the variability of alcohol dependence over time. Findings build on the larger alcoholism literature identifying alcoholic subgroups and provide important information regarding alcoholism trajectories and associated features. Future studies are needed with regard to better understanding of the psychosocial influences related to the different alcoholism trajectories, as well as characterizing the different trajectories as individuals transition into older age.
识别酒精行为不同的发展轨迹是构建酒精中毒病因和病程理论的基础。本研究的目的是确定从饮酒开始到中年期酒精中毒发展途径的差异。
对越南时代双胞胎登记处的330名终身诊断为酒精依赖（AD）的男性进行了与酒精相关的行为和精神状态评估。使用斯金纳终身饮酒史的修改版本，确定了在饮酒量、频率和背景方面存在差异的不同饮酒阶段。创建了人年数据，以表明从饮酒开始到41岁之间的每一年是否符合AD标准。
使用潜在增长混合模型，确定了一个四类模型：重度慢性酒精中毒者；重度非慢性酒精中毒者（SNCA）；迟发性酒精中毒者；以及青年酒精中毒者。在更大规模的酒精中毒文献中可以找到三种轨迹的对应类型，而第四种类型（SNCA）尽管其看似重要且普遍存在，但尚未被描述。
目前的研究结果支持不同酒精中毒轨迹的存在，并提供了对酒精依赖随时间变化的更完整理解。研究结果建立在识别酒精中毒亚组的更大规模酒精中毒文献基础上，并提供了有关酒精中毒轨迹和相关特征的重要信息。未来需要进行研究，以更好地理解与不同酒精中毒轨迹相关的社会心理影响，以及随着个体步入老年对不同轨迹进行特征描述。
