Ammon Lyndsay, Bond Jason, Matzger Helen, Weisner Constance
Alcohol Research Group, 6475 Christie Avenue, Suite 400, Emeryville, California 94608, USA.
J Stud Alcohol Drugs. 2008 Jan;69(1):140-50. doi: 10.15288/jsad.2008.69.140.
The purpose of this study was to examine how community service contacts and informal support are related to the course of drinking for dependent and problem-drinking persons in a population-based sample of women versus men over 7 years.
Alcohol-dependent (n = 600) and problem-drinking (n = 992) men and women were identified through probability surveys in the general population and treatment programs throughout a California county. Participants were interviewed at baseline and again 1, 3, 5, and 7 years later. Models predicting the differential impact of community services and informal influences on men and women's alcohol consumption over time were estimated using a multilevel mixed model, while controlling for demographic characteristics and problem severity.
Dependent and problem-drinking men consumed more than women, yet a trend of reduced drinking over time was found for both men and women. Alcoholics Anonymous attendance was related to decreased consumption for men and women regardless of severity; contact with the mental health system was similarly related to decreased consumption for both genders. For problem-drinking women, welfare contacts were related to decreased consumption. A family intervention was the only informal influence that had differential effects on dependent and problem-drinking men and women's alcohol consumption.
Findings point to the continued benefits of facilitating social support and mental health visits for both dependent and problem-drinking men and women. Developing means to identify and intervene in the range of community service settings, particularly in the mental health and legal system, continues to be important. Innovative interventions for families to encourage engagement in chemical dependency treatment are also warranted.
本研究旨在探讨在一个基于人群的7年随访样本中,社区服务接触和非正式支持与男性及女性酗酒者和问题饮酒者饮酒过程之间的关系。
通过对加利福尼亚州一个县的普通人群和治疗项目进行概率调查,确定了600名酒精依赖者和992名问题饮酒者(男性和女性)。参与者在基线时接受访谈,并在1年、3年、5年和7年后再次接受访谈。使用多级混合模型估计预测社区服务和非正式影响对男性和女性随时间饮酒量差异影响的模型,同时控制人口统计学特征和问题严重程度。
酒精依赖者和问题饮酒者中男性饮酒量多于女性,但男性和女性随时间饮酒量均呈下降趋势。无论严重程度如何,参加戒酒互助会与男性和女性饮酒量减少有关;与心理健康系统接触同样与两性饮酒量减少有关。对于问题饮酒的女性,与福利机构接触与饮酒量减少有关。家庭干预是唯一对酒精依赖者和问题饮酒者的男性和女性饮酒量有不同影响的非正式影响因素。
研究结果表明,为酒精依赖者和问题饮酒者的男性和女性提供社会支持和心理健康咨询仍有持续的益处。开发识别和干预各类社区服务环境的方法,特别是在心理健康和法律系统方面,仍然很重要。还需要创新的家庭干预措施,以鼓励家庭成员参与药物依赖治疗。