Department of Psychiatry, Virginia Commonwealth University, Richmond, USA.
Alcohol Clin Exp Res. 2011 May;35(5):1011-4. doi: 10.1111/j.1530-0277.2010.01432.x. Epub 2011 Feb 15.
The Rutgers Alcohol Problem Index (RAPI) is widely used to assess adolescent drinking-related problems. We asked how well RAPI, administered in late adolescence, predicts alcohol diagnoses at age 25 in a 7-year follow-up.
At age 18, a population-based sample of Finnish twins completed RAPI by postal questionnaire; 597 (300 male) twins, from pairs discordant and concordant for age 18 RAPI scores, were interviewed at age 25 with the SSAGA, yielding DSM-IIIR diagnoses. Polychoric correlations between RAPI and alcohol diagnoses and symptoms, the area under the response operator characteristic (ROC) curve, and the odds ratio of outcome diagnosis per unit change in adolescent RAPI were analyzed. Twin pairs discordant for both adolescent RAPI and adult diagnoses permitted within-family replications for the full sample and separately by sex.
Nearly half the interviewed twins met diagnostic criteria for alcohol dependency (46.2%) or abuse (1.5%). Age 18 RAPI scores significantly correlated with diagnoses (0.52) and symptom counts (0.55). ROC analysis found a 74% probability that adolescent RAPI scores will be higher among those with an alcohol diagnosis at age 25 than for those without. The odds ratio of outcome alcohol diagnosis per unit increase in adolescent 18 RAPI exceeded 10.0. Within-family comparisons of 117 twin pairs discordant for both age 18 RAPI and age 25 alcohol diagnoses replicated the between-family associations. In both between-family and within-family analyses, RAPI was more predictive of alcohol diagnoses among females.
Our results offer evidence, including that from informative comparisons of co-twins discordant for both predictor and outcome, that RAPI scores in late adolescence robustly predict alcohol diagnoses in early adulthood. Accordingly, our results also provide new evidence that one pathway to problem drinking in early adulthood is a direct one from problem drinking in adolescence.
罗格斯酒精问题指数（RAPI）被广泛用于评估青少年饮酒相关问题。我们询问了在 7 年的随访中，青少年晚期的 RAPI 评分在多大程度上预测了 25 岁时的酒精诊断。
在 18 岁时，芬兰双胞胎的一个基于人群的样本通过邮寄问卷完成了 RAPI；597 名（300 名男性）双胞胎，来自 18 岁时 RAPI 评分不一致和一致的双胞胎对，在 25 岁时通过 SSAGA 进行访谈，得出 DSM-III-R 诊断。RAPI 与酒精诊断和症状之间的偏相关系数、反应算子特征（ROC）曲线下的面积，以及青少年 RAPI 每单位变化的结局诊断的比值比进行了分析。青少年 RAPI 和成人诊断均不一致的双胞胎对允许对全样本和按性别分别进行家庭内复制。
接受访谈的双胞胎中，近一半符合酒精依赖（46.2%）或滥用（1.5%）的诊断标准。18 岁时的 RAPI 评分与诊断（0.52）和症状计数（0.55）显著相关。ROC 分析发现，在 25 岁时有酒精诊断的青少年 RAPI 评分高于没有酒精诊断的青少年 RAPI 评分的可能性为 74%。青少年 RAPI 每增加一个单位，出现酒精诊断的几率超过 10.0。在青少年 18 岁时 RAPI 和 25 岁时酒精诊断均不一致的 117 对双胞胎的家庭内比较复制了家庭间的关联。在家庭间和家庭内分析中，RAPI 对女性的酒精诊断预测更为准确。
我们的结果提供了证据，包括来自对预测因子和结果均不一致的同卵双胞胎的信息性比较，表明青少年晚期的 RAPI 评分能很好地预测成年早期的酒精诊断。因此，我们的结果还提供了新的证据，即成年早期出现问题性饮酒的途径之一是直接从青少年时期的问题性饮酒发展而来。
