Lee Matthew R, Chassin Laurie, MacKinnon David P
Department of Psychological Sciences, University of Missouri, Columbia, Missouri.
Department of Psychology, Arizona State University, Tempe, Arizona.
Alcohol Clin Exp Res. 2015 Jun;39(6):1064-74. doi: 10.1111/acer.12715. Epub 2015 May 22.
Research has shown a developmental process of "maturing out" of problem drinking beginning in young adulthood. Perhaps surprisingly, past studies suggest that young adult drinking reductions may be particularly pronounced among those exhibiting relatively severe forms of problem drinking earlier in emerging adulthood. This may occur because more severe problem drinkers experience stronger ameliorative effects of normative young adult role transitions like marriage.
The hypothesis of stronger marriage effects among more severe problem drinkers was tested using 3 waves of data from a large ongoing study of familial alcohol disorder (N = 844; 51% children of alcoholics).
Longitudinal growth models characterized (i) the curvilinear trajectory of drinking quantity from ages 17 to 40, (ii) effects of marriage on altering this age-related trajectory, and (iii) moderation of this effect by premarriage problem drinking levels (alcohol consequences and dependence symptoms). Results confirmed the hypothesis that protective marriage effects on drinking quantity trajectories would be stronger among more severe premarriage problem drinkers. Supplemental analyses showed that results were robust to alternative construct operationalizations and modeling approaches.
Consistent with role incompatibility theory, findings support the view of role conflict as a key mechanism of role-driven behavior change, as greater problem drinking likely conflicts more with demands of roles like marriage. This is also consistent with the developmental psychopathology view of transitions and turning points. Role transitions among already low-severity drinkers may merely represent developmental continuity of a low-risk trajectory, whereas role transitions among higher-severity problem drinkers may represent developmentally discontinuous "turning points" that divert individuals from a higher- to a lower-risk trajectory. Practically, findings support the clinical relevance of role-related "maturing out processes" by suggesting that they often reflect natural recovery from clinically significant problem drinking. Thus, understanding these processes could help clarify the nature of pathological drinking and inform interventions.
研究表明,从青年期开始就存在问题饮酒“逐渐消失”的发展过程。也许令人惊讶的是,过去的研究表明,在成年初期表现出相对严重问题饮酒形式的人群中,青年期饮酒量的减少可能尤为明显。这可能是因为更严重的问题饮酒者会从婚姻等正常的青年期角色转变中体验到更强的改善效果。
利用一项正在进行的关于家族性酒精障碍的大型研究中的三波数据(N = 844;51%为酗酒者的子女),对更严重问题饮酒者中婚姻影响更强这一假设进行了检验。
纵向增长模型刻画了:(i)17岁至40岁饮酒量的曲线轨迹,(ii)婚姻对改变这一与年龄相关轨迹的影响,以及(iii)婚前问题饮酒水平(酒精后果和依赖症状)对这种影响的调节作用。结果证实了这一假设,即对于饮酒量轨迹而言,婚前问题饮酒越严重,婚姻的保护作用就越强。补充分析表明,研究结果对于替代结构操作化和建模方法具有稳健性。
与角色不相容理论一致,研究结果支持将角色冲突视为角色驱动行为改变的关键机制这一观点,因为更严重的问题饮酒可能与婚姻等角色的要求冲突更大。这也与发展心理病理学中关于转变和转折点的观点一致。对于饮酒问题较轻者而言,角色转变可能仅仅代表低风险轨迹的发展连续性,而对于问题饮酒较严重者而言,角色转变可能代表发展上不连续的“转折点”,使个体从高风险轨迹转向低风险轨迹。实际上,研究结果支持了与角色相关的“逐渐消失过程”在临床上的相关性,表明它们常常反映了从临床上显著的问题饮酒中自然恢复的过程。因此,理解这些过程有助于阐明病理性饮酒的本质并为干预提供依据。