美国与墨西哥边境两侧的饮酒模式与《精神疾病诊断与统计手册》第五版中的酒精使用障碍
Alcohol Use Patterns and DSM-5 Alcohol Use Disorder on Both Sides of the U.S.-Mexico Border.
作者信息
Greenfield Thomas K, Ye Yu, Lown E Anne, Cherpitel Cheryl J, Zemore Sarah, Borges Guilherme
机构信息
Alcohol Research Group, Public Health Institute, Emeryville, California.
Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, San Francisco, California.
出版信息
Alcohol Clin Exp Res. 2017 Apr;41(4):769-778. doi: 10.1111/acer.13356. Epub 2017 Mar 13.
BACKGROUND
Alcohol consumption patterns on the U.S.-Mexico border and their relationships with DSM-5 alcohol use disorders (AUD) have been understudied. Yet, the effects of drinking by Mexican-origin individuals may differ between cities on versus off the border both in the United States and in Mexico. We characterize prior 12-month drinking patterns and examine their relationships with AUD, in border and off-border cities of Texas and adjacent Mexican states.
METHODS
Data come from the U.S.-Mexico Study of Alcohol and Related Conditions involving 2,336 Mexican Americans in Texas and 2,460 Mexicans in bordering states of Nuevo Leon and Tamaulipas in Mexico. Drinking pattern was defined as an interaction between volume and maximum amount, or intensity (never vs. ever 5+/4+ [men/women], 8+, and 12+ drinks in a day). DSM-5 AUD was assessed using an adaptation of the Alcohol Section of the World Health Organization Composite International Diagnostic Interview core. Separately by gender, 5 logistic regressions models controlling for age were estimated predicting symptoms in 2 or more AUD criteria domains from volume, heavy pattern and, successively, effects of country, and (by country) residing on vs. off the border, or in each of 3 cities/country.
RESULTS
A segmentation analysis for Texas males based on rate of experiencing AUD generated several distinct volume groups, each partitioned by an empirically selected maximum, and helped identify a drinking-pattern typology. In gender-stratified models of AUD rates using this typology, adjusting for age, significant volume and intensity effects were seen, more strongly in the United States. Border versus interior differences implied more AUD for given patterns at the border in the United States and the reverse in Mexico, with some city differences also evident.
CONCLUSIONS
Drinking-pattern analyses confirm that border proximity may affect drinking problems but in opposite directions in the United States and Mexico, possibly related to economic and psychological stresses specific to respective communities.
背景
美国 - 墨西哥边境地区的饮酒模式及其与《精神疾病诊断与统计手册》第五版(DSM - 5)酒精使用障碍(AUD)的关系尚未得到充分研究。然而,墨西哥裔个体的饮酒影响在美国和墨西哥边境城市与非边境城市可能存在差异。我们对得克萨斯州边境和非边境城市以及相邻墨西哥州之前12个月的饮酒模式进行了特征描述,并研究了它们与酒精使用障碍的关系。
方法
数据来自美国 - 墨西哥酒精及相关状况研究,涉及得克萨斯州的2336名墨西哥裔美国人以及墨西哥新莱昂州和塔毛利帕斯州边境地区的2460名墨西哥人。饮酒模式被定义为饮酒量与最大饮酒量或饮酒强度之间的相互作用(从不饮酒与每日饮酒5杯以上/4杯以上[男性/女性]、8杯以上和12杯以上)。DSM - 5酒精使用障碍通过改编世界卫生组织综合国际诊断访谈核心中的酒精部分进行评估。按性别分别估计了5个控制年龄的逻辑回归模型,以预测在2个或更多酒精使用障碍标准领域中,饮酒量、重度饮酒模式以及国家影响(按国家)、居住在边境还是非边境或每个城市/国家中的症状。
结果
基于酒精使用障碍发生率对得克萨斯州男性进行的分段分析产生了几个不同的饮酒量组,每个组由根据经验选择的最大饮酒量划分,并有助于确定一种饮酒模式类型。在使用这种类型的酒精使用障碍发生率的性别分层模型中,调整年龄后,发现了显著的饮酒量和饮酒强度影响,在美国更为明显。边境与内陆的差异表明,在美国边境地区,特定饮酒模式下的酒精使用障碍更多,而在墨西哥则相反,一些城市差异也很明显。
结论
饮酒模式分析证实,靠近边境可能会影响饮酒问题,但在美国和墨西哥的影响方向相反,这可能与各自社区特有的经济和心理压力有关。
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