Grant B F, Harford T C
National Institute on Alcohol Abuse and Alcoholism, Division of Biometry and Epidemiology, Rockville, MD 20857.
J Subst Abuse. 1988;1(2):231-52. doi: 10.1016/s0899-3289(88)80026-9.
The purpose of this investigation was to quantify the relationship between ethanol consumption and DSM-III alcohol use disorders using mathematical modeling techniques that allowed for the simultaneous control of several extraneous factors and the assessment of potential interaction. Although gender, education, ethnicity, and marital status were not identified as actual confounders in the logistic regression model, the ethanol intake-dependence association was found to be stronger among younger adults than in the later stages of life. Age was an influential confounder of the ethanol intake-abuse relationship, but the magnitude of the association was generally weaker for abuse than for dependence. Separate analyses in which the abuse and dependence criteria served as outcome measures qualified the interpretation of the overall ethanol intake-disorder associations. Implications of these results are discussed in terms of age differences in exposure and context of consumption, differential interpretation of withdrawal symptoms, and the relationship between abuse and dependence. The need for future research to refine our descriptions of risk of alcohol use disorders in relation to levels of intake is highlighted.
本研究的目的是使用数学建模技术来量化乙醇消费与《精神疾病诊断与统计手册》第三版（DSM-III）酒精使用障碍之间的关系，该技术能够同时控制多个外部因素并评估潜在的相互作用。尽管在逻辑回归模型中，性别、教育程度、种族和婚姻状况未被确定为实际的混杂因素，但发现乙醇摄入量与依赖之间的关联在年轻人中比在生命后期更强。年龄是乙醇摄入量与滥用关系的一个有影响的混杂因素，但滥用的关联程度通常比依赖弱。分别以滥用和依赖标准作为结果指标进行的分析，对整体乙醇摄入量与障碍之间关联的解释进行了限定。从饮酒暴露和消费背景的年龄差异、戒断症状的不同解释以及滥用与依赖之间的关系等方面讨论了这些结果的意义。强调了未来研究需要完善我们对与饮酒水平相关的酒精使用障碍风险描述的必要性。
