Drug Alcohol Depend. 2020 Dec 1;217:108274. doi: 10.1016/j.drugalcdep.2020.108274. Epub 2020 Sep 10.
Denial of an overarching alcohol problem despite endorsement of specific alcohol-related difficulties may be central to development and continuation of alcohol use disorders (AUDs). However, there is limited information about which characteristics of drinkers and which drinking problems relate most closely to that denial.
Using data from two generations of the San Diego Prospective Study (SDPS), we compared AUD subjects who considered themselves non-problematic drinkers (Group 1) with those with AUDs who acknowledged a general alcohol problem (Group 2). Comparisons included demography, alcohol-related patterns and problems, drug use, as well as impulsivity and sensation seeking. Variables were first evaluated as univariate characteristics after which significant group differences were entered in logistic regression analyses.
Sixty-seven percent of 94 AUD probands and 82 % of 176 AUD offspring reported themselves as light or moderate social drinkers despite averages of up to 12 maximum drinks per occasion and four DSM problems. Regression analyses indicated deniers evidenced less intense alcohol and drug-related problems and identified DSM-IV criterion items that they were most likely to deny.
A large majority of two generations of SDPS participants whose interviews indicated a current AUD did not characterize themselves as problem drinkers. Despite drinking amounts that far exceeded healthy limits and admitting to important life problems with alcohol, these individuals give misleading answers regarding their condition when asked general questions about drinking by health care deliverers. The authors offer suggestions regarding how to identify those drinkers in need of advice regarding dangers of their behaviors.
尽管承认与酒精相关的具体困难，但仍否认总体上存在酒精问题，这可能是酒精使用障碍（AUD）发展和持续的核心。然而，关于哪些饮酒者的特征以及哪些饮酒问题与这种否认最相关，信息有限。
使用圣地亚哥前瞻性研究（SDPS）两代人的数据，我们将认为自己是无问题饮酒者的 AUD 受试者（第 1 组）与承认存在一般酒精问题的 AUD 受试者（第 2 组）进行了比较。比较包括人口统计学、与酒精相关的模式和问题、药物使用以及冲动性和寻求刺激。首先评估变量作为单变量特征，然后将有显著组间差异的变量纳入逻辑回归分析。
94 名 AUD 先证者中有 67%和 176 名 AUD 后代中有 82%报告自己是轻度或中度社交饮酒者，尽管平均每次最多饮用 12 杯，有 4 项 DSM 问题。回归分析表明，否认者的酒精和药物相关问题不那么严重，并确定了他们最有可能否认的 DSM-IV 标准项目。
两代 SDPS 参与者中，绝大多数接受访谈表明存在当前 AUD 的参与者并不将自己描述为问题饮酒者。尽管他们的饮酒量远远超过了健康限制，并承认与酒精有关的重要生活问题，但当医疗服务提供者询问他们关于饮酒的一般问题时，这些人会给出关于他们病情的误导性答案。作者就如何识别那些需要有关其行为危险的建议的饮酒者提出了建议。
