Bottomley Jamison S, Williams Joah L, Pavlacic Jeffrey M, Gex Kathryn S, Rheingold Alyssa A
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.
Department of Psychology, University of Memphis, Memphis, Tennessee, USA.
Alcohol Clin Exp Res (Hoboken). 2025 Jan;49(1):175-184. doi: 10.1111/acer.15496. Epub 2024 Nov 24.
Problematic alcohol use (PAU) is highly prevalent in the United States. Although bereavement, a highly stressful and ubiquitous experience across the lifespan, is believed to increase the risk for PAU based on a small number of studies, research using large diverse samples of bereaved adults has yet to be conducted. Therefore, relations between PAU and bereavement remain poorly understood, hampering the reach and effectiveness of alcohol interventions. The current study addresses this limitation by investigating rates and correlates of PAU and service utilization among a large national sample of bereaved adults.
Participants were adults who reported the death of a significant other in their lifetime (N = 1529). Most participants identified as female (69.1%) and White (68.2%), with an average age of 44.7 (SD = 16.29). Online self-report surveys assessed the prevalence of PAU using the AUDIT-C, mental health service utilization, and associated characteristics.
Nearly one-third (n = 463; 30.3%) screened positive for PAU, which surpasses rates found in the general US population. After accounting for other characteristics, time since the death (OR, 3.63; 95% CI, 2.59-5.08) and meeting presumptive criteria for depression (OR, 2.28; 95% CI, 1.64-3.18) and prolonged grief disorder (PGD; OR, 1.66; 95% CI, 1.13-2.25) significantly increased risk for PAU among the bereaved. Approximately half (n = 244; 52.7%) of bereaved adults with PAU received any mental health service since the death. Time since the death (OR, 4.19; 95% CI, 2.38-7.48) and presumptive depression (OR, 2.16; 95% CI, 1.25-3.74) were associated with service utilization after accounting for other characteristics.
The high prevalence of PAU among bereaved adults, particularly among those with a diagnosis of PGD, and limited use of support services underscore the need for greater empirical attention and integrated substance use care for bereaved adults.
问题性饮酒在美国极为普遍。虽然丧亲之痛是一种在一生中极具压力且普遍存在的经历，基于少数研究，人们认为它会增加问题性饮酒的风险，但尚未对大量不同的丧亲成年人样本进行研究。因此，问题性饮酒与丧亲之痛之间的关系仍未得到充分理解，这阻碍了酒精干预措施的覆盖范围和效果。本研究通过调查一个大型全国性丧亲成年人样本中问题性饮酒的发生率、相关因素及服务利用情况来解决这一局限性。
参与者为报告其一生中重要他人死亡的成年人（N = 1529）。大多数参与者为女性（69.1%）和白人（68.2%），平均年龄44.7岁（标准差 = 16.29）。通过在线自我报告调查，使用酒精使用障碍识别测试简版（AUDIT-C）评估问题性饮酒的患病率、心理健康服务利用情况及相关特征。
近三分之一（n = 463；30.3%）的人问题性饮酒筛查呈阳性，这一比例超过了美国普通人群中的发生率。在考虑其他特征后，丧亲后时长（比值比[OR]，3.63；95%置信区间[CI]，2.59 - 5.08）、符合抑郁症推定标准（OR，2.28；95% CI，1.64 - 3.18）以及持续性悲伤障碍（PGD；OR，1.66；95% CI，1.13 - 2.25）显著增加了丧亲者问题性饮酒的风险。在有问题性饮酒的丧亲成年人中，约一半（n = 244；52.7%）自亲人死亡后接受过任何心理健康服务。在考虑其他特征后，丧亲后时长（OR，4.19；95% CI，2.38 - 7.48）和推定抑郁症（OR，2.16；95% CI，1.25 - 3.74）与服务利用情况相关。
丧亲成年人中问题性饮酒的高患病率，尤其是那些被诊断为持续性悲伤障碍的人，以及支持服务利用有限，凸显了对丧亲成年人进行更多实证关注和综合物质使用护理的必要性。
