Brennan P L, Moos R H
Center for Health Care Evaluation, Palo Alto VA Health Care System, CA 94304, USA.
J Subst Abuse. 1996;8(2):167-80. doi: 10.1016/s0899-3289(96)90227-8.
Recent research emphasizes the importance of identifying older problem drinkers. However, very little is known about the longitudinal course and predictors of late-life problem drinking. This prospective study of late-life problem drinkers (N = 581) focused on predictors of alcohol consumption, drinking problems, depression, and treatment seeking over a 4-year interval. Heavier baseline alcohol use and being male independently predicted more alcohol consumption 4 years later; more baseline drinking problems and early-onset status independently predicted more drinking problems at follow-up. Independent of other factors, more initial depressive symptoms and chronic health stressors portended more depressive symptoms at follow-up. Individuals who initially sought more treatment, and who had more chronic health and spouse stressors at baseline, were more likely to seek help 4 years later. Heavier reliance on avoidance coping strategies heightened the risk that stressors and friends' approval of drinking would lead to more drinking problems at follow-up. However, for individuals who had more drinking problems at baseline, such environmental risk factors as negative health events and friend stressors predicted fewer subsequent drinking problems.
近期研究强调了识别老年问题饮酒者的重要性。然而,对于晚年问题饮酒的纵向发展过程及预测因素,我们知之甚少。这项针对晚年问题饮酒者(N = 581)的前瞻性研究聚焦于4年期间酒精消费、饮酒问题、抑郁及寻求治疗的预测因素。基线酒精使用量较大以及男性身份独立预测了4年后更多的酒精消费;更多的基线饮酒问题和早发状态独立预测了随访时更多的饮酒问题。独立于其他因素之外,更多的初始抑郁症状和慢性健康应激源预示着随访时更多的抑郁症状。最初寻求更多治疗且基线时有更多慢性健康和配偶应激源的个体,4年后更有可能寻求帮助。对回避应对策略的更强依赖增加了应激源和朋友对饮酒的认可在随访时导致更多饮酒问题的风险。然而,对于基线时有更多饮酒问题的个体,诸如负面健康事件和朋友应激源等此类环境风险因素预示着随后较少的饮酒问题。