Bucholz K K, Heath A C, Reich T, Hesselbrock V M, Kramer J R, Nurnberger J I, Schuckit M A
Department of Psychiatry, Washington University, School of Medicine, St. Louis, Missouri 63108-3729, USA.
Alcohol Clin Exp Res. 1996 Nov;20(8):1462-71. doi: 10.1111/j.1530-0277.1996.tb01150.x.
We attempt to identify distinctive subtypes of alcoholics using latent class analysis with data from 2551 relatives of alcoholic probands, all participants in the Collaborative Study of the Genetics of Alcoholism. Latent class analysis is a multivariate technique using cross-classified data to identify unobserved ("latent") classes that explain the relationships among observed variables. Data on 37 life-time symptoms of alcohol dependence from 1360 female and 1191 male relatives were analyzed, with a 4 class solution selected as the best fitting among the 2 through 6 class solutions that were examined. We observed the following classes: class 1, nonproblem drinkers (39.6% male, 50% female); class 2, mild alcoholics (persistent desire to stop, tolerance, and blackouts) (31.8% male, 28.7% female); class 3, moderate alcoholics (social, health, and emotional problems) (18.9% male, 14.6% female); and class 4, severely affected alcoholics (withdrawal, inability to stop drinking, craving, health, and emotional problems) (9.7% male, 6.7% female). There was little evidence for the construct of alcohol abuse; endorsement probabilities for abuse symptoms (e.g., arrest and DWIs) were very low for all classes, whereas hazardous use was common among men in class 1. In addition to those in class 3 and class 4, a majority of men in class 2 qualified for DSM-III-R alcohol dependence, suggesting a biomodal distribution of drinkers and alcoholics, with little nondependent problem drinking among men in this high-risk sample. We conclude that, in this sample, alcoholism is not differentiated by symptom profiles but rather lies on a continuum of severity, with the possible exception of withdrawal, which characterized only class 4 individuals.
我们试图通过潜在类别分析，利用来自2551名酒精成瘾先证者亲属的数据来识别酒精成瘾者的不同亚型，这些参与者均来自酒精成瘾遗传学合作研究项目。潜在类别分析是一种多变量技术，使用交叉分类数据来识别未观察到的（“潜在”）类别，以解释观察变量之间的关系。对1360名女性和1191名男性亲属的37种酒精依赖终身症状数据进行了分析，在检查的2至6类解决方案中，选择4类解决方案作为最佳拟合。我们观察到以下几类：第1类，无问题饮酒者（男性占39.6%，女性占50%）；第2类，轻度酒精成瘾者（持续有戒酒欲望、耐受性和昏厥）（男性占31.8%，女性占28.7%）；第3类，中度酒精成瘾者（社交、健康和情绪问题）（男性占18.9%，女性占14.6%）；第4类，受严重影响的酒精成瘾者（戒断反应、无法戒酒、渴望饮酒、健康和情绪问题）（男性占9.7%，女性占6.7%）。几乎没有证据支持酒精滥用这一概念；所有类别中滥用症状（如被捕和酒后驾车）的认可概率都非常低，而第1类中的男性普遍存在危险饮酒行为。除了第3类和第4类中的男性，第2类中的大多数男性符合《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）中酒精依赖的标准，这表明饮酒者和酒精成瘾者存在双峰分布，在这个高风险样本中，男性中几乎没有非依赖性问题饮酒者。我们得出结论，在这个样本中，酒精成瘾并非由症状特征来区分，而是处于严重程度的连续统一体上，可能戒断反应除外，它仅为第4类个体所特有。
