Nelson C B, Heath A C, Kessler R C
World Health Organization, Geneva, Switzerland.
J Consult Clin Psychol. 1998 Jun;66(3):474-83. doi: 10.1037//0022-006x.66.3.474.
General population data are presented on patterns and predictors of temporal progression of alcohol dependence symptoms in the general population. The data come from the National Comorbidity Survey, a nationally representative general population survey of respondents ages 15-54. Lifetime symptom classes were estimated with latent class analysis (LCA). A 4-class LCA solution, including a 1st asymptomatic class and 3 progressively more serious symptomatic classes, was found to fit the data. Probability of initial symptom onset among drinkers was found to be highest in the 10-24 age range, to be higher among men than women, and to have increased dramatically in the past 4 decades. Age, gender, and cohort effects were less powerful in predicting symptom progression. A narrowing of the gender difference over time was due largely to a convergence in initial symptom onset among men and women ages 10-24. These results suggest that a rise in initial problems was more important than an increase in the transition from problems to dependence in accounting for the growing prevalence of alcohol dependence during the post-World War II years in the United States.
文中呈现了普通人群中酒精依赖症状随时间发展的模式及预测因素的数据。这些数据来自全国共病调查，这是一项针对15至54岁受访者的具有全国代表性的普通人群调查。采用潜在类别分析（LCA）估计终生症状类别。结果发现，一个包含第1类无症状类别和3个症状逐渐加重类别的4类别LCA解决方案符合数据。饮酒者中初始症状发作的概率在10至24岁年龄范围内最高，男性高于女性，且在过去40年中显著增加。年龄、性别和队列效应在预测症状进展方面的作用较小。随着时间推移，性别差异缩小主要是由于10至24岁男性和女性在初始症状发作方面的趋同。这些结果表明，在美国二战后时期，酒精依赖患病率不断上升的原因中，初始问题的增加比从问题到依赖的转变增加更为重要。
