Defining risk heterogeneity for internalizing symptoms among children of alcoholic parents
Defining risk heterogeneity for internalizing symptoms among children of alcoholic parents
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DOI：
10.1017/s0954579408000084
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发表时间：
2008-12-01
影响因子：
3.3
通讯作者：
Zucker, Robert A.
中科院分区：
文献类型：
--
作者：
Hussong, Andrea M.;Flora, David B.;Zucker, Robert A.
采用发展流行病学的角度来看，目前的研究探讨了风险异质性的来源，内化酗酒的父母（COA）的儿童之间的酗酒。基于父母的因素，包括共病诊断和家庭中酗酒父母的数量，以及基于儿童的因素，即儿童性别，形成了异质性的指标。一种新的方法交叉研究的方法，我们提出了一个三阶段的分析，涉及测量开发项目反应理论，检查研究的影响，随着时间的推移，潜在的轨迹使用潜在曲线模型，并预测这些潜在的轨迹测试我们的理论推导出的假设在两个纵向调查母亲和自我报告的asthatology。具体来说，我们重复了以前的研究结果，即父母酗酒对儿童内化症状有独特的影响，超过了父母抑郁和反社会人格障碍。然而，我们也发现了重要的亚组差异，解释了COA风险特征的异质性，包括家庭中酗酒父母的数量、酗酒父母的共病诊断以及自我报告的症状、儿童性别。这些因素有助于完善COA之间的风险定义，建议更严重受损的目标群体进行预防性干预，确定家族性酒精中毒的意义，随着时间的推移内在症状的个体差异，并进一步指定的远端风险矩阵的内在途径酒精参与。
Adopting a developmental epidemiology perspective, the current study examines sources of risk heterogeneity for internalizing symptomatology among children of alcoholic parents (COAs). Parent-based factors, including comorbid diagnoses and the number of alcoholic parents in the family, as well as child-based factors, namely child gender, formed the indicators of heterogeneity. Following a novel approach to cross-study methods, we present a three-stage analysis involving measurement development using item response theory, examination of study effects on latent trajectories over time using latent curve modeling, and prediction of these latent trajectories testing our theoretically derived hypotheses in two longitudinal investigations across both mother- and self-reported symptomatology. Specifically, we replicated previous findings that parent alcoholism has a unique effect on child internalizing symptoms, above and beyond those of both parent depression and antisocial personality disorder. However, we also found important subgroup differences, explaining heterogeneity within COAs' risk profile in terms of the number of alcoholic parents in the family, comorbid diagnoses for the alcoholic parent and, for self-reported symptoms, child gender. Such factors serve to refine the definition of risk among COAs, suggesting a more severely impaired target group for preventive interventions, identifying the significance of familial alcoholism in individual differences underlying internalizing symptoms over time, and further specifying the distal risk matrix for an internalizing pathway to alcohol involvement.