The link between family history and early onset alcoholism: Earlier initiation of drinking or more rapid development of dependence?
The link between family history and early onset alcoholism: Earlier initiation of drinking or more rapid development of dependence?
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DOI：
10.15288/jsa.2000.61.637
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发表时间：
2000-09-01
期刊：
影响因子：
--
通讯作者：
Dawson, DA
中科院分区：
文献类型：
--
作者：
Dawson, DA
目的：本研究检验；研究早发性酒精中毒与家族史之间的关系，以确定家族酒精中毒史是否预示着较早开始饮酒，或一旦开始饮酒后更迅速地开始依赖，或两者兼而有之。方法：使用来自美国成年人的大型全国代表性样本的横断面回顾性数据，使用离散时间比例风险模型来评估家族史饱和度（酗酒的一级和二级亲属百分比）对以下因素的影响：(1)所有成年人开始饮酒的风险（N = 42,862; 58.4%，女性）和(2)终生饮酒者从开始饮酒到开始依赖的风险（N = 27,616； 50.7%男性）。对不同时期的模型进行了估计，以观察家族史饱和的影响是否随着时间的推移而变化，这表明家族史饱和与早发依赖性有更强的联系。结果：家族史饱和度对开始饮酒风险的正向影响在15岁前最强，随着年龄的增长稳步下降。男性的这种情况略弱于女性。在控制了早期开始饮酒后，家族史饱和对发展为依赖风险的直接积极影响随着时间的推移而增加，在18岁之前开始饮酒的个体中略有降低。家族史对发展为依赖风险的间接影响，通过其对早期饮酒作为依赖风险因素的影响，在开始饮酒后3至9年的时间间隔中最为强烈。结论：家族史与早发性酒精中毒之间的关联似乎最明显地受到家族史预测早期饮酒的驱动。在开始饮酒后的前3年内，家族史对依赖发展的影响较弱，这可能反映了这一时期发育限制性依赖的优势。这些数据与寻求新奇、冲动和早期酗酒之间建立的联系是一致的。虽然这些发现支持了通过多巴胺能和血清素能功能产生遗传影响的可能性，但也表明环境因素可能在帮助解释家族史和早发性酒精中毒之间的联系方面发挥重要作用。
Objective: This study examine!; the association between early onset alcoholism and family history to determine whether family history of alcoholism is predictive of earlier initiation of drinking, more rapid onset of dependence once drinking has begun, or both. Method: Using cross-sectional, retrospective data from a large, nationally representative sample of U.S. adults, discrete time proportional hazards models were used to assess the effects of family history saturation (% of alcoholic first- and second-degree relatives) on: (1) the risk of initiating drinking among all adults (N = 42,862; 58.4 %, female) and (2) the risk of progressing from initiation of drinking to onset of dependence among lifetime drinkers (n = 27,616; 50.7 % male). Models were estimated for different time periods, to see if the effect of family history saturation varied over time in a manner suggestive of a stronger association with early onset dependence. Results: The positive effect of family history saturation on the risk of initiating drinking was strongest prior to age 15 and declined steadily with increasing age. It was slightly weaker for men than women. After controlling for early initiation of drinking, the direct positive effect of family history saturation on the risk of progressing to dependence increased over time and was slightly reduced among individuals who starred drinking before age 18. The indirect effect of family history on the risk of developing dependence, via its effect on early drinking as a risk factor for dependence, was strongest in the interval from 3 to 9 years after initiation of drinking. Conclusions: The association between family history and early onset alcoholism appears to be driven most clearly by family history predicting earlier initiation of drinking. The weak effect of family history on the development of dependence within the first 3 years after initiation of drinking may reflect the preponderance of developmentally limited dependence during this time period. The data are consistent with the links established between novelty seeking, impulsivity and early onset alcoholism. While supporting the possibility of genetic effects via dopaminergic and serotonergic function, these findings also suggest that environmental factors may play an important part in helping to explain the association between family history and early onset alcoholism.