WOMEN'S DRINKING: SECONDARY ANALYSES OF 20-YEAR DATA

描述（由申请人提供）：本申请提出了对20年妇女饮酒及其前因和结果的独特全国调查数据的新分析。国家妇女健康和生活经历研究（NSHLEW）于1981年、1991年、1996年和2001年访问了具有代表性的美国妇女全国样本。2001年的调查数据使评估对妇女饮酒行为和饮酒轨迹的长期影响的新模式成为可能，还提供了关于答复者使用处方精神活性药物的详细信息，关于老年妇女健康的新信息，以及复制和扩展20年前获得的终生饮酒史的信息。所提出的分析将(1)检验对妇女危险饮酒的长期影响的多波模型；(2)识别女性饮酒轨迹的模式、前因和后果；(3)评估(a)回顾性饮酒史的可靠性和效用（例如，确定饮酒轨迹），(b)就业对妇女饮酒的背景影响，(c)终生饮酒模式与老年妇女健康的关联，以及(d)妇女同时使用酒精和处方药的前因和后果；(4)比较从典型数量频率问题和毕业频率问题中获得的饮酒自我报告。结合回顾性数据和三波调查数据的结构方程模型将用于检验以下因素对女性饮酒的假设影响：(1)幼儿经历，(2)儿童期和成年期的性受害，以及(3)成人亲密关系特征。将分析饮酒轨迹（通过潜在生长混合模型和先验标准分类）与前因（如童年）、伴随变化（如婚姻状况）和结果（如健康问题）的关联。从终生饮酒史得出的轨迹，如果证明是可靠的，将进行类似的评估。其他分析将检验以下假设：(1)就业对女性饮酒的背景影响的历史变化，(2)具有不同终生饮酒史的老年妇女的健康状况，以及(3)酒精与处方精神活性药物联合使用的后果。一项方法学实验将显示，女性在回答频率分级问题时是否比回答典型饮酒频率和数量问题时报告的饮酒量更高。本文提出的二次分析结果将提高对妇女终生饮酒及其前因和后果的认识，有助于设计对性别问题更敏感、更有效的治疗、预防和酒精政策方法。

DESCRIPTION (provided by applicant): This application proposes new analyses of unique 20-year national survey data on women's drinking and its antecedents and outcomes. The National Study of Health and Life Experiences of Women (NSHLEW) interviewed representative national samples of U.S. women in 1981, 1991, 1996, and 2001. The 2001 survey data make it possible to evaluate new models of long-term influences on women's drinking behavior and drinking trajectories, and also provide detailed information about respondents' use of prescribed psychoactive medications, new information about older women's health, and lifetime drinking histories replicating and extending those obtained 20 years earlier. The proposed analyses will (1) test multi-wave models of long-term influences on women's hazardous drinking; (2) identify patterns, antecedents, and consequences of women's drinking trajectories; (3) evaluate (a) the reliability and utility of retrospective drinking histories (e.g., to identify drinking trajectories), (b) contextual influences of employment on women's drinking, (c) associations of lifetime drinking patterns with older women's health, and (d) antecedents and consequences of women's combined use of alcohol and prescribed medications; and (4) compare drinking self-reports obtained from typical quantity-frequency questions vs. graduated-frequency questions. Structural equation models combining retrospective data and three waves of survey data will be used to test hypothesized effects on women's drinking from (1) early childhood experiences, (2) sexual victimization in childhood and adulthood, and (3) characteristics of adult intimate relationships. Drinking trajectories (classified by latent growth mixture modeling and by a priori criteria) will be analyzed for associations with antecedents (as in childhood), accompanying changes (as in marital status), and outcomes (such as health problems). Trajectories derived from lifetime drinking histories, if shown to be reliable, will be evaluated similarly. Other analyses will test hypotheses about (1) historical change in contextual effects of employment on women's drinking, (2) the health of older women with different lifetime drinking histories, and (3) consequences of combined use of alcohol with prescribed psychoactive medications. A methodological experiment will show whether women report higher levels of alcohol consumption in response to graduated-frequency questions than to questions about typical drinking frequency and quantity. Results of the secondary analyses proposed here will improve knowledge about women's lifetime drinking and its antecedents and consequences, in ways that can aid the design of more gender-sensitive and effective approaches to treatment, prevention, and alcohol policy.