Analyzing Lifetime Drinking Trajectories

超出提供的空间。尽管终生饮酒模式对酒精障碍和慢性病的发展具有关键影响，但评估和分析过程中涉及的挑战在很大程度上排除了对其进行系统研究。为了满足这一需求，我们开发了一种计算机辅助的个人访谈来评估终生饮酒模式，认知终生饮酒史(CLDH)，用于1994年至1999年的酒精临床和医学流行病学中心。然而，直到最近才开发出用于轨迹分析的统计程序和软件，使我们能够全面检查CLDH提供的数据，并考虑到饮酒模式随时间的变化。该软件提供的程序可以：(1)确定一生中酒精消费的常见变化模式；(2)提供减少轨迹的充分性的统计测试；以及(3)提供轨迹本身与问题结果之间关系的统计测试(Nagin，1999)。我们建议将轨迹分析应用于慢性疾病和酒精中毒的中心病例对照研究的数据，如下：(1)正常饮酒轨迹(N=3637个对照)；(2)LDTS和慢性病的危险因素，即血压、氧化应激和血脂(仅限对照)；(3)LDTS和心肌梗死(N=3402,707例，加上与年龄、性别、居住县匹配的对照频率)；(4)未治疗和治疗的酗酒人群中的LDTS(N=335)；和(5)LDTS与未经治疗或进入治疗的酒精中毒的康复。目前，适度饮酒的医疗建议和指南是基于流行病学研究的，在这些研究中，酒精摄入量只在一个时间点进行了测量，很少有人考虑饮酒模式。这些研究将首次提供关于终生饮酒模式与长期健康结果的关系的数据。大多数酗酒者从不寻求治疗。尽管许多人最终康复了，但人们对所涉及的过程和后果知之甚少。拟议的研究有可能帮助评估未得到满足的治疗需求，哪些问题饮酒者可能从短暂的干预中受益，以及影响治疗进入的因素。表演网站========================================Section End===========================================

EXCEED THE SPACE PROVIDED. Despite the critical impact that lifetime drinking patterns have on the development of alcohol disorders and chronic diseases, the challenges involved in their assessment and analysis have largely precluded their systematic study. To address this need, we developed a computer-assisted personal interview to assess lifetime drinking patterns, the Cognitive Lifetime Drinking History (CLDH), for use in the Center for Clinical and Medical Epidemiology of Alcohol from 1994 to 1999. However, only recently were statistical procedures and software developed for trajectory analysis that would allow us to fully examine data provided by the CLDH, taking changes in drinking patterns over time into consideration. This software provides procedures that can: (1) identify common patterns of change in alcohol consumption over a lifetime; (2) provide statistical tests of the adequacy of the reduced trajectories; and (3) provide statistical tests of the relations between the trajectories themselves and problem outcomes (Nagin, 1999). We propose to apply trajectory analysis to data from Center case-control studies of chronic disease and alcoholism to investigate lifetime drinking trajectories (LDTs), as follows: (1) normative LDTs (N=3637 controls); (2) LDTs and risk factors for chronic disease, i.e., blood pressure, oxidative stress, and blood lipids (controls only); (3) LDTs and myocardial infarction (N=3402, 707 cases, plus controls frequency matched for age, gender, county of residence); (4) LDTs among untreated and treated alcoholic populations (N=335); and (5) LDTs and recovery from alcoholism without treatment or entry into treatment. Currently, medical advice and guidelines for moderate drinking are based on epidemiological studies in which alcohol intake was measured at only one point in time, and few have considered drinking patterns. These studies will provide data for the first time on the relation of lifetime drinking patterns to long-term health outcomes. The majority of alcoholics never seek treatment. Although many eventually recover, the processes and consequences involved are poorly understood. The proposed studies have the potential to aid in assessing unmet needs for treatment, which problem drinkers are likely to benefit from brief interventions, and factors influencing treatment entry. PERFORMANCE SITE ========================================Section End===========================================