Impact of Services on Problem Drinking Trajectories

描述（由申请人提供）：酒精领域的卫生服务研究的基础是对问题饮酒的长期过程以及健康和人类服务（包括酒精治疗和自助）如何影响该过程的理解。建议的纵向研究确定了11年的时间路径的消费模式和不断变化的酒精相关的问题，从一个县的家庭人口（N=672）的依赖和问题饮酒者的代表性样本的决定因素。没有其他研究使用概率抽样方法，反映了从问题饮酒者到酒精依赖者的问题严重程度，并定期跟踪他们7年。该应用程序将这些随访时间延长至9年和11年。问题饮酒的时间路径或轨迹在酒精领域具有理论和应用相关性，在酒精领域，饮酒问题越来越被视为慢性，周期性和复发性。这项研究探讨了各种各样的健康和人类服务在长期的酒精问题中所起的潜在作用--在人们好转、保持不变或进展到更严重的过程中。 问题结束了。分析使用潜在曲线增长技术来比较问题饮酒轨迹的形状及其决定因素。分析开始是通过建立个人特征（包括酗酒的遗传和发育倾向的标志物、人口统计学特征、成熟效应和心理脆弱性，如精神病严重程度、药物使用和依赖）影响问题饮酒轨迹的方式。接下来，我们研究的方式，社会网络的反应和自助改变了11年的过程中的酒精问题和一般健康和福利和人类服务的影响。最后一组分析建立在 这些早期阶段通过建模的持久性和累积的专业酒精治疗干预的轨迹问题饮酒和发展的综合因果解释如何社交网络，自助，一般健康和福利服务提供者的干预有助于酒精治疗的长期影响。

DESCRIPTION (provided by applicant): Fundamental to health services research in the alcohol field is an understanding of the long-term course of problem drinking and how health and human services, including alcohol treatment and self-help, impact that course. The proposed longitudinal study identifies the determinants of 11-year time paths of consumption patterns and changing alcohol-related problems in a representative sample of dependent and problem drinkers drawn from a single county's household population (N=672). No other study of such drinkers has used a probability sampling approach, reflecting the range of problem severity from problem drinkers to those who are alcohol dependent, and followed them regularly for 7 years. This application extends those follow-ups to 9 and 11 years. Time paths, or trajectories, of problem drinking have both theoretical and applied relevance to the alcohol field, where drinking problems are increasingly viewed as chronic, cyclical, and relapsing. The study addresses the underlying roles that a wide spectrum of health and human services play in the long-term course of alcohol problems--in people getting better, staying the same, or progressing to more serious problems over. Analyses use latent curve growth techniques to compare both the shape of trajectories of problem drinking and their determinants. Analyses begin by establishing the ways individual characteristics (including markers of genetic and developmental predispositions towards alcoholism, demographic characteristics, maturation effects, and psychological vulnerabilities, such as psychiatric severity, drug use, and dependence) affect trajectories of problem drinking. We next examine the manner in which social network responses and self-help alter the 11-year course of alcohol problems and the influence of general health and welfare and human services. A final set of analyses builds upon these earlier stages by modeling the persistence and cumulation of specialty alcohol treatment interventions on trajectories of problem drinking and develops integrated causal 'explanations of how social networks, self-help, and interventions by general health and welfare services providers contribute to the long-term effects of alcohol treatment.