Impact of Services on Problem Drinking Trajectories

描述（由申请人提供）：酒精领域健康服务研究的基础是了解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，如何影响这一过程。提出的纵向研究确定了消费模式的11年时间路径的决定因素，以及从单个县的家庭人口（N=672）抽取的依赖和问题饮酒者的代表性样本中不断变化的酒精相关问题。没有其他关于这类饮酒者的研究使用概率抽样方法，反映问题严重程度的范围，从问题饮酒者到酒精依赖者，并定期跟踪他们7年。该应用程序将这些随访延长至9年和11年。饮酒问题的时间路径或轨迹在酒精领域具有理论和应用相关性，饮酒问题越来越被视为慢性、周期性和复发性。这项研究阐述了广泛的健康和人类服务在酒精问题的长期过程中所起的潜在作用——在人们好转、保持不变或变得更严重的过程中

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.