Predictors of symptom course in alcohol use disorder
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[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI SYSTEM AT AUTHOR'S REQUEST.] Alcohol Use Disorder (AUD) has traditionally been viewed as a chronic, progressive, relapsing disorder (Jellinek, 1960; National Institute on Drug Abuse, 2018). However, research has found considerable variability in the course of AUD (Grant et al., 2012; Rohde et al., 2001; Verges et al., 2012). Even less is known about the course of individual AUD criteria. To the extent that individual symptoms represent the focus of some treatments (e.g., withdrawal, craving), understanding the course of specific criteria, and individual differences in symptom course, can inform treatment efforts and future research directions. The current study examined 34,653 participants form Wave 1 (2001-2002) and Wave 2 (2003-2004) of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC; Grant, Moore, and Kaplan, 2003; Grant, Kaplan, and Stinson, 2005), using logistic regression to analyze the extent in which AUD symptom course is predicted by alcohol consumption, family history of alcohol use disorders, and lifetime diagnosis of Conduct Disorder. The course of all AUD symptoms was significantly influenced by all four external criteria, with the magnitude of the prediction varying across different symptoms and different aspects of course. Heavy drinking was the strongest predictor of symptom course, and symptom onset was more strongly influenced by the four external predictors than symptom persistence and symptom recurrence. Not surprisingly, the course of all AUD symptoms was strongly associated with the prevalence of the given symptom in the overall population. A next step in understanding factors influencing symptom course is examining how individual symptoms can modify the course of other individual symptoms within these groups of at-risk drinkers.
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