New onset, recurrence, and persistence of alcohol dependence : criteria maturing out at the symptom level
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[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT AUTHOR'S REQUEST.] Epidemiological studies have consistently shown a decrease in the prevalence of Alcohol Dependence (AD) with age after its peak in young adulthood. Although this pattern has been traditionally explained as a result of higher rates of desistance during young adulthood, recent evidence shows that rates of AD persistence are stable across the lifespan. One potential explanation for these findings is that some AD criteria might be overly endorsed by younger adults, thus leading to higher rates of false positives which, in turn, lead to inflated rates of persistence in this group. In addition, recent studies have examined the extent to which the seven AD criteria prospectively predict the onset or persistence of AD. Although informative, these studies have not investigated differential prediction by age. The current study used longitudinal data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to decompose the prevalence of each AD criterion at wave 2 as a function of new onset, recurrence, and persistence from wave 1. In addition, the predictive association between each criterion at wave 1 and the new onset, recurrence, and persistence of syndromal AD was investigated. Results indicated that some criteria (particularly quit/control and physical/psychological problems) are both less persistent and less predictive of AD course among younger adults. These findings help to understand measurement issues that are implicated in the maturing out phenomenon and provide insights into potential improvements in the way AD criteria are currently measured.
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