(Press-News.org) Adolescence is often a time of novelty seeking and risk taking, including the initiation of drinking. While heavy drinking that begins in adolescence can lead to problematic alcohol use later in life, other risk factors are also involved in trajectories of alcohol use that may develop. A study of factors predicting alcohol use and patterns of use over time has identified six distinct trajectories that concern level of alcohol use, rate of increase in use during early adolescence, and persistence of use into adulthood.
Results will be published in the March 2013 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.
"Increased levels of exploration and risk taking seem to mark the transition from adolescence to adulthood," said Marieke Wichers, associate professor at Maastricht University Medical Centre as well as corresponding author for the study. "From an evolutionary point of view, this boost of explorative behaviour may be advantageous to adolescents in order to get to know the world around them and become independent. Thus, we see that that all over the world – on average – adolescents have higher levels of novelty seeking and are more risk taking that other age groups."
"Some teens begin adult behaviors ranging from sexual behavior to driving to taking their first job very early while others delay initiating these behaviors," added Victor Hesselbrock, professor of psychiatry at the University of Connecticut School of Medicine. "Novelty seeking is likely one of several personality factors that may influence the timing of the initiation of drinking behaviors. Many do consider teenage drinking a 'rite of passage,' given the ubiquity of the behavior across different environments and cultures."
"We tried to identify whether subgroups exist that follow similar changes in alcohol use over time," said Wichers. "This is important in order to differentiate adolescents in terms of their future course of alcohol use and identify the characteristics that may predict which course adolescents will follow."
"Most current studies of alcohol and other substance use in adolescence now use some variant of the 'developmental trajectories' approach," noted Hesselbrock. "This study is somewhat unique in that the sample size is fairly large and contains both girls and boys. Importantly, it assesses a number of relevant psychological traits and environmental factors considered either risk or protective for onset of drinking behavior. The sample also covers the age range of 15 to 36 years of age. This is important as it captures the typical age of initiation of drinking but also other drinking milestones such as first intoxication, onset of regular drinking, appearance of early drinking problems, as well as the period of time in early adulthood when drinking behaviors further diverge into different patterns."
Wichers and her colleagues obtained retrospective data from 1,560 adult male twins concerning their average monthly alcohol use, as well as risk and protective factors in their lives, through interviews and questionnaires. The age span addressed was from 15 to 36 years of age. Risk factors included parental alcohol use, poor school performance, and specific personality traits. Protective factors included religiosity, parental monitoring, and social activities.
"We found six different subgroups of individuals that could be clustered together in terms of their trajectories of alcohol use," said Wichers. "Alcohol use in these six trajectories differed in terms of, one, overall level of use, in that some subgroups used more alcohol than others, two, peak of alcohol use, in that some subgroups had a more pronounced early peak of use in early adolescence than other subgroups, and three, persistence of use, in that two subgroups were both characterized by a sharp increase in use during adolescence and high levels of use."
"Again, the sample of 15-36 years of age is important as it captures the typical age of initiation of drinking to the time of maximum consumption, typically ages 18-22," said Hesselbrock. "However, it also captures other drinking milestones into adulthood when drinking patterns further diverge, typically showing either significant decreases in alcohol consumption or a trajectory towards chronic alcoholism."
"After identifying these different subgroups, a second aim of this study was to find personal characteristics that might predict to what subgroup individuals may belong," said Wichers. "We found that a number of risks that predicted average alcohol consumption did not always predict the pattern of alcohol use over time. For instance, sensation seeking and low school performance were associated with a higher average level, but not with an early peak pattern, of alcohol use. On the other hand, peer deviance, ADHD symptoms, and genetic risk of externalizing disorders impacted on the timing of alcohol use in early adolescence. Among the most striking findings was that genetic risk for externalizing problem behavior and peer deviance was the strongest predictor of belonging to subclasses with initial high average consumption and an early peak in alcohol consumption during adolescence. In summary, this study showed that these predictors do not all influence alcohol use in the same manner: some predict increased level of use while others predict pattern of use in early adolescence or persistence of high-level alcohol use. Thus, indeed there seems to be a varied influence of certain factors at different stages in one's life."
Hesselbrock agreed. "This study clearly shows that 'one size' or one risk factor does not fit all," he said. "The importance of different vulnerability varies from latent class to latent class, with different risk factors affecting consumption levels and consumption patterns over time. Similarly, so does the importance of different well-known protective factors such as church attendance, parental attitudes, and parental monitoring."
Both Wichers and Hesselbrock said that future research is a necessity.
"Before a clinician can use these findings to construct an effective intervention, other research needs to examine whether these identified predictors are causal," said Wichers. "Then clinicians may use this knowledge to construct intervention strategies and identify individuals at risk."
"We need to determine whether behavioral, pharmacological, or both types of treatments targeted for specific classes will be more effective," said Hesselbrock. "We need to identify more specific genetic determinants that can be addressed either pharmacologically or by a behavioral intervention. It will also be interesting to see how these findings relate to quantity and patterns of use of other substances such as tobacco and marijuana, given that teens typically use a variety of substances, not just alcohol alone. Treatment providers should keep these different trajectories in mind and adjust their treatment plans as necessary as they follow their patients forward. Remember that this study is observational; the question remains whether these different class memberships and drinking trajectories can be changed with treatment."
### Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, "Genetic and Environmental Predictors of Latent Trajectories of Alcohol Use from Adolescence to Adulthood: A Male Twin Study," were N.A. Gillespie of the Department of Psychiatry in the Virginia Institute for Psychiatric and Behavioral Genetics at Virginia Commonwealth University School of Medicine, as well as the Queensland Institute of Medical Research in Brisbane; and K.S. Kendler of the Department of Psychiatry in the Virginia Institute for Psychiatric and Behavioral Genetics, as well as the Department of Human and Molecular Genetics, at Virginia Commonwealth University School of Medicine. The study was funded by the Dutch Medical Council, the National Institutes of Health, and the National Institute on Drug Abuse. This release is supported by the Addiction Technology Transfer Center Network at http://www.ATTCnetwork.org.
Alcohol use from adolescence to adulthood follows different, complex pathways
2013-01-23
ELSE PRESS RELEASES FROM THIS DATE:
New test predicted presence of harmful BRCA mutations
2013-01-23
PHILADELPHIA — A new multiple gene expression profile test was able to predict the presence of harmful BRCA1 or BRCA2 mutations in otherwise healthy women carrying the mutations, according to data published in Cancer Prevention Research, a journal of the American Association for Cancer Research.
"This novel technology aims to provide a layer of information regarding the cell functionality aspect of BRCA mutations that could greatly enhance the doctor's ability to identify high-risk carriers," said Asher Y. Salmon, M.D., a breast cancer specialist at the Hadassah Hebrew ...
A brain protein called vimentin can indicate damage to the hippocampus following binge drinking
2013-01-23
Contact: Kimberly Nixon
kim-nixon@uky.edu
859-218-1025
The University of Kentucky
Contact: Fulton T. Crews
ftcrews@med.unc.edu
919-966-5678
University of North Carolina at Chapel Hill
Alcoholism: Clinical & Experimental Research
A brain protein called vimentin can indicate damage to the hippocampus following binge drinking
Binge drinking is known to increase the risk of developing dementia and/or brain damage.
A new study used rodents to test markers of neurodegeneration to determine a threshold for brain damage.
The vimentin brain protein can ...
UCLA study first to image concussion-related abnormal brain proteins in retired NFL players
2013-01-23
Sports-related concussions and mild traumatic brain injuries have grabbed headlines in recent months, as the long-term damage they can cause becomes increasingly evident among both current and former athletes. The Centers for Disease Control and Prevention estimates that millions of these injuries occur each year.
Despite the devastating consequences of traumatic brain injury and the large number of athletes playing contact sports who are at risk, no method has been developed for early detection or tracking of the brain pathology associated with these injuries.
Now, ...
Less tau reduces seizures and sudden death in severe epilepsy
2013-01-23
HOUSTON (Jan. 23, 2013) – Deleting or reducing expression of a gene that carries the code for tau, a protein associated with Alzheimer's disease, can prevent seizures in a severe type of epilepsy linked to sudden death, said researchers at Baylor College of Medicine and the Mayo Clinic in Jacksonville, Fla., in a report in the current issue of the Journal of Neuroscience.
A growing understanding of the link between epilepsy and some forms of inherited Alzheimer's disease led to the finding that could point the way toward new drugs for seizure disorders said Dr. Jeffrey ...
Beta carotene may protect people with common genetic risk factor for type-2 diabetes
2013-01-23
STANFORD, Calif. — Stanford University School of Medicine investigators have found that for people harboring a genetic predisposition that is prevalent among Americans, beta carotene, which the body converts to a close cousin of vitamin A, may lower the risk for the most common form of diabetes, while gamma tocopherol, the major form of vitamin E in the American diet, may increase risk for the disease.
The scientists used a "big data" approach to hunt down interactions between gene variants previously associated with increased risk for type-2 diabetes and blood levels ...
Emergency department use within 30 days of hospital discharge common
2013-01-23
CHICAGO – In a study that included more than 4 million patients, nearly 20 percent of hospitalizations resulted in at least 1 acute care encounter within the 30 days following discharge, with emergency department visits accounting for about 40 percent of post-discharge hospital-based acute care use, according to a study appearing in the January 23/30 issue of JAMA.
"Hospital readmissions within 30 days of discharge are common, costly, and often related to the index hospitalization," according to background information in the article. "Current efforts to improve health ...
Research finds substantial variation in readmission rate among children's hospitals
2013-01-23
CHICAGO – In a national sample of 72 children's hospitals, 6.5 percent of hospitalized children experienced an unplanned readmission within 30 days, with significant variability in readmission rates across conditions and hospitals, according to a study appearing in the January 23/30 issue of JAMA.
"Clinicians, hospitals, health systems, patients, and purchasers of health care are using readmission rates as an indicator of the quality of care that patients receive during a hospital admission and after discharge," according to background information in the article. "Although ...
Hospital readmission for older patients often for different illness
2013-01-23
CHICAGO – Among approximately 3 million Medicare patients hospitalized for heart failure, heart attack, or pneumonia, readmissions were frequent throughout the 30 days following the hospitalization, and resulted from a wide variety of diagnoses that often differed from the cause of the index hospitalization, according to a study appearing in the January 23/30 issue of JAMA.
"Hospital readmissions are common and can be a marker of poor health care quality and efficiency. To lower readmission rates, the Centers for Medicare & Medicaid Services (CMS) began publicly reporting ...
Readmissions frequent in month after hospital discharge
2013-01-23
Following hospitalization for heart attacks, heart failure, or pneumonia, patients are at high risk of being readmitted for a broad spectrum of medical conditions in the month following hospital discharge, research at Yale School of Medicine shows. The study appears in the Jan. 23/30 issue of the Journal of the American Medical Association.
Hospital readmission has garnered significant interest from patient advocates, payers such as insurance companies, and policymakers, but neither the timing nor causes of readmissions have been well described.
The authors studied ...
Emergency room redux for many patients after hospitalization
2013-01-23
Following a hospitalization, patients face many challenges as they transition home. A new study of this vulnerable period published by Yale School of Medicine researchers in JAMA found that a substantial number of patients return to the emergency department soon after leaving the hospital, and, while such patients are not usually readmitted, the study raises concerns that many more patients require acute medical care after hospital discharge than previously recognized.
A hospital's readmission rate is a marker of hospital quality of care and the success of patient transitions ...