A multi‐site study of alcohol subtypes: classification and overlap of unidimensional and multi‐dimensional typologies

Epstein, Elizabeth E.; Labouvie, Erich W.; McCrady, Barbara S.; Jensen, Noelle; Hayaki, Jumi

doi:10.1046/j.1360-0443.2002.00164.x

Cited by 89 publications

(68 citation statements)

References 44 publications

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“…The sharing of common features with prior typologies is not surprising since we have selected model variables that are, in part, based upon extant typologies. Furthermore, others have identified overlap among the extant AD typologies, and have also demonstrated a significant degree of heterogeneity within these established AD subtypes (Anthenelli et al, 1994;Epstein et al, 2002). Importantly, in the current analyses, we were able to assign each respondent to an individual class according to their most likely class membership (i.e., the highest posterior class probabilities).…”

Section: Discussionmentioning

confidence: 67%

Subtypes of alcohol dependence in a nationally representative sample

Moss

Chen²,

Yi³

2007

Drug and Alcohol Dependence

219

162

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Objective-The authors sought to empirically derive Alcohol Dependence (AD) subtypes based on clinical characteristics using data from a nationally representative epidemiological survey.Method-A sample of 1,484 respondents to the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) with past-year AD was subjected to latent class analysis in order to identify homogeneous subtypes.Results-The best fitting model was a five-cluster solution. The largest cluster (Cluster 1: ~31%) was comprised of young adults, who rarely sought help for drinking, had moderately high levels of periodic heavy drinking, relatively low rates of comorbidity, and the lowest rate of multigenerational AD (~ 22%). In contrast, Clusters 4 and 5 (~21% and 9%, respectively) had substantial rates of multigenerational AD (53% and 77%, respectively), had the most severe AD criteria profile, were associated with both comorbid psychiatric and other drug use disorders, lower levels of psychosocial functioning, and had engaged in significant help-seeking. Clusters 2 and 3 (~19% each) had the latest onset, the lowest rates of periodic heavy drinking, medium/low levels of comorbidity, moderate levels of help-seeking, and higher psychosocial functioning.Conclusion-Five distinct subtypes of AD were derived, distinguishable on the basis of family history, age of AD onset, endorsement of DSM-IV AUD criteria, and the presence of comorbid psychiatric and substance use disorders. These clinically relevant subtypes, derived from the general population, may enhance our understanding of the etiology, treatment, natural history, and prevention of AD and inform the DSM-V research agenda.

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Section: Discussionmentioning

confidence: 67%

Subtypes of alcohol dependence in a nationally representative sample

Moss

Chen²,

Yi³

2007

Drug and Alcohol Dependence

219

162

View full text Add to dashboard Cite

show abstract

“…Entre as limitações desse estudo ressalta-se o fato de: a) não ter sido possível a identificação de 2 das 17 dimensões utilizadas por Babor et al 3 -"distúrbios da infância" e "severidade vitalícia"; e b) ter sido feito uso de algumas variáveis não idên-ticas às do estudo original -uma dificuldade já referida por diversos autores [7][8][9][10]27 .…”

Section: Limitaçõesunclassified

Aplicabilidade da classificação de alcoolismo tipo A/tipo B

Ribeiro

Souza

et al. 2009

J. bras. psiquiatr.

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“…to review diagnoses. Participants were followed up at 6 and 12 months after baseline (see Epstein et al, 2002). The present study focuses on pretreatment variables.…”

Section: Methodsmentioning

confidence: 99%

“…The sample of 286 patients (76% male) who met lifetime or current (prior 6 months) alcohol abuse or dependence diagnostic criteria (according to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised [DSM-III-R]; American Psychiatric Association, 1987) with or without a non-alcohol/drug use diagnosis (n = 263, 92%) or met criteria for current or lifetime nonalcohol drug use disorder only (n = 23, 8.0%) was drawn from a larger study of 418 consented participants in four treatment outcome studies conducted through the alcohol research center at the Rutgers University Center of Alcohol Studies (see Epstein et al, 2002, for more complete description). Participants missing data relevant for the current study (n = 105) or who had no diagnosable SUD (n = 9) were excluded, as were 18 participants who could not be classifi ed conclusively as primary versus secondary depressive disorder.…”

Section: Participantsmentioning

confidence: 99%

Pretreatment Clinical and Risk Correlates of Substance Use Disorder Patients With Primary Depression

Cohn

Epstein²,

McCrady³

et al. 2011

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: The current study examined the distinction between primary and secondary depression among substance use patients to test whether the primary depressed subgroup presents to treatment with a unique profi le of clinical and vulnerability characteristics. Method: The heterogeneous sample comprised 286 individuals (76% male) with alcohol and/or drug abuse or dependence (according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised) across four treatment outcome studies conducted at the alcohol research center at the Rutgers University Center of Alcohol Studies. Participants were classifi ed as having comorbid lifetime history of primary depression (21%), secondary depression (24%), or no depression (55%). Results: Participants in the primary depression and secondary depression groups were comparable in severity of substance use, and both of these groups had more severe substance use problems than the no-depression group. The primary depression group presented with more severe depression histories, higher levels of current depressive symptoms, and higher rates of additional Axis I comorbidity at treatment entry. In terms of vulnerability indices, the primary depression subgroup had a uniquely high family history risk for major depressive disorder; underlying personality vulnerability to depression was also evident in the primary depression group, with higher neuroticism and lower extraversion relative to secondary depression patients. Conclusions: The fi ndings suggest that careful assessment of lifetime depression symptoms vis-à-vis substance use history and severity yields important information identifying the primary depression subtype of substance use patients as a group with a unique and more severely affected clinical presentation of depression and other Axis I psychopathology relative to secondary depression patients. Effectiveness of substance use interventions may be augmented with depression treatment for primary depression patients, given their more severe clinical presentation and vulnerability characteristics. (J. Stud. Alcohol Drugs, 72,

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A multi‐site study of alcohol subtypes: classification and overlap of unidimensional and multi‐dimensional typologies

Cited by 89 publications

References 44 publications

Subtypes of alcohol dependence in a nationally representative sample

Subtypes of alcohol dependence in a nationally representative sample

Aplicabilidade da classificação de alcoolismo tipo A/tipo B

Pretreatment Clinical and Risk Correlates of Substance Use Disorder Patients With Primary Depression

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