The Clinical Course of Alcoholism in 243 Mission Indians

Ehlers, Cindy L.; Wall, Tamara L.; Betancourt, Michelle; Gilder, David A.

doi:10.1176/appi.ajp.161.7.1204

Cited by 91 publications

(169 citation statements)

References 45 publications

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“…However, both advancing age and younger age at onset of alcohol dependence were associated with increased duration of alcohol dependence. These data are consistent with previous findings in this sample that alcohol dependence runs a typical clinical course which includes duration as well as symptomatology (3). These data are not consistent with the notion that, from the standpoint of remission, there may be two groups of alcohol dependent individuals: those with early onset who have a shorter course of alcoholism and those with later onset who have a longer course that has been suggested for other populations (16,40).…”

Section: In Contrast To Dawson and Colleaguessupporting

confidence: 83%

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Factors Associated With Remission From Alcohol Dependence in an American Indian Community Group

Gilder¹,

Lau²,

Corey³

et al. 2008

AJP

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Objective-This study identified factors associated with remission from DSM-III-R alcohol dependence in an American Indian community group.Method-Participants were assessed using the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA).Results-Five hundred and eighty participants were assessed for alcohol use and alcohol use symptoms; 254 participants were found to have alcohol dependence. The rate of remission in this sample was 59%. Thirty-four percent of remitters and 39% of non-remitters had received treatment for alcohol problems. Remission from alcohol dependence was associated with being female, older, and married; an earlier age of onset of alcohol dependence; and self-reported depression symptoms from drinking. Absence of remission was associated with continuing to drink despite knowing one had medical problems from drinking and self-reported anxiety symptoms from drinking.Conclusion-Attention to factors associated with remission from alcohol dependence may be important in designing more effective treatment and prevention programs in this high risk population.

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Section: In Contrast To Dawson and Colleaguessupporting

confidence: 83%

“…The available evidence suggests that rates of remission from alcohol dependence are also substantial in Native American communities (3)(4)(5)23). Ehlers and colleagues (3), in a study of the first 243 American Indian adults who participated in the present study, found a remission rate of 61% from DSM-III-R alcohol dependence.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated With Remission From Alcohol Dependence in an American Indian Community Group

Gilder¹,

Lau²,

Corey³

et al. 2008

AJP

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“…The demographic characteristics of this sample are similar to available information for the tribe from US Census data. As reported previously in this population [see Ehlers et al, 2004] a total of 280 out of a larger sample of 466 participants (60%) met the criteria for a lifetime DSM-III-R diagnosis of alcohol dependence. Men were significantly more likely to be alcohol dependent (N ¼ 74%) than women (N ¼ 53%) (w 2 ¼ 9.76, df ¼ 1, P < 0.002).…”

Section: Resultssupporting

confidence: 67%

“…They were recruited using a combination of a venue-based method [Kalton and Anderson, 1986;Muhib et al, 2001] and a respondent-driven procedure [Heckathorn, 1997], as previously described [Ehlers et al, 2004].…”

Section: Participantsmentioning

confidence: 99%

Genomic screen for loci associated with alcohol dependence in Mission Indians

Ehlers

Gilder

Wall

et al. 2004

American J of Med Genetics Pt B

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Alcohol dependence is a leading cause of morbidity and mortality in Native Americans, yet biological factors underlying the disorder in this ethnic group remain elusive. This study's aims were to map susceptibility loci for DSM-III-R alcohol dependence and two narrower alcohol-related phenotypes in Mission Indian families. Each participant gave a blood sample and completed an interview using the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA) that was used to make alcohol dependence diagnoses and the narrower phenotypes of withdrawal, and drinking severity. Genotypes were determined for a panel 791 microsatellite polymorphisms. Analyses of multipoint variance component LOD scores for the dichotomous DSM-III-R phenotype revealed no peak LOD scores that exceeded 2.0 at any chromosome location. Two chromosomes, 4 and 12, had peak LOD scores that exceeded 2 for the alcohol use severity phenotype and three chromosomes 6, 15, 16 were found to have peaks with LOD scores that exceeded 2 for the withdrawal phenotype. Evidence for linkage to chromosomes 4 and 15, and 16 have been reported previously for alcohol related phenotypes whereas no evidence has as yet been reported for chromosomes 6 and 12. Combined linkage and association analysis suggest that alcohol dehydrogenase 1B gene polymorphisms are partially responsible for the linkage result on chromosome 4 in this population. These results corroborate the importance of several chromosomal regions highlighted in prior segregation studies in alcoholism and further identify new regions of the genome that may be unique to either the restricted phenotypes evaluated or this population of Mission Indians.

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“…As part of a larger study examining the etiology of substance use disorders in a community sample of American Indians living on reservations (see Ehlers et al, 2001Ehlers et al, , 2004Ehlers et al, , 2007Gilder et al, 2004Gilder et al, , 2009), the present study applied IRT methods to accomplish two specifi c aims: (a) to evaluate whether cannabis misuse symptoms assess a continuous latent trait that indexes the severity of cannabis use in both Native Americans living on reservations and European Americans and (b) to evaluate whether individual cannabis misuse symptoms differentially index severity in these two populations. Because the Native American community under study has been shown to exhibit very high rates of substance use disorders (e.g., 70% alcohol dependent, 60% cannabis dependent), we chose to use an equally affected population of European Americans for the present report, the University of California, San Francisco (UCSF) Family Alcoholism Study population (70% alcohol dependent, 44% cannabis dependent), which is a nationwide population-based sample selected for the presence of alcohol dependence (Ehlers et al, 2010).…”

mentioning

confidence: 99%

Contributions of Ethnicity to Differential Item Functioning of Cannabis Abuse and Dependence Symptoms

Gizer

Gilder

Lau

et al. 2013

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: Cannabis is the most widely used illicit drug in the United States, and as a result, it is associated with signifi cant public health costs. The present study sought to investigate whether item response theory (IRT) methods could be used to identify meaningful differences in how cannabis abuse and dependence symptoms (determined by criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) function as indices of the severity of misuse across two ethnic groups: Native Americans and European Americans. Method: Participants were drawn from two previously collected samples, a population of Native Americans living on contiguous reservations (n = 406) and the University of California at San Francisco Family Alcoholism Study (n = 728). Cannabis use disorder symptoms were assessed using the Semi-Structured Assessment for the Genetics of Alcoholism.Results: Exploratory factor analysis demonstrated that the cannabis abuse and dependence symptoms indexed a single latent trait measuring severity of cannabis use. IRT and multiple indicators multiple causes (MIMIC) analyses suggested meaningful differences in the functioning of these symptoms across ethnic groups. Withdrawal represented a more prevalent and less severe symptom among Native Americans relative to European Americans, whereas each of the cannabis abuse symptoms and a symptom assessing psychological and health problems resulting from cannabis use were less prevalent but more severe in Native Americans. Conclusions:The fi ndings suggest differences in how cannabis use disorders manifest in these populations and thus have implications for the assessment of these disorders as well as theories attempting to explain the increased rates of substance use diagnoses more generally among Native Americans living on reservations. (J. Stud. Alcohol Drugs, 74, 320-328, 2013)

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The Clinical Course of Alcoholism in 243 Mission Indians

Abstract: Understanding the course of Mission Indian alcoholism can help identify unique alcohol-related phenotypes as well as guide the development of treatment and prevention programs in this underserved population.

Cited by 91 publications

References 45 publications

Factors Associated With Remission From Alcohol Dependence in an American Indian Community Group

Factors Associated With Remission From Alcohol Dependence in an American Indian Community Group

Genomic screen for loci associated with alcohol dependence in Mission Indians

Contributions of Ethnicity to Differential Item Functioning of Cannabis Abuse and Dependence Symptoms

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