Abstract

Objective

We investigated the impact of stressful life events (SLEs) for males and females on transitions in problematic alcohol involvement, both progression and recovery, over a 3-year interval.

Method

Participants of both Wave 1 (2001–2002) and Wave 2 (2004–2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were stratified by sex (14,233 males and 19,550 females). Latent transition analysis estimated the impact of experiencing ≥3 SLE in the year preceding the Wave 1 interview on the probability of transitioning between three empirically-derived stages of alcohol involvement (patterns of alcohol use disorder [AUD] symptoms), across waves. Propensity score methods adjusted for confounding.

Results

For males, three or more SLEs were associated with progression from the moderate to the severe problem stage (odds ratio [OR] = 2.23, 95% confidence interval [CI] = 1.17, 4.26). Among those in the severe problem stage, SLEs negatively impacted recovery regardless of sex. Employment/Financial SLEs were associated with a higher odds of transition from the moderate to the no problem stage (OR = 1.60, 95% CI = 1.03, 2.46) and lower odds of transitions from the severe to the moderate problem stage (OR = 0.40, 95% CI = 0.16, 0.99) among males, and from the severe to the no problem stage (OR = 0.26, 95% CI = 0.07, 0.88) among females.

Conclusion

Stressful life events appear to affect transitions in alcohol involvement over time among those who already have alcohol problems, rather than impacting a transition among those without AUD problems.

中文翻译：

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美国成年人的压力性生活事件和有问题的酒精使用参与的转变

摘要

客观的

我们调查了男性和女性的压力性生活事件 (SLE) 对有问题的酒精参与转变的影响，包括进展和恢复，时间间隔为 3 年。

方法

国家酒精及相关疾病流行病学调查 (NESARC) 第 1 波（2001-2002 年）和第 2 波（2004-2005 年）的参与者按性别分层（14,233 名男性和 19,550 名女性）。潜在转变分析估计了在第 1 波采访前一年经历 ≥3 次 SLE 对跨浪潮的酒精参与的三个经验衍生阶段（酒精使用障碍 [AUD] 症状的模式）之间转变的概率的影响。针对混杂因素调整的倾向评分方法。

结果

对于男性，三个或更多 SLE 与从中度到重度问题阶段的进展相关（优势比 [OR] = 2.23, 95% 置信区间 [CI] = 1.17, 4.26）。在处于严重问题阶段的患者中，无论性别如何，SLE 都会对康复产生负面影响。就业/财务 SLE 与从中度问题阶段过渡到无问题阶段的几率较高（OR = 1.60, 95% CI = 1.03, 2.46）和从严重问题阶段过渡到中度问题阶段的几率较低（OR = 0.40）相关, 95% CI = 0.16, 0.99) 在男性中，从严重到无问题阶段 (OR = 0.26, 95% CI = 0.07, 0.88) 在女性中。

结论

压力性生活事件似乎会影响那些已经有酒精问题的人随着时间的推移在酒精参与方面的转变，而不是影响那些没有 AUD 问题的人的转变。