Alcohol Research : Current Reviews最新文献

Gene variants encoding several of the alcohol-metabolizing enzymes, alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH), are among the largest genetic associations with risk for alcohol dependence. Certain genetic variants (i.e., alleles)--particularly the ADH1B*2, ADH1B*3, ADH1C*1, and ALDH2*2 alleles--have been associated with lower rates of alcohol dependence. These alleles may lead to an accumulation of acetaldehyde during alcohol metabolism, which can result in heightened subjective and objective effects. The prevalence of these alleles differs among ethnic groups; ADH1B*2 is found frequently in northeast Asians and occasionally Caucasians, ADH1B*3 is found predominantly in people of African ancestry, ADH1C*1 varies substantially across populations, and ALDH2*2 is found almost exclusively in northeast Asians. Differences in the prevalence of these alleles may account at least in part for ethnic differences in alcohol consumption and alcohol use disorder (AUD). However, these alleles do not act in isolation to influence the risk of AUD. For example, the gene effects of ALDH2*2 and ADH1B*2 seem to interact. Moreover, other factors have been found to influence the extent to which these alleles affect a person's alcohol involvement, including developmental stage, individual characteristics (e.g., ethnicity, antisocial behavior, and behavioral undercontrol), and environmental factors (e.g., culture, religion, family environment, and childhood adversity).

Many college students drink heavily and experience myriad associated negative consequences. This review suggests that a developmental perspective can facilitate a better understanding of college drinking. Specifically, using an emerging adulthood framework that considers the ongoing role of parents and neurodevelopmental processes can provide insight into why students drink. Most college students drink and tend to drink more and more heavily than their non-college-attending peers. These drinking patterns are affected by environmental and temporal characteristics specific to the college environment, including residential campus living, the academic week, and the academic year. Additional psychosocial factors are of particular relevance to the drinking behavior of college-age people, and include exaggerated peer norms, the development and use of protective behavioral strategies, and mental health considerations. Understanding the unique interaction of person and environment is key to designing prevention/intervention efforts.

Substance abuse research among racial, ethnic, and sexual minority populations historically has lagged behind that conducted with majority samples. However, interesting and potentially important advances in prevention, brief interventions, and treatment have been made in the last few years, at least among some minority populations, such as American Indian youth. New prevention efforts have focused on point-of-sale interventions for alcohol, as well as on family-unit interventions designed with subpopulation cultural values in mind. In addition, previously established evidence-based and culturally relevant interventions are being combined with computer technology. Empirical data support using brief interventions with patients of color in medical settings, capitalizing on teachable and reachable moments during a physical trauma or other health crisis. Finally, use of empirically supported treatment may be helpful, with a caveat that these interventions must appropriately match cultural traditions and respect the values of the clients. More research clearly is needed, especially among certain minority populations in the United States. A greater emphasis should be placed on developing novel, culturally grounded interventions in partnership with communities, in addition to adapting existing mainstream interventions for use by other cultures.

Rates of alcohol use and alcohol use disorder (AUD) vary with geographic location. Research on risks for AUD associated with living in a rural versus urban setting is complicated by the varied systems used to classify geographic location. Studies comparing the prevalence of heavier or binge drinking and AUD based on a dichotomous urban/rural classification have mixed findings when compared with those using more detailed urban-to-rural categories. In addition, urban/rural residence interacts with other demographic factors such as age, U.S. region, and race/ethnicity to affect alcohol use. Social and cultural factors help explain the relationship between geographic location and alcohol use. However, this area of research could be improved by the use of standardized definitions as well as the analysis of a more complete urban-to-rural continuum (e.g., urban, suburban, and rural areas). Having a better understanding of how geographic characteristics influence alcohol use would help inform and improve prevention and treatment efforts.

Asian Americans represent the fastest- growing population in the United States (Le 2010). At the same time, there is evidence that problematic drinking rates are increasing among young-adult Asian Americans (Grant et al. 2004). Accordingly, it is essential to understand the etiological determinants and mechanisms of risk that may help explain this growth in problematic alcohol use among this group. The high prevalence of the ALDH2*2 and ADH1B*2 alleles in a large percentage of Asian subgroups has been studied as a potential protective factors against alcohol abuse, yet some individuals who possess these genes still engage in problematic alcohol use (Wall et al. 2001). Other social and psychological factors may account for this discrepancy. Thus, some factors, such as negative physiological alcohol expectancies, are protective against alcohol abuse in this population (Hendershot et al. 2009). Sociocultural factors such as acculturation and nativity also may help explain drinking patterns among this group. The literature suggests that vast and significant within-group differences exist among Asian Americans, such that individuals who were born in the United States and/or are more acculturated are at elevated risk for alcohol abuse and related problems (Hahm et al. 2003). Differences also have been observed among Asian-American ethnic subgroups, with some groups (e.g., Japanese, Korean, and multi-Asian Americans) reporting higher rates of drinking compared with others (e.g., Chinese and Vietnamese Americans) (Iwamoto et al. 2012). Furthermore, Asian Americans who report higher levels of depressive symptoms, psychological distress, and perceived discrimination seem to be at a heightened risk for abusing alcohol (Iwamoto et al. 2011a; Nishimura et al. 2005; Yoo et al. 2010). Finally, an emerging body of research examining gender-relevant factors, including feminine and masculine norms, may help explain within-group differences among Asian-American women and men. Thus, traditional norms that may directly pertain to hyperfemininzed Asian-American women, including modesty and sexual fidelity, may protect against heavy episodic drinking (Young et al. 2005). Conversely, the risk for heavy episodic drinking may be enhanced in men who strive to demonstrate traditional notions of masculinity through risk-taking and endorsement of playboy norms (Iwamoto et al. 2010). Although this review has illustrated the contemporary state of research on alcohol use among Asian Americans, it also highlights the significant limitations in this literature. Many of the studies reviewed here have used cross-sectional data, which do not allow researchers to infer causality between the various sociocultural factors and problematic alcohol use. One way of addressing this gap in the existing literature may be to implement longitudinal designs to further understand how the temporal relationship between sociocultural factors, including acculturation and gender norms, may impact

Alcohol consumption is common across subpopulations in the United States. However, the health burden associated with alcohol consumption varies across groups, including those defined by demographic characteristics such as age, race/ ethnicity, and gender. Large national surveys, such as the National Epidemiologic Survey on Alcohol and Related Conditions and the National Survey on Drug Use and Health, found that young adults ages 18-25 were at particularly high risk of alcohol use disorder and unintentional injury caused by drinking. These surveys furthermore identified significant variability in alcohol consumption and its consequences among racial/ethnic groups. White respondents reported the highest prevalence of current alcohol consumption, whereas alcohol abuse and dependence were most prevalent among Native Americans. Native Americans and Blacks also were most vulnerable to alcohol-related health consequences. Even within ethnic groups, there was variability between and among different subpopulations. With respect to gender, men reported more alcohol consumption and binge drinking than women, especially in older cohorts. Men also were at greater risk of alcohol abuse and dependence, liver cirrhosis, homicide after alcohol consumption, and drinking and driving. Systematic identification and measurement of the variability across demographics will guide prevention and intervention efforts, as well as future research.

Socioeconomic status (SES) is one of the many factors influencing a person's alcohol use and related outcomes. Findings have indicated that people with higher SES may consume similar or greater amounts of alcohol compared with people with lower SES, although the latter group seems to bear a disproportionate burden of negative alcohol-related consequences. These associations are further complicated by a variety of moderating factors, such as race, ethnicity, and gender. Thus, among individuals with lower SES, members of further marginalized communities, such as racial and ethnic minorities and homeless individuals, experience greater alcohol-related consequences. Future studies are needed to more fully explore the underlying mechanisms of the relationship between SES and alcohol outcomes. This knowledge should be applied toward the development of multilevel interventions that address not only individual-level risks but also economic disparities that have precipitated and maintained a disproportionate level of alcohol-related consequences among more marginalized and vulnerable populations.