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Chunk #43 — IV. Discussion

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The relationships of the level of response to alcohol and additional characteristics to alcohol use disorders across adulthood: a discrete-time survival analysis.
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While this longitudinal evaluation provides greater understanding of the unique impact of a low LR to alcohol on the development of AUDs across adulthood, several caveats should be noted. First, once probands were diagnosed at any given assessment they were considered to have experienced that event even if their diagnosis remitted at subsequent assessments. Future survival-based studies will examine both the onset and offset of AUDs, possibly using the “multiple spells” methodology which captures repeatable outcomes over time (Lavori et al., 1996; Singer & Willett, 2003). The SDPS is in a unique position to follow-through on such analyses with additional future data collection, as well as examine specific characteristics that predict subsequent remission for probands diagnosed with AUD at the first followup (T10). Second, the predictors were all taken from the baseline assessment to ensure temporal precedence. While time-varying effects of these predictors were examined (and allowed for in the case of T1 age) in the tests for proportionality, future studies will expand on these findings by evaluating the effects of time-varying covariates measured at the followups (i.e. proband drinking,