Gender differences in the relationship of internalizing and externalizing psychopathology to alcohol dependence: likelihood, expression and course.
paper
Cited
Public
- Authors
- Dawson, Deborah A; Goldstein, Risë B; Moss, Howard B; Li, Ting-Kai; Grant, Bridget F
- Year
- 2010
- Journal
- Drug and alcohol dependence
- PMID
- 20558014
- DOI
- 10.1016/j.drugalcdep.2010.04.019
- PMCID
- PMC2953598
OBJECTIVE: To determine whether internalizing and externalizing psychopathology were differentially associated with alcohol dependence in men and women. METHODS: Four categories of lifetime psychopathology were examined: neither internalizing nor externalizing (NINE), internalizing only (IO), externalizing only (EO) and both internalizing and externalizing (BIE). Multivariate models assessed gender differences in the adjusted associations of these categories with the odds of lifetime alcohol dependence in a representative sample of 43,093 U.S. adults 18 and older and with clinical course and expression in a subsample of 4781 lifetime alcoholics. RESULTS: The excess odds of lifetime alcohol dependence associated with IO, EO and BIE were significantly greater for women than men, OR=2.6, 8.8 and 10.7 versus 1.9, 4.0 and 6.5, respectively. Regardless of gender, the ORs were significantly higher for EO than IO and for BIE than EO. Gender differences in the expression and course of alcoholism were most pronounced for the categories of NINE and IO, with men having greater consumption, dependence severity and treatment but less familial alcoholism. Gender variation in the association of psychopathology with the expression and course of alcoholism was most evident in the BIE category, where the associations were stronger for women. Lifetime externalizing psychopathology was associated with an increased likelihood of treatment utilization, especially among women. CONCLUSIONS: Findings highlight the need to increase alcoholism screening, prevention and intervention among women with psychopathology, especially externalizing. The greater numbers of internalizing than externalizing alcoholics emphasize the need to treat symptoms of depression and anxiety in alcohol treatment settings.
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| Name | Type |
|---|---|
| 12-step participation local | phenotype |
| 2000 Decennial Census local | cohort |
| ADHD | phenotype |
| adolescents | cohort |
| adult antisocial behavior | phenotype |
| adult antisocial behavior not preceded by conduct disorder local | phenotype |
| affective disorders | phenotype |
| age at first drink | phenotype |
| Age at Onset of Dependence local | phenotype |
| aggression | phenotype |
| alcohol | phenotype |
| alcohol dependence | phenotype |
| alcoholism | phenotype |
| Alcohol Problems | phenotype |
| Alcohol treatment | phenotype |
| Alcohol Use | phenotype |
| Alcohol Use Disorder | phenotype |
| alcohol use disorders | phenotype |
| antisocial personality disorder | phenotype |
| anxiety | phenotype |
| Apollonian problem drinkers local | phenotype |
| attention deficit hyperactivity disorder | phenotype |
| AUD | phenotype |
| average daily volume of ethanol intake local | phenotype |
| axis I disorder | phenotype |
| Behavioral inhibition/externalizing local | phenotype |
| Behavioral response to drinking local | phenotype |
| BIE local | cohort |
| BIE local | phenotype |
| Binge Intake (BIE) local | phenotype |
| Binge/Intoxication Episodes local | phenotype |
| BIO local | phenotype |
| bipolar disorder | phenotype |
| bipolar I disorder | phenotype |
| bipolar II disorder | phenotype |
| Both internalizing and externalizing local | phenotype |
| Carpenter and Hasin 2001 general population sample local | cohort |
| cocaine | phenotype |
| Collaborative Studies on the Genetics of Alcoholism | cohort |
| comorbidity | phenotype |
| conduct disorder | phenotype |
| Consumption Level local | phenotype |
| density of familial alcoholism local | phenotype |
| Dependence symptoms | phenotype |
| Developmentally limited alcoholic subtype local | phenotype |
| Dionysian problem drinkers local | phenotype |
| drinkers | phenotype |
| drinking | phenotype |
| Drinking expectancies local | phenotype |
| Drinking motivation local | phenotype |
| drinks per week | phenotype |
| drug | drug |
| drug dependence | phenotype |
| DSM-IV alcohol dependence | phenotype |
| dysthymia | phenotype |
| early alcohol use | phenotype |
| Early- and rapid-onset dependence local | phenotype |
| Early and rapid onset of alcoholism local | phenotype |
| early onset | phenotype |
| Early Onset (EO) local | phenotype |
| EO local | cohort |
| Epidemiologic Catchment Area Study local | cohort |
| episodes of dependence local | phenotype |
| Epstein et al. 2002 treatment sample local | cohort |
| ethanol consumption | phenotype |
| European Study of the Epidemiology of Mental Disorders local | cohort |
| European Study of the Epidemiology of Mental Disorders (ESEMeD) local | cohort |
| externalizing behavior | phenotype |
| externalizing disorders | phenotype |
| Externalizing only local | phenotype |
| family history of alcoholism | phenotype |
| family history positive | phenotype |
| fear | phenotype |
| Female alcoholics | phenotype |
| generalized anxiety disorder | phenotype |
| general population | cohort |
| heaviest drinking local | phenotype |
| heavy drinking | phenotype |
| Higher dependence screening scores local | phenotype |
| Higher severity local | phenotype |
| Higher treatment utilization local | phenotype |
| human alcoholics | phenotype |
| illicit drug dependence | phenotype |
| Infrequent Onset (IO) local | phenotype |
| internalizing dimension local | phenotype |
| internalizing disorders | phenotype |
| Internalizing only local | phenotype |
| IO local | cohort |
| Lahmek et al. 2009 treatment sample local | cohort |
| Largest quantity of drinks local | phenotype |
| Lifetime alcoholics local | cohort |
| Lifetime Alcoholics local | cohort |
| lifetime alcoholism local | phenotype |
| Lifetime alcohol treatment local | phenotype |
| lifetime alcohol use | phenotype |
| lifetime drinkers local | phenotype |
| lifetime treatment local | phenotype |
| major depressive disorder | phenotype |
| Male alcoholics | phenotype |
| marijuana | phenotype |
| medical consequences | phenotype |
| men | cohort |
| mood disorders | phenotype |
| Moss et al. 2007 general population sample local | cohort |
| Multiple Disorders local | phenotype |
| Multiple Episodes of Dependence local | phenotype |
| National Comorbidity Survey | cohort |
| National Comorbidity Survey (NCS) local | cohort |
| National Epidemiologic Survey on Alcohol and Related Conditions | cohort |
| NESARC | cohort |
| NESARC sample local | cohort |
| nicotine | drug |
| nicotine dependence | phenotype |
| NINE local | cohort |
| NINE local | phenotype |
| Non-externalizing psychopathology local | phenotype |
| onset of dependence local | phenotype |
| Other Psychopathology local | phenotype |
| panic disorder | phenotype |
| personality disorders | phenotype |
| Physical consequences | phenotype |
| Poor psychological quality of life local | phenotype |
| Post-Traumatic Stress Disorder | phenotype |
| psychiatric disorders | phenotype |
| Psychological Condition local | phenotype |
| psychological distress | phenotype |
| psychopathology | phenotype |
| remission | phenotype |
| Remission from Dependence local | phenotype |
| Severe chronic alcoholic subtype local | phenotype |
| sex | phenotype |
| social consequences | phenotype |
| social desirability bias | phenotype |
| social phobia | phenotype |
| Somatic Condition local | phenotype |
| specific phobia | phenotype |
| substance abuse | phenotype |
| substance use | phenotype |
| tobacco use | phenotype |
| treatment samples | cohort |
| treatment utilization | phenotype |
| Twin cohort | cohort |
| Type A alcoholic patients local | phenotype |
| Type A alcoholics | phenotype |
| Type B alcoholic patients local | phenotype |
| Type B alcoholics | phenotype |
| United States | cohort |
| U.S. adults 18 years or older local | cohort |
| voluntary alcohol consumption | phenotype |
| Wave 1 NESARC sample local | cohort |
| Wave 1 remission local | phenotype |
| wave 2 | cohort |
| Windle and Scheidt 2004 treatment sample local | cohort |
| women | cohort |
| Young antisocial alcoholic subtype local | phenotype |
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