A5 Addiction: Early Recognition and Intervention Across the Lifespan (AERIAL)
As part of the project „Addiction: Early Recognition and Intervention Across the Lifespan (AERIAL)”, project AERIAL-P8 focuses on the identification of risk factor profiles for the onset and stability of alcohol use disorders and hazardous alcohol use. To achieve this goal, analyses of epidemiological data are conducted at Technische Universitaet Dresden (Prof. Gerhard Bühringer, Dr. Silke Behrendt) and the Universitaet Potsdam (Prof. Michael Rapp, Dr. Daniel Schad). The project started in 02/2015. It is funded by the Federal Ministry of Education and Research and is part of the Research Network on Mental Disorders.
Background: Comorbid mental disorders in alcohol use disorders (AUD) and problematic alcohol use (PAU) can represent underlying shared psychopathology vulnerabilities or putative independent risk factors for AUD and PAU. However, the role of psychopathology risk profiles in the onset and course of AUD and PAU remains understudied. Also, it is unclear whether risk profiles and their putative roles in AUD and PAU differ by age group.
Aims: To investigate psychopathology risk profiles as predictors of subsequent AUD-incidence and -stability in adolescents and young adults as well as in middle-aged and older subjects from the community.
Methods: Data from two epidemiological studies are used: the prospective-longitudinal EDSP study and the cross-sectional DEGS1-MH study. To investigate risk-profiles and their associations with AUD-outcomes, latent class analysis with auxiliary variables is applied.
Results: Among adolescents and young adults, a normative-male class (45.9%), an internalizing class (5.3%), and a “nicotine dependence” class (4.5%) were associated with a higher risk of incident alcohol dependence (p<0.05). A baseline comorbidity profile with elevated AUD and other substance use disorder (SUD) probabilities (11.6%) predicted any subsequent AUD (OR 8.5, 95% CI 5.4 – 13.3). Among middle aged and older adults, risk profiles showed two normative classes (45.5%, 44.9%) with low mental disorder and high male respectively female gender probabilities, a “male-substance use disorder-depression” (4.0%) and a “female-internalizing” class (5.5%). The male-normative and the “male-substance use disorder” class were associated with a higher 12-month PAU-risk (e.g. drinking in excess of different health guidelines).
Conclusions: In adolescence and young adulthood, an internalizing vulnerability may constitute a pathway to AUD incidence. In contrast, no indication for a role of internalizing comorbidity profiles in AUD-stability was found. This may indicate a limited importance of such profiles in AUD stability for this age group. Among middle aged and older adults, the large group of male individuals with low mental disorder probabilities may be relevant for predicting critical alcohol use behaviors. It may profit from low-threshold general preventive measures. The smaller male group with elevated lifetime substance use disorder and depression risk may rather profit from adapted clinical interventions. For both age groups under consideration, the mechanisms behind the association between the male normative groups and AUD respectively PAU need to be investigated in future research. Substance use disorder-related profiles appear to be relevant for AUD and PAU in both age groups, while the relevance of internalizing profiles appears to differ by age group and the alcohol-related outcome of interest.
PI: Prof. Gerhard Bühringer, Prof. Michael Rapp (Universität Potsdam)
Staff: Dr. Silke Behrendt, Dr. Daniel Schad; Funding: BMBF
Duration: 02/2015 – 06/2018
Publications:
Behrendt, S., Bühringer, G., Höfler, M., Lieb, R., Beesdo-Baum, K. (2017). Prediction of incidence and stability of alcohol use disorders by latent internalizing psychopathology risk profiles in adolescence and young adulthood. Drug and Alcohol Dependence. DOI: 10.1016/j.drugalcdep.2017.06.006.