RESUMO
BACKGROUND: Daily drinking is an important public health concern and informative for evaluating diagnostic classification. In particular, daily binge drinkers might be considered as the prototype of some forms of alcoholism, as this drinking pattern may drive many alcohol use disorder (AUD) symptoms. However, daily drinking potentially captures a wide range of drinkers, including light-moderate daily drinkers who exhibit presumed control over their drinking behavior and might benefit from salutary effects on health. This study examined the heterogeneity of daily drinkers in detail. METHODS: Data from the 2 waves of the National Epidemiologic Survey on Alcohol and Related Conditions were used. Participants who reported drinking "every day" during the last 12 months were classified as daily drinkers. A series of regression and logistic regression analyses were conducted to investigate the association between daily drinking and various outcomes. RESULTS: Daily drinkers were found to vary considerably from each other with respect to diagnostic status, level of consumption, demographic composition, and a range of drinking and health correlates. Further, a substantial number of daily binge drinkers were not diagnosed with AUD under the DSM-IV or DSM-5, although in most groups, the DSM-5 criteria diagnosed a larger percentage of participants. CONCLUSIONS: Daily drinkers represent a highly heterogeneous group, and the correlates of daily drinking depend on the usual quantity of daily drinks and the frequency of alcohol-related problems in a given sample. Moreover, AUD, defined both according to DSM-IV and DSM-5, did not capture more than 68% of daily binge drinkers. Given that daily binge drinking is an extremely high threshold for use, this finding may present a challenge for our current classification system.
Assuntos
Alcoolismo/diagnóstico , Alcoolismo/epidemiologia , Consumo Excessivo de Bebidas Alcoólicas/diagnóstico , Consumo Excessivo de Bebidas Alcoólicas/epidemiologia , Autorrelato , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Consumo de Bebidas Alcoólicas/tendências , Consumo Excessivo de Bebidas Alcoólicas/tendências , Estudos Transversais/métodos , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
BACKGROUND: Binge drinking (BD) has been associated with an increase in the risk of alcohol-related injuries. Alcohol continues to be the main substance consumed by truck drivers, a population of special concern, since they are often involved in traffic accidents. The aim of this study was to estimate the prevalence of BD and its interference in the executive functioning among truck drivers in Sao Paulo, Brazil. METHODS: A non-probabilistic sample of 684 truck drivers was requested to answer a structured research instrument on their demographic data and alcohol use. They performed cognitive tests to assess their executive functioning and inventories about confounding variables. The participants were then divided according to their involvement in BD. RESULTS: 17.5% of the interviewees have reported being engaged in BD. Binge drinkers showed a better performance on one test, despite having done so at the expense of more mistakes and lower accuracy. More interestingly, binge drinkers took three seconds longer than non-binge drinkers to inhibit an inadequate response, which is worrisome in the context of traffic. Overall, the deleterious effect of BD on performance remained after controlling for the effects of confounding variables in regression logistic models. CONCLUSIONS: As the use of alcohol among truck drivers may be as a way to get by with their work conditions, we believe that a negotiation between their work organization and public authorities would reduce such use, preventing negative interferences on truck drivers' cognitive functioning, which by its turn may also prevent traffic accidents.
Assuntos
Condução de Veículo/psicologia , Consumo Excessivo de Bebidas Alcoólicas/psicologia , Etanol/efeitos adversos , Função Executiva/efeitos dos fármacos , Veículos Automotores , Testes Neuropsicológicos , Acidentes de Trânsito/prevenção & controle , Acidentes de Trânsito/estatística & dados numéricos , Adulto , Condução de Veículo/estatística & dados numéricos , Consumo Excessivo de Bebidas Alcoólicas/diagnóstico , Consumo Excessivo de Bebidas Alcoólicas/epidemiologia , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , PrevalênciaRESUMO
BACKGROUND: This study examines the association between perceived neighborhood violence, perceived neighborhood collective efficacy, and binge drinking among Mexican Americans residing on the U.S.-Mexico border. METHODS: Data were collected from a multistage cluster sample of adult Mexican Americans residing in the U.S.-Mexico border areas of California, Arizona, New Mexico, and Texas (N = 1,307). The survey weighted response rate was 67%. Face-to-face interviews lasting approximately 1 hour were conducted in respondents' homes in English or Spanish. Path analysis was used to test whether collective efficacy mediated the impact of perceived neighborhood violence on binge drinking. RESULTS: Among 30+-year-old women, perceived neighborhood collective efficacy mediated the effects of perceived neighborhood violence on binge drinking in a theoretically predicted way: Lower perceptions of violence predicted an increased perception of collective efficacy, which in turn, predicted less binge drinking. Direct effects of violence perceptions on binge were nonsignificant. Younger 18- to 29-year-old women showed a similar (but nonsignificant) pattern of effects. Perceived collective efficacy also mediated the effects of perceived violence on binge drinking among men, but in opposite ways for older and younger men. Older men showed the same mediating effect as older women, but the effect reversed among younger men due to a strong, positive relation between collective efficacy and binge drinking. There were also age differences in the direct effect of violence perceptions on binge drinking: Perceptions of violence predicted more binge drinking among young men, but less among older men. CONCLUSIONS: These results highlight the complexity of people's responses to neighborhood characteristics in regard to their drinking. Young men in particular seem to react very differently to perceptions of collective efficacy than other groups. However, among both men and women, collective efficacy may come to play an increasingly important protective role in health outcomes with age.
Assuntos
Consumo Excessivo de Bebidas Alcoólicas/diagnóstico , Consumo Excessivo de Bebidas Alcoólicas/etnologia , Americanos Mexicanos/etnologia , Percepção , Características de Residência , Adulto , Arizona/etnologia , Consumo Excessivo de Bebidas Alcoólicas/psicologia , California/etnologia , Análise por Conglomerados , Feminino , Humanos , Masculino , Americanos Mexicanos/psicologia , México/etnologia , Pessoa de Meia-Idade , New Mexico/etnologia , Texas/etnologia , Adulto JovemRESUMO
INTRODUCTION: Few studies have investigated the association between environmental factors and patrons' binge drinking in nightclubs, and such studies are rare in developing countries. OBJECTIVE: To identify environmental factors associated with binge drinking among patrons in nightclubs in São Paulo, Brazil, using a mixed-methods design. METHOD: The study used a two-stage cluster sampling survey design. Two levels of data were collected: observational data and portal survey data. Individual-level data were collected by a portal survey of 2422 subjects at the entrance and 1822 subjects at the exit of 31 nightclubs. Weighted multilevel analysis was used to investigate the association between patrons' binge drinking (as measured by breath alcohol concentration ≥0.38 mg L(-1) ) at nightclub exit, with environmental-level variables collected through observation and controlled for individual-level data. RESULTS: Pre-drinking was the variable most strongly associated with binge drinking BrAC levels when exiting the venue [adjusted odds ratio (aOR) = 5.98, 95% confidence interval (CI) [4.37, 8.17], P < 0.001). The environmental variables significantly associated with binge drinking were 'all you can drink' service (aOR = 2.44, 95% CI [1.03, 0.79]; P = 0.043), two or more dance floors (aOR = 1.92, 95% CI [1.16, 3.18]; P = 0.011), and higher sound levels (aOR = 1.04 per each decibel increased, 95% CI [1.01, 1.08]; P = 0.048). Data triangulation showed an association between lower alcohol intoxication and ketamine use in three LGBT nightclubs. DISCUSSION: Pre-drinking showed that individual-level characteristics could be more important in binge drinking than the venues' environmental characteristics. Previous studies failed to include pre-drinking in environmental analysis. CONCLUSION: Environmental control interventions, isolated from individual-level approaches, may have limited efficacy in the prevention of alcohol abuse in nightclubs.