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1981 Survey Sample

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1981 Survey Sample

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  1. Risk Factors for Problem Drinking in Women:Findings from a 20-Year Longitudinal StudySharon C. Wilsnack, Ph.D.Department of Clinical NeuroscienceUniversity of North Dakota School of Medicine & Health SciencesSymposium on Sex, Gender, and Drug AbuseUniversity of Michigan Substance Abuse Research Center & Institute for Research on Women and GenderOctober 16, 2008

  2. National Study of Health and Life Experiences of Women(NSHLEW)Sharon C. Wilsnack, Ph. D. Richard W. Wilsnack, Ph. D.Principal InvestigatorsArlinda F. Kristjanson, Ph. D. Nancy D. Vogeltanz-Holm, Ph. D. Project Director Research Psychologist Perry Benson, M. A. Chunzi Peng, Ph.D.Database Manager/Program Analyst Research Associate Qing Li, M.D., Dr.P.H.Postdoctoral Fellow University of North Dakota School of Medicine & Health SciencesGrand Forks, North DakotaSupported by Research Grant AA004610 from the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health

  3. 1981 Survey Sample • National probability sample stratified to interview all women reporting consumption > 4 drinks/week (moderate to heavy drinkers), and 25% of women reporting less drinking • 4,032 households screened for potential respondents • Ninety-minute structured interviews with: - 500 moderate to heavy drinking women (89% of those eligible) - 378 light drinking or abstaining women (83% of those eligible) - 386 men representing all drinking levels (66% of those eligible)

  4. 1986 Survey Sample • Follow-up interviews with: a. PROBLEM DRINKERS b. NON PROBLEM DRINKERS • 91% of respondents located successfully • Follow-up interviews completed with - 143 problem drinkers (94% completion rate) - 157 nonproblem drinkers (93% completion rate

  5. 1991 Followup National Sample • 75-minute structured face-to-face interviews with - 696 women first interviewed in 1981 (ages 31+ in 1991; 85% completion rate) - 403 younger women new to the study (ages 21-30 in 1991; stratified to include all moderate-to-heavy drinkers; 91% completion rate)

  6. 1996 Survey Sample • 15-year follow-up of women initially interviewed in 1981 • 5-year follow-up of women age 21-30 added to sample in 1991 • Personal interviews with 711 women age 21-49 in 1991 (87% completion rate) • Personal interviews with 369 spouses or partners (76% completion rate)

  7. 2001 SURVEY SAMPLE 75-minute CAPI interviews with. . . • 785 women first interviewed in 1981 or 1991 (age 31 and older) (88% completion rate) • 341 women new to the study (age 21-30) (79% completion rate)

  8. NSHLEW INTERVIEW QUESTIONNAIRE • Detailed questions about drinking behavior, drinking contexts and expectancies, and adverse consequences of drinking • Questions about hypothetical antecedents and consequences of alcohol consumption, including demographic characteristics, family history and socialization, personality traits and values, social roles, close interpersonal relationships, stressful life events, depression, sexual experience, reproductive disorders, drug use, and antisocial behavior

  9. Prevalence of 12-Month Drinking:U.S. Women, 1981 - 2001 Source: Wilsnack et al., 2006.

  10. Prevalence of Any Heavy Episodic Drinking Among 12-Month Drinkers, 1981 - 2001 Source: Wilsnack et al., 2006.

  11. Prevalence of Any Intoxication Among 12-Month Drinkers, 1981 – 2001 Source: Wilsnack et al., 2006.

  12. SOME RISK FACTORS FOR WOMEN’S DRINKING • Family history of alcohol problems

  13. SOME RISK FACTORS FOR WOMEN’S DRINKING • Family history of alcohol problems • Age: Younger women

  14. EMPLOYMENT RISK FACTORS FOR WOMEN’S DRINKING

  15. EMPLOYMENT AND WOMEN’S DRINKING • Role overload vs. role deprivation

  16. Percentages of Women Drinkers Age 21-34 Reporting Problem Consequences and Alcohol Dependence Symptoms in Preceding 12 Months, by Marital and Work Roles One or more problem consequences Tau C=.117, p<.05 One or more alcohol dependence symptoms Tau C=.252, p<.001 Percent n=301 Source: Wilsnack & Cheloha, 1987.

  17. RELATIONSHIP RISK FACTORS FOR WOMEN’S DRINKING

  18. RELATIONSHIP RISK FACTORS FOR WOMEN’S DRINKING • Marital/relationship status - Cohabiting women

  19. RELATIONSHIP RISK FACTORS FOR WOMEN’S DRINKING • Marital/relationship status - Cohabiting women - Divorce: Risk or benefit?

  20. Remission of Alcohol Dependence Symptoms as Related to Divorce or Separation over Five Years, Among Time 1 Problem Drinking Women Time 2 Dependence Symptoms (% 1+) 42% 30% β= -.24, (p<.05) Source: Wilsnack et al., 1991. See also Walitzer & Dearing, 2006.

  21. RELATIONSHIP RISK FACTORS FOR WOMEN’S DRINKING • Marital/relationship status - Cohabiting women - Divorce: Risk or benefit? • Drinking partnerships - Heavy-drinking partner

  22. RELATIONSHIP RISK FACTORS FOR WOMEN’S DRINKING • Marital/relationship status - Cohabiting women - Divorce: Risk or benefit? • Drinking partnerships - Heavy-drinking partner - Drinking discrepancies

  23. RELATIONSHIP RISK FACTORS FOR WOMEN’S DRINKING • Marital/relationship status - Cohabiting women - Divorce: Risk or benefit? • Drinking partnerships - Heavy-drinking partner - Drinking discrepancies • Intimate partner violence

  24. Physical Partner Aggression Events by Past-12-Month Heavy Episodic Drinking: U.S. Women N=1103 Source: Wilsnack et al., in press. See also Caetano et al., 2005; Drapkin et al., 2005.

  25. SEXUALITY RISK FACTORS FOR WOMEN’S DRINKING

  26. SEXUAL EXPERIENCE AND WOMEN’S DRINKING • Sexuality-related alcohol expectancies

  27. Perceived Effects of Drinking on Sexual Inhibition How true is it that when you drink you feel less inhibited about sex? n : 166 256 107 Source: Wilsnack, Plaud et al., 1997. See also Bogren et al., 2007.

  28. Perceived Effects of Drinking on Sexual Pleasure How true is it that when you drink, sexual activity is more pleasurable for you? n : 164 254 105 Source: Wilsnack, Plaud et al., 1997. See also Schacht et al., 2007.

  29. SEXUAL EXPERIENCE AND WOMEN’S DRINKING • Sexuality-related alcohol expectancies • Sexual dysfunction

  30. SEXUAL EXPERIENCE AND WOMEN’S DRINKING • Sexuality-related alcohol expectancies • Sexual dysfunction • Childhood sexual abuse

  31. NSHLEW QUESTIONS ON CHILDHOOD SEXUAL ABUSE • Exposure of the respondent’s genitals • Exhibitionism by the perpetrator • Touching/fondling • Sexual kissing • Oral-genital activity (as initiator and recipient) • Anal intercourse • Vaginal intercourse

  32. WYATT DEFINITION OF CHILDHOOD SEXUAL ABUSE Intra-familial - Respondent was age 17 or younger - Sexual experience was unwanted, or involved family member 5+ years older Extra-familial - Respondent was age 17 or younger and sexual experience was unwanted, OR - If respondent was under age 13, involved another person 5+ years older - Voluntary experiences occurring between ages 13 and 17 with partners 5+ years older are not considered abuse Source: Wyatt, 1985.

  33. Abused vs. Non-Abused Women (%) Reporting Alcohol Use and Heavier Consumption Alcohol Use Heavy EpisodicDrinking Intoxication 43.6 30.4 27.4 19.1 15.9 10.6 Adjusted Odds Ratio = 1.79 (p<.01) Adjusted Odds Ratio = 1.58 (n.s.) Adjusted Odds Ratio = 1.65 (p<.05) Odds ratios adjusted for age, ethnicity, and parental education. CSA=Childhood sexual abuse Source: Wilsnack, Vogeltanz et al., 1997; Wilsnack et al., 2004.

  34. Abused vs. Non-Abused Women (%) Reporting Adverse Drinking Consequences Alcohol Dependence Symptoms ProblemConsequences Problem Drinking Index Adjusted Odds Ratio = 2.52(p<.001) Adjusted Odds Ratio = 2.39(p<.01) Adjusted Odds Ratio = 3.04(p<.001) Odds ratios adjusted for age, ethnicity, and parental educations. Source: Wilsnack, Vogeltanz et al., 1997. See also Hughes et al., 2007; Sartor et al., 2007.

  35. Effects of Less Severe and More Severe CSA on Women's Depression and Hazardous Drinking over 20 Years HazardousDrinking T2 Childhood Sexual Abuse (more severe) HazardousDrinking T3 DepressionT3 Source: S. Wilsnack et al., 2007. See also Schacht et al., 2007.

  36. Risk factor findings suggest importance of relational issues in treatment of women • Partner’s drinking • Marital/relationship distress • Intimate partner violence • Sexual adjustment/satisfaction

  37. Central importance of childhood sexual victimization suggests attention to . . . • Treatment of major sequelae of CSA (including shame/self-blame, anxiety, depression, impaired relationships, avoidant coping strategies) • Early intervention with CSA victims • Community-based prevention of CSA and other child maltreatment

  38. THANK YOU Sharon C. Wilsnack (swilsnac@medicine.nodak.edu) Department of Clinical Neuroscience University of North Dakota School of Medicine & Health Sciences P.O. Box 9037 Grand Forks, ND 58202-9037

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