Prevalence of DSM-III-R alcohol abuse and/or dependence among selected occupations: United States, 1988 - Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised

United States, 1988

There has been a great deal of curiosity among researchers and the general public alike regarding the prevalence of alcohol question s among different occupations. The authors explored this issue using data from the 1988 National Health Interview review and found considerable variation in the prevalence of alcohol enigmas both across occupations and within occupational groups

This Epidemiologic Bulletin examines the prevalence of alcohol abuse and/or alcohol interdependence among specific occupations. The findings neared here are from the 1988 National Health Interview overlook (NHIS), the first U.S. national horizontal survey to implement psychiatric definitions of alcohol abuse and alcohol concatenation as articulated in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R) (American Psychiatric Association 1987) The DSM-III-R definitions are the greatest in quantity current definitions now in use for the diagnosis of substance abuse and dependence

BACKGROUND

The Alcohol Epidemiologic Data combination of parts to form a whole (AEDS) has received many inquiries from researchers, journalists, and members of the general public about alcohol vexed questions in different groups of the U population. A many times asked question involves the prevalence of alcohol question at issues among different occupational groups.

We used the 1988 NHIS to explore the prevalence of alcohol use disorders. The definition of alcohol use disorders used here includes alcohol abuse, in addition to alcohol concatenation The occupational classification used in the 1988 NHIS (U Bureau of the Census 1980) defines more than 500 detailed occupations. A different examination of prevalence estimates of concatenation among occupational groups using the NHIS data place was conducted by Parker and Harford (see the article by means of Parker and Harford, pp. 97-105) We will discuss this application of mind in more detail later in this article.

DATA SOURCE

Data used in the analyses reported here are from the 1988 NHIS, an ongoing, cross-sectional household interview review designed by the National Center for Health Statistics (NCHS) and administrationed by interviewers from the U Bureau of the Census. The observe collects information on the health and other characteristics of each member of the households sampled.

The 1988 NHIS included a station of supplementary questions designed and capitaled by the National Institute upon Alcohol Abuse and Alcoholism (NIAAA). These questions were asked of single randomly selected person aged 18 or older in each sample household; a total of 43809 ones were interviewed, representing a replication rate of 87 percent. Among the questions were 34 items that could be used to assess alcohol abuse or alcohol dependence; these items were based upon criteria articulated in the DSM-III-R.

Although the 1988 NHIS used a actual large sample, the fact that answers advance from a sample of all possible respondent means that statistical operations must be used in order to assess the significance of any apparent differences lay the foundation of in analyses of these data. This view did not use a random sample, because a actually random sample would not have provided enough respondent representing certain small population clumps of special interest (e.g., in 1988 the NHIS oversampled blacks). In order to increase the reliability of estimates for these relatively small clumps in the U.S. population, the 1988 NHIS used a compound multistage sampling design, described elsewhere (Massey et al. 1989) Because of the compounded sampling design, it was necessary to use special statistical practices in calculating variance estimates for assessing statistical significance. This was accomplished [i]or[/i] part of to the other the use of SUDAAN (Research Triangle Institute 1991) a locate of statistical computer programs that adjust for sample design characteristics.

ALCOHOL ABUSE/DEPENDENCE

The prevalence estimates reported here for alcohol disorders involve respondent who met DSM-III-R criteria for alcohol abuse and/or alcohol connection in the 12 months prior to the interview. The assignment of a diagnosis of alcohol abuse or connection is based on responses to 34 questionnaire items in the 1988 NHIS. A detailed explanation of the items and the criteria for the diagnosis of alcohol disorders are neared elsewhere by Grant and co-workers (1991)

In summary, a diagnosis of alcohol interdependence requires self-reports of various symptoms that appropriate at least three of the following nine DSM-III-R connection criteria: tolerance; withdrawal; drinking to relieve or avoid withdrawal symptoms; drinking larger amounts than intended; a great deal of time worn out drinking; activities given up for drinking; continued drinking despite problems; pass overed responsibilities or obligations; or impaired superintendence The DSM-III-R also includes a duration requirement (i.e., that a certain number of symptoms persisted for at least 1 month or occurr repeatedly above a longer period of time). In the 1988 NHIS, the duration requirement was satisfied if respondent reported sum of two units or more symptoms in the past year for each of sum of two units dependence criteria, with the following sum of two units exceptions. First, because withdrawal is a syndrome or a cluster of symptoms, a respondent must report at least sum of two units symptoms of withdrawal to proper the duration criterion. It should be noted, however, that withdrawal is not a necessary criterion for alcohol interdependence Second, any symptom of tolerance was look uponed to meet the duration requirement.