Gender differences in the relationship of community services and informal support to seven-year drinking trajectories of alcohol-dependent and problem drinkers.

摘要

OBJECTIVE: The purpose of this study was to examine how community service contacts and informal support are related to the course of drinking for dependent and problem-drinking persons in a population-based sample of women versus men over 7 years. METHOD: Alcohol-dependent (n = 600) and problem-drinking (n = 992) men and women were identified through probability surveys in the general population and treatment programs throughout a California county. Participants were interviewed at baseline and again 1, 3, 5, and 7 years later. Models predicting the differential impact of community services and informal influences on men and women's alcohol consumption over time were estimated using a multilevel mixed model, while controlling for demographic characteristics and problem severity. RESULTS: Dependent and problem-drinking men consumed more than women, yet a trend of reduced drinking over time was found for both men and women. Alcoholics Anonymous attendance was related to decreased consumption for men and women regardless of severity; contact with the mental health system was similarly related to decreased consumption for both genders. For problem-drinking women, welfare contacts were related to decreased consumption. A family intervention was the only informal influence that had differential effects on dependent and problem-drinking men and women's alcohol consumption. CONCLUSIONS: Findings point to the continued benefits of facilitating social support and mental health visits for both dependent and problem-drinking men and women. Developing means to identify and intervene in the range of community service settings, particularly in the mental health and legal system, continues to be important. Innovative interventions for families to encourage engagement in chemical dependency treatment are also warranted.