The relationship between ethanol intake and DSM-III alcohol use disorders: a cross-perspective analysis

The purpose of this investigation was to quantify the relationship between ethanol consumption and DSM-III alcohol use disorders using mathematical modeling techniques that allowed for the simultaneous control of several extraneous factors and the assessment of potential interaction. Although gender, education, ethnicity, and marital status were not identified as actual confounders in the logistic regression model, the ethanol intake-dependence association was found to be stronger among younger adults than in the later stages of life. Age was an influential confounder of the ethanol intake-abuse relationship, but the magnitude of the association was generally weaker for abuse than for dependence. Separate analyses in which the abuse and dependence criteria served as outcome measures qualified the interpretation of the overall ethanol intake-disorder associations. Implications of these results are discussed in terms of age differences in exposure and context of consumption, differential interpretation of withdrawal symptoms, and the relationship between abuse and dependence. The need for future research to refine our descriptions of risk of alcohol use disorders in relation to levels of intake is highlighted.