Variation in the association of alcohol consumption with five DSM-IV alcohol problem domains

Data from a nationally representative sample of the U.S. adult population were used to investigate the association between alcohol consumption and five discrete problem domains included in the DSM-IV formulations for alcohol abuse and dependence. Two dimensions of consumption were considered in the analysis: average daily ethanol intake and the relative frequency of drinking five or more drinks. The sample consisted of 22,102 adults defined as current drinkers. After controlling for various sociodemographic characteristics, family history of alcoholism, and age at onset of drinking, both consumption measures retained significant levels of association within all five problem domains. The magnitudes of the odds ratios at selected levels of consumption were approximately 50% greater for the domains of impaired control, continued drinking despite problems and hazardous drinking than for the domains of tolerance and withdrawal. Moreover, the factors that modified the effect of the consumption measures varied markedly across domains, with age, college education, and race the most consistent modifiers of the effect of alcohol consumption.