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The Answer You Get Depends on the Question You Ask

  • Marc A. Schuckit
    Correspondence
    Address correspondence to Marc A. Schuckit, M.D., University of California, San Diego, Distinguished Professor of Psychiatry, School of Medicine, 8950 Villa La Jolla Drive, Suite B-218, La Jolla, CA 92037
    Affiliations
    Department of Psychiatry, School of Medicine, University of California, San Diego, California
    Search for articles by this author
      The article by King et al. (
      • King A.C.
      • McNamara P.J.
      • Hasin D.S.
      • Cao D.
      Alcohol challenge responses predict future alcohol use disorder symptoms: A 6-year prospective study.
      ) has many strengths and raises issues relevant to substance use disorders and psychiatry overall. The goal was to identify characteristics that contributed to future alcohol problems and heavy episodic drinking (i.e., binges) in 104 heavier drinking subjects aged 21 to 40 (mean age 25). Predictors of these outcomes included feelings of sedation, stimulation, and liking and wanting more alcohol after drinking and at a breath alcohol level (BrAC) of ~80 mg/dL. Relationships between predictors and outcomes were analyzed using 1) general estimating equations with all 104 subjects, asking if each baseline characteristic predicted adverse outcomes; 2) trajectory groups (e.g., the 10 subjects with the most severe outcome who carried the greatest weight in this step); and 3) exploratory cluster analyses to identify subgroups of relationships between predictors and outcomes. Analyses were well done, follow-up rates were excellent, and the authors concluded that in this population alcohol stimulation and reward sensitivity best predicted alcohol problems and heavy episodic drinking.
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      References

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