Study lists 13 risk factors for alcoholism
A new study details 13 risk factors for developing a problem with alcohol — from being impulsive to lacking coping skills.
Researchers hope the study can be used to better identify and help people at risk.
People currently are diagnosed with alcohol use disorder if drinking leads to negative consequences, said study lead author Cassie Boness, formerly at the University of Missouri and now a research assistant professor at the University of New Mexico Center on Alcohol, Substance Use and Addictions.
Drinking could be interfering with their relationships, hurting their ability to work responsibly or harming their physical and mental health, she said.
Boness said the current diagnostic process focuses too narrowly on the negative consequences of people’s actions. Looking at the 13 risk factors could help identify people earlier and lead to tailored treatment options.
“Eventually we’d like to see assessment tools that more comprehensively capture the factors articulated in our framework so that we can identify individual profiles of risk and potentially intervene during earlier stages of addiction,” Boness said.
For the study, researchers examined decades of research to compile the list of risk factors. Some are personality traits. But Boness said that with the right therapy, training and — in some cases — medication, people can defend themselves against their own personal risk factors.
Therapy and training, for example, can boost people’s cognitive control. People with strong cognitive control are better at planning ahead, sticking with a task and controlling their impulses, decisions and actions, Boness said.
“It exists in varying degrees in the population. We all differ in cognitive control,” she said.
People can be taught to slow down, think about the outcomes of their actions and make better decisions, she said.
Boness noted cognitive control is not the same as intelligence.
“A person can be very intelligent and very impulsive,” she said.
Some people prone to alcohol use disorder may benefit from the medication naltrexone, Boness said. Naltrexone helps block the pleasurable effects of alcohol and drugs while curbing cravings.
Bonnes said people can learn drink-refusal skills so they know the right words to say before they get in a situation where they’re offered alcohol.
The 13 risk factors predict who is more likely to develop alcohol use disorder and continue to struggle with drinking long-term, she said.
Being aware of the risk factors could prompt more people to seek help, and could aid addiction treatment providers in creating more tailored plans. The risk factors are:
- Not being conscientious — Conscientious people are cautious, dutiful, thoughtful in their decision-making, have self control and like order. A lack of conscientiousness can lead people to be poor at planning and perseverance.
- Low ability to control responses — If you feel an impulse to do something, how likely are you to be able to stop yourself from acting on the impulse? Are you able to stop yourself from losing control?
- Prefer immediate rewards — Do you tend to choose smaller, short-term rewards over larger, long-term rewards? Do you have difficulties planning your actions and waiting for a future reward? People who prefer immediate rewards, for example, might choose to binge drink tonight even if that endangers their ability to work the next day.
- Heightened sensitivity to rewards — Do you have a heightened desire to seek rewards, and do you get more pleasure from rewards than most people? Heightened reward sensitivity can lead to reckless behavior, drug and alcohol use and irresponsible sexual activity. But it also encourages us to have social interactions, try new experiences and become more independent. Most teens have elevated reward sensitivity. Their brains release more feel-good dopamine from rewards, research shows.
- Low sensitivity to punishments — How sensitive are you to the negative effects of drinking, like having a hangover? Over time, alcohol consumption can lessen people’s sensitivity to negative effects.
- Lack of coping skills — Do you choose healthful options such as exercising and talking with others in response to setbacks and negative emotions, or do you turn to drinking or other potentially harmful behavior? Do you have skills to alter how you feel and think about a negative situation? How well can you tolerate negative emotions?
- Prone to negative emotions — People who are prone to negative emotions are more at risk of developing alcohol use disorder if they drink. Chronic drinking can also cause more negative emotions.
- Prone to positive emotions — Having generally positive feelings can help protect people against alcohol use disorder. However, some positive people drink to increase their positive feelings.
- Expecting a positive outcome from drinking — Having positive expectations about drinking can increase risk. Some people expect to feel more sociable or more excited when they drink.
- Not expecting a negative outcome from drinking — People who don’t anticipate negative outcomes from drinking are more at risk.
- Drinking has become a habit — Drinking has become an ingrained, almost automatic habit that’s hard to break despite negative consequences and attempts to quit.
- Drinking cues become rewarding — Drinking buddies, bars and other things associated with your drinking trigger rewarding feelings and prompt alcohol cravings.
- Compulsive use and difficulty abstaining — You have less ability to resist urges and control your drinking even when your drinking leads to problems.
The study, titled “The etiologic, theory-based, ontogenetic hierarchical framework of alcohol use disorder: A translational systematic review of reviews,” was published in Psychological Bulletin.
For help and information about alcohol or drug use disorder, call the Substance Abuse and Mental Health Services Administration National Helpline at 1-800-662-4357 or visit samhsa.gov.
Reach Mail Tribune reporter Vickie Aldous at 541-776-4486 or firstname.lastname@example.org. Follow her on Twitter @VickieAldous.