Mediation of effects of the level of response to alcohol and impulsivity 15 years later in 36-year-old men: Implications for prevention efforts

Abstract

Background: Although the prevalence of alcohol use disorders (AUDs) has increased in older individuals in the recent decade, there are few programs to mitigate that increase. The current analyses evaluate the feasibility of applying to older drinkers elements of an approach to prevent heavier drinking in young adults by focusing on mediators of effects of two risk factors for alcohol problems, low levels of response to alcohol (low LRs) and higher impulsivity.

Methods: Data were extracted from the San Diego Prospective Study (SDPS). Structural Equation Models evaluated relationships among age 36 low LRs and higher impulsivity; age 46 perceived peer drinking, alcohol expectancies, and drinking to cope; and age 51 alcohol problems, even after controlling for age 36 alcohol problems.

Results: Relationships of age 36 low LRs to later alcohol problems was both direct and linked to age 46 heavy drinking peers. LR also operated indirectly through peer drinking to alcohol expectancies and drinking to cope. Age 36 impulsivity had no direct path to later alcohol problems and operated primarily through mediation by alcohol expectancies and via expectancies to drinking to cope. After controlling for age 36 alcohol problems, the low LR and impulsivity results remained robust.

Conclusions: Programs for mitigating increases in alcohol problems in middle-age drinkers should consider identifying individuals with low LRs and/or higher impulsivity and implementing prevention approaches similar to a program used in young adults. The approach should emphasize some different mediators for older drinkers with low LRs and those with higher impulsivity.

Keywords: Alcohol problems; Impulsivity; Low levels of response to alcohol; Mediation; Prediction.