Temporal progression of alcohol dependence symptoms in the U.S. household population: results from the National Comorbidity Survey

J Consult Clin Psychol. 1998 Jun;66(3):474-83. doi: 10.1037//0022-006x.66.3.474.


General population data are presented on patterns and predictors of temporal progression of alcohol dependence symptoms in the general population. The data come from the National Comorbidity Survey, a nationally representative general population survey of respondents ages 15-54. Lifetime symptom classes were estimated with latent class analysis (LCA). A 4-class LCA solution, including a 1st asymptomatic class and 3 progressively more serious symptomatic classes, was found to fit the data. Probability of initial symptom onset among drinkers was found to be highest in the 10-24 age range, to be higher among men than women, and to have increased dramatically in the past 4 decades. Age, gender, and cohort effects were less powerful in predicting symptom progression. A narrowing of the gender difference over time was due largely to a convergence in initial symptom onset among men and women ages 10-24. These results suggest that a rise in initial problems was more important than an increase in the transition from problems to dependence in accounting for the growing prevalence of alcohol dependence during the post-World War II years in the United States.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Alcohol Drinking / trends
  • Alcohol-Related Disorders / diagnosis
  • Alcohol-Related Disorders / epidemiology*
  • Alcoholism / diagnosis
  • Alcoholism / epidemiology*
  • Child
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Health Surveys
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Models, Statistical
  • United States / epidemiology