Level of response to alcohol within the context of alcohol-related domains: An examination of longitudinal approaches assessing changes over time

Background: The manner in which a low level of response (LR) to alcohol relates to domains that enhance the risk for heavy drinking has traditionally been studied through cross-sectional models. However, many of the relevant domains, such as the maximum number of drinks consumed in 24 hours (MAXDRINK) and drinking among peers (PEER) typically decrease across adulthood. This study evaluated whether a person's LR to alcohol predicted alcohol-related domains at multiple time-points and examined longitudinal relations among these domains in a sample of probands from the San Diego Prospective Study. Methods: LR to alcohol was assessed in 174 male probands from the San Diego Prospective Study at baseline (T1), and measures of MAXDRINK, PEER, and drinking to cope (COPE) were collected at the 15-year (T15), T20, and T25 follow-ups. Results: A low LR to alcohol at T1 predicted higher levels of MAXDRINK and COPE at T15, consistent with prior studies. Using latent growth curve models, higher levels of T15 MAXDRINK predicted less decreases in PEER drinking over time. Additional analyses found a time-specific effect of T20 COPE on T25 MAXDRINK even after accounting for the growth factors of both domains. Conclusion: These evaluations illustrate that LR prospectively predicted relevant outcomes, and clarify how alcohol-related domains related to each other as the probands progressed through middle adulthood. Treatment implications are discussed and drinking to cope may be an important intervention target for problematic alcohol use.