A Latent Class Analysis of Alcohol Abuse and Dependence Symptoms Among Puerto Rican Youth

Abstract

The study aim was to classify youths into homogenous groups based on their symptoms of Alcohol Abuse and Dependence. An NIDA-funded cross-sectional survey was administered to 622 middle and high school students in San Juan, Puerto Rico in 2000. Latent class analysis (LCA) examined the Alcohol Abuse and Dependence symptoms. Three distinct classes of drinkers were found: low (86.0% of sample), moderate (11.7% of sample), and high (2.3% of sample) severity classes which were distinguished by differing estimated probabilities of symptom reporting. The study has implications for the diagnosis of Alcohol Abuse and Dependence among Puerto Rican youths. Limitations are also noted.

RÉSUMÉ

Analyse de structure latente des symptômes de l'Abus d'Alcool et de la Dépendance à l'Alcool chez les jeunes Portoricains

La présente étude a pour objectif de classer les jeunes en groupes homogènes en fonction des symptômes d'abus d'alcool et de dépendance à l'alcool qu'ils présentent. Une enquête transversale financée par le NIDA a été menée en 2000 auprès de 622 élèves d’écoles intermédiaires et secondaires de San Juan, Porto Rico. L'analyse de structure latente a examiné les symptômes d'abus d'alcool et de dépendance à l'alcool. Trois catégories de consommateurs ont été déterminées. Les catégories de gravité suivantes: limitée (86%), modérée (11,7%) et forte (2,3%) ont été déterminées en s'appuyant sur les estimations de probabilité de signalement des symptômes. La présente étude peut avoir des répercussions sur le diagnostic de l'abus d'alcool et de la dépendance à l'alcool chez les jeunes portoricains. Des limites ont également été signalées.

Mots clés

Manuel Diagnostique et Statistique des Troubles Mentaux (DSM), Abus, Dépendance, Adolescent, Porto Rico, Analyse de la structure latente

RESUMEN

Análisis de clases latentes de Alcohol Abuso i Dependencia en jovenes de Puerto Rico

El principal objetivo de este estudio es clasificar los jovenes en grupos homogenios de acuerdo a sus sintomas por abuso y dependencia del Alcohol. Este estudio transversal fue financiado por el NIDA y administrado a 622 estudiantes de los niveles primaria i secundaria de la ciudad de San Juan de Puerto Rico en el ano 2000. El estudio utilizado fue análisis de clases latentes (LCA) mediante el cual se examinan los sintomas del Abuso y Dependencia del Alcohol. En este estudio se encontro tres clases de bebedores: Bajos bebedores (86.0%), Moderados bebedores (11.7%), i Altos bebedores (2.3%). Estas clases de diferencias se clasifican en base a los sintomas reportados. Este estudio tiene implicaciones por el diagnostico del Abuso y Dependencia del Alcohol de los jovenes de San Juan de Puerto Rico.

Palabras Claves

Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM), Alcohol, Abuso, Dependencia, Adolescentes, Puerto Rico, LCA

Keywords :

• DSM
• alcohol
• abuse
• dependence
• adolescent
• Puerto Rico
• latent class analysis

THE AUTHORS

Dr. Brent E. Mancha, Ph.D., M.H.S., is a research associate in the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health (JHSPH). He is currently assistant director of the Hubert H. Humphrey Fellowship Program at Johns Hopkins. He is a graduate of the PhD program in the Department of Mental Health at JHSPH and an alumnus of the NIDA Drug Dependence Epidemiology Training (DDET) Program. During his first two years of doctoral study, he was a recipient of the NIMH Child Mental Health Services Training Program fellowship. While at Johns Hopkins, he has worked extensively with Dr. William Latimer. Dr. Mancha's research focuses on the epidemiology of alcohol and drug dependence, with a special interest in alcohol use during adolescence. His dissertation examined patterns of DSM-IV alcohol problems among youths from the US and Puerto Rico and utilized LCA to examine different profiles of adolescent drinkers. Dr. Mancha has experience analyzing multiple datasets, including the National Survey of Drug Use and Health (NSDUH) and several of Dr. Latimer's datasets, and has experience using multiple statistical techniques.

Dr. Alicia Hulbert, M.S., M.D. is a physician scientist. Her current research focus is on the etiology, prevention, diagnosis, and treatment of HIV-infected lung cancer patients across racial and ethnic groups both domestically and internationally. In addition, Dr. Hulbert was a recipient of the NIDA T32 fellowship in Drug Dependence Epidemiology at the Johns Hopkins Bloomberg School of Public Health where she focused on the epidemiology, prevention, and treatment of infectious disease and drug dependence.

Dr. William W. Latimer, Ph.D., M.P.H. is the Elizabeth Faulk professor and chair of the Department of Clinical and Health Psychology in the College of Public Health and Health Professions at the University of Florida. Dr. Latimer's research has been NIDA-funded since 1995 and focuses on the epidemiology, prevention, and treatment of infectious disease and drug dependence, with a special focus on neurobehavioral risk factors of disease, treatment engagement, and outcome. His epidemiologic research focuses on neuropsychological and social-behavioral risk factors of HIV and other infectious diseases among drug using populations in the US, South Africa, and Russia. Dr. Latimer's HIV and drug prevention research focuses on evaluation of efficacy and effectiveness of interventions that coordinate cognitive-behavioral and family systems approaches. Dr. Latimer's drug treatment research also focuses on evaluating neurobehavioral and process factors influencing the efficacy and effectiveness of cognitive-behavioral, family systems, and 12-Step approaches for adolescent and adult drug abuse. Since 2001, Dr. Latimer has conducted five R01 studies in Baltimore City, including randomized trial studies to test IFCBT efficacy to reduce HIV risk behavior and foster drug abstinence among adults with drug dependence and epidemiologic studies of HIV risk behavior among adult heroin and cocaine addicts.

Notes

1 The reader is reminded that these two posited processes concepts are often noted in the literature, without adequately describing and understanding their dimensions (linear, nonlinear), their “demands”, the critical necessary conditions (endogenously as well as exogenously; from a micro to a macro level) that are necessary for either of them to operate (begin, continue, become anchored, and integrate, change as de facto realities change, cease, etc.) or not to and whether their underpinnings are theory-driven, empirically-based, individual, and/or systemic stake holder- bound, based upon “principles of faith”, historical observation, precedents and traditions that accumulate over time, perceptual and judgmental constraints, “transient public opinion” or what. This is necessary to clarify and to consider if these terms are not to remain as yet additional shibboleths in a field of many stereotypes.