Family cohesion and pride, drinking and alcohol use disorder in Puerto Rico

ABSTRACT

Background: The extended multigenerational family is a core value of Hispanic culture. Family cohesion/pride can have protective effects on drinking- and drug-use-related behavior among Hispanics. Objectives: To examine the association between family cohesion/pride, drinking, binge drinking, and DSM-5 alcohol use disorder (AUD) in Puerto Rico. Methods: Data are from a household random sample of 1510 individuals 18–64 years of age in San Juan, Puerto Rico. Results: Bivariate analyses showed that family cohesion/pride was not associated with the average number of drinks consumed per week but was associated with binge drinking among men. Family cohesion/pride was also associated with DSM-5 AUD. Results of the multivariate analyses were consistent with these bivariate results for DSM-5 AUD. Respondents with low (OR = 2.2, 95CL = 1.21–3.98; p < .01) and medium (OR = 1.88; 95CL = 1.12–3.14; p < .01) family cohesion/pride were more likely than those with high family cohesion/pride to have a positive diagnosis of DSM-5 AUD. More liberal drinking norms and positive attitudes toward drinking were also strong predictors of the average number of drinks consumed per week. More liberal drinking norms also predicted binge drinking, and DSM-5 AUD. Conclusions: Higher family cohesion/pride may have a protective effect against DSM-5 AUD. This may have practical implications for clinical and prevention programs. As long as high cohesion is not enabling drinking, these programs can enhance and support family cohesion/pride to help clients in treatment and recovery and prevent drinking problems.

KEYWORDS:

• Family cohesion
• drinking
• binge drinking
• DSM-5 AUD
• Puerto Rico

Strengths and limitations

The study has many strengths. It is based on analyses of a random sample of the adult population of San Juan, which was interviewed face to face in a survey with a particularly high response rate of 83%. Data collection covered several drinking outcomes in detail. Data analyses took into account important confounders of the association between family cohesion and the drinking outcomes under analysis. The study also has limitations. Data collection was based on self-reports, which may lead to under reporting of alcohol consumption. The study design was cross-sectional, which does not allow for assessments of temporal associations. Results may not be representative of Puerto Ricans living outside the San Juan metropolitan area, where respondents were interviewed. It is also possible that potential confounders of predictors in the analyses in Tables 2 and 3 were not considered, and potential moderating effects were not tested.

Financial disclosures

The authors report no relevant financial conflicts.