The Prevalence of DSM-III-R Alcohol Dependence in Two American Indian Populations

Authors

  • Paul Spicer,

    Corresponding author
    1. American Indian and Alaska Native Programs, University of Colorado Health Sciences Center, Aurora, Colorado.
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  • Janette Beals,

    1. American Indian and Alaska Native Programs, University of Colorado Health Sciences Center, Aurora, Colorado.
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  • Calvin D. Croy,

    1. American Indian and Alaska Native Programs, University of Colorado Health Sciences Center, Aurora, Colorado.
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  • Christina M. Mitchell,

    1. American Indian and Alaska Native Programs, University of Colorado Health Sciences Center, Aurora, Colorado.
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  • Douglas K. Novins,

    1. American Indian and Alaska Native Programs, University of Colorado Health Sciences Center, Aurora, Colorado.
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  • Laurie Moore,

    1. American Indian and Alaska Native Programs, University of Colorado Health Sciences Center, Aurora, Colorado.
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  • Spero M. Manson,

    1. American Indian and Alaska Native Programs, University of Colorado Health Sciences Center, Aurora, Colorado.
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  • the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project Team

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    • *

      The American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project team also includes Cecelia Big Crow, Dedra Buchwald, Buck Chambers, Michelle Christensen, Denise Dillard, Karen DuBray, Paula Espinoza, Fay Flame, Candace Fleming, Ann Frederick, Joseph Gone, Diana Gurley, Lori Jervis, Shirlene Jim, Carol Kaufman, Ellen Keane, Suzell Klein, Denise Lee, Monica McNulty, Denise Middlebrook, Christina Mitchell, Tilda Nez, Ilena Norton, Theresa O'Nell, Heather Orton, Carlette Randall, Angela Sam, James Shore, Sylvia Simpson, and Lorette Yazzie.


  • This study was supported by National Institute of Mental Health Grants R01 MH48174 (SMM and JB, principal investigators) and P01 MH42473 (SMM, principal investigator). In addition to these grants, analyses for and the writing of this article were partially supported by grants from the NIAAA [R01 AA11932 (cofunded by the National Center for Minority Health and Health Disparities; PS, principal investigator) and R01 AA013800 (DKN, principal investigator)]. The National Comorbidity Survey was supported by the following grants: R01 MH/DA46376 and R01 MH49098 (NIMH), supplement to R01 MH/DA46376 (NIDA), and 90135190 (W.T. Grant Foundation) RC Kessler, PI.

Paul Spicer, PhD, AIANP, P.O. Box 6508, MS F800, Aurora, CO 80045; Fax: 303-724-1474; E-mail: paul.spicer@uchsc.edu.

Abstract

Background: Evidence suggests that American Indian (AI) populations may be at increased risk for problems with alcohol, but a lack of community-based research using diagnostic criteria has constrained our ability to draw inferences about the extent of severe alcohol problems, such as dependence, in AI populations.

Methods: This article draws on data collected by the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (AI-SUPERPFP), which involved interviews with 3084 AI people living on or near their reservations. The AI-SUPERPFP sample was drawn from two culturally distinct tribes, which were designated with geographical descriptions: Northern Plains (NP) and Southwest (SW). Comparisons with data collected by the National Comorbidity Survey (NCS) were explored by using shared measures to situate the findings from AI-SUPERPFP in a national context.

Results: Lifetime rates of DSM-III-R alcohol dependence for men in both AI-SUPERPFP samples were 50% higher than those found in the NCS. Rates of lifetime alcohol dependence for women varied by sample, however; NP women had twice the rate of women in the NCS, but SW women had rates quite similar to those of NCS women. Patterns for 12-month alcohol dependence in AI-SUPERPFP were generally more similar to those found in NCS.

Conclusions: The rates of DSM-III-R alcohol dependence found in AI-SUPERPFP were generally higher than US averages and justify continued attention and concern to alcohol problems in AI communities, but they are not nearly as high as those in other reports in the literature that rely on less stringent sampling methods. Furthermore, significant sociocultural influences on the correlates of alcohol dependence in AI communities are evident in these data, underscoring the need to appreciate the complex and varying influences on the patterning of alcohol problems in the diverse cultural contexts of the US.

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