Predictors of Symptom Course in Alcohol Use Disorder

Objective: Alcohol Use Disorder (AUD) has traditionally been viewed as a chronic, progressive, relapsing disorder (Jellinek, 1960; National Institute on Drug Abuse, 2018). However, little is known about the course of individual AUD criteria. To the extent that individual symptoms represent the focus of some treatments (e.g., withdrawal, craving), understanding the course of specific symptoms, and individual differences in symptom course, can inform treatment efforts and future research directions.Method: The current study examined 34,653 participants form Wave 1 (2001-2002) and Wave 2 (2003-2004) of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC; Grant, Moore, & Kaplan, 2003; Grant, Kaplan, and Stinson, 2005), using logistic regression to analyze the extent to which AUD symptom course is predicted by heavy alcohol consumption, family history of alcoholism, and lifetime diagnosis of Conduct Disorder. Results: The course of all AUD symptoms was significantly influenced by all four external criteria, with the magnitude of the prediction varying across different symptoms and different aspects of course. Conclusion: The strength of the relationship appeared to be related to the theoretical proximity of a given predictor to AUD symptomatology, with heavy drinking being the strongest and family history of AUD being the weakest. The course of all AUD symptoms was strongly associated with the prevalence of the given symptom in the overall sample. Future work should include examining the interchangeability of AUD symptoms and considering heavy alcohol consumption as a criterion for AUD diagnosis.