104 



liol abuse and dependence were quite 

 similar (7 14 for whites. 7.98 for non- 

 whites). Finally, in the oldest age group, 

 the rates of alcohol abuse and depen- 

 dence among nonwhice males were 13.3 

 percent greater than those among white 

 males. The pattern for nonwhite and 

 white females was similar to that for 

 males, as demonstrated in the nonwhite 

 to white ratios in Table 2. 



Although alcohol abuse and depen- 

 dence was greater among males than 

 among females, there was evidence of 

 convergence of the rates between sexes 

 in the younger age groups. The male to 

 female ratios were lowest in the 18-29 

 age group for whites and nonwhites 

 (Table 2). Thus, alcohol abuse and de- 

 pendence was more prevalent in the 

 younger age groups, particularly among 

 young women. This trend is highlighted 

 in Figure 1. where rates for white fe- 

 males are shown to exceed those for 

 nonwhite males in the youngest age 

 group. 



Discussion 



Nearly 9.0 percent of adults surveyed 

 met DSM-III-R cnteria for I -year alco- 

 hol abuse and dependence. Males were 

 about three times more likely than fe- 

 males to suffer from alcohol abuse and 

 dependence. However, the fact that the 

 difference in prevalence between males 

 and females is least in the youngest age 

 group suggests that females may be 

 catching up. The decrease in the white 

 to nonwhite ratio of 1-year prevalence 

 wich incivasing age suggesu that at 



least part of the decline in prevalence 

 with age observed in this sample may 

 be due to a true cohort effect. If the de- 

 cline in the prevalence of alcohol abuse 

 and dependence were due entirely to 

 faulty recall in the older cohorts, one 

 would have to make the unlikely as- 

 sumption that nonwhites have twtter re- 

 call than whites, especially among 

 females. 



The overall prevalence estimates and 

 corresponding population estimates of 

 alcohol abuse and dependence present- 

 ed in this report do not differ greatly 

 from those for the year 1984 (Williams 

 et al. 1989), even though these earlier 

 figures were based on diagnostic crite- 

 ria from the DSM-llI (American 

 Psychiatric Association 1980), and not 

 the DSM-III-R. The prevalence of 

 DSM-Ill alcohol abuse and dependence 

 reported by the 1984 National Survey 

 on Alcohol Use was 8.58 percent for 

 the total sample, with a corresponding 

 population estimate of 15,100.000. 

 Although this figure is nearly identical 

 with the prevalence of DSM-lll-R al- 

 cohol use disorders found in the 1988 

 NHIS sample, caution must be exer- 

 cised in assuming the stability of these 

 rates between 1984 and 1988. Because 

 the definitions of alcohol use disorders 

 differed between the two surveys, no 

 conclusions can be made concerning 

 trends in (he rates of alcohol abuse and 

 dependence over time 



The next major opportunity to up- 

 date these national prevalence and pop- 

 ulation estimates will occur in 1993 

 when the data from Wave I of 

 NlAAAs National Longitudinal 



Alcohol Epidemiologic Survey 

 (NLAES) become available The 

 1991-1992 NLAES contains a compre- 

 hensive list of symptoms measuring def- 

 initions of alcohol abuse and 

 dependence from DSM-III. 

 DSM-III-R, the proposed DSM-IV 

 (unpublished memorandum, DSM-IV 

 Substance Abuse Committee 1990), and 

 the International Classification of 

 Diseases-Tenth Revision (ICD-10; 

 World Health Organization 1990) 

 Representation of multiple definitions of 

 alcohol use disorders will facilitate di- 

 rect comparisons between the NLAES 

 DSM-llI estimates and the DSM-III es- 

 timates of the 1984 National Survey on 

 Alcohol, and between the DSM-lll-R 

 prevalence estimates derived from the 

 1988 NHIS reported here and the 

 1991-1992 NLAES It remains to be 

 seen whether the consistencies in preva- 

 lence and population estimates of alco- 

 hol abuse and dependence, found 

 between earlier reports and the present 

 report, will generalize to newer defini- 

 tions of alcohol use disorders (i c . from 

 the DSM-IV and ICD-IOi appeaiins: in 

 the NLAES ■ 



RllH.RKM i;,s 



AiiKncjn Psycliialric A-VMH.ijliim. OitiK't""!!* 

 anil StalislHiit Mtiiuuit nfMciiutl thxitrtlvrs. 

 Tfiiiil Etiitiim. Wa.sliinj:loii. DC: llic AsHdcialiim, 

 I9KII 



Aiilcncjil Psytllialrit A\S(>i.iJlltin, 0(c(t;""v"< (""' 

 SialtMuol Mouiitil i'/M<iiitil l>ixt'ntvis. Tliiiil 

 Ednnm. Rei'i.\ril. Wusliin|;lon. DC. IlK AsMKialitiii. 

 I9S7 



M*sst\ . J T.. M(X)Hi;. T F . Pak-Siins. V.L,: ,^N^» 

 Taoros. W OcvHif'f mill EMniintimi fnt llu- 



Null: / Hrud/l /iilt-rvin.- Jiin-i-v, IVXS-IVH Vilal 



jiHl Hcjilh Slullsllt.^ Rtfpiwl Scrio 2 1 1 nil, 

 Hyall^vilie. MO' Nalional Cenler I'lW Hollh 

 Slall■.llt^. l')H'» 



Rc-Ncaivh Tnaiigle liislilulc it'llwiire fur Siincv 

 Dala Aiinh-iiiji ISUOAANI. Vtrxiiii f.lO RcNC.tah 

 Tnan^k Park. Ihc InMtlulc. IWI 



Williams, CD.; Grant. B.F.; Hahfsord. T.S.; and 

 Nonui. i Populalion pmjecliitns using DSM-III tn- 

 lena: Alcohol abux jihJ licpcodenctf. 19911-211(10. 

 Aluiliol Heollli Jl Rexeanli World l.lUl:,l&<)-}70. 

 1989 



World Heallti Orgjnilunion. Tlie Prtifuiicd 

 lillenuilitmal Cluxiif'ii tilioii of Dncu^es. Tenllt 

 «?r(j(mMlCD-IOl. Geneva. SwilEcriand: the 

 Organi7.al(On. 1990, 



ALCOHOL Health & Research World 



