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Stressful life experiences, alcohol consumption, and alcohol use disorders: the epidemiologic evidence for four main types of stressors

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Abstract

Background

Exposure to stress is potentially important in the pathway to alcohol use and alcohol use disorders. Stressors occur at multiple time points across the life course, with varying degrees of chronicity and severity.

Method

We review evidence from epidemiologic studies on the relationship between four different stressors (fateful/catastrophic events, child maltreatment, common adult stressful life events in interpersonal, occupational, financial, and legal domains, and minority stress) and alcohol consumption and alcohol use disorders.

Results

Studies generally demonstrate an increase in alcohol consumption in response to exposure to terrorism or other disasters. Research has demonstrated little increase in incident alcohol use disorders, but individuals with a history of alcohol use disorders are more likely to report drinking to cope with the traumatic event. Childhood maltreatment is a consistent risk factor for early onset of drinking in adolescence and adult alcohol use disorders, and accumulating evidence suggests that specific polymorphisms may interact with child maltreatment to increase risk for alcohol consumption and disorder. Stressful life events such as divorce and job loss increase the risk of alcohol disorders, but epidemiologic consensus on the specificity of these associations across gender has not been reached. Finally, both perceptions of discrimination and objective indicators of discrimination are associated with alcohol use and alcohol use disorders among racial/ethnic and sexual minorities.

Conclusion

Taken together, these literatures demonstrate that exposure to stress is an important component in individual differences in risk for alcohol consumption and alcohol use disorders. However, many areas of this research remain to be studied, including greater attention to the role of various stressors in the course of alcohol use disorders and potential risk moderators when individuals are exposed to stressors.

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Acknowledgements

This research was supported in part by grants from the National Institute on Alcoholism and Alcohol Abuse (K05 AA014223, Hasin; U01 AA018111; Hasin), a fellowship from the National Institute of Drug Abuse (F31-DA026689, Keyes), the Robert Wood Johnson Health and Society Scholars program (Hatzenbuehler), and New York State Psychiatric Institute (Hasin). The authors report no conflicts of interest. We would like to thank Philip Bender for assistance in manuscript preparation.

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  1. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA

    Katherine M. Keyes & Deborah S. Hasin

  2. New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, Box 123, New York, NY, 10032, USA

    Katherine M. Keyes & Deborah S. Hasin

  3. Center for the Study of Social Inequalities in Health, Mailman School of Public Health, Columbia University, New York, NY, USA

    Mark L. Hatzenbuehler

  4. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    Deborah S. Hasin

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  1. Katherine M. Keyes
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  3. Deborah S. Hasin
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Correspondence to Deborah S. Hasin.

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Keyes, K.M., Hatzenbuehler, M.L. & Hasin, D.S. Stressful life experiences, alcohol consumption, and alcohol use disorders: the epidemiologic evidence for four main types of stressors. Psychopharmacology 218, 1–17 (2011). https://doi.org/10.1007/s00213-011-2236-1

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