Dopamine transporter (DAT1) VNTR polymorphism and alcoholism in two culturally different populations of South India

It is well established that the central dopaminergic reward pathway is likely involved in alcohol intake and the progression of alcohol dependence. Dopamine transporter (DAT1) mediates the active re-uptake of DA from the synapse and is a principal regulator of dopaminergic neurotransmission. The gene for the human DAT1 displays several polymorphisms, including a 40-bp variable number of tandem repeats (VNTR) ranging from 3 to 16 copies in the 3′-untranslated region (UTR) of the gene. To assess the role of this gene in alcoholism, we genotyped the VNTR of DAT1 gene in a sample of 206 subjects from the Kota population (111 alcohol dependence cases and 95 controls) and 142 subjects from Badaga population (81 alcohol dependence cases and 61 controls). Both populations inhabit a similar environmental zone, but have different ethnic histories. Phenotype was defined based on the DSM-IV criteria. Genotyping was performed using PCR and electrophoresis. The association of DAT1 with alcoholism was tested by using the Clump v1.9 program which uses the Monte Carlo method. In both Kota and Badaga populations, the allele A10 was the most frequent allele followed by allele A9. The genotypic distribution is in Hardy–Weinberg equilibrium in both cases and control groups of Kota and Badaga populations. The DAT1 VNTR was significantly associated with alcoholism in Badaga population but not in Kota population. Our results suggest that the A9 allele of the DAT gene is involved in vulnerability to alcoholism, but that these associations are population specific.

The role of genetics in suicide and the link with major depression and alcoholism.

A clear genetic influence in suicide has been established. In addition, both the serotonergic and noradrenergic systems appear to have a role in suicide, mood disorders and alcoholism. This paper reviews some of the genes that may possibly be involved in suicide and their link to major depression and alcoholism. The genes that are reviewed act on various enzymes within the serotonergic and catecholaminergic systems. With further study, these entities may form a spectrum along the same disease process associated with variable expressivity of the responsible genes.

The burden of alcohol-related ill health in the United Kingdom

Background Although moderate alcohol consumption has been shown to confer a protective effect for specific diseases, current societal patterns of alcohol use impose a huge health and economic burden on modern society. This study presents a method for estimating the health and economic burden of alcohol consumption to the UK National Health Service (NHS).

Methods Previous estimates of NHS costs attributable to alcohol consumption were identified by systematic literature review. The mortality and morbidity due to alcohol consumption was calculated using information from the World Health Organization Global Burden of Disease Project and routinely collected mortality data. Direct health-care costs were derived using information on population attributable fractions for conditions related to alcohol consumption and NHS cost data.

Results We estimate that alcohol consumption was responsible for 31 000 deaths in the UK in 2005 and that alcohol consumption cost the UK NHS £3.0 billion in 2005–06. Alcohol consumption was responsible for 10% of all disability adjusted life years in 2002 (male: 15%; female: 4%) in the UK.

Conclusions Alcohol consumption is a considerable public health burden in the UK. The comparison of the health and economic burden of various lifestyle factors is essential in prioritizing and resourcing public health action.

Relationship between alcohol abuse upper gastro-intestinal haemorrhage and nutritional status during acute hospital admission

This thesis is concerned with the effect of alcohol consumption on the pathogenesis of bleeding from the upper gastrointestinal tract via nutritional pathways. Altered nutritional status is a frequently recognised clinical accompaniement of heavy alcohol consumption in hospitalized patients. Similarly, upper gastrointestinal bleeding is frequently accompanied by the presence of heavy alcohol consumption. Nevertheless, the clinical quantification of alcohol intake is often descriptive, so that a link between alcohol use and upper gastrointestinal haemorrhage via nutritional mechanisms has been only generally defined. In the literature review, the methods of defining alcohol use and abuse, using interview, biochemical and haematological techniques are noted. The relationship between alcohol abuse and nutrient imbalances is reviewed, especially in relation to possible effects on the gastrointestinal tract, appetite and eating habits. A further section reviews the relationship between alcohol use and anatomical lesions of the upper gastrointestinal tract likely to lead to bleeding. Following the chapter in which the methods used in this thesis are described. Chapter 4 seeks to describe the study population and its subgroups in this thesis in relation to interview, biochemical and haematological methods. Alcohol use is defined in relation to (1) a clinical classification of heavy or light drinking, based on a questionnaire administered in Casualty, (2) a quantified method of determining alcohol consumption during a subsequent ward dietetic assessment, (3) in relation to a biochemical definition (recent drinking and non-drinking), and a classification of (1) and (2) called, for the purposes of this thesis, 'alcohol abusers' and 'nonabusers'. Heavy, regular and recent drinkers and alcohol abusers tend to be male and younger than light, infrequent and nonrecent drinkers and nonabusers. Chapter 5 relates the nutritional status of those patients admitted acutely to hospital in relation to the groups defined in Chapter 4, Nutritional status is defined in terms of food intake, anthropometry, biochemical and haematological parameters. Different methods of defining alcohol use give rise to different patterns of nutritional impairment. Chapter 6 relates the nutritional status of those patients admitted acutely to hospital in relation to the presence or absence of an endoscopically defined site of upper gastrointestinal bleeding. A difference is seen between those bleeding from a Mailory-weiss tear and other sites of bleeding, similarly, biochemical differences in nutritional status emerge between those patients who presented in shock, and those who did not. Chapter 7 explores the relationships between biochemical markers of nutritional status and haemostatic variables in the groups of abusers/non-abusers, the various sites of primary bleeding/controls, and shock/non-shock. Serum copper appears to be related to altered haemostasis in a manner not apparently described elsewhere.

Smoking and drinking behaviours : the role of Reinforcement Sensitivity Theory

This thesis examines the predictions of Jeffrey Gray's Reinforcement Sensitivity Theory in the development of smoking and hazardous drinking behaviours in young women. Impulsivity was found to significantly predict alcohol use and young women who smoked and drank at hazardous levels were significantly more impulsive than hazardous drinkers.

Reinforcement sensitivity theory : a paradigm for understanding the motivational processes underlying alcohol use

Provides an examination of the processes which motivate individuals to drink alcohol. It was found that heavier drinkers are highly sensitive to reward yet more likely to experience negative affect, both generally, and in response to alcohol-related cues. Based on these findings a model focusing on the links between personality, mood and craving for alcohol was developed.

The role of alcohol consumption in recovering drug users

This thesis found that alcohol consumption by illicit drig users has not been well researched. A qualitative study found alcohol was used as a substitute and believed to be related to illicit substance use. While the quantitative study generated no overall consensus, the research highlighted the need to conduct additional studies into substance abuse. The portfolio explored the relationship between maltreatment and the development of Reactive Attachment Disorder through four case studies of child clients.

Civil society, social capital and the Twelve Step group

This article examines the nature of community and family by using the concept of civil society through a Twelve Step group called Al-Anon. Al-Anon is related to Alcoholics Anonymous and is a support group for families of alcoholics. The concept of civil society is addressed by looking at its development in political philosophy and sociology. The work of Putnam, in particular, is used to understand how civil society and the associations which make it up develop social capital [Making Democracy Work: Civic Traditions in Modern Italy, Princeton University Press (1993); Journal of Democracy, 6(1), 65-78 (1995); The Responsive Community, 5(2), 18-33 (1995)]. Social capital is understood to be norms and values such as trust and reciprocity that enable sociability or social connectedness. Community, then, embodies these norms of trust and reciprocity through their development in Al-Anon. Al-Anon is studied as an example of an association in civil society. The data come from an ethnographic study in Australia and five European countries as well as in-depth interviews with women members in Australia. The article reviews the similarities and differences between the various countries as well as the form that social capital takes for individual members.

Alcohol expectancies and drinking refusal self-efficacy mediate the association of impulsivity with alcohol misuse

Background: Recent work suggests that 2 biologically based traits convey risk for alcohol misuse: reward sensitivity ⁄ drive and (rash) impulsiveness. However, the cognitive mechanisms through which these traits convey risk are unclear. This study tested a model predicting that the risk conveyed by reward sensitivity is mediated by a learning bias for the reinforcing outcomes of alcohol consumption (i.e., positive alcohol expectancy). The model also proposed that the risk conveyed by rash impulsiveness (RI) is mediated by drinkers’ perceived ability to resist alcohol (i.e., drinking refusal self-efficacy).
Methods: Study 1 tested the model in a sample of young adults (n = 342). Study 2 tested the model in a sample of treatment-seeking substance abusers (n = 121). All participants completed a battery of personality, cognitive, and alcohol use questionnaires and models were tested using structural equation modeling.
Results: In both studies, the hypothesized model was found to provide a good fit to the data, and a better fit than alternative models. In both young adults and treatment-seeking individuals, positive alcohol expectancy fully mediated the association between reward sensitivity and hazardous alcohol use. For treatment seekers, drinking refusal self-efficacy fully mediated the association between RI and hazardous drinking. However, there was partial mediation in the young adult sample. Furthermore, neither trait was directly associated with the other cognitive mediator.
Conclusions: The hypothesized model was confirmed on a large sample of young adults and replicated on a sample of treatment-seeking substance abusers. Taken together, these findings shed further light on the mechanisms through which an impulsive temperament may convey risk for alcohol misuse.