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INDEX Abstinence biological markers and, 155 and cognitive function, 275 - 276 from concomitant substance use, 258 group meeting attendance and, 186 and hypertension, 319 and organ damage, 267, 281 and sleep, 274 and treatment efficacy, 232 as treatment goal, 13, 61, 65, 218 - 220, 223 Abstinence syndrome, 169 Acetaldehyde, 40, 221 Active treatment, 169, 170 Acupuncture, 189 Addiction Research Foundation of Ontario, 173 Addiction Severity Index (ASI), 150, 152 Adenylate cyclase, 156 Adolescents automobile accidents, 88 circumvention of minimum purchase age, 91 community prevention research, 109 identification of risk in, 47, 53 peer groups and, 55 pregnancy, 3, 8, 40, 11~120 primary prevention and, 121, 123 public information campaigns and, 84 smoking prevention research, 118-119 suicide, 78 television and, 87 treatment, evaluation of, 187 treatment matching, 237 treatment research needs, 299 300 verbal reporting, 154 Adult children of alcoholics. See Children of alcoholics Adult Children of Alcoholics (ACOA), 179 Advertising alcohol industry spending on, 27, 85 in cancer prevention, 117 - 118 -325 influences on drinking behavior, 6, 82, 85 - 86 treatment recruitment, 10, 143, 162 Aerobic exercise, 183 Aftercare. See Relapse prevention Age alcohol price and consumption by, 77, 81 and cognitive function recovery, 276 Agent. See Alcohol Age-graded influences, 48 Aggregate-level descriptive studies, 161 - 162 Aggressive behavior, 4, 52, 54 AIDS research, 39, 313, 316 Alanine aminotransferase (SGPT), 155 - 156 AlAnon, 179, 181 - 182, 194 Alaproclate, 173 AlaTeen, 181 - 182 Alcohol. See also Alcohol dependence; Alcohol-related problems; Alcohol use administration in therapies, 176, 274 alternatives to, 117, 254 carbimide reactions, 172 cardiovascular effects, 278 - 279 disulfiram reactions, 171 effects on sleep, 273 - 275 emotional effects, 60 ingestion, testing for, 33 metabolism of, 33, 34, 40, 155 neuromuscular effects, 35 physiological and behavioral effects, 31 - 32 in public health model, 2, 24 - 25, 27 withdrawal, 169, 253 - 254, 268 - 275 Alcohol, Drug Abuse and Mental Health Administration (ADAMHA), 309, 313, 316, 317, 319 Alcohol Clinical Index, 222 Alcohol dependence. See also Alcoholics; Alcohol use as clinical entity, 24, 131, 222 comorbidity with drug use, 14, 144, 158

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conceptualization, vi, 10, 149 genetic determinants of, 66 intensity of treatment, 189 labeling, 223 moderation as treatment goal, 61 nicotine dependence comorbidity, 260 prevalence of, 144 progression of, 61 public perceptions of, 141 risk for, 145 severity, classification of, 15~151 severity of, 13, 234, 235, 241, 269 social learning of, 58 subtypes, 152 treatment effectiveness, 198 Alcohol Dependence Scale, 152 Alcohol expectancy questionnaire, 63, 152 Alcoholic amnestic disorder, 275 Alcoholic beverage control (ABC) commissions, 75, 76, 90 Alcoholic beverage industry advertising, 27, 85 health promotion and, 117 Alcoholic dementia, 275 Alcoholics. See also Alcohol dependence; Children of alcoholics concomitant depression, 177, 178 denial of problems, 252 health care costs, 292 - 293 reinforcement and, 60 61 spouses of, 181 subpopulations of, 189 Alcoholics Anonymous (AA), 9 - 10, 142, 143, 191, 247 adolescent treatment, 300 attribution for change, 249 effectiveness of, 196, 197 meeting attendance, 186, 194, 239, 240 relapse prevention, 184 research on, 178 - 179 treatment, evaluation of, 187 treatment effects, 158, 159, 186 Alcoholism. See Alcohol dependence Alcoholism, Alcohol Abuse and Related Problems: Opportunities for Research (IOM), vi Alcohol and Public Policy: Beyond the Shadow of Prohibition (NRC), vii, 20, 24 Alcohol-related cues, 258 Alcohol-related disorders, 235 Alcohol-related problems in assessment, 151 conceptualization, 10, 149, 223 continuum model of, vi, 1 - 2, 10, 23 diversity of, 144 epidemiology, 2 - 3, 31, 44 implications of public health research, 121 - 123 in primary care, 224 progression of, 222 public health model of, 2, 24 - 27 secondary prevention of, 215 Alcohol use attitudes about, 247 biological markers of, 153, 155 - 157 and blood pressure, 278 - 279 community prevention research, 10~110 concomitant drug use, 235, 238, 258 consumption rates advertising and, 85 availability and, 6, 75, 76 - 77, 128 context and setting effects, 6, 91, 92 minimum purchase age and, 6, 78 - 80 prices and, 6, 76, 77 - 78, 81, 129, 13~131 zoning and conditional- use permits and, 80 costs of, 23 cultural drinking behavior, 60, 92, 129 health consequences, 15, 267 historical patterns, 128 identification of at-risk individuals, 47 mortality, vi, 1, 23 periodic problem drinking, 53 severity of, 13, 234 smoking and, 247 - 248 in smoking prevention studies, 119 social learning of, 58 - 59 testing for, 11, 155-7 Alcohol Use Inventory, 152 Alpha-2 adrenergic agonists, 268 Alzheimer's disease, 278 American Hospital Association Annual Survey, 161 American Medical Association, 176 -326

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American Psychiatric Association, 10, 150, 235, 247 Amethystic agents, 267 Angiotensin converting enzyme antagonists, 279 Antabuse. See Disulfiram therapy Antidepressant medication, 173, 174, 197, 25~260 Antidipsotropic medication, 17~172, 239 Anti-Drug Abuse Act (1986), 315, 320 Anti-Drug Abuse Act (1988), 41 Antipsychotic medication, 174, 259 Antisocial behavior, 4, 52, 54 Antisocial personality disorder comorbidity with alcoholism, 144 and treatment, 13, 234, 235, 241, 257 Anxiety, 170, 183 effect of alcohol on, 36 Anxiolytics, 259 Apneic aversion therapy, 175 Apoliprotein A-I and A-II, 156 Aspartate aminotransferase (SOOT), 155 - 156 Assertiveness training, 183 Assessment technology, 15~158 Attention-span deficit, 54 Attribution for change, 249 Australia, 89, 115 Automobile accidents alcohol and, 3, 23, 31, 33, 35, 78 alcohol prices and, 77 blood alcohol level in, 8% drunk driving laws and, 6, 89, 90 epidemiology, 34 minimum purchase age and, 79 risk for, 88 seat belt use and, 116 Autopsy, 33 Autoregression, 129 Aversion therapies, 11 - 12, 175? 191, 253 Baltimore, 120 Bars, 26, 92 Bartenders, 131 Beer consumption advertising and, 85 decline in, 145 pitcher sales and, 91 price and, 77 purchase age and, 78, 7~80 Behavioral development, 48 Behavioral risk factors, 49, 215 Behavioral self-control training, 18~181, 215 effectiveness of, 11 - 12, lg6 and moderation outcome goals, 219 Behavioral therapy, 253 Behavior change attribution for, 249 education and, 120 legislation and, 116 motivation for, 12, 63 64, 65, 193 - 195, 235, 251 - 252 readiness to, 5, 63 64, 65, 235, 248 smoking cessation, 253, 261 stages of, 248 Behavior change theory, 123 Benzodiazepines, 259, 268, 270, 271, 272 Beta blockers, 268, 279 Biochemical imbalances, 57 Biochemical tests, 221 Biofeedback-assisted relaxation training, 183 Biological markers, 11, 66, 153, 155 - 157, 221 - 222 Biological vulnerabilities, 57, 149 Biomedical research, 8, 132 Bipolar affective disorder, 174 Birth defects, maternal drinking and, 40 Bisexuals, 39 Blacks cancer in, 117 hypertension in, 278-279 smoking rate, 255 Blood alcohol concentrations (BAC), 221 in automobile accidents, 88 biological markers of, 11, 155 in falls, 35 - 36 self-monitoring of, 62 and sleep, 273 Blood-gas exchange, 36 Blood pressure, 111, 115j 278 - 279 Bone, 282 Border effects, 79 Boston City Hospital, 218 Breath analysis, 11, 89, 159 Broadening the Base of Trea~n`ent rim. Alcohol Problems (IOM), vii "Cafeteria" matching strategy, 13 - 14, 232, 233, 242 CAGE questions, 221 Calcium carbimide, 172 Calcium channel blockers, 267, 26S, 279 California, 76 -327

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alcohol zoning in, 80 community prevention research, 82, 110, 112 Cancer, 23 heavy drinking and, 2%2 mortality, blacks, 255 prevention studies, 8, 117 - 118, 133 research, 316 treatment, 196 Carbohydrate-deficient transferrin, 156 Carbon disulfide breath analysis, 159 Carbon monoxide, 37 testing, 114, 118 Cardiac arrhythmias, 278, 279 - 280, 316 Cardiomyopathy, 278, 282 Cardiovascular collapse, 36 Cardiovascular disease community prevention studies, 7, 27, 111 - 115, 133 mortality, blacks, 255 smoking and, 118 Cardiovascular effects, 278 - 280 Ca rove ri n e, 268 Carrier Foundation, 186 Case finding, 221 Causes and Consequences of Alcohol Problems (IOM), vi, 1, 5, 20, 24, 47, 66, 267, 275, 282 Centers for Disease Control, 310 Central nervous system, 54, 267, 272, 275 - 278 Cesium fluoride, 156 Chemical aversion therapy, 175, 191 Child-abuse, alcohol and, 3, 38 Childhood factors, 53 Children of alcoholics, 145 coping skills training, 64 family dynamics and, 54 - 55 risk for, 5, 66 therapy groups, 181 - 182 treatment matching, 146, 237 Chlordiaz.epoxide, 170, 270, 274 Cholesterol levels, 111, 115 Chromosomal markers, 5, 66 Citalopram, 173 Clinical decision making, 233 Clinical examinations, 150 Clinical Institute Withdrawal Assessment for Alcohol (CIWA-A), 269 Clinical trials difficulties of, 291, 314 early intervention, 221 multicenter, 160, 162 Clinical Trials Cooperative Groups, 316 Clonidine, 252, 268 Cocaine craving, 258, 259 dependence, 259, 260, 272 dependence treatment, 256, 319, 320 Cocaine-alcohol dependency, 235, 238 Codependence, 145, 146 Cognitive-behavioral mediators, 65 Cognitive-behavioral processes, 57 Cognitive-behavioral therapy, 177, 184 Cognitive impairment, 15, 178, 267, 275 - 277 Cognitive restructuring, 5, 62~3, 177, 183, 277 - 278 Cognitive variables, 248-249 Cohort effects, 48, 55 - 56 College prevention programs, 129 Communication-behavior change model, 112 Communication-persuasion model, 112 Community change, 114 initiatives, 311 mental health centers, 143 reinforcement, 183, 197 as risk factor, 49, 50 Community Mental Health Centers Act, 141 Community organization model, 112, 113 Community-wide prevention, 7 - 8, 64, 130 alcohol, 10~110, 128 cardiovascular disease, 7, 27, 111 - 115 cost of data collection, 133 implications from other public health fields, 121 - 123 ~JIAAA and, 309 CompCare, 185 Compliance, 12, 193 - 194 with disulfiram therapy, 159, 171 Composite International Diagnostic Intelview, Substance Abuse Module (CID I-SAM), 1 50 Comprehensive Drinker Profile, lS0 Computerized assessments, 154, 157 Computer modeling, 129, 132, 133 - 134 Conditioned response, 58, 6(}61, 257 - 258 counterconditioning, 175 Condoms, 39 Confounding variables, 161 -328

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Confrontational therapy, 177, 181 - 182, 194 Conjoint therapy, 11 - 12, 181 - 182 Connecticut, University of, 313 Constructive confrontation, 194 Contamination, 130 Contemplation phase, 63 Contraceptive use, 120 Controlled trials importance of, 169, 198 intensity and duration of treatment, 12, 88 treatment evaluation, 187 in treatment matching studies, 232 Cooperative agreements, 316, 317, 318 - 319 Coping skills, 5 deficits in, 58, 250 training, 6102, 63, 65 Coronary artery disease, 278 Cost containment, 296 Cost-effectiveness Alcoholics Anonymous, 179 prevention, 9, 134 treatment, 16, 188, 289, 294 - 295 Cost offset effect, 15 - 16, 292 - 296, 299 Counterconditioning, 175 Counties, 76 Couples therapy, 12, 181-2 Court conviction rates, drunk-driving laws, 88 - 89 Covariance analysis, 161 Covert sensitization, 176 - 177, 191, 258 Craving, 14D, 152 antidipsotropics and, 172 cognitive, 58 drug, 257 - 258, 259 Criminal behavior, 38, 52 Criminal justice programs, 142 Critical conditions, 191 Cross-cultural research, 151 Cue exposure, 184, 185 Cultural change, 64 Data collection automation of, 157 - 158 cost of, 133 longitudinal, 56 Death. See Mortality Deglycosylated transferrin, 156 Delirium tremens, treatment of, 271, 272 Demography, 10, 143 - 144 Denial, 252 Depression, 170 comorbidity with alcoholism, 144, 174, 177, 178 in drug dependence, 250260 effect of alcohol on, 36 and smoking cessation, 250 Desialotransferrin, 156 Desipramine, 259, 260 Detection, 221 Detoxification, 169, 236 cocaine, 256 and sleep, 274 Developmental epidemiology, 27, 51 Dexamethasone, 272 Diagnosis, 15~151 Diagnostic Interview Schedule (DIS), 150, 152 Diagnostic and Statistical Manual of Mental Disorders (DSM-III), 1~11, 150, 151 Diagnostic and Statistical Manual of Mental Disorders, revised (DSM-III R), 150, 151, 235, 247 Diary procedures, 155 Diazepam, 268, 270, 272 Diet, 8, 117, 123, 275 Differential assessment, 11, 151 - 153 Diffusion theory, 112 Diphenylhydantoin, 27~271 Distilled spirits consumption, advertising and, 85 consumption, price and, 77 decline in consumption of, 145 Disulfiram therapy, 143, 158, 17~172, 239, 316 compliance with, 159, 171 --I-, 7 Diuretics, 279 Doxepin, 259 Dram shop laws. See Server liability Driving-while-intoxicated (DWI) behavioral self-control training and, 18~181 deaths from accidents, 23, 34, 78 drinking context and, 26, 93 education programs, 10, 84, 142 legal environment, 6, 87~0, 129 public interest groups on, 145 treatment programs, 194 and vehicular injuries, 34, 35 Drowning, 3, 31, 36 Drug use alcohol use and, 88 -329

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community prevention research, 109, 119 comorbidity with alcoholism, 14, 144, 258 conditioned responses, 257 - 258 during pregnancy, 40 placebo therapy, 217 school-based prevention programs, 27 psychopathology and, 174 psychopharmacological treatments, 25~260 psychotherapy, 256 - 257 and sexual activity, 39 treatment effectiveness, 300 verbal reporting, 154 withdrawal, 174 Drug-use stress, 57 Early identification, 13, 215, 221 Ecological fallacy, 131 Economic environment, 24, 90, 131 Economic Opportunity Act, 141 Edgehill Newport, 186 Educational intervention, 11 - 12, 178 pretesting of, 113 Effect-altering medications, 170, 173 - 174 Electrical aversion therapy, 175 Emetic drugs, 175 Emotions, 54, 58 Empathy, 192 Employee assistance programs, 10, 16, 194 - 195, 215, 224 and cost research, 297, 298 Encainide, 279 Endocrine organs, 282 Environment, 20 change in, 114 context and setting, 91~3 controls on alcohol availability, 75 - 80 individual interactions with, 6 - 7, 23, 26, 57 influences on drinking behavior, 81~3 legal, 24, 87 - 91, 122, 123, 310 and moderate drinking, 24 normative, 82 - 87 in public health model, 2, 24 - 25 risk factors in, 50 treatment and, 149 Epidemiological catchment area studies, 144, 162, 298 Epidemiology adolescent pregnancy, 40 alcohol-related problems, 2 - 3, 31, 144 child abuse, 38 - 39 crime, 38 developmental, 27, 51 fetal alcohol syndrome, 4(}41 injuries, 31 - 37 sexually transmitted diseases, 3~40 suicide, 38 Esophagus, 282 Ethanol. See Alcohol Ethnic groups, 52, 60 61 Ethnographic methods, 128 Etiology, 151 genetic factors, 49 methodology and, 32 preventive trials and, 25 prospective research opportunities, 55 - 56 Expectancies, learned, 5, 60, 62~3, 152 Experimental designs, methodology, 159, 160 Extinction procedures, 258 Falls, 3, 23, 31, 35, 36 Family genetic studies, 66 history of alcoholism, 5, 234, 235, 241 as risk factor, 49, 50, 54 - 55 and social learning, 58 and treatment, 1(), 144, 234, 235 Family therapy, 12, 181 - 182, 197, 24(}241 Federal employees alcohol program, 142 Feedback designs, 233, 242 Females alcohol-related problems in, 144 fire death risks, 37 inhibition of risk in, 55 pregnant, interventions with, 13, 142, 217 - 218 in prospective research, 52 in public information campaigns, 84 remission of problem drinking in, 53 and smoking cessation, 255 television and, X? treatment matching, 237, 238 Fermentation, 34 Fetal alcohol effects, 3, 13, 41, 217 - 218 Fetal alcohol syndrome (FAS), 3, 13, -330

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217 - 218 epidemiology, 4~41 Field research, 8, 128, 13~131 Finland, llS Fire and burns, 3, 31, 37 Fluoxetine, 173 Fluvoxamine, 173, 275 Follow-up studies, 55 Food labeling, 115 Formative evaluation, 7, 9, 113, 121 Formative research, 83 - 84, 113 - 114, 130, 133 Formula grants, 141, 142 France, Centers of Nutritional Hygiene, 216 Funding ,= , and evaluation of research, 132 and longitudinal data bases, 56 prevention research, 16 - 17, 309 treatment research, 17 - 18, 141 - 142, 146, 290, 313 - 320 Gamma glutamyl transpeptidase (GGT), 155 - 156, 216, 221 Gender differences, 56, 81. See also Females; Males Genetic determinants in aversion therapy, 176 of maternal alcohol metabolism, 40, 41 of risk for alcohol problems, 5, 47, 49, 66, 222 Great Britain, 89 Group psychotherapy, 177, 194, 239, 257 Hallucinosis, 272 Ha lo perido l , 272 Happy hours, 77, 129, 131 Hazelden treatment model, 185 Head Start, 255 Health care cost offset of treatment, 15 - 16, 292 - 296, 299 costs, 15 Health Care Financing Administration, 316 Health care professionals, 13, 224 Health consciousness, 59, 145 Health insurance and adolescent care, 300 cost offsets and, 292 costs, 296 - 299 industry, 236, 315, 319 policy analysis, 290 reimbursement policy, 9, 142, 188, 224, 236, 240, 297 and smoking Cessation, 255 Health maintenance organizations (HMO), 143, 215, 294, 298, 299 Heart, 282 Heavy drinkers, vi, 23 and alcohol-related problems, 144 biological markers and, 221 brief interventions and, 216 cardiovascular risks, 278 differentiation of, 131 and expectancies, 60 health risks, 282 interventions for, 145 liver effects, 280 - 281 self-monitoring training, 62 stroke risk, 279 treatment recruitment, 223 Hematopoietic system, 282 Hemoglobin acetaldahyde adduct (Al factor, 156 Hepatic cirrhosis, 156, 28~281 mortality, 15, 267 as surrogate measure of drinking, 77 Hepatitis, 155, 156, 280-281 Heroin addicts, 181 High-density lipoprotein cholesterol (HDLC), 156 High-fiber cereals, 117, 118 Hispanics, 144, 238 Historical analysis, 128 HIV infection, 3~40 Homeless persons, 10, 144, 237; 270 Homicide, alcohol and, 38 Homosexuals, 39 Hospitalization, 154, 181, 188 - 189, 239 Host. See Individual Hughes Act (1971), 141 Hyperactive behavior, 4, 52, 54 Hypercapnia, 267 Hypertension, 278 - 279, 319 Hypothermia, 36 Hypoxia, 280 Ibuprofen, 267 Illinois, 79 Immunological tests, 221 Implementation analysis, 113 Impulsiveness, 54 Incentives, 117 Income, 90 Indalpine, 173 -331

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Indiana, 109 Indicated interventions 2, 26, 53 treatment as, 140 Individual behavior change, 114, 120, 123, 131 consumption history, 131 development of, 47, 55, 132 environmental interaction, 3 - 5, 26, 47,50,57,75 in public health model, 2, 24 - 25 risk factors in, 49 Individual therapy, 159, 177, 239, 24~241, 257 . , . . injuries epidemiology of, 3, 31 - 37 falls, 23, 31 methodological problems in studying, 32 - 34 vehicular, 34, 35, 88 Inoculation, social, 84, 132 Inpatient treatment, - 10, 142, 143, 170 costs, 291 Insight-oriented therapy, 177 Insomnia, 273 - 275 Institute of Medicine (IOM), vi, vii, 1, 24, 47, 231, 267 Insurance Institute for Highway Safety, 88 International Classification of Diseases (ICD-10), 150, 151 Interrupted time-series analysis, 129 Intoxication environmental interaction and, 23, 26 estimating, 130 health consequences, 267 risk of other problems, 215 social norms and, 60 Investigator-initiated grant, 16, 142, 309, 313, 314, 319 Job performance, 221 JWK Corporation, 290 Kaiser-Permanente, 278, 298 Kansas, 109 Kellogg Company, 8, 117 Labeling, 223 Laboratory research, 8, 128, 13~131 Labyrinthitis, caloric, 36 LaIyngospasm, 36 Least-squares regression, 129 Legal environment, 24, 87~1, 121, 123, 310 Liability insurance, 91 5, Life-course development, 4, 132 identification of risk factors, 47 - 50 and readiness to change, 64, 65 Liquor. See Distilled spirits Liquor by the drink (LBD), 76 Lithium, 174, 267 Liver. See also Hepatic cirrhosis; Hepatitis disease, 23 dysfuntion, 37 effects of alcohol on, 15, 280 281 enzymes, 155 - 156, 216 transplantation, 281 Lofexidine, 268 Longitudinal research, 133, 146 data bases, 56 methodological problems, 295 Lorazepam, 270 Los Angeles, 119 Maine, 89 90, 129 Males alcoholic fathers and, 54 comorbidities in, 235 remission of problem drinking in, 53 risk factors, 4, 37, 52 Managed care, 16, 296, 298 Mandated treatment, 12, 145, 194 - 195 Marijuana, 34 community prevention research, 109 in smoking prevention studies, 119 Marital conflict, 4, 52 Marital therapy, 181 - 182, 197 Massachusetts drunk driving laws, 89 minimum drinking age, 78 - 79 Media alcohol advertising, 6, 85 - 86 in community prevention studies, 7, 111, 117, 128 fictional depictions of alcohol use, 6, 86 - 87 public information campaigns, 6, 82 - 85, 88, 89 in smoking prevention, 119 social learning and, 58, 60 treatment recruitment, 143, 162, 223 Medication, 196 abuse and dependence, 174 in smoking cessation, 252 Meditation, 183 Memos, 154, 275 - 276 training, 277 -332

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Men. See Males Mental health, 63 Mental retardation, maternal drinking and, 40 Meprobamate, 268 Meta-analysis, 290, 291, 292 Methadone maintenance, 170, 181, 259 Methodology cost research, 295 patient-treatment matching, 231 - 233 policy analysis, 290 - 292 prevention research design, 8 - ,128 - 134 problems with self-reported data, 11 problems in studying alcohol-related injuries, 3, 32 - 34 problems in treatment evaluation, 186 - 187 proxy variables, 120 treatment research, 15~163 Michigan minimum drinking age, 79 seat belt law, 116 Michigan Alcoholism Screening Test (MAST), 152, 221 Midwestern Prevention Project (MPP), 109 Minimum purchase age, 6, 75, 76, 78 - 80, 87 Minnesota Heart Health Study, 115, 130 Minnesota Multiphasic Personality Inventory, 234 Minnesota treatment model, 185 Minorities - in prospective research, 52 television and, 87 Missouri, 109 Model Alcoholic Beverage Retail Licensee Liability Act (1985), 90 Moderate drinkers, 23 biological markers in, 156 differentiation of, 131 and environmental factors, 24 in treatment outcome, 21~220 Moderation, as treatment goal, 13, 61, 218 - 220, 223 Moral deficiencies, 57 Mortality alcohol availability and, 76, 77 alcohol use, vi, 1, 23 automobile accidents, 23, 34, 78 cardiovascular disease, 112, 255 cirrhosis and hepatitis, 15, 77, 267, 280 drowning, 36 early intervention and, 224 falls, 35 fire and burns, 37 injuries, 3, 31 Mothers Against Drunk Driving, 87, 110 Motivation for change, 12, 63 64, 65, 193 - 195, 235, 251 - 252 Movie theaters, 84 Multistage sampling, 56 Multivariate analysis, 55, 129, 131, 161, 232 Muscle, 282 Music Television, 84 Mutual help groups, 11 - 12, 119, 178 - 180 Naloxone, 267 Naltrexone, 259 Narcotics Anonymous, 186, 300 National Alcoholism and Drug Abuse Program Inventory (NDAPI), 161 National Alcoholism Program Information System (NAPIS), 142 National Association of Alcoholism Treatment Programs, 161 National Cancer Institute (NCI), 8, 17, 117, 309, 310, 313, 316 National Drug and Alcoholism Treatment Utilization SuIvey (NDATUS), 161 - 162 National Health Interview Survey, 144 National Heart, Lung, and Blood Institute (NHLBI), 17, 309, 310, 313, 316, 319 National Highway Traffic Safety Administration, 80, 92 National Institute on Alcohol Abuse and Alcoholism (NIAAA), vi, vii, 1, 9, 20 aggregate-level studies, 161 Alcohol Research Centers, 17 - 18, 315, 318 and community prevention study, 110, 133 cooperative research, 316 and diagnosis, 150 Division of Clinical and Prevention Research, 9, 17, 142, 309, 313 intramural research, 142 and longitudinal data bases, 56 preventive research funding, 16, 309 prevention research -333

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recommendations, 310, 311, 312 treatment funding, 16, 141 - 142, 146, 290 treatment research funding, 313, 318, 319, 320 National Institute of Mental Health (NIMH), 141, 316, 319 Treatment of Depression Collaborative Research Program, 318 National Institute on Allergy and Infectious Diseases, 313, 316 National Institute on Drug Abuse (NIDA), 17, 110, 146, 310, 314, 315, 318, 319 National Institutes of Health (NIH), 30~310, 313, 316, 317 National Research Centers Program, 142 National Research Council, vii, 20, 24 Native Americans, 40, 237 Naturalistic studies, 92~93, 131, 291 Natural raters, 49, 50 Nausea, induced, 175, 176 Needs analysis, 113 - 114, 121 Nerves, peripheral, 282 Neurophysiological variables, 49 Nevada, 76 New Hampshire, 76 Newspapers, 87 New York, 79 Nicotine chewing gum, 253 Nicotine fading, 253 - 254 Nootropic drugs, 278 Norepinephrine reuptake, 173 Normative environment, 24, 26, 48, 82 - 87 North Carolina, 76 North Karelia Project, 115 Norzimelidine, 173 Nutrition education, 115 Observational learning, 59 60 Observational studies, 128 Occupational alcohol programs, 142 Office of Economic- Opportunity, 141 Office of Substance Abuse Prevention (OSAP), 17, 309, 310, 311, 313 Omnibus Anti-Drug Abuse Act (1986), 309 Ontario, Canada, 76, 77 Ontario Detoxication System, 269 Ontogenetic influences, 48 Operating-under-the-influence. See Driving-while-intoxica ted Opiate abuse, 258, 272, 319 antagonists, 173 withdrawal, 259 Organ damage, 154, 155, 267 Osteoporosis, 35 Outcome. See Treatment: effectiveness of Outpatient treatment, 183, 216 costs, 291, 293 patient-treatment matching, 239, 240, 241 social supports and, 13, 234 Oxazepam, 269 - 270 Pancreas, 282 Paranoia, 272 Partial correlation, 161 Path-analytic procedures, 132 Patient-treatment matching, 13 - 14, 14~150, 237 - 241 methodology, 231 - 233 patient measurement, 233 - 235, 241 readiness to change and, 248 recommendations, 241 - 242, 315 treatment measurement, 235 - 236 Pavlovian learning theory, 191 Pawtucket Heart Health Study, 115, 129 Peer groups coping skills training and, 61, 119 as risk factor, 49, 50, 55 social learning and, 58, 60 Pennsylvania, 115 Per se laws, 87, 88 Personality tests, 234 Personality variables, 49 Pharmacotherapies, 11 - 12, 17~175, 261 alcohol withdrawal, 268 - 269 drug dependence, 25~260 Phenobarbital, 271 Phenothiazine, 312 Physical deformities, maternal drinking and, 40 Physician counseling, 254 Physiological indicators of susceptibility, 66 Placebo therapy, 217 Planned Approach to Community Health, 310 Platelet monoamine oxidase, 156 Point-of-purchase components, 115 Police enforcement, 88 - 89, 131 Policy development, vii, 9, 15 - 16, 20, 133 - 134 -334

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analysis, 290 292, 299 patient attitudes and, 301 Pregnancy adolescent, 3, 8, 40, 11~120 drinking during, 40 interventions, 13, 142, 217 - 218 Prevention Demonstration and Education Program, 309 Prevention research cost-effectiveness, 9, 134 funding, 16~17, 309 implications of social learning theory, 59 61 importance of theory, 12~130 limitations of, 110 methodology, 128 - 130 program design, 128 131 recommendations, 131 133 practical significance of, 131 process evaluation, 7, 121, 129 public health perspective and, 26 - 28 systems approach, 27 - 28 Preventive trials, 25 - 26, 51 implications from prospective research, 53 - 56 interventions with pregnant women, 13, 142, 217 - 218 life-course development and, 53 - 56 recommended, 310 Primary care, 224, 240, 242 Primary prevention, 1 - 2, 26, 53 adolescent pregnancy, 11~120 and adolescents, 121 cancer, 117 - 118 cardiovascular disease studies, 111 - 115 coping skills training, 61~2, 65 prospective research and, 5~51 seat belt use, 116 - 117 smoking, 118 - 119 Private industry, - 10, 117 - 118, 142, 143 Problem behavior theory, 57 Prohibition, 48, 75 Propylthiouracil (PTU), 155, 280 281 Prospective research implications for preventive trials, 53 - 56 limitations of, 52 - 53 risk factor identification, 5~52 Prostaglandin E, 156 Psychiatric Diagnostic Interview (PDI), 150 Psychiatric disorders alcoholism comorbidity, 144, 153, 174, 177, 178, 241, 319 diagnosis, 13, 150, 234 drug dependence comorbidity, 261 and medical care utilization, 297 and treatment outcome, 152 Psychological interventions, 173 Psychological learning theory, 152 Psychosis, 170, 319 Psychotherapy, 11 - 12,177 - 178,240,261 in drug treatment, 256 - 257 Psychotropic medication, 170, 174, 178, 257 Public health model of alcohol-related problems, 2, 24 - 27 Public Health Service, 18, 316 Public Health Service Act, 315 Public information campaigns, 6, 82 - 85 Public service announcements, 84, 113 Punishment, 60 Quanine nucleotide, 156 Quasi-experimental designs, 129, 131, 198 data for, 157 methodology, 8, 159, 16~161 patient-treatment matching, 232 treatment evaluation, 187 Radio, 84 Rand Corporation, 142, 298, 315 Readiness to change, 5, 63~4, 65, 235, 248 Recall cues, 155 Reciprocal determinism, 57 Red blood cells, mean corpuscular volume (MCV), 156, 221 Reinforcement, 60 61 Relapse prevention, 11 - 12,169,170,235 alcohol administration in, 176 broad-spectrum treatment in, 182 calcium carbimide in, 172 compliance, 194 outcome research, 184 - 185 patient-treatment matching, 24~241, 242 research on, 152, 18~190 smoking, 250 Research See also Methodology; Prevention research; Research opportunities; Treatment formative, 83 - 84, 113 - 114, 130, 133 -335

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recommendations, vii study Types, 32 - 33 Research opportunities adolescent treatment, 300 advertising, effects of, 86 alcohol availability, 81 alcohol-impaired driving, 90 alcohol withdrawal, 272, 273 antidipsotropics, 172 aversion therapies, 176 - 177 behavioral self-control training, 181 biological markers, 157 broad-spectrum treatment, 184 cardiovascular effects, 279, 280 cognitive impairment, 277, 278 cognitive variables, 249 conditioned responses, 258 cost offset, 295 - 296 data collection, 157 - 158 diagnosis, 151 differential assessment, 153 drinking context, 93 education, 178 effect-altering medications, 173 - 174 health insurance, 298 - 299 liver transplantation, 281 longitudinal data bases, 56 managed care, 296 methodology, 162 - 163, 233, 292 motivation, 195, 252 outcome variables, 159 patient-treatment matching, 235, 236, 238 - 239, 240242 physician counseling, 255 prevention, 2 - , 31~312 prospective etiology studies, 55 - 56 psychopharmacological treatments, 260 psychotherapy, 178, 180, 182, 257 psychotropics, 175 public information campaigns, 84 public policy, 301 relapse prevention, 185, 190, 250 sleep disorders, 275 smoking cessation, 248 social learning models, 65~6 social support, 251 special populations, 255 stages of change, 248 therapist variables, 192 - 193 traditional treatment programs, 188 treatment, - 16, 146, 189, 191, 254, 290 verbal report methods, 154 - 155 Resistance skills training, 124 Response effects, 154 Restaurants, 92 Restriction fragment-length polymorphisms (RFLP), 66 Rhode Island, 115 Riboflavin, 159, 280 Risk factors behavioral, 49, 215 biological, 57, 149 environmental, 4, 50 genetic, 5, 66 identification of, 47, 5 ~ 52, 53 intraindividual, 4, 49 in preventive trials, 25 Risk-taking behavior, 35 Role models, 58, 63, 65 Romberg test, 35 Royal Edinburgh Infirmary, 216 San Diego VA Hospital, 313 Schizophrenia, 50, 174, 235, 260, 312 School achievement, 4, 52 School-based prevention, 128, 130 adolescent pregnancy, 8, 11~120 School counselors, 224 Scientist Development Clinicians, 314, 319 Screening, 13, 221 - 222, 224 Seasonality, 129 Seat belt use Award for alcohol use and, 34, 88 legislation and, 8, 124 promotion campaigns, 8, 116 - 117. 121 Secondary prevention, 2, 26, 53, 215, 221 coping skills training, 61ff2, 65 Seizures, treatment of, 27~271 Selected interventions, 2, 26, 64 life-course development and, 53 - 54 Self-efficacy, 5, 58, 59, 65, 184, 191, 248, 249 Self-esteem, 57, 177 Self-help, 239 manuals, 13, 112, 215 - 216, 223, 235, 253 smoking cessation, 261 Self-monitoring, 5, 62, 253 Self-regulation, 57, 58, 60 Self-selection, treatment, 233, 237 - 238 Serotonin uptake inhibitors, 173 -336

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Server interventions, 6, 26 - 27, 91~2, 129 Server liability, 6, 90 91 Sexual activity, 3, 39, 40 Sexual dysfunction, 172 Sexually transmitted diseases, 3, 3~40 Shy behavior, 4, 52, 55 Side effects disulfiram, 172 zimelidine, 173 Sleep disorders, 273 - 275 SMART, Project, 119 Smoking and alcohol dependence, 14, 144, 260 and cardiovascular disease, 111, 115 cues, 258 during pregnancy, 40 and house fires, 37 withdrawal, 252, 253, 259 Smoking cessation approaches to change, 261 cost-effectiveness, 112 incentives, 117 quit-smoking contests, 113, 114, 119 readiness to change stages, 63 special populations, 255 treatment methods, 252 - 254 treatment process, 247 - 252 Smoking prevention programs and alcohol use, 130 community prevention research, 8, 109, 118 - 119, 123 inoculation in, 84 school-based, 27 Social adaptational status (SAS), 49, 50 Social drinkers, 131 Social fields, 49, 50 Social host liability, 91 Social instability, 152 Social learning theory, 182 and behavior change, 112, 132 and fictional drinking depictions, 86 implications for prevention research, 59~1 models of, 4 - 5, 47, 57 - 59, 66 Social marketing, 112 - 113, 117, 121, 123, 133 Social norms, 57, 130, 132 Social pressure resistance training, 118 Social skills training, 183, 191, 197 Social stability/social supports, 13, 234, 25~251 Socioeconomic status, 32, 38 39, 241 Soothability, 54 South Africa, 115 Soviet Union, 175 Speeding, 6, 34, 88, 89 90 Spontaneous fractures, 35 Spontaneous remission, 52 53 Stanford Center for Research in Disease Prevention, 310 Stanford Five-City Project (FCP), 7, 111 - 115, 119, 130, 311 Stanford Three-Community Study (TCS), 7, 111 - 115, 130, 311 STAR, Project. See Midwestern Prevention Project State laws alcoholic beverage control (ABC) commissions, 75, 76 drinking age, 87 drunk driving, 87~0 seat belt use, 116 Stomach, 282 Stress management training, 183, 197 Stroke, 279 Structural modeling, 132 Structured diagnostic interviews, 152 Student assistance programs, 21S Students Against Drunk Driving, 87, 110 Suicide, 3, 36, 38 Surgeon General's Report on Smoking and Health (1964), 119 Survival model, 184 Sweat markers, 11, 155 Sweden, 223 Switzerland, 115 Synergism, 27, 130, 133 Systems approach, 27-28 Tachyarrhythmias, 279 Taste aversion therapy, 176 Taxation, 75, 76, 77, 110 Telephone surveys, 154 Television alcohol advertising, 84 - 85 influences on drinking behavior, 82, 86 - 87 public information campaigns, 84 - 85 Temperament, 49, 54 Temperance movement, 127 Texas, 79 Theory, importance of, 7, 8, 12~130, 132 Therapist variables, 12, 158, 191 - 193, 195, 197 -337

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Time-line follow-back, 155 Tissue damage, 15, 156, 157 Tourism, 76 Transfernn, 221 Treatment. See also Patient-treatment matching alcohol withdrawal, 268 - 275 assessment of, 158 - 159 brief interventions, 12, 13, 216 - 217, 221, 224, 235, 239 broad-spectrum strategies, 11 - 12, 182 - 184 cognitive impairment and, 276 cost of, 15, 143, 188, 290, 291, 292 cost-benefit analysis, 280290 cost-effectiveness analysis, 16, 289, 294 - 295 cost offset effect, 15 - 16, 292 - 296, 299 demography and epidemiology, 143 - 145 early intervention, 215 - 216, 221,224 effectiveness, 195 - 198, 289 - 290, 29~300 evaluation of, 8, 11 - 12, 121, 142, 14~150, 237, 310 outcome expectancies, 248 - 249 outcome objectives, multiple, 120 outcome research, 169 - 170, 218 - 220 outcome variables, 159 efficacy, 231, 242, 313 - 314 mechanisms of, 19(~191 efficiency, 290 funding, 9, 17 - 18,141 - 142,313 - 320 historical factors in, - 10 implementation, 224 as indicated intervention, 140 intensity and duration of, 12, 14, 188 - 189, 239 methodology, 15~163 phases of, 169 process, 12, 158, 159, 19(~195, 197 - 198, 248 - 252 recruitment, 9 - 10, 223 research methodology, 159 - 163 research recommendations, 9 - 16, 146 setting, 315 smoking cessation, 253 - 254 traditional programs, evaluation of, 185 - 187 trends in, 142 - 143, 145 variables, 158 Treatment centers, data reporting, 161 - 162 Tryptophan, 278 Uncontrolled studies, 169 treatment evaluation, 12, 186, 187 Unemployment rates, and drunk driving, 88 Universal interventions, 2, 26, 53, 64 Urine markers, 11, 155, 280 281 United States Air Force, 290 Coast Guard, 36 Congress, vi, 1, 142, 185, 315 Department of Defense, 311, 316, 319 Department of Education, 311 Department of Health and Human Services, 311 Department of Transportation, 89, 311, 319 Navy, 91 Ventricular fibrillation, 279 Verbal report methods, 11, 153 - 155 Vermont, 76 Veterans Administration, 141 clinics, 170 collaborative study, 18, 174 funding, 16 hospitals, 143 prevention research, 311 treatment research funding, 313, 316, 318, 319, 320 Videocassettes, 84 Violence, 3, 33, 38 Viqualine, 173 Vitamins, 275 Vulnerability. See Risk factors Warning labels, 41 Washington, D.C., 76, 117 Washington, University of, 40 Wernicke-Korsakoff syndrome, 275 Wine consumption, advertising and, 85 Women. See Females Women for Sobriety, 179 Work setting, as risk factor, 49, 50, 93 Work site prevention trials, 128, 130 -338

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Mark sHe-b=~ in=nl~, 8, 116, 117, 120 ma_ ~, 1 alcohol awry pm~m, 319 Sol Use Dbo~e~ Identi0=lion ~1 (AIDS, 2~ ~1~1 Pawn ~5 ~meUdine, 173, ~7, 278 atoning and ~ndidonaL~e permits 76, -339