Key to an understanding of alcohol use disorder (AUD) are the drinking-related reductions that begin in young adulthood and continue throughout the adult lifespan. Research is needed to precisely characterize the form of these reductions, including possible developmental differences across the lifespan. Using U.S.-representative data, we estimated multiple-group Markov models characterizing longitudinal transitions among five drinking statuses and differences in transition patterns across six adult age periods. While past research indicates relative developmental stability in overall AUD-desistance rates, we found far higher rates of Severe AUD desistance in young adulthood relative to later ages. Especially considering the dramatic change reflected by Severe AUD desistance (from 6+ symptoms to 0–1 symptoms), this result indicates a substantial developmental shift, with Severe AUD desistance rates peaking at 43% to 50% across ages 25 to 34 and then dropping to 22% to 24% across ages 35 to 55. We discuss implications regarding practical significance of young-adult “maturing out” and predictions regarding lifespan variability in desistance mechanisms.
AdamsW. L.SmithN. S. (1995). Epidemiology of problem drinking among elderly people. The International Journal of the Addictions, 30(13–14), 1693–1716.
2.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
3.
BachmanJ. G.WadsworthK. N.O’MalleyP. M.JohnstonL. D. (1997). Smoking, drinking, and drug use in young adulthood: The impacts of new freedoms and new responsibilities. Hillsdale, NJ: Lawrence Erlbaum Associates, Inc.
4.
CaetanoR.BaborT. F. (2006). Diagnosis of alcohol dependence in epidemiological surveys: An epidemic of youthful alcohol dependence or a case of measurement error?Addiction, 101(Suppl. 1), 111–114. doi: 10.1111/j.1360-0443.2006.01599.x
5.
ChassinL.SherK. J.HussongA.CurranP. (2013). The developmental psychopathology of alcohol use and alcohol disorders: Research achievements and future directions. Development and Psychopathology, 25(4pt2), 1567–1584.
6.
ChatfieldM. D.BrayneC. E.MatthewsF. E. (2005). A systematic literature review of attrition between waves in longitudinal studies in the elderly shows a consistent pattern of dropout between differing studies. Journal of Clinical Epidemiology, 58(1), 13–19.
7.
CicchettiD.TothS. L. (2009). The past achievements and future promises of developmental psychopathology: The coming of age of a discipline. Journal of Child Psychology and Psychiatry, 50(1–2), 16–25.
8.
CurranP. J.MuthenB. O.HarfordT. C. (1998). The influence of changes in marital status on developmental trajectories of alcohol use in young adults. Journal of Studies on Alcohol, 59, 647–658.
9.
DerrickJ.LeonardK. (2016). Substance use in committed relationships. In SherK. J. (Ed.), The Oxford handbook of substance use and substance use disorders (pp. 549–578). New York, NY: Oxford University Press.
10.
GfroererJ.PenneM.PembertonM.FolsomR. (2003). Substance abuse treatment need among older adults in 2020: The impact of the aging baby-boom cohort. Drug and Alcohol Dependence, 69(2), 127–135.
11.
GossopM.NetoD.RadovanovicM.BatraA.TotevaS.MusalekM.SkutleA.GoosC. (2007). Physical health problems among patients seeking treatment for alcohol use disorders: A study in six European cities. Addiction Biology, 12(2), 190–196.
12.
GothamH. J.SherK. J.WoodP. K. (2003). Alcohol involvement and developmental task completion during young adulthood. Journal of Studies on Alcohol, 64, 32–42.
13.
GrantB. F.KaplanK. K.StinsonF. S. (2005). Source and accuracy statement for the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism.
14.
HaenyA. M.LittlefieldA. K.SherK. J. (2014). Repeated diagnoses of lifetime alcohol use disorders in a prospective study: Insights into the extent and nature of the reliability and validity problem. Alcoholism: Clinical and Experimental Research, 38(2), 489–500.
15.
HanB.GfroererJ. C.ColliverJ. D.PenneM. A. (2009). Substance use disorder among older adults in the United States in 2020. Addiction, 104(1), 88–96.
16.
HarfordT. C.GrantB. F.YiH.ChenC. M. (2005). Patterns of DSM-IV alcohol abuse and dependence criteria among adolescents and adults: Results from the 2001 national household survey on drug abuse. Alcoholism: Clinical and Experimental Research, 29, 810–828. doi:10.1097/01.ALC.0000164381.67723.76
17.
JacksonK. M.SartorC. E. (2016). The natural course of substance use and dependence. In SherK. J. (Ed.), The Oxford handbook of substance use and substance use disorders (pp. 67–134). New York, NY: Oxford University Press.
18.
JohnstonL. D.O’MalleyP. M.BachmanJ. G.SchulenbergJ. E.MiechR. A. (2014). Monitoring the Future national survey results on drug use, 1975-2013: Volume II, college students and adults ages 19-55. Ann Arbor: Institute for Social Research, The University of Michigan.
19.
KaplanD. (2008). An overview of Markov chain methods for the study of stage-sequential developmental processes. Developmental Psychology, 44(2), 457.
20.
KerrW. C.GreenfieldT. K.BondJ.YeY.RehmJ. (2009). Age–period–cohort modelling of alcohol volume and heavy drinking days in the US National Alcohol Surveys: Divergence in younger and older adult trends. Addiction, 104(1), 27–37.
21.
KlingemannH. K.SobellL. C. (2007). Promoting self-change from addictive behaviors: Practical implications for policy, prevention, and treatment. New York, NY: Springer.
22.
LeeM. R.ChassinL.MacKinnonD. (2010). The effect of marriage on young adult heavy drinking and its mediators: Results from two methods of adjusting for selection into marriage. Psychology of Addictive Behaviors, 24, 712–718. doi:10.1037/a0020983
23.
LeeM. R.ChassinL.VillaltaI. K. (2013). Maturing out of alcohol involvement: Transitions in latent drinking statuses from late adolescence to adulthood. Development and Psychopathology, 25(4pt1), 1137–1153.
24.
LeeM. R.SherK. J. (in press). “Maturing out” of binge and problem drinking. Alcohol Research: Current Reviews.
25.
LiT. K.HewittB. G.GrantB. F. (2007). Is there a future for quantifying drinking in the diagnosis, treatment, and prevention of alcohol use disorders?Alcohol and Alcoholism, 42(2), 57–63.
26.
MartinC. S.ChungT.LangenbucherJ. (2016). Historical and cultural perspectives on substance use and substance use disorders. In SherK. J. (Ed.), Oxford handbook of substance use and substance use disorders (pp. 29–49). New York, NY: Oxford University Press.
27.
MillerW. R.RollnickS. (2002). Motivational interviewing: Preparing people for change (2nd ed.). New York, NY: Guilford Press.
28.
MoffittT. E.CaspiA.TaylorA.KokauaJ.MilneB. J.PolanczykG.PoultonR. (2010). How common are common mental disorders? Evidence that lifetime prevalence rates are doubled by prospective versus retrospective ascertainment. Psychological Medicine, 40(6), 899–909.
29.
MuthénL. K.MuthénB. O. (2012). Mplus user’s guide (7th ed.). Los Angeles, CA: Muthén & Muthén.
30.
National Institute on Alcohol Abuse and Alcoholism. (2008). Wave 2 NESARC data notes. Rockville, MD: Author.
O’ConnellH.ChinA. V.CunninghamC.LawlorB. (2003). Alcohol use disorders in elderly people—Redefining an age old problem in old age. BMJ, 327(7416), 664–667.
33.
RadlerB. T.RyffC. D. (2010). Who participates? Accounting for longitudinal retention in the MIDUS National Study of Health and Well-Being. Journal of Aging and Health, 22(3), 307–311.
34.
RutterM. (1989). Age as an ambiguous variable in developmental research: Some epidemiological considerations from developmental psychopathology. International Journal of Behavioral Development, 12(1), 1–34.
35.
SchulenbergJ.MaggsJ. L.O’MalleyP. M. (2003). How and why the understanding of developmental continuity and discontinuity is important: The sample case of long-term consequences of adolescent substance use. In MortimerJ. T.ShanahanM. (Eds.), Handbook of the life course (pp. 413–436). New York, NY: Kluwer Academic/Plenum Publishers.
36.
SobellL. C.EllingstadT. P.SobellM. B. (2000). Natural recovery from alcohol and drug problems: Methodological review of the research with suggestions for future directions. Addiction, 95(5), 749–764.
37.
StaffJ.SchulenbergJ. E.MaslowskyJ.BachmanJ. G.O’MalleyP. M.MaggsJ. L.JohnstonL. D. (2010). Substance use changes and social role transitions: Proximal developmental effects on ongoing trajectories from late adolescence through early adulthood. Development and Psychopathology, 22, 917–932.
38.
StallR.BiernackiP. (1986). Spontaneous remission from the problematic use of substances: An inductive model derived from a comparative analysis of the alcohol, opiate, tobacco, and food/obesity literatures. Substance Use & Misuse, 21(1), 1–23.
39.
VergésA.JacksonK. M.BucholzK. K.GrantJ. D.TrullT. J.WoodP. K.SherK. J. (2012). Deconstructing the age-prevalence curve of alcohol dependence: Why “maturing out” is only a small piece of the puzzle. Journal of Abnormal Psychology, 121(2), 511–523.
40.
VergésA.SteinleyD.TrullT. J.SherK. J. (2010). It’s the algorithm! Why differential rates of chronicity and comorbidity are not evidence for the validity of the abuse-dependence distinction. Journal of Abnormal Psychology, 119, 650–661.
41.
WatsonA. L.SherK. J. (1998). Resolution of alcohol problems without treatment: Methodological issues and future directions of natural recovery research. Clinical Psychology: Science and Practice, 5, 1–18.
42.
YamaguchiK.KandelD. B. (1985a). Dynamic relationships between premarital cohabitation and illicit drug use: An event-history analysis of role selection and role socialization. American Sociological Review, 50, 530–546.
43.
YamaguchiK.KandelD. B. (1985b). On the resolution of role incompatibility: A life event history analysis of family roles and marijuana use. American Journal of Sociology, 90, 1284–1325.
44.
ZuckerR. A.HicksB. M.HeitzegM. M. (2016). Alcohol use and the alcohol use disorders over the life course: A cross-level developmental review. In CicchettiD. (Ed.), Developmental psychopathology: Risk, disorder, and adaptation (Vol. 3, pp. 1–40). Hoboken, NJ: Wiley.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
