Academic journal article Alcohol Research

Introduction to the National Epidemiologic Survey on Alcohol and Related Conditions

Academic journal article Alcohol Research

Introduction to the National Epidemiologic Survey on Alcohol and Related Conditions

Article excerpt

In 2001/2002, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) conducted the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), the largest and most ambitious comorbidity study ever conducted. In addition to an extensive battery of questions addressing present and past alcohol consumption, alcohol use disorders (AUDs), and utilization of alcohol treatment services, NESARC included similar sets of questions related to tobacco and illicit drug use (including nicotine dependence and drug use disorders). Furthermore, NESARC contained questions that operationalized the criteria set forth in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) for the following psychiatric disorders:

* Five mood disorders (major depressive disorder, bipolar I and bipolar II disorders, dysthymia, and hypomania)

* Four anxiety disorders (panic with and without agoraphobia, social phobia, specific phobia, and generalized anxiety)

* Seven personality disorders (avoidant, dependent, obsessive-compulsive, paranoid, schizoid, histrionic, and antisocial disorders).

The unprecedented sample size of NESARC (n = 43,093) made it possible to achieve stable estimates of even rare conditions. Moreover, its oversampling of Blacks and Hispanics as well as the inclusion of Hawaii and Alaska in its sampling frame yielded enough minority respondents to make NESARC an ideal vehicle for addressing the critical issue of race and/or ethnic disparities in comorbidity and access to health care services.

NESARC's diagnostic classifications were based on the Alcohol Use Disorder and Associated Disability Interview Schedule-DSM-IV Version (AUDADIS-IV), a state-of-the-art, semistructured diagnostic interview schedule designed for use by lay interviewers. The reliability and validity of this instrument have been documented in a wide range of international settings, using both general population and clinical samples (for an extensive list of publications on reliability and validity, see the data notes section of the NESARC Web site).

GENERAL CHARACTERISTICS AND PURPOSE OF NESARC

The NESARC longitudinal survey consists of a first wave (Wave 1), which was conducted from 2001 to 2002, and a second wave (Wave 2), which was conducted from 2004 to 2005. The NESARC sample represents the civilian, noninstitutionalized adult population of the United States, including residents of the District of Columbia, Alaska, and Hawaii. It includes people living in households, military personnel living off base, and people residing in the following group quarters: boarding or rooming houses, nontransient hotels and motels, shelters, facilities for housing workers, college quarters, and group homes. All potential NESARC respondents were informed in writing about the nature of the survey, the statistical uses of the survey data, the voluntary aspect of their participation, and the Federal laws that rigorously provide for the confidentiality of identifiable survey information. Respondents who consented to participate after receiving this information were interviewed. The research protocol, including informed-consent procedures, received full ethical review and approval from the U.S. Census Bureau and the U.S. Office of Management and Budget.

Data were collected in face-to-face, computer-assisted personal interviews conducted in respondents' homes. The NESARC response rate was 81 percent.

The major purposes of the Wave 1 and Wave 2 NESARC are to:

* Determine the prevalence, incidence, stability, and recurrence of AUDs and their associated disabilities in the general U.S. population.

* Estimate the magnitude of health disparities in AUDs and their associated disabilities among population subgroups defined by gender, race/ethnicity, disability, sexual orientation, age, and socioeconomic status.

* Estimate the size, characteristics, and changing nature of populations of special concern, including alcohol abusers and other people in the general population who are impaired or affected by the use of alcohol (e. …

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