Limits...
Alcohol use and spousal mental distress in a population sample: the Nord-Trøndelag Health Study.

Rognmo K, Torvik FA, Røysamb E, Tambs K - BMC Public Health (2013)

Bottom Line: However, the picture seems to be more complex, as some results do not show a significant effect or even less mental distress among spouses of alcohol abusers with the highest alcohol consumption.Results revealed that alcohol consumption was significantly associated with a decrease in spousal mental distress, whereas alcohol-related problems were associated with an increase in spousal mental distress when adjusted for each other.All effect sizes were small, but the trends were clear, challenging the notion that a high consumption of alcohol is exclusively and under all circumstances negative for the spouse.

View Article: PubMed Central - HTML - PubMed

Affiliation: Norwegian Institute of Public Health, Division of Mental Health, PO BOX 4404, Nydalen, Oslo N-0403, Norway. kamilla.rognmo@fhi.no

ABSTRACT

Background: It is a widely held notion that alcohol abuse is related to mental distress in the spouse. Research has substantiated this notion by showing a tendency for spouses of alcohol abusers to experience more mental distress than spouses of non-abusers. However, the picture seems to be more complex, as some results do not show a significant effect or even less mental distress among spouses of alcohol abusers with the highest alcohol consumption. The present study investigates the association between spousal mental distress and both a high consumption of alcohol and having experienced alcohol related problems.

Methods: Norwegian population-based questionnaire data from the Nord-Trøndelag Health Study (HUNT 2) were analyzed. In total 11,584 couples were eligible for analysis. Alcohol consumption was measured by numerical indicators of alcohol amount and frequency of drinking, whereas alcohol-related problems (i.e. having been criticized for excessive drinking) were measured by the CAGE Alcohol Screening Questionnaire. Multivariate hierarchical regression analyses were performed.

Results: Results revealed that alcohol consumption was significantly associated with a decrease in spousal mental distress, whereas alcohol-related problems were associated with an increase in spousal mental distress when adjusted for each other. Interaction effects indicated that couples discordant for drinking problems experienced more mental distress than spouses concordant for drinking problems.

Conclusions: The results of our study indicate that alcohol-related problems constitute a clear risk factor for spousal mental distress. On the other hand, a high consumption of alcohol per se was related to lower levels of spousal mental distress, after adjusting for the alcohol-related problems perceived by the alcohol consumer him/herself. All effect sizes were small, but the trends were clear, challenging the notion that a high consumption of alcohol is exclusively and under all circumstances negative for the spouse.

Show MeSH

Related in: MedlinePlus

Some possible causal pathways between index persons’ and spouses’alcohol abuse and mental health.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3649917&req=5

Figure 1: Some possible causal pathways between index persons’ and spouses’alcohol abuse and mental health.

Mentions: The effect of alcohol consumption/problems in the index person on mental health in the spouse may be somewhat confounded by the index person’s mental distress, because the index person’s mental distress may have an impact both on their own alcohol consumption/problems and on the spouse’s mental health. Likewise the spouse’s own alcohol consumption or alcohol-related problems may affect both the index person’s alcohol consumption/problems and the spouse’s mental health, and accordingly act as a confounder. Just as likely, however, these variables (the index person’s mental distress and the spouse’s alcohol consumption and alcohol-related problems) may act as mediators. That is, the index person’s alcohol consumption/problems cause distress in the index person and increased alcohol consumption/problems in the spouse, and these again cause distress in the spouse. Research has shown that alcohol abuse most likely causes within-person mental distress, rather than the other way around [17], suggesting that the spouse’s mental distress may act more as a mediator than as a confounder. Research regarding the causality of spousal concordance for alcohol consumption implies that both assortative mating and spousal convergence over time are involved [18], suggesting that alcohol use and alcohol-related problems may both confound and mediate the effect of index persons’ alcohol consumption/problems on spouses’ mental distress. The possible causal pathways between index persons’ and spouses’ alcohol variables and mental distress are presented in Figure 1. In conclusion, whereas model 4 may be somewhat under-adjusted, model 5, including index person’s mental distress and spousal alcohol variables, may be over-adjusted because it probably adjusts for mediator effects.


Alcohol use and spousal mental distress in a population sample: the Nord-Trøndelag Health Study.

Rognmo K, Torvik FA, Røysamb E, Tambs K - BMC Public Health (2013)

Some possible causal pathways between index persons’ and spouses’alcohol abuse and mental health.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3649917&req=5

Figure 1: Some possible causal pathways between index persons’ and spouses’alcohol abuse and mental health.
Mentions: The effect of alcohol consumption/problems in the index person on mental health in the spouse may be somewhat confounded by the index person’s mental distress, because the index person’s mental distress may have an impact both on their own alcohol consumption/problems and on the spouse’s mental health. Likewise the spouse’s own alcohol consumption or alcohol-related problems may affect both the index person’s alcohol consumption/problems and the spouse’s mental health, and accordingly act as a confounder. Just as likely, however, these variables (the index person’s mental distress and the spouse’s alcohol consumption and alcohol-related problems) may act as mediators. That is, the index person’s alcohol consumption/problems cause distress in the index person and increased alcohol consumption/problems in the spouse, and these again cause distress in the spouse. Research has shown that alcohol abuse most likely causes within-person mental distress, rather than the other way around [17], suggesting that the spouse’s mental distress may act more as a mediator than as a confounder. Research regarding the causality of spousal concordance for alcohol consumption implies that both assortative mating and spousal convergence over time are involved [18], suggesting that alcohol use and alcohol-related problems may both confound and mediate the effect of index persons’ alcohol consumption/problems on spouses’ mental distress. The possible causal pathways between index persons’ and spouses’ alcohol variables and mental distress are presented in Figure 1. In conclusion, whereas model 4 may be somewhat under-adjusted, model 5, including index person’s mental distress and spousal alcohol variables, may be over-adjusted because it probably adjusts for mediator effects.

Bottom Line: However, the picture seems to be more complex, as some results do not show a significant effect or even less mental distress among spouses of alcohol abusers with the highest alcohol consumption.Results revealed that alcohol consumption was significantly associated with a decrease in spousal mental distress, whereas alcohol-related problems were associated with an increase in spousal mental distress when adjusted for each other.All effect sizes were small, but the trends were clear, challenging the notion that a high consumption of alcohol is exclusively and under all circumstances negative for the spouse.

View Article: PubMed Central - HTML - PubMed

Affiliation: Norwegian Institute of Public Health, Division of Mental Health, PO BOX 4404, Nydalen, Oslo N-0403, Norway. kamilla.rognmo@fhi.no

ABSTRACT

Background: It is a widely held notion that alcohol abuse is related to mental distress in the spouse. Research has substantiated this notion by showing a tendency for spouses of alcohol abusers to experience more mental distress than spouses of non-abusers. However, the picture seems to be more complex, as some results do not show a significant effect or even less mental distress among spouses of alcohol abusers with the highest alcohol consumption. The present study investigates the association between spousal mental distress and both a high consumption of alcohol and having experienced alcohol related problems.

Methods: Norwegian population-based questionnaire data from the Nord-Trøndelag Health Study (HUNT 2) were analyzed. In total 11,584 couples were eligible for analysis. Alcohol consumption was measured by numerical indicators of alcohol amount and frequency of drinking, whereas alcohol-related problems (i.e. having been criticized for excessive drinking) were measured by the CAGE Alcohol Screening Questionnaire. Multivariate hierarchical regression analyses were performed.

Results: Results revealed that alcohol consumption was significantly associated with a decrease in spousal mental distress, whereas alcohol-related problems were associated with an increase in spousal mental distress when adjusted for each other. Interaction effects indicated that couples discordant for drinking problems experienced more mental distress than spouses concordant for drinking problems.

Conclusions: The results of our study indicate that alcohol-related problems constitute a clear risk factor for spousal mental distress. On the other hand, a high consumption of alcohol per se was related to lower levels of spousal mental distress, after adjusting for the alcohol-related problems perceived by the alcohol consumer him/herself. All effect sizes were small, but the trends were clear, challenging the notion that a high consumption of alcohol is exclusively and under all circumstances negative for the spouse.

Show MeSH
Related in: MedlinePlus