This RO3 grant application asks for a two year award for analyses of data from the National Longitudinal Alcohol Epidemiologic Survey - 1992 (NLAES) to examine two critical issues for the further development of a typology of alcoholism: generalizability and validity. The typology has promise for distinguishing subtypes based on relative genetic and environmental influence and shows potential to be homogenous within subtypes, inclusive of all alcoholics but mutually exclusive between subtypes, easily identifiable, clinically relevant and valid. Prior development of genetic and environmental symptom scales using twin data, and subtypes based on those scales in the Epidemiologic Catchment Area sample, identified three subtypes (mild, severe and dyssocial) among alcoholic Caucasian men. Generalizability of the typology will be addressed by testing how well the subtypes replicate in the NLAES among the minority male alcoholics, female alcoholics and also male Caucasian alcoholics. Construct validity as applied to a typology is measured by the degree to which differences between subtypes are conceptually predictable and empirically reliable. Three aspects of alcoholism will assess the validity of the typology: differences between subtypes in etiology, clinical characteristics and clinical outcomes. The NLAES is a nationally representative study (N=42,862) designed to collect comprehensive data on alcoholism and associated characteristics. Use of these public access data enable the proposed study to examine differences between subtypes in familial history of alcoholism, patterns of alcohol consumption, substance use comorbidity, treatment utilization, and medical consequences of alcoholism. Potential public health benefits include: greater understanding of etiology, especially with respect to the identification of specific genes and environmental factors, and better prediction of clinical course and treatment outcome.
