The aims of this competing renewal are to further investigate the course and validity of DSM-IV alcohol dependence and abuse. In 1991 and 1992, we established a sample of 962 community residents whose drinking increased their risk for DSM-IV alcohol abuse and dependence. These subjects participated in a detailed interview on drinking history and symptoms of alcohol use disorders. About a year later, 91 % of the subjects were re-interviewed. The sample provides a unique resource to investigate the natural history of DSM-IV alcohol dependence and abuse. We seek to extend the study by conducting an additional 9-year follow-up, using the AUDADIS and a Cognitive Lifetime Drinking History modified to focus on the years since the baseline interview. We also propose further analyses with existing data from this study and with data from a 1992 national survey. Methods of analysis will include survival analysis and General Linear Models for longitudinal data, specifically Markov models and marginal models with GEE parameter estimation. We propose these main aims: (1)To investigate the longitudinal course and natural history of DSM-IV alcohol dependence; (2) To investigate the independence of DSM-IV alcohol abuse and dependence, using Community Study and NLAES data; (3) To investigate the validity of the new partial remission category of DSM-IV alcohol dependence remission through analyses of longitudinal and cross-sectional differentiation from full dependence and full remission; (4) To further test the validity of the 3-symptom threshold for DSM-IV alcohol dependence; (5) To investigate the prognostic validity of the Type A(1)/TypeB (2) subtypes of DSM-IV alcohol dependence; (6) To further investigate predictions about drinking from the ADS and DSM- IV alcohol dependence, incorporating a direct measure of impaired control, using Community Study and NLAES data; (7) To further investigate the physiological subtype of alcohol dependence and the validity of the DSM- III and DSM-III-R tremors requirement for alcohol withdrawal in the Community Study sample and in NLAES data; (8) To determine if differential correlates of dependence and abuse change after 8 years; (9) To determine if a severity indicator of DSM-IV alcohol dependence remains valid after 8 years.
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