Predicting the new onset of perceived need for care and help-seeking for alcohol use disorders in the National Epidemiologic Survey on Alcohol and Related Conditions

Abstract

Epidemiologic studies have found that approximately one third of individuals will experience either alcohol abuse or dependence during their lifetime. However, only a minority will seek help or perceive a need for help. The purpose of this thesis is to provide a longitudinal investigation of the predictors of new onset perceived need for care and help-seeking in individuals with a lifetime alcohol use disorder who have no prior history of perceived need or help-seeking. Methods: Data were drawn from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; n=34,653), a 3-year longitudinal nationally representative survey of the United States population. Results: Respondents with an incidence of perceived need and help-seeking were more likely to be male, younger, less educated, and black. Those who sought help and perceived a need for help were more likely to have a concurrent Axis I or II disorder after controlling for sociodemographic differences and social, legal, economic problems. They also had very high odds of having a persistent alcohol use disorder (OR=4.68) and experiencing social or legal problems related to their alcohol use after controlling for sociodemographics and psychiatric comorbidity (AOR’s from 5.59-38.42). Conclusion: Individuals with a history of having no perceived need for care or help-seeking may represent a unique group among those with an alcohol use disorder. Psychiatric comorbidity and social or legal problems related to alcohol use were both independent predictors of perceived need and help-seeking.