Abstract
BACKGROUND: Correlates of recovery from alcohol dependence have been identified through a variety of study designs characterized by different strengths and limitations. The goal of this study was to compare correlates of recovery based on a 3-year prospective design with those based on cross-sectional analyses of data from the same source. METHODS: Data from the 2001 to 2002 Wave 1 and 2004 to 2005 Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were used to examine baseline characteristics associated with Wave 2 recovery from alcohol dependence, among those who classified with past-year DSM-IV alcohol dependence at Wave 1 (n = 1,172). RESULTS: Abstinent recovery was significantly associated with Black/Asian/Hispanic race/ethnicity, children <1 year of age in the household at baseline, attending religious services greater than or equal to weekly at follow-up, and having initiated help-seeking that comprised/included 12-step participation within <3 years prior to baseline. Nonabstinent recovery was positively associated with being never married at baseline, having job problems or being unemployed in the year preceding baseline, attending religious services less than weekly at follow-up, baseline smoking and volume of ethanol intake, and having terminated a first marriage within <3 years prior to baseline. Findings, including others of marginal significance (0.05 < p < 0.10), generally supported results from prior pseudo-prospective survival analyses with time-dependent covariates but differed in many ways from cross-sectional analyses of Wave 1 NESARC data. CONCLUSIONS: Various aspects of study design must be considered when interpreting correlates of recovery. Cross-sectional analyses of lifetime correlates of recovery are highly subject to misinterpretation, but pseudo-prospective survival analyses with time-dependent covariates may yield results as valid as those from prospective studies.