Proximal vs. distal predictors of alcohol use disorders and treatment utilization in at-risk men in early middle age

Understanding factors that predict both development and treatment of alcohol misuse and its consequences can inform prevention and treatment efforts. This study used measures of both proximal (e.g., behaviors) and distal (e.g., traits) risk factors that were predicted to relate to both an alcohol use disorder (AUD) and to treatment utilization among AUD-diagnosed men to test the hypothesis that both type of factors predict AUDs but only proximal factors influence treatment-seeking. Analyses of variance with contrasts were used to compare the means for risk factors between men with an AUD and AUD-free men and-given an AUD diagnosis-between men who were treated for an AUD and untreated men (n = 181). As predicted, men with AUDs differed on a broad range of proximal and distal factors, including number of alcohol problems, alcohol-related influences of peers and partners, alcohol expectancies, familial factors, and psychopathology. As hypothesized, only proximal risk factors predicted treatment-seeking among the AUD men, particularly alcohol problems and related consequences.