In this issue.

hyperten- sion patients could yield promising results.

conditions and disorders are impor tant for both research and clinical prac tice. Treatment studies, human genetics research, and national prevalence esti mates of alcoholism all rely on certain sets of criteria to define alcohol abuse and dependence. The most widely used definitions for alcohol use disorders are found in two major classification sys tems of disease: the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association, and the International Classification of Disease (ICD) of the World Health Organization. Dr. Deborah Hasin provides historical background on the development of the current classification systems and describes the key similarities and differences between DSM-III-R, DSM-IV, and ICD-10. She concludes with a discus sion of the reliability and validity of the alcohol dependence and abuse diag noses. (pp. 5-17)

METHODOLOGICAL ISSUES IN MEASURING ALCOHOL USE
W hen conducting surveys to mea sure a population's alcohol con sumption patterns, researchers must consider numerous methodological issues to obtain valid and meaningful information, writes Dr. Deborah A. Dawson. For example, investigators must determine the most appropriate reference period for the surveys (i.e., whether to assess consumption over the past week, month, or year) or whether to assess overall consumption or consump tion for various types of beverages. The choice of questions also influences the accuracy of the data. With the quantity/ frequency (QF) approach, researchers inquire only about the overall frequency of alcohol consumption and the typical number of drinks consumed per occa sion. The graduated frequency (GF) approach asks respondents how often during the reference period they con sumed a certain number of drinks and thus generates more detailed informa tion. The specific definitions of drinking status (e.g., abstainer or drinker) as well as the mode of the interview (e.g., face to face vs. telephone) also can affect the responses and, accordingly, estimates of alcohol consumption. (pp. 18-29) TRACKING ALCOHOL CONSUMPTION OVER TIME R esearchers regularly track a nation's alcohol consumption not only to discern current drinking patterns but also to monitor trends in drinking patterns that might influence prevention or intervention approaches and policy changes. Drs. Thomas K. Greenfield and William C. Kerr review the main approaches to measuring alcohol con sumption over time. One method is the use of aggregate measures, which sum marize the volume of consumption of many individuals to yield a group total or average consumption. Aggregate measures are used primarily to generate models of alcohol-related outcomes, such as alcohol-related mortality. Investigators also conduct surveys (crosssectional and longitudinal) to measure people's consumption either at one point or repeatedly over time. Survey data make it possible to obtain a clearer picture of the dynamic forces that shape a population's consumption patterns. (pp. 30-38)

ALCOHOL-RELATED MORBIDITY AND MORTALITY
A lcohol use is a contributing factor in a wide range of negative health consequences, including injuries, disease, and disability. Research on alcoholrelated morbidity and mortality examines the effects of overall alcohol consumption as well as varying drinking patterns. As Drs. Jürgen Rehm, Gerhard Gmel, Christopher T. Sempos, and Maurizio Trevisan explain, this epidemiological research indicates that alcohol use increases the risk for both chronic health consequences (e.g., disease) and acute consequences (e.g., traffic crashes). The authors note too that certain patterns of regular, light-to-moderate drinking may have beneficial effects, such as a decrease in the risk of coronary heart disease. The authors discuss the methodology involved in studying alcohol-related morbidity and mortality, including mea suring alcohol consumption and outcomes. (pp. 39-51) HARMFUL ALCOHOL USE M isuse of alcohol affects not only the drinker but also his or her family, friends, community, and society as a whole. Drs. Gerhard Gmel and Jürgen Rehm examine research on some of the social harms commonly associ ated with drinking, including lowered worker productivity and increased rates of accidental injuries, aggressive and vio lent behavior, and child and spouse abuse. The authors note that although drinking is linked to many of these social harms, the exact association is not clear. The authors describe the method ological flaws that characterize much of the research in this area and specify areas where research can be improved. States are alcohol related, and crashes involving alcohol are more likely to result in injuries and deaths than nonalcohol-related crashes. Dr. Ralph Hingson and Mr. Michael Winter review the epidemiology of alcoholrelated crashes, injuries, and deaths and the relationship between blood alcohol concentration (BAC), driver impair ment, and fatal crashes. The authors also examine characteristics of alcoholrelated crashes and fatalities with respect to the driver's age when he or she first began drinking. Drinking and driving survey data and trends in drinking and driving also are discussed. (pp. 63-78)

ALCOHOL USE AMONG ADOLESCENTS AND YOUNG ADULTS
Y oung people in the United States have high rates of alcohol use and often engage in dangerous drinking practices such as binge drinking. Dr. Michael Windle reviews epidemiologi cal data on alcohol use among adoles cents, college students, and young adults not in college, as well as the prevalence of health-compromising behaviors such as tobacco use and drinking and driving that often co-occur with alcohol use in this age group. The author explains that the patterns and consequences of drink ing experienced by young people often are related to the physical locations or the contexts in which alcohol is con sumed. Information on drinking loca tions and contexts may be especially use ful for identifying appropriate targets for effective interventions and social poli cies. (pp. 79-86)

ALCOHOL USE AND RELATED PROBLEMS AMONG ETHNIC MINORITIES IN THE UNITED STATES
H ow do minority groups in the United States differ from one another and from Whites in their drink ing patterns and in the prevalence of alcohol-related problems? Drs. Frank H. Galvan and Raul Caetano examine the epidemiology of alcohol use and related problems among the four main U.S. minority groups: Hispanics, African Americans, Asian Americans, and Native Americans. The authors review factors thought to account for these ethnic/ racial differences, including social or cul tural factors such as drinking norms and attitudes and, in some cases, genetic fac tors. Understanding ethnic differences in alcohol use patterns and the factors that influence alcohol use can help guide the development of culturally appropriate alcoholism treatment and prevention programs. (pp. 87-94)

INTERNATIONAL COMPARISONS OF ALCOHOL CONSUMPTION
I n recent years, researchers have attempted to compare data on drink ing for various countries to further advance theoretical knowledge of the social, cultural, political, or environ mental factors that influence drinking behavior. In these cross-national analy ses, investigators must consider factors such as differences in drinking cultures (e.g., the role that alcohol plays in everyday life), variations in drink sizes and strengths, and differing methods for measuring consumption. With these considerations in mind, Drs. Kim Bloomfield, Tim Stockwell, and Gerhard Gmel and Ms. Nina Rehn summarize the findings of international research. Although the existing studies already have generated much informa tion about drinking behavior in several countries, numerous questions and methodological concerns remain, neces sitating further research. (pp. 95-109)