Objective: A predictable sequence of alcohol-related problems has been hypothesized to be applicable to the clinical course of alcoholism. However, few recent data are available on this question. Method: The age of first occurrence of 44 alcohol-related life experiences was determined for 478 DSM-III-R defined alcohol-dependent (alcoholic) individuals (317 men and 161 women), and for 444 drinking but not alcohol-dependent subjects (183 men and 261 women). Data were gathered through personal interviews with alcohol-dependent subjects and their relatives using a structured psychiatric interview (SSAGA). Results: A high level of similarity (Spearman's rho = .81, p = .0004) was found for the retrospective reports of the order of appearance of alcohol-related problems between the present sample and an analysis of 636 alcoholic male inpatients who participated in a prior study. Within the present group of 478 alcoholics, the order of appearance of alcohol-related problems was similar for men and women (rho = .84, p < .0001), and the time course of development of problems was similar for treated and untreated alcoholic subgroups (rho = .86, p < .001). Analyses of 19 alcohol-related life experiences in 444 drinking but not alcohol-dependent individuals indicated an overall rank order for occurrence of problems similar to those observed for alcohol-dependent individuals (rho = .76, p < .001). Conclusions: These data corroborate the high level of predictability regarding the order of occurrence of major alcohol-related life problems among alcohol-dependent men and women, extending the previous findings to women with alcohol dependence and to alcoholics who have never received inpatient treatment.
