DÄ internationalArchive37/2009Binge Drinking in Childhood and Adolescence – Epidemiology, Consequences, and Interventions: In reply

Correspondence

Binge Drinking in Childhood and Adolescence – Epidemiology, Consequences, and Interventions: In reply

Dtsch Arztebl Int 2009; 106(37): 595-6. DOI: 10.3238/arztebl.2009.0595b

Stolle, M

LNSLNS Zimmermann and Laucht, in the context of risk constellations for binge drinking among adolescents, rightly point out the importance of genetic protective factors and risk factors that become effective in association with early-life stress. We ourselves did place due importance on the interaction, or correlation, of genes and the environment in our review article.

We also mentioned in our article alcohol induced brain damage, as mentioned by Zimmermann. We wish to add to this an article by de Bellis et al (2005), who found a volume reduction of the prefrontal cortex and a reduction of the white matter located therein in adolescents with alcohol related disorders (including binge drinking).

Children and adolescents at particularly high risk of developing alcohol related disorders can be identified by considering the multiconditional genesis of alcohol misuse and risk of addiction (neurobiological aspects, comorbid psychological disorders, psychosocial factors). However, we remain critical of our colleagues’ conclusion, that such high risk children and adolescents can be informed about their personal risk by means of motivational interviewing and thereby prompted to engage in actively considering their risk, from which they can then draw the right conclusions. Motivational interviewing does not solely aim to provide information. Prevention research has shown that such an approach may actually engender resistance (Thomasius et al, 2009). Motivational interviewing gains its effectiveness through an empathetic underlying attitude while abstaining from confrontation, and by promoting the understanding of discrepancies (“If I continue to consume alcohol in this manner I will neither pass my driving test nor manage to pass the school finals”). This technique is also used to develop confidence in the self efficacy of children and adolescents (Miller and Rollnik, 1999).

DOI: 10.3238/arztebl.2009.0595b

Dr. med. Martin Stolle
Deutsches Zentrum für Suchtfragen des Kindes und Jugendalters
Univeritätsklinkum Hamburg-Eppendorf
Martinistraße 52
20246 Hamburg, Germany
M.Stolle@uke.de

Conflict of Interest Statement
The authors of both contributions declare that no conflict of interest exists according to the guidelines of the International Committee of Medical Journal Editors.
1.
De Bellis MD, Narasimhan A, Thatcher DL, Keshavan MS, Soloff P, Clark DB: Prefrontal cortex, thalamus, and cerebellar volumes in adolescent and young adults with adolescent-onset alcohol use disorders and comorbid mental disorders. Alcohol Clin Exp Res 2005; 9: 1590–600. MEDLINE
2.
Miller WR, Rollnik S: Motivierende Gesprächsführung. Freiburg im Breisgau: Lambertus 2009.
3.
Thomasius R, Stolle M, Sack PM: Entwicklungspsychopathologisches Modell. In: R Thomasius, M Schulte-Markwort, UJ Küstner, P Riedesser (Hrsg.): Handbuch der Suchtstörungen im Kindes- und Jugendalter. Stuttgart: Schattauer 2009; 139–46.
4.
Stolle M, Sack PM, Thomasius R: Binge drinking in childhood and adolescence: epidemiology, consequences, and interventions [Rauschtrinken im Kindes- und Jugendalter: Epidemiologie, Auswirkungen und Intervention]. Dtsch Arztebl Int 2009; 106(19): 323–8. MEDLINE
1. De Bellis MD, Narasimhan A, Thatcher DL, Keshavan MS, Soloff P, Clark DB: Prefrontal cortex, thalamus, and cerebellar volumes in adolescent and young adults with adolescent-onset alcohol use disorders and comorbid mental disorders. Alcohol Clin Exp Res 2005; 9: 1590–600. MEDLINE
2. Miller WR, Rollnik S: Motivierende Gesprächsführung. Freiburg im Breisgau: Lambertus 2009.
3. Thomasius R, Stolle M, Sack PM: Entwicklungspsychopathologisches Modell. In: R Thomasius, M Schulte-Markwort, UJ Küstner, P Riedesser (Hrsg.): Handbuch der Suchtstörungen im Kindes- und Jugendalter. Stuttgart: Schattauer 2009; 139–46.
4. Stolle M, Sack PM, Thomasius R: Binge drinking in childhood and adolescence: epidemiology, consequences, and interventions [Rauschtrinken im Kindes- und Jugendalter: Epidemiologie, Auswirkungen und Intervention]. Dtsch Arztebl Int 2009; 106(19): 323–8. MEDLINE