The contention that Religion/Spirituality (R/S) influences the development of alcohol dependence (AD) is increasingly supported, but risk factors have not been adequately examined together with protective R/S factors so as to determine the nature and relative strength of these domains at different stages in the development of alcoholism. Secondary data analysis of a sample of 4,002 young adult female twins used conditional Cox proportional hazards survival models to examine three distinct stages in the development of alcoholism: years to initiation of drinking, years from first drink to at-risk drinking, and years from at-risk drinking to AD. Risk and protective factors from models of alcoholism etiology and studies of R/S dimensionality were modeled simultaneously as predictors of each discrete stage and compared. Findings demonstrated that both risk factors and R/S variables influenced initiation of alcohol use; only R/S variables influenced subsequent progression to at-risk drinking; and risk factors primarily influenced further progression to AD. Protective factors (R/S variables being an exemplar) appeared to be critical determinants of intermediate-stage progression, thus suggesting that R/S factors and other psychosocial interventions might be particularly effective in delaying progression toward AD at this stage. In contrast, after the onset of at-risk drinking, the influence of (genetically based) risk factors appeared to accelerate AD regardless of most other influences. Thus, the timing of psychosocial interventions appears critical to their potency and impact.
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