Family cohesion and pride, drinking and alcohol use disorder in Puerto Rico.

BACKGROUND: The extended multigenerational family is a core value of Hispanic culture. Family cohesion/pride can have protective effects on drinking- and drug-use-related behavior among Hispanics.

OBJECTIVES: To examine the association between family cohesion/pride, drinking, binge drinking, and DSM-5 alcohol use disorder (AUD) in Puerto Rico.

METHODS: Data are from a household random sample of 1510 individuals 18-64 years of age in San Juan, Puerto Rico.

RESULTS: Bivariate analyses showed that family cohesion/pride was not associated with the average number of drinks consumed per week but was associated with binge drinking among men. Family cohesion/pride was also associated with DSM-5 AUD. Results of the multivariate analyses were consistent with these bivariate results for DSM-5 AUD. Respondents with low (OR = 2.2, 95CL = 1.21-3.98; p < .01) and medium (OR = 1.88; 95CL = 1.12-3.14; p < .01) family cohesion/pride were more likely than those with high family cohesion/pride to have a positive diagnosis of DSM-5 AUD. More liberal drinking norms and positive attitudes toward drinking were also strong predictors of the average number of drinks consumed per week. More liberal drinking norms also predicted binge drinking, and DSM-5 AUD.

CONCLUSIONS: Higher family cohesion/pride may have a protective effect against DSM-5 AUD. This may have practical implications for clinical and prevention programs. As long as high cohesion is not enabling drinking, these programs can enhance and support family cohesion/pride to help clients in treatment and recovery and prevent drinking problems.