{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T19:40:09Z","timestamp":1777750809405,"version":"3.51.4"},"reference-count":45,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T00:00:00Z","timestamp":1729555200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Soc Psychiatry"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Little is known about whether the protective effect of marriage on alcohol use disorder (AUD) varies by cultural background.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Using Swedish national data, we examined whether marriage is associated with a stronger reduction in AUD risk among Swedes of a Swedish background (i.e. those with two Swedish-born parents) compared to Swedes with a foreign background (i.e. one or two foreign-born parents) and whether the protective effect of marriage depends on whether the spouse has a Swedish or foreign background.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Among those born in Sweden 1960 to 1990 (3,093,439; 49% female), associations between cultural background and AUD registration during marriage were estimated with Cox models. Analyses of intra- and intermarriage on AUD registration were examined with Cox models and limited to groups of focal individuals for which there was sufficient statistical power, which included Swedes with two Swedish-born parents, two Finnish-born parents, or bicultural background (one Swedish and one foreign-born parent). Models were sex stratified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Marriage was associated with reductions in AUD risk among those with Swedish and with foreign backgrounds, though less protective for males of Finnish versus Swedish background as indicated by a significant interaction between marital status and parental region of birth, HR\u2009=\u20090.80, 95% CI [0.71, 0.90]. Marriage was also less protective for those with a bicultural versus Swedish background, HR\n                      <jats:sub>males<\/jats:sub>\n                      \u2009=\u20090.87, 95% CI [0.81, 0.92] and HR\n                      <jats:sub>females<\/jats:sub>\n                      \u2009=\u20090.88, 95% CI [0.81, 0.97]. Among those of Swedish background, marriage to a spouse with a foreign versus Swedish background was associated with increased risk of AUD, HR\n                      <jats:sub>males<\/jats:sub>\n                      \u2009=\u20091.26, 95% CI [1.19, 1.34] and HR\n                      <jats:sub>females<\/jats:sub>\n                      \u2009=\u20091.20, 95% CI [1.10, 1.31]. This risk was diminished when family-level confounders (genes, rearing environment) were controlled for.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The protective effect of marriage depends on cultural background, with some evidence that increased risks associated with a spouse\u2019s foreign background are confounded by family-level factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00207640241288211","type":"journal-article","created":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T06:58:02Z","timestamp":1729580282000},"page":"168-178","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Examining cultural background and the protective effect of marriage on alcohol use disorder in Sweden"],"prefix":"10.1177","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5504-5087","authenticated-orcid":false,"given":"Jessica E","family":"Salvatore","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Larsson L\u00f6nn","sequence":"additional","affiliation":[{"name":"Center for Primary Health Care Research, Lund University, Malmo, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2410-2584","authenticated-orcid":false,"given":"Karen G","family":"Chartier","sequence":"additional","affiliation":[{"name":"School of Social Work, Virginia Commonwealth University, Richmond, USA"},{"name":"Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Sundquist","sequence":"additional","affiliation":[{"name":"Center for Primary Health Care Research, Lund University, Malmo, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth S","family":"Kendler","sequence":"additional","affiliation":[{"name":"Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, USA"},{"name":"Department of Psychiatry, Virginia Commonwealth University, Richmond, USA"},{"name":"Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"Sundquist","sequence":"additional","affiliation":[{"name":"Center for Primary Health Care Research, Lund University, Malmo, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,10,22]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"crossref","unstructured":"Bachman J. 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