Over the last decade, several large studies have spotlighted the importance of conducting health research in the English-speaking Caribbean in general and Trinidad in particular. It appears that the Caribbean is a cultural/biological "crossroad" that has allowed important insights into potential gene/environment interactions. Recent studies in the Caribbean have also spurned the generation of a new set of theories on the etiology of several different health disorders including alcoholism. The overall objective of the proposed research is to enhance understanding of the biological and psychosocial risk and protective factors related to level of alcohol involvement (alcohol use and alcohol-related problems/ diagnoses) on the Islands of Trinidad and Tobago. The project CO-I, Dr. Karelia Montaine-Jaime, and the PI, Dr. Cindy Ehlers, have engaged a highly skilled group of investigators to work on this research program that include: faculty and graduate students from the University of the West Indies, St. Augustine campus Trinidad, psychiatrists and social workers from clinics and hospitals on the islands of Tobago and Trinidad, as well as statisticians and epidemiologists from the Caribbean Epidemiology center. The hypothesis that specific biological and psychosocial factors may influence alcohol involvement in the two ethnic groups in Trinidad has been tested in a pilot study. Preliminary results suggest that alcohol involvement and morbidity from drinking is influenced by: ADH genotype, expectations of the effects of alcohol, religion, co-morbidity with depression, level of response to alcohol, and cultural identification. Collaborations with geneticists at the University of North Carolina Bowles Alcohol Center and the University of Indiana have been established in order to conduct genetic association and linkage studies. Study findings can be compared to similar studies being conducted in the US. We believe these studies will not only allow for the identification of risk and protective factors for alcoholism in these islands but also guide the development of culturally sensitive prevention and intervention programs.