РефератыИностранный языкPaParental Alcoholism As A Determinant Of Drinking

Parental Alcoholism As A Determinant Of Drinking

Styles In Their Adult Children: A Review Essay, Research Paper


Parental Alcoholism as a Determinant of


Drinking Styles in Their Adult Children: A Review


Running head: PARENTAL ALCOHOLISM AS A DETERMINANT OF


DRINKING


Parental Alcoholism as a Determinant of


Drinking Styles in Their Adult Children: A review


Considerable research has been conducted in recent years on


the personality characteristics of adult and adolescent children


of alcoholics ( Berkowitz & Perkins, 1988; Seefeldt & Lyon,


1992). In order for us to examine some of the literature


concerning the drinking patterns of adult children, we will


begin by examining other defining traits that are seen as


generally characteristic of adult children of alcoholics. Adult


children will henceforth be referred to as ACOA’S.


An important factor in addressing any issue related to


ACOA’s is a definition of alcoholism (Shuckit, 1987). The


A.P.A. (1987) in its definition of alcoholism requires symptoms


such as heavy drinking over a time, the inability to stop


drinking at will, major life problems, tolerance to drinking,


impaired social or occupational functioning, and withdrawal


symptoms upon quitting use. Shuckit points to the fact that


alcoholism has been defined as genetic in nature by many


studies. This viewpoint allows us to begin a review of the


offspring of alcoholics and their possible genetic


predisposition to alcoholism. Another consideration in the


discussion of children of alcoholics and their tendencies toward


alcoholism is


the environmental factors involved in growing up in an


alcoholic home. These environmental factors have been more


difficult to research and, as a result, have been documented


less frequently than heredity and genetics. Although this


review will focus primarily on the possible biological basis for


the familial transmission of alcoholism, the environmental


factors will also be examined. For our purposes, we will define


“environmental” as being any external influence encountered by


the children of alcoholics, especially the attitudes and


behaviors of the alcoholic parents.


Early research, such as that of Woititz (1983) indicates


that children of alcoholics are a clearly distinguishable


subgroup with well-defined characteristics. These assumptions


are based primarily on clinical observation during ACOA


treatment. Research has recently shed doubt on the findings of


Woititz and other theorists who delineate specific defining


characteristics of children of alcoholics. The studies by


Berkowitz & Perkins (1988) and Seefeldt & Lyon (1992) both


indicated that children of alcoholics are not definable by their


specific negative set of response styles or personality


characteristics. In other words, COA’s are not a homogeneous


group. Most early research described ACOA’s as individuals who


have developed certain maladaptive behaviors and personality


traits to compensate for extreme dysfunction within the family


system. Much of the recent research has contradicted the work


of Woititz (1983) and has brought the question of “what truly


defines an ACOA?” to the forefront. My goal in the current


discussion will be to present some of the past and present


research on one major characteristic of ACOA’s, their tendency


to inherit drinking styles or alcoholism from their alcoholic


parent or parents (and even grandparents). We will examine


literature by pioneers in the field of children of alcoholics


and by their current successors.


The Early Effects of Parental Alcoholism


An initial subject of relevance in this review is the


effect of parental drinking on children and adolescents. This


information is pertinent since the personality is defined during


childhood and adolescence. We will, hopefully, be able to view


some of the possible precursors to drinking patterns in ACOA’s


in this discussion of children and adolescent substance use and


abuse. A study by Mckenna & Pickens (1981) examined alcoholics


who had parents who were also alcoholics. The results


indicated that children of two alcoholics are more likely to


manifest behavioral problems related to alcoholism than children


of one alcoholic. These individuals are younger upon first


intoxication and usually have a shorter time between first


intoxication and treatment than do children of only one


alcoholic. The results of this study may be attributed to


genetic influences i.e. the presence of alcoholism in both


parents or environmental influences, that is, both parents


modeling the drinking behaviors. A more recent study on


adolescent substance use (Chassin, Rogosch, & Barrera, 1991)


analyzed the relationship of parental alcoholism to adolescent


alcohol and drug use. The results indicated a strong


correlation between recent parental alcohol use and adolescent


alcohol and drug use. The results did not, however,


differentiate among parental psychopathology and environmental


considerations as possible concurrent risk factors. The effects


of alcoholism on parenting skills were seen as pervasive


factors that had a non-specific influence on the outcome of the


study. Paternal alcoholism was found to have a more profound


effect on the drinking behaviors of adolescents than maternal


drinking. Overall, the two reviewed studies tended to


demonstrate a significant correlation between parental


alcoholism and the degree of alcohol involvement in their


children. Although actual drinking was difficult to predict,


the drinking that tended to be problematic was more obvious.


El-Guebaly & Offord (1977) made a comprehensive review of


the literature on the effects of parental drinking on the


offspring. They described the effects of parental drinking on


infants through ACOA’s. Their findings indicated that ACOA’s


seemed to have a tendency toward more psychological distress


than did children of non-drinking parents. This study indicated


the need for more studies that compared ACOA’s to the children


of parents with other psychological disorders. In other words,


the research of that period did not account for other variables


that may have influenced the outcomes of many of the studies.


Genetic Aspects of Alcoholism in ACOA’s


Numerous studies have indicated that ACOA’s have more of a


tendency toward alcoholism than non-ACOA’s. For example, Cotton


(1979) completed a comprehensive review of studies on the rates


of alcoholism in ACOA’s and non-ACOA’s. Most of the studies


indicated higher rates of alcoholism in ACOA’s. Unfortunately,


these studies were unable to account for other mediating


variables in the occurrence of increased rates of alcoholism.


A study by Goodwin (1979) suggested that future research should


focus on not only the genetic transmission of alcoholism, but


also on the concurrent societal conditioning that seems to


predispose individuals for alcoholism. His study consisted of a


twin study in which he found the adopted children of alcoholics


to be at an equal risk of developing alcoholism as those who


remained in the alcoholic family. The study added further


support to the early work of the alcoholism pioneer Jellinek and


his colleague Jolliffe (1940) who originally discussed the idea


of a “familial alcoholism.” These findings were further


supported in the work of Cloninger, Bowman, & Sigvardsson (1981)


who conducted a study on the inheritance of alcoholism in a


Swedish adoption study. Their research mentioned the difficulty


in categorizing ACOA’s as alcoholic strictly on the basis of


parental alcoholism. They noted that a consideration of an


individual’s environment had a significant effect on the


severity of an individual’s alcoholism. While the ACOA’s had a


higher incidence of alcoholism than non-ACOA’s, the point of


considering both environmental and genetic factors was addressed


as a necessary step in evaluating the alcoholism. The study


suggested that the impact of societal attitudes concerning


alcoholism have the potential to strongly influence alcoholism


rates, regardless of any genetic predisposition.


The works of Goodwin (1979) and Shuckit (1987) point to


concrete biological responses that may have some bearing on


alcoholism in ACOA’s. Both indicated a differential biological


response to alcohol consumption in ACOA’s and non-ACOA’s.


According to Shuckit, the sons of alcoholics appear to have a


decreased response to moderate doses of alcohol than others.


Goodwin states that, contrary to popular belief, people may be


protected from alcoholism by a genetic mechanism which allows


them to consume only a little alcohol. A popular belief is that


alcoholics have the inherited allergy to alcohol which causes


them to react to the drug in pathological ways. Shuckit &


Sweeney (1987) examined parental or relative alcoholism as


determinants of alcohol-related problems in ACOA’s. Their


findings indicated a significant correlation between alcohol


related problems and alcoholism in first and second degree


relatives. Also of interest in this study, no significant


correlation was discovered between alcoholism and a family


history of depression or schizophrenia. This would seem to


assist in ruling out other genetic psychological factors in the


prediction of ACOA alcoholism or substance use/abuse. As a


result, the association of parental alcoholism to ACOA drinking


patterns is more easily determined.


Another study that examined problem drinking in ACOA’s in


relation to alcoholism in first and second degree relatives was


done by Perkins & Berkowitz (1991). This study involved a


sample of collegiate children of alcoholics. The work


emphasized the importance of including grandparents in the


definition of “children of alcoholics.” Grandparents, the


authors state, are frequently overlooked as potential genetic


and environmental influences on their grandchildren. In an


extended family living environment, the grandparents may have as


much influence as the parents. The emphasis of the study was on


differentiating among different types of ACOA’s and drawing


attention to multi-generational alcoholism. This would assist


in identifying a genetic link in those ACOA’s who have no


parental history of alcoholism, but have grandparents who are


alcoholic. ACOA’s who had both parents and grandparents who


were alcoholic were found as more likely to be problem drinkers


than were other students.


A history of parental alcoholism has been found to provide


significant information about the character of persons in


treatment for alcoholism (Svanum & McAdoo, 1991). This study


was supportive of the study by McKenna and Pickens (1981) which


found that children of alcoholics had a tendency toward an early


onset of alcohol consumption. However, the study contrasted


with McKenna and Pickens in that the Svanum & McAdoo study found


a significant correlation between early onset of alcohol use and


the severity of the alcoholism.. Another interesting aspect of


the study was that it reflected a high percentage of alcoholics


in treatment who were abusive of other drugs as well. This is


supportive of the trend that seems to be developing within


treatment centers today. The study discovered a tendency for


alcoholics in treatment who had alcoholic parents to be much


more likely involved in the use of other drugs. Obviously, the


results of the study are descriptive of alcoholics who enter


treatment and not ACOA’s in general. They do, however, give us


the idea that ACOA’s may have a proclivity toward other drug use


and possibly dependence.


Environmental and Other Non-genetic Aspects


A longitudinal study on the familial transmission of


alcohol use (Webster et al.,


1989) provides us with more information on drinking patterns


that are not necessarily associated with alcoholism. This study


and several others focus on familial, but not biological,


factors involved in children of alcoholics’ drinking styles.


Thus, this section of my discussion will focus on the


interaction of genetic and non-genetic aspects of ACOA drinking


patterns. Hopefully, we will be able to gain insight into some


of the environmental aspects involved in ACOA drinking patterns.


The longitudinal study demonstrated several important factors


related to the transmission of drinking styles. First, the


offspring of non-drinking parents were found to have, generally,


a lower rate of drinking or to be abstemious themselves. The


study indicated that sons of heavy drinking mothers tended to


demonstrate an aversive response to drinking themselves,


possibly as a result of observing the mother in a


non-traditional drinking role. The study also suggested a


polarization response in which the children of alcoholics tended


to be either abstemious or high volume drinkers with a relative


absence of medium volume drinkers. The tendency of the offspring


of abstemious parents to avoid drinking was seen as a factor of


an overall family transmission of values, frequently religious


in nature, which taught against the use of alcohol. Sons of


heavy drinking parents were likely to be heavy drinkers


themselves. Interestingly, the daughters demonstrated no


significant trend in this area. The study points to the idea


that a


change in the drinking norms of women may make the imitation of


parental drinking patterns by opposite sex offspring much more


prevalent.


Harburg, Davis, & Caplan (1982) described a similar


polarization type response in their study of the transmission of


parental drinking styles. Their study focused on imitative and


aversive transmission of drinking styles. The results support


other research that states that the children of alcoholics tend


to imitate the drinking styles of the same sex parent. The most


consistent support of this idea was seen in the sons of heavy


drinking fathers. Additionally, the offspring tended to have


drinking patterns opposite from those of the opposite sex


parent. Possible explanations given for the aversive response


include one mentioned by Webster et al. (1989) that attributed


the aversion to a strongly religious family system which is


prohibitive of the use of alcohol. Some children, however,


react against this lifestyle and become members of the “deviant”


group. Another reason given for the abstaining children of


alcoholics is the negative influence of parental drinking. Many


children are subjected to extremely negative home environments


as a result of parental alcoholism. These children frequently


see the negative consequences suffered by their alcoholic parent


or parents and vow to avoid alcohol for the rest of their lives.


In yet another study, Johnson, Leonard, & Jacob (1989

)


compare drinking styles in the children of alcoholics,


depressives, and controls. The study involved adolescents in


which patterns of alcohol use related to parental consumption


have not been as well documented as in adults. The children of


the different groups of the study demonstrated no significant


difference in drinking habits. Thus, the adolescent children of


alcoholics were shown to be no different from controls in their


drinking behaviors. These results would seem to place a


stumbling block in the way of predicting future patterns of


drinking in children of alcoholics. A significant difference


was encountered in the drug use of children of alcoholics. They


were found to have been involved in experimentation or use of a


wider variety of illicit drugs than their counterparts. This


may indicate that parental alcohol use exerts a broad,


generalized influence on the tendency of children to abuse


substances. The study also points to the significance of other


research that suggests that drinking styles and psychopathology


define different subgroups of alcoholics. Studying these


subgroups may be a crucial step in understanding the risk status


of children of alcoholics.


Parker & Harford (1987) discussed an increased risk for


heavy drinking in the children of heavy drinking parents. More


specifically, the children of dependent problem drinkers were


found likely to be dependent problem drinkers themselves. No


correlation was found between dependent problem drinking parents


and non-dependent problem drinking children. This demonstrates


that children of alcoholics have a tendency toward alcoholism,


but not problem drinking. A significant environmental factor


encountered in the study was that ACOA’s in blue collar


professions had more of a tendency toward alcoholism than their


white collar counterparts. Overall, the adult children who were


characterized by heavy drinking parents and lower socioeconomic


status had a strong tendency toward heavy drinking and alcohol


related problems themselves.


Yet another study, by Parker & Harford (1988), examined


adult children of alcohol abusers and their difficulties with


alcohol-related problems, marital disruption, and depression.


Again, parental alcohol abuse was a significant predictor of


alcohol-related problems in the adult children. Men with less


family income were more likely to be dependent problem drinkers.


This was correlative with their brief report of the year before


(Parker & Harford, 1987), which yielded the same results. The


study also points to the significant need of assessing the


effects of different types of parental drinking on the


offspring. The authors point to research by Cloninger and


associates (1981), which is also reviewed in this paper, as


indicative of the differing risk factors to which the offspring


of varying types of alcoholics were exposed. Cloninger et al.


in their Swedish adoption study found that the children involved


were placed at risk by varying factors. They also discussed the


existence of Type I and Type II alcoholics. The Type I’s were


characterized by an age of onset greater than age 25 and a high


dependency on alcohol. The Type II’s had an early age of onset


and a relatively low dependence on alcohol. Parker & Harford


suggest the possibility of dividing ACOA’s into groups of


low-dependent and high-dependent drinkers to determine a


possible environmental influence that may cause a shift from


Type II alcoholism to Type I.


Personality variables as risk factors in the development of


alcoholism in ACOA’s are seen as essential considerations.


According to Rogosch et al. (1990), these personality variables


must be specified considering the role they play in mediating


and moderating between familial history and alcohol abuse.


First, they indicate the existence of research that supports


basic personality characteristics that indicate a genetic


predisposition to alcoholism. Their study did not support this


idea. They found, instead, that personality characteristics may


tend to be moderators of ACOA alcohol use. High levels of


self-awareness may have a tendency to allow individuals to be


more aware of the possible risks of their drinking behaviors due


to their family histories. In other words, family history and


self-awareness combine to protect individuals from engaging in


drinking behaviors. Conversely, a combination of family history


risk and aggressive, undercontrolled personality factors combine


to predict the degree of alcohol involvement and negative social


or societal consequences an ACOA will experience.


Summary


The findings of most of the reviewed studies indicated


significant correlations between parental drinking styles and


drinking styles of their adult children. As a result, this


review tends to confirm my assumption that parental alcoholism


has a direct (and sometimes indirect) effect on the drinking


styles of their children. Many of the studies examined the


biological basis for the transmission of alcoholism. The


articles reviewed did not, however, include material concerning


specific neurological and genetic research. This research,


while relevant to this subject area, was seen as exceedingly


technical and, essentially, beyond the scope of this brief


review.


The consensus among the research community seems to be that


alcoholism is significantly influenced by genetics.


Additionally, drinking patterns also tend to be inherited,


although they may be influenced equally by biological and


environmental factors. The research reviewed was representative


of various methods of sample selection for their studies. Some


of the studies selected from community samples, others from


universities, and others from treatment settings. As a result,


the findings may be generalizable to society as a whole.


Additionally, the studies span a significant period of time and


results remain relatively consistent. For example, studies


conducted in 1989 may have yielded similar results as a study


conducted in 1981.


Conclusion


The literature makes a strong case for the existence of a


familial predisposition to alcoholism. It also suggests


correlations between parental drinking styles and ACOA drinking


styles. None of the articles disputed these correlations. An


interesting research statistic that I encountered in my brief


review was that, in terms of personality type, ACOA’s were not


significantly different from non-ACOA’s. This seems odd


considering the fact that ACOA’s tend to have generally higher


levels of drinking than non-ACOA’s. The primary indicators of


personality type differences, it would seem, may tend to emerge


more readily within a treatment setting. Most of the current


literature that discusses ACOA’s in terms of their “abnormal”


characteristics is derived from clinical practice and not


scientific research.


The future research in the area of ACOA’s and their


inherited drinking styles might focus on the complex interaction


between genetic and environmental influences. Also,


consideration of different types of parental alcoholism might be


investigated. The studies of Cloninger et al. (1981) seem to


indicate the need for this type of research. Additional


articles confirm this assertion.


In my opinion, we have only scratched the surface in


studying the effects of parental drinking on the offspring.


Obviously, this review has discussed only one aspect of the


alcoholic parent-ACOA relationship. As therapists and


researchers in the chemical dependency field, we must always be


aware of the influences exerted upon the children of alcoholics.


This clinical population tends to be the most highly


represented group within alcoholism treatment settings today and


continuous discussion and research on ACOA’s is necessary.


Parental Alcoholism as a Determinant of


Drinking Styles in Their Adult Children: A Review


Running head: PARENTAL ALCOHOLISM AS A DETERMINANT OF


DRINKING


Parental Alcoholism as a Determinant of


Drinking Styles in Their Adult Children: A review


Considerable research has been conducted in recent years on


the personality characteristics of adult and adolescent children


of alcoholics ( Berkowitz & Perkins, 1988; Seefeldt & Lyon,


1992). In order for us to examine some of the literature


concerning the drinking patterns of adult children, we will


begin by examining other defining traits that are seen as


generally characteristic of adult children of alcoholics. Adult


children will henceforth be referred to as ACOA’S.


An important factor in addressing any issue related to


ACOA’s is a definition of alcoholism (Shuckit, 1987). The


A.P.A. (1987) in its definition of alcoholism requires symptoms


such as heavy drinking over a time, the inability to stop


drinking at will, major life problems, tolerance to drinking,


impaired social or occupational functioning, and withdrawal


symptoms upon quitting use. Shuckit points to the fact that


alcoholism has been defined as genetic in nature by many


studies. This viewpoint allows us to begin a review of the


offspring of alcoholics and their possible genetic


predisposition to alcoholism. Another consideration in the


discussion of children of alcoholics and their tendencies toward


alcoholism is


the environmental factors involved in growing up in an


alcoholic home. These environmental factors have been more


difficult to research and, as a result, have been documented


less frequently than heredity and genetics. Although this


review will focus primarily on the possible biological basis for


the familial transmission of alcoholism, the environmental


factors will also be examined. For our purposes, we will define


“environmental” as being any external influence encountered by


the children of alcoholics, especially the attitudes and


behaviors of the alcoholic parents.


Early research, such as that of Woititz (1983) indicates


that children of alcoholics are a clearly distinguishable


subgroup with well-defined characteristics. These assumptions


are based primarily on clinical observation during ACOA


treatment. Research has recently shed doubt on the findings of


Woititz and other theorists who delineate specific defining


characteristics of children of alcoholics. The studies by


Berkowitz & Perkins (1988) and Seefeldt & Lyon (1992) both


indicated that children of alcoholics are not definable by their


specific negative set of response styles or personality


characteristics. In other words, COA’s are not a homogeneous


group. Most early research described ACOA’s as individuals who


have developed certain maladaptive behaviors and personality


traits to compensate for extreme dysfunction within the family


system. Much of the recent research has contradicted the work


of Woititz (1983) and has brought the question of “what truly


defines an ACOA?” to the forefront. My goal in the current


discussion will be to present some of the past and present


research on one major characteristic of ACOA’s, their tendency


to inherit drinking styles or alcoholism from their alcoholic


parent or parents (and even grandparents). We will examine


literature by pioneers in the field of children of alcoholics


and by their current successors.


The Early Effects of Parental Alcoholism


An initial subject of relevance in this review is the


effect of parental drinking on children and adolescents. This


information is pertinent since the personality is defined during


childhood and adolescence. We will, hopefully, be able to view


some of the possible precursors to drinking patterns in ACOA’s


in this discussion of children and adolescent substance use and


abuse. A study by Mckenna & Pickens (1981) examined alcoholics


who had parents who were also alcoholics. The results


indicated that children of two alcoholics are more likely to


manifest behavioral problems related to alcoholism than children


of one alcoholic. These individuals are younger upon first


intoxication and usually have a shorter time between first


intoxication and treatment than do children of only one


alcoholic. The results of this study may be attributed to


genetic influences i.e. the presence of alcoholism in both


parents or environmental influences, that is, both parents


modeling the drinking behaviors. A more recent study on


adolescent substance use (Chassin, Rogosch, & Barrera, 1991)


analyzed the relationship of parental alcoholism to adolescent


alcohol and drug use. The results indicated a strong


correlation between recent parental alcohol use and adolescent


alcohol and drug use. The results did not, however,


differentiate among parental psychopathology and environmental


considerations as possible concurrent risk factors. The effects


of alcoholism on parenting skills were seen as pervasive


factors that had a non-specific influence on the outcome of the


study. Paternal alcoholism was found to have a more profound


effect on the drinking behaviors of adolescents than maternal


drinking. Overall, the two reviewed studies tended to


demonstrate a significant correlation between parental


alcoholism and the degree of alcohol involvement in their


children. Although actual drinking was difficult to predict,


the drinking that tended to be problematic was more obvious.


El-Guebaly & Offord (1977) made a comprehensive review of


the literature on the effects of parental drinking on the


offspring. They described the effects of parental drinking on


infants through ACOA’s. Their findings indicated that ACOA’s


seemed to have a tendency toward more psychological distress


than did children of non-drinking parents. This study indicated


the need for more studies that compared ACOA’s to the children


of parents with other psychological disorders. In other words,


the research of that period did not account for other variables


that may have influenced the outcomes of many of the studies.


Genetic Aspects of Alcoholism in ACOA’s


Numerous studies have indicated that ACOA’s have more of a


tendency toward alcoholism than non-ACOA’s. For example, Cotton


(1979) completed a comprehensive review of studies on the rates


of alcoholism in ACOA’s and non-ACOA’s. Most of the studies


indicated higher rates of alcoholism in ACOA’s. Unfortunately,


these studies were unable to account for other mediating


variables in the occurrence of increased rates of alcoholism.


A study by Goodwin (1979) suggested that future research should


focus on not only the genetic transmission of alcoholism, but


also on the concurrent societal conditioning that seems to


predispose individuals for alcoholism. His study consis

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