Parental Alcoholism As A Determinant Of Drinking Styles In Their Adult Children: A Review 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 Jelliffe (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.

Hamburg, 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, under controlled 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.