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Language         : English
Subject          : Drugs
Title            : Parental Alcoholism as a Determinant of Drinking Styles in Their Adult Children: A review
Grade            : 95
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Country          : USA
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Date             : 1994
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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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