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.