Personality Factors
It is often difficult to know whether personality factors are antecedents or consequences of alcohol abuse. However, as discovered by Marlatt, a history of antisocial behavior and high levels of depression or low self-esteem have been found in many studies of alcohol abusers (McCarty, 2000). Some researchers are skeptical about personality as a determining factor in alcohol abuse, however, partly on the grounds that, although many early behaviors reported to be predictive of later abuse are very prevalent in the general population, although most people do not become dependent on alcohol. In particular, they questioned the predictive value of early antisocial behavior, arguing that a large number of abusers have never displayed antisocial behavior and that many people who show that behavior early in life do not become addicts (Ketchan & Asbury, 2000).
Alcohol Expectancies
There is evidence that direct pharmacological effects alone may not be sufficient for either the development or the maintenance of alcohol and drug abuse. Social learning, in which information about the consequences of behavior is transmitted through observation of others as well as through one’s own experiences, also plays an important role. Such nonpharmacological contributors include expectations about the direct pharmacological actions of alcohol on the individual, as well as expectations about its indirect effects on their behavior and social functioning (Malik, 2000). According to Marlatt and colleagues, the most notable and most widely held belief, and therefore expectation, about alcohol is that it is something of a “magic elixir” that can enhance social and physical pleasure, sexual performance and responsiveness, power and aggression, and social competence (Ketchan & Asbury, 2000). The power of expectancy is suggested by research showing that people can experience alcohol-like effects when they only think they have consumed alcohol but have instead consumed a placebo beverage, as shown in Abrams’ and Wilson’s study (Bellinir, 2000).
There is even evidence that people can acquire expectations about alcohol long before they take their first drink and that these early expectancies are strong predictors of alcohol dependence in adulthood. In comparing adolescent alcohol abusers with demographically similar non-abusing peers, Brown found that the alcohol abusers expected more positive effects from alcohol (Vaillant, 1983). A subsequent study by Mann examined alcohol expectancies among adolescents at high and low risk of future alcoholism and found that high-risk adolescents expected enhanced cognitive and motor functioning and reduced tension, whereas low-risk adolescents expected altered social behavior ( Jang & Vernon, 2000).
To test the role of expectancies in a controlled manner, Newlin and colleagues have developed an experimental approach in which subjects are divided into two groups, one receiving an alcohol placebo and the other receiving a nonalcoholic beverage that is not purported to be alcoholic. Thus two conditions are created: expectation of alcohol but none received, and no expectation of alcohol and none received. The design allows an alcohol expectancy effect to be measured against a control condition in which alcohol is neither expected nor received. The expectancy effect measured in these studies was the heart rate. The pharmacological action of alcohol normally accelerates the heart rate, but it was confirmed in young college men that alcohol expectancy decreased the heart rate. This effect, called the antagonistic placebo response, was not found in women, however. Expectancy of receiving alcohol increased the heart rate in women as alcohol itself would do (Bender, 1997). The same experimental design was also used in a study of sons of alcoholics to test the hypothethesis that they would show a greater antagonistic placebo response than sons of non-alcoholics. It was confirmed that an alcohol placebo produced significantly greater reduction of the heart rate in the sons of alcoholics. The reductions could not be attributed to differences in baseline heart rate, drinking practices, or personality measures. The sons of alcoholics also reported feeling more “intoxicated” after consuming the placebo drink than the sons of non-alcoholics, suggesting the possible existence of some fundamental differences in the two groups in their ability to perceive drug states (Jang & Vernon, 2000).
Levenson also tested a hypothesis that individuals at greater risk for alcoholism tend to get greater reinforcement from drinking because they find it more rewarding. The hypothesis was supported in a comparison of alcohol-induced stress attenuation in high- and low-risk subjects in which the effects of a high dose of alcohol on both physiological (cardiovascular and motor responses) and self-reported psychological effects for stress from aversive stimulation were measured. Although all subjects received the same amount of alcohol on a body weight basis, those judged at risk for alcohol dependence (because they had an alcoholic parent or matched a personality pattern thought to be associated with the development of alcoholism) experienced a smaller response to the stressor after drinking than control subjects who had neither risk factor. The enhanced stress reduction was evident in subjects with either type of alcoholism risk factor, but no additional stress attenuation was seen in subjects who had both risk factors. There were no differences in the responses of male and female subjects at risk (Secretary, 1990).
Finn and Pihl also measured the effects of alcohol on cardiovascular responses to aversive stimulation. The subjects, all males, were in three groups: those judged at high risk because they had alcoholic fathers and a multigenerational family history of alcoholism, those judged at moderated risk because there was no alcoholism in the generation preceding that of their alcoholic fathers, and those judged at low risk because they had no family history of alcoholism. Before drinking, the high-risk group was found to have greater cardiovascular reactivity to the stressor than the moderate-risk group. After drinking, however, the high-risk group showed a dramatic reduction of cardiovascular response to the stressor, while the moderate- and low-risk groups shoed increased reactivity. The evidence suggested that the greater baseline reactivity to stress and the heightened stress-dampening effect of alcohol in individuals at high risk of alcoholism may make them more disposed to use alcohol in adverse situations (Landes, Jacobs, & Foster, 1993). The similar reactivity of the moderate- and low-risk groups in contrast to the high-risk group indicated a need to look more closely at the frequency of alcoholism in an alcoholic family history before judging the risk of alcoholism in any one family member. In a subsequent study by the same investigators, that replicated the findings of the first, it was concluded that investigators should ascertain that familial alcoholism has existed for at least two successive generations before judging an individual to be at risk because of family history. The researchers, however, observed that the majority of high-risk studies published have apparently not gone beyond one generation in describing family history of alcoholism (Landes, Jacobs, & Foster, 1993).
Longitudinal Studies on Environmental Factors
Longitudinal studies of the children of alcoholics have explored childhood factors and their relationship to the development of alcoholism in adulthood. One such study of children focused on factors that allow some offspring of alcoholics to go through childhood and adolescence without developing any serious problems. Asian and Polynesian natives of Hawaii having at least one alcoholic parent and having experienced alcohol-related family problems as children were selected for study; control subjects were from the same cohort of native Hawaiians. Serious problems at home, school, work, or in the community had developed by age eighteen in forty-one percent of the children of alcoholic parents, and thirty percent had records of repeated or serious delinquency. A striking contrast was found with respect to contacts with social services and mental health agencies – thirty-seven percent of the children of alcoholics had made such contacts during their teens, compared with only seven percent of the children without alcoholic parents. The frequency of adjustment problems associated with parental alcoholism was significant in this study (Silverstein, 1990).
Nevertheless, nearly sixty percent of the offspring of alcoholics had not developed such problems by age eighteen. Interviews and community records indicated that the members of the resilient group did well in school, at work, and in social life and that they had realistic goals and expectations for the future. Further evaluation of the resilient and nonresilient children of alcoholics indicated differences in the two groups in temperament, communication skills, and locus of control (the belief as to whether one’s life is controlled by oneself or by external factors). Characteristics differentiating the problem-free offspring of alcoholics from others included relative intelligence, achievement orientation, early social skills, responsible and caring attitude, positive self-concept, and belief in their own effectiveness. One of the factors that most strongly influenced outcome in the children was the presence or absence of alcoholism in the mother; 25 percent of the nonresilient offspring had an alcoholic mother, compared with only 3.5 percent of resilient offspring (Silverstein, 1990).
Conclusion
There is a wealth of evidence, especially due to twin and adoption studies, that one of the greatest risk factors for becoming an alcoholic is to be the son, daughter, or sibling of one. This familial nature of alcoholism has stimulated a great deal of research to identify the causes and mechanisms of the transmission of alcoholism in families. In general, these investigations focus on either genetics, psychological and social factors, or the interaction of the two. The studies presented here indicate that both genetics and environmental factors are involved in the development of alcoholism. For, although genetics is certainly a cause of the disease, there must be other contributing factors as the majority of individuals genetically predisposed to alcoholism never suffer from it. Psychological and social factors such as the pharmacological effects of alcohol, the psychological state of the user, and the user’s expectations about alcohol’s effects on them influence drinking behaviors, and research is continuing on the environmental factors involved in the development of alcoholism. Therefore, it can be determined that the interaction of genetics and environment is a fundamental cause of the dedetermined that the interaction of genetics and environment is a fundamental cause of the development of alcoholism, and future research on the disease will no doubt focus increasingly on this interaction.
Citations
Bellenir, K. (2000). Alcoholism Sourcebook. 81-86.
Bender, D. (1997). Chemical Dependency: Opposing Viewpoints. 49-79.
Jang, K. & Vernon, P. (2000). Personality Disorder Traits, Family Environment, and Alcohol Misuse: a Multivariate Behavioral Genetic Analysis. Addiction. 95. 6. 873-888.
Ketcham, K. & Asbury, W. (2000). Beyond the Influence: Understanding and Defeating Alcoholism. 28-39.
Landes, A., Jacobs, N., & Foster, C. (1993). Illegal Drugs and Alcohol – America’s Anguish. 39-53.
Malik, K. (2000). The Gene Genie. New Statesman. 13. 612. 53-54.
McCarty, D. (2000). Detoxification Centers: Who’s in the Revolving Door? The Journal of Behavioral Health Services