Alcohol challenge with sons of alcoholics: A critical review and analysis.

Studies are reviewed in which response to acute administration of alcohol was compared between individuals with and without family histories of alcoholism (FH+, FH–). This research represents a search for a psychobiological marker for alcoholism. A methodological critique of the procedures reported in this literature is then presented. Finally, a conceptual model is suggested in which differences in the response to alcohol between FH+ individuals and FH– individuals must be understood in relation to time after drinking alcohol. This Newtonian differentiator model proposes that sons of alcoholics exhibit acute sensitization as blood alcohol level rises and acute tolerance as blood alcohol level falls, compared with sons of nonalcoholics. Therefore, FH+ Ss find alcohol more rewarding because they accentuate the pleasurable, excitatory aspects of initial intoxication and attenuate the feelings of anxiety and depression that predominate as blood alcohol levels drop. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Men at high risk for alcoholism: The effect of alcohol on cardiovascular response to unavoidable shock.

Three groups of 12 nonalcoholic men at differing degrees of genetic risk for alcoholism were tested with and without alcohol for their cardiovascular response to an aversive stimulus. A high-risk group consisted of sons of alcoholic fathers with extensive transgenerational family histories of alcoholism. A moderate-risk group included sons of alcoholic fathers whose previous generation was essentially negative for other alcoholic diagnoses. The low-risk group consisted of men with negative family histories for the disorder. Heart rate and digital blood volume amplitude were measured in each subject while resting and during a signaled shock procedure. Results show that the high-risk group was more cardiovascularly reactive to the stressor than the moderate-risk group when sober. Alcohol consumption led to a dramatic reduction in the degree of reactivity in the high-risk group, and it led to increased reactivity in the moderate-risk group. The trend for the low-risk group was similar to the moderate-risk group with no significant differences between the two. The methodology and results are discussed in terms of their relevance in the etiology of alcoholism in high-risk men and in terms of the need for generational controls in studying sons of alcoholics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Loss of control drinking in alcoholics: An experimental analogue.

Presented 2 groups of 32 male 23-65 yr old nonabstinent alcoholics and social drinkers with an ad-lib supply of either alcoholic or nonalcoholic beverages in a taste-rating task. Ss were assigned to 1 of 2 instructional set conditions in which they were led to expect that the beverage to be rated contained alcohol (vodka and tonic) or consisted only of tonic. The actual beverage administered consisted of either vodka and tonic or tonic only. Results show that instructional set is a significant determinant of the amount of beverage consumed and posttask estimates of the alcoholic content of the drinks. The actual beverage administered did not significantly affect the drinking rates of either alcoholics or social drinkers. Loss-of-control drinking, in the form of increased consumption by alcoholics who were administered alcohol, did not occur during the drinking task. Results are discussed in terms of implications for treatment and for the conception of alcoholism as a disease. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The disease controversy and psychotherapy with alcoholics

This article discusses conducting psychotherapy with alcoholics in light of the controversy about whether alcoholism is a disease. The belief that alcoholism is a disease forces many clinicians to offer abstinence from alcohol as the only option for alcoholics who seek treatment. From this perspective, the alcoholic must be helped to accept the idea that he or she has a disease and that to recover from this problem, drinking must stop. Others maintain that alcoholism may not be a disease and view alcoholic drinking as maladaptive behavior. From this vantage point, helping the patient to control or to moderate drinking might be considered. These two distinct paradigms lead to divergent treatment goals, which leaves the clinician in a quandary about how best to treat an individual who experiences a drinking problem. To resolve this dilemma, it is suggested that the clinician who works with alcoholics entertain a multiplicity of perspectives and should not be blinded by any one paradigm. While control of alcohol intake must take place if such patients are to improve their functioning, the author argues that recovery can occur either by abstinence or through moderating drinking.     

Local interaction fields and adaptive regularizers for surface reconstruction and image relaxation

This study investigates familial alcoholism effects and the comparative probability of risk for alcohol dependence in adult children of alcoholics (ACAs) with a control group of non-ACAs. A cohort of 12,686 young adults from the National Longitudinal Survey of Youth (NLSY) is examined over a five-year period and conventional and lineal intergenerational models of alcoholism transmission are assessed. The results of multivariate logistic regression analyses indicate that the risk is relatively greater for male ACAs; sons of alcoholics drink significantly more heavily, experience problems earlier, and develop alcohol dependence more extensively than female ACAs or non-ACAs of either gender. The extent of dependence found in subjects with a lineal history of alcoholism on the father's side of the family, as well as heavy drinking, cigarette smoking and drinking onset in adolescence should be considered as critical predisposing factors of high risk for dependence at later ages. These observations corroborate clinical studies and support a growing body of biopsychosocial research literature.     

Child sexual and physical abuse and alcoholism: a review

OBJECTIVE: To examine possible relations between child sexual or physical abuse and adult alcoholism. METHOD: Studies reviewed included prospective studies, retrospective studies on the prevalence of child sexual or physical abuse in alcoholics and nonalcoholics, and retrospective studies in mental health clients and in population samples comparing the prevalence of alcohol use disorders in abused and nonabused subjects. RESULTS: Prospective studies do not indicate a significant association between child sexual or physical abuse and alcoholism. In contrast, studies among alcoholic women do suggest a relationship. Also, a significantly higher prevalence of alcohol problems in abused women than in nonabused women is found in population samples. The results of studies among mental health clients are inconclusive. In addition, several methodological limitations should be taken into consideration when evaluating results of the available studies. CONCLUSIONS: Current evidence is insufficient to draw conclusions about relationships between child sexual or physical abuse and alcoholism among men. Among females, however, there is a higher likelihood of alcohol problems if they were sexually or physically abused as children.     

Mental disorders in the offspring of alcoholic fathers (children from an early age to 28)

The examined groups included 175 children whose fathers were alcoholics and 73 individuals from nonalcoholic parents. The study group was divided by age into children from infantile age to 15 years and 16-28-year-olds. The wide range of psychopathologic disorders were revealed in children up to 15 years of age: syndrome of hyperactivity, neurotic disturbances, mental retardation, epileptic-like syndrome. Alcoholism was found in sons only (3.77%). Mental disorders were revealed significantly more frequently in sons of alcoholic fathers than in their daughters. Their incidence increased with the age of the sons. The disturbances occurred significantly more frequently in the test group as compared with the control one (19 and 6.38%, respective by). In the older group (16-28-year-olds) the spectrum of mental disorders consisted of alcoholism, mental retardation, psychopathic-like and neurotic disorders. Alcoholism occurred most frequent and its rate depended on the age and sex. Frequency of alcoholism was 66.7% in sons aged 21-28 years and 15.38% in daughters of the same age. The conclusion was made about multiple risk for children of alcoholic fathers. More vulnerable contingent was the sons for which the risk of alcoholism was very high.     

Alcoholic-spouse interaction as a function of alcoholism subtype and alcohol consumption interaction.

This study assessed the impact of alcoholism subtype on marital interaction, a research focus stimulated by the investigators' earlier findings linking drinking style with differential levels of marital satisfaction and stability. In the current effort, observations of 49 alcoholics and their wives were conducted during sessions when alcohol was consumed and during nondrinking sessions. Different patterns of interactions emerged for episodic and steady alcoholics. On the drink nights, episodic alcoholic couples evidenced less problem solving than did the steady alcoholic couples. Additionally, among episodic couples, the husbands were more negative on the drink nights than were the wives, whereas among steady couples, wives were more negative than were the alcoholic husbands. The interaction displayed by the episodic alcoholics and their spouses was suggestive of a coercive control pattern. In contrast, the steady alcoholic and his spouse displayed a pattern suggestive of high levels of problem solving. Further research is necessary to determine whether these two different interaction patterns are predictive of continued alcohol abuse or the exacerbation of marital problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An heuristic model for the inherited predisposition to alcoholism.

Presents a research program for studying individuals genetically at high risk for alcoholism. Data from multigenerational nonproblem-drinking sons of male alcoholics indicate that the sons display a pattern of autonomic hyperreactivity to a variety of stimuli. This pattern of reactivity is significantly dampened by high doses of alcohol. These individuals also display difficulty on cognitive tests suggestive of prefrontal lobe dysfunction. This response pattern is not characteristic of controls nor of daughters of multigenerational male alcoholics. A model is presented that hypothesizes a cognitive disturbance underlying the hyperreactivity and posits a problem in the attribution of meaning to novel stimuli and threatening events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of serum beta-hexosaminidase isoenzyme B activity with serum carbohydrate-deficient transferrin and other markers of alcohol abuse

We have compared beta-hexosaminidase (beta-Hex) activity, carbohydrate-deficient transferrin (CDT), mean corpuscular volume (MCV), gamma-glutamyltransferase (GGT), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) values in serum from male alcoholic patients with the corresponding values in moderate and non-drinking subjects. The total beta-Hex activity was 2.5 times higher in the alcoholics than in the moderate drinkers and this increase was mainly due to a 5-fold increase in the activity of the B-isoform of the enzyme. This was expressed as a percentage of the total beta-Hex activity and called 'beta-Hex B%'. Strong correlations were found between alcohol consumption (g/ day) and beta-Hex B% (r = 0.757, P < 0.001, n = 42), alcohol consumption and CDT (r = 0.671, P < 0.001, n = 42), and beta-Hex B% and CDT (r = 0.628, P < 0.001, n = 57). Serum beta-Hex B% had a sensitivity of 94% and a specificity of 91% in detecting alcoholic drinking of > 60 g/day. As a single marker of alcoholic drinking, it was markedly more sensitive than MCV and the liver enzymes GGT, AST and ALT, and slightly more sensitive than serum CDT (94 vs 83%). At the CDT cut-off level of 20 U/l, 17% of the moderate and non-drinkers would have been classified as alcoholic drinkers and 17% of the alcoholics would have been classified as moderate drinkers. Some of these misclassifications were eliminated if the beta-Hex B% results were taken into account. We suggest that serum beta-Hex B% can be a useful and inexpensive laboratory test for alcohol abuse.     

The effects of familial risk, personality, and expectancies on alcohol use and abuse.

This study tested a structural model of the association between familial risk, personality risk, alcohol expectancies, and alcohol abuse in a sample of 224 young adult offspring of alcoholics and 209 offspring of nonalcoholics. The results provided support for 2 personality-risk pathways, a social deviance proneness and an excitement/pleasure seeking path, that accounted for a significant portion of the association between a familial alcoholism and alcohol abuse. The path from familial alcoholism to social deviance proneness lead directly to alcohol problems. The path from familial alcoholism to excitement/ pleasure seeking was associated with increased drinking, which, in turn, was associated with alcohol problems. Positive alcohol expectancies accounted for part of the association between excitement seeking and alcohol use. The results suggest 2 different biopsychosocial mechanisms that elevate risk for abuse in the offspring of alcoholics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Heterogeneity in the families of sons of alcoholics: The impact of familial vulnerability type on offspring characteristics.

In 2 samples of sons of alcoholics (family history positive for alcoholism; FHP: N?=?74 & N?=?72), cluster analyses identified 3 subtypes of familial vulnerability: 1 with low levels of familial psychopathology (FHP-LP) and moderate levels of familial alcoholism; a 2nd with high levels of familial antisocial personality (FHP-ASP), violence, and alcoholism; and a 3rd with high levels of familial depression (FHP-DEP), mania, anxiety disorder, and alcoholism. Compared with family history negative (FHN) participants (N?=?106), FHP offspring had higher levels of alcohol problems. FHP-ASP offspring had elevated levels of antisocial traits and negative affect. Compared with FHN participants, FHP-DEP offspring elevated levels of antisocial traits, hypomania, and experience seeking. FHP-LP offspring had moderate levels of antisocial traits. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factors associated with marital aggression in male alcoholics.

Male alcoholics who were physically aggressive toward their wives in the year before alcoholism treatment (n?=?71) were compared with nonaggressive counterparts (n?=?36). Two key patterns were associated with marital aggression: (a) binge drinking linked with coercive marital conflicts and (b) markers of a severe early onset alcoholism syndrome. Maritally aggressive men were younger and exhibited more binge drinking, higher prevalence of arrest, more verbal aggression, greater alcohol problem severity, earlier alcohol problem onset, more alcoholism among male biological relatives, less maternal alcohol use, less confidence in their ability to manage interpersonal conflict without drinking, and stronger beliefs that alcohol causes marital problems. Marital adjustment levels were not associated with marital aggression, and very few differences were found between moderate and severe violence groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Statistics of Alcohol Use and Alcoholism in Canada.

Reviews the book, Statistics of Alcohol Use and Alcoholism in Canada. 1871-1956: First Report by R. E. Popham & W. Schmidt (1970). This volume is the first in what is proposed as an annual census of alcoholism undertaken by the Alcoholism Research Foundation of Ontario. The report includes cataloguing of alcohol statistics by (a) size and characteristics of the drinking population, (b) apparent consumption of alcoholic beverages, (c) convictions for offences involving alcohol, (d) statistics relating to the prevalence of alcoholism and (e) census population estimates. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aggressiveness, family history of alcoholism, and the heart rate response to alcohol intoxication.

Some sons of male alcoholics (SOMAS) are characterized by an increased heart rate (HR) response to alcohol intoxication, which is thought to reflect increased sensitivity to alcohol-induced reward. Such a response has also been related to increased physical aggression. However, the confounding effect of aggression in SOMAS may be obscuring the interpretation of these findings. The HR response to alcohol was therefore assessed in 4 groups: high/low aggressive SOMAS and high/low aggressive non-SOMAS. Results indicate that aggressive SOMAS had the highest intoxicated HR response and that they reported the most alcohol consumption. This suggests that in some cases the high comorbidity between alcohol misuse and aggression is related to an increased sensitivity to alcohol-induced reward. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hormonal (ACTH, cortisol, beta-endorphin, and met-enkephalin) and cardiovascular responses to hyperthermic stress in chronic alcoholics

Chronic alcohol drinking causes profound alterations in hypothalamic-pituitary function. In the present study, endocrine [corticotropin (ACTH), beta-endorphin, cortisol, and met-enkephalin] and cardiovascular (blood pressure) changes in response to hyperthermic stress (sauna at 90 degrees C for 30 min) were evaluated in 25 normal men (25 to 50 years old) and in 48 male alcoholic subjects (34 to 56 years old) after 5 weeks of abstinence. Significantly lower increments in systolic blood pressure were observed in alcoholics than in control subjects. Furthermore, alcoholics showed lower ACTH, beta-endorphin, and cortisol increments in response to sauna than normal controls. In contrast, sauna-induced hyperthermia did not change significantly the circulating met-enkephalin levels in either normal controls or chronic alcoholics. These data suggest that an impairment in the adaptive response to stress affects alcoholic men even after a few weeks of abstinence from alcohol.     

Trajectories of Alcohol and Drug Use and Dependence From Adolescence to Adulthood: The Effects of Familial Alcoholism and Personality.

This study describes trajectories of substance use and dependence from adolescence to adulthood. Identified consumption groups include heavy drinking/heavy drug use, moderate drinking/experimental drug use, and light drinking/rare drug use. Dependence groups include alcohol only, drug only, and comorbid groups. The heavy drinking/heavy drug use group was at risk for alcohol and drug dependence and persistent dependence and showed more familial alcoholism, negative emotionality, and low constraint. The moderate drinking/experimental drug use group was at risk for alcohol dependence but not comorbid or persistent dependence and showed less negative emotionality and higher constraint. Familial alcoholism raised risk for alcohol and drug use and dependence in part because children from alcoholic families were more impulsive and lower in agreeableness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of abstinence and family history for alcoholism on platelet adenylyl cyclase activity

Platelet adenylyl cyclase (AC) activity was measured in 32 alcohol-dependent subjects and 27 control subjects who were categorized as either family history-positive (FHP) or family history-negative (FHN) for alcoholism. The interview and blood sample collections were performed shortly after cessation of heavy drinking in the alcoholic group, and repeat blood samples were obtained at the end of the first and second weeks of monitored abstinence. Control subjects received the same interview and provided blood samples at the time of the interview. When subjects were not segregated for FHP or FHN status, there were no statistically significant differences in basal, cesium fluoride (CsF)-, or forskolin-stimulated mean AC activities between the controls and the alcoholics, at study entry or with 1 or 2 weeks of abstinence. On the other hand, over the 2-week course of sobriety from heavy drinking, the CsF-stimulated AC activity of FHP alcohol-dependent subjects decreased significantly (p = 0.03). FHP alcohol-dependent subjects after 2 weeks of sobriety had significantly lower mean CsF-stimulated AC activity than FHN controls (p = 0.04), whereas the FHN alcoholic subjects' CsF-stimulated AC activity did not differ significantly from FHN controls at this point in time. When all subjects were pooled and then categorized as either FHP or FHN, there was a significant difference in mean CsF-stimulated AC activity (p = 0.02) between the FHP and FHN subject groups. Genetic factors and abstinence appear to have roles in determining low platelet AC activity in alcoholic and nonalcoholic subjects. CsF-stimulated platelet AC activity, in particular, appears to act as a trait marker for a genetic vulnerability to developing alcoholism, but recent heavy drinking in male alcoholics is a factor that can mask differences between FHP and FHN subjects.     

Alcohol and drug abuse: a retrospective analysis of incidence in a regional hospital 1993-1994

This retrospective study analyzes and compares the incidence of admissions for alcohol and drug (i.e.: heroin and cocaine) induced diseases to the internal medicine service of Locarno Regional Hospital (61 beds plus intensive care unit) between January 1, 1993 and December 31, 1994. Of 4038 admissions, 298 (7.4%) were related to alcoholism and drug addiction. 4.2% of all hospital days were due to alcohol abuse, whereas 3.2% were related to drug abuse (of these 1.8% were for HIV-associated diseases and 0.9% for withdrawal treatment). The male/female ratio was 3:1 in both groups, the average age of women being significantly lower in the alcoholic group (50.5 +/- 14.4 years vs. 58.1 +/- 12.9; p = 0.003). Over 90% of the patients with alcohol-induced conditions continued to consume alcohol. On the contrary, only 16% of the HIV-positive patients were still drug-addicted. The in-hospital mortality was 6% (5% in the alcoholic group; 1.6% and 12%, respectively, in the HIV-negative and HIV-positive groups of drug addicts). This study confirms the high prevalence of diseases related to alcohol and drug abuse. Women are less affected, but show complications of alcohol abuse earlier. Despite the HIV epidemic in our area, the admissions of alcoholics to the hospital are more frequent than those of drug addicts. Most of the drug addicts with an HIV-associated condition are in remission, whereas alcoholics with alcohol-induced diseases continue, for the most part, to be alcohol-dependent.