Book T of C
Chap T of C
This is the 2007 version. Click here for the 2017 chapter 14 table of contents.
Polls show that about a third of the families in America are troubled by alcohol abuse, and eight out of ten Americans agree that alcohol abuse is a major national problem. One leading pollster described that as an "overwhelming figure" because it is rare for eight out of ten Americans to agree on anything. A full third said their families had been directly affected by alcohol-related problems.
What are typical checklist items for defining alcoholism?
Checklists for defining alcoholism are commonplace. Typical questions are like this:
1. Do you ever drink first thing in the morning?
2. Do you ever hide alcoholic beverages from those around you, for your private consumption?
3. Do you ever suffer memory blackouts from alcohol?
People who say "Yes" to those items are more likely to be alcoholics. To the surprise of some researchers, simple checklists are more reliable than biochemical tests in uncovering alcoholics. However, some researchers dislike the checklist approach. It leads people to play games with themselves, such as saying, "I don't drink first thing in the morning—I wait until noon—so I must not be an alcoholic." Royce (1981) defined alcoholism as a combination of three things:
How did Royce define alcoholism?
1. Some loss of control. It need not be total: "Most alcoholics can take one or two drinks under certain circumstances without getting drunk, but this does not prove they are not alcoholic. Sooner or later they are in trouble again."
2. Dependence or need. "Discomfort if deprived of alcohol and inability to quit on one's own." The alcohol withdrawal syndrome (detoxification) includes sweating, sickness, tremors, and hallucinations.
3. Interference with normal functioning. Multiple arrests for drunk driving, repeated fights while drunk, absenteeism and employment problems due to alcohol-all these indicate alcoholism.
What is some evidence that genetic factors can influence alcohol preference?
Alcohol does not have an equal attraction for all people. There is evidence of genetic factors influencing alcohol preference in laboratory animals. Selective breeding can produce rats that prefer alcohol. In one experiment (Waller and colleagues, 1984) an alcohol-preferring line of rats consumed over 13 times as much alcohol as the other, when both had free access to alcohol. Animal populations bred to prefer alcohol have greater sensitivity to the neurotransmitter GABA, which responds to alcohol (Wafford, Burnett, Dunwiddie, & Harris, 1990). In humans as well, alcoholics metabolize alcohol differently from non-alcoholics (e.g. Borg, Kvande, & Sedvall, 1981).
What are the best predictors of alcoholism in humans?
Certain ethnic groups among humans are more vulnerable to alcoholism than others. For example, the Irish are disproportionately vulnerable, even when adopted into non-Irish families. Vaillant and colleagues (1982) reported the results of a 33-year study which suggested South European ethnicity and number of alcoholic relatives are the best predictors of alcoholism in humans.
Alcoholics often report a pleasurable first encounter with alcohol. Adams (1983) reported that many alcoholics remember an extremely positive reaction to their first episode of drinking to intoxication—"This is what I want!" Non-alcoholics, by contrast, typically get sick or have a bad reaction the first time they get drunk.
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