Does growing up in an alcoholic/dysfunctional home contribute to the development of Attention Deficit Disorder?
ADD and ADHD sufferers are often bright, extremely gifted people. They can sometimes appear absent minded, spaced out and disorganized.
Famous Attention Deficit sufferers include:
Albert Einstein
Benjamin Franklin
Thomas Edison
Galileo
Mozart
Wright Brothers
Leonardo da Vinci
Walt Disney
John Lennon
Winston Churchill
Henry Ford
Stephen Hawkings
Jules Verne
Alexander Graham Bell
John F. Kennedy
Louis Pasteur
F. Scott Fitzgerald
Beethoven
But just what is ADD or ADHD?
According to http://www.add-adhd-help-center.com/symptoms_add_adhd.htm, symptoms include:
_ Often fidgeting with hands or feet, or squirming while seated.
_ Having difficulty remaining seated.
_ Being easily distracted by extraneous stimuli.
_ Having difficulty awaiting turn in games or group activities.
_ Often blurting out answers before questions are completed.
_ Having difficulty in following instructions.
_ Having difficulty sustaining attention in tasks or play activities.
_Often shifting from one uncompleted task to another.
*(One of the Common ACA Characteristics is "Having difficulty in following a project through from beginning to end.")
_ Having difficulty playing quietly.
_Often talking excessively.
_ Often interrupting or intruding on others.
_ Often not listening to what is being said.
_Often forgetting things necessary for tasks or activities.
_Often engaging in physically dangerous activities without considering possible consequences.
*(Another Common ACA Characteristic is "Locking themselves into a course of action without giving serious consideration to alternate behaviors or possible consequences.")
What Causes ADD?
Causes of ADD are thought to include emotional and physical trauma and heredity. People from alcoholic/dysfunctional families may be at risk for all THREE of these factors.
Emotional/Physical Trauma
"Both physical and emotional neglect contribute to ADD. Abuse causes a rush of stress hormones and chemicals that poison a baby's or child's brain. Stress hormones damage the memory centers and chronic stress causes the brain to become hyperalert, leading to severe distractibility and an inability to filter out extraneous stimuli." -"Healing ADD" by Daniel Amen, M.D
"When the noise and chaos in a family reach a certain level, the child is likely to tune it out. They do this by slowing down their brain- the slowed brain is less alert to what is going on. It is slow brainwave rhythms that characterize ADD.
In our clinic, we have seen the same slow brainwave patterns in children who are yelled at constantly and we have also seen this in verbally abused spouses. It is possible to conclude that anyone who lives in chaos and discord could suffer an emotional brain injury and would exhibit many classic ADD-type symptoms." - "Getting Rid Of Ritalin" by Robert Hill, Ph. D. and Eduardo Castro, M.D.
"Our data indicate a constellation of mild dysmorphic features of fetal alcohol syndrome, findings of hyperactivity and persistent school learning difficulties in children with normal intelligence born to heavy drinking mothers. Alcohol exposure in utero (during pregnancy) may be an important, preventable determinant of attention deficit syndromes in childhood." -"Hyperactivity - A.D.D. and Behavior Disorders Linked With Alcohol Exposure" Journal of Pediatarics, 96:978, 1990
"Attention, distraction and impulsive behavior problems were found to occur more often in a study of 475 young school age children whose mothers drank moderate amounts of alcohol during pregnancy." -Neurobehavioral Toxicology and Teratology, 8:717-725, 1986
Heredity
"NIMH investigators found important differences between people who have ADHD and those who don't. In people with ADHD, the brain areas that control attention used less glucose, indicating that they were less active. It appears from this research that a lower level of activity in some parts of the brain may cause inattention.
Other research shows that attention disorders tend to run in families,so there are likely to be genetic influences. Children who have ADHD usually have at least one close relative who also has ADHD. And at least one-third of all fathers who had ADHD in their youth bear children who have ADHD. Even more convincing: the majority of identical twins share the trait." -http://www.add.org/articles/causeadd.html
The Cycle
Alcohol use appears to be part of a vicious cycle- often a factor in both the cause and effect of ADD. Children of alcoholic parents may experience emotional and physical damage that leads to developing ADD. And many of them then grow up to try and control their ADD by self medicating with alcohol.
"Alcohol helped David Miller become more focused and calm, initially correcting low dopamine and GABA neurotransmitter levels, but eventually created more problems than it solved. Mr. Miller provides an excellent description of the heightened anxiety and overstimulation occurring in the newly abstinent alcoholic." -"Overload: Attention Deficit Disorder and the Addictive Brain" by David K. Miller & Kenneth Blum
"Attention deficit hyperactivity disorder (ADHD) is a childhood mental health disorder that can lead to alcohol and other drug (AOD)-related problems if it persists into adolescence and adulthood. Among adult patients receiving treatment for alcohol and other drug (AOD) abuse, the rate of ADHD has been estimated to be approximately 25 percent (Wilens 1998)." -http://findarticles.com/p/articles/mi_m0CXH/is_2_26/ai_95148614
Check out our website at: Orange County Adult Children
Saturday, February 17, 2007
Wednesday, February 7, 2007
Children of Alcoholics: Important Facts
Selected excerpts from:
http://www.athealth.com/consumer/disorders/COAFacts.html
Seventy six million Americans, about 43% of the U.S. adult population, have been exposed to alcoholism in the family.
Almost one in five adult Americans (18%) lived with an alcoholic while growing up.
Roughly one in eight American adult drinkers is alcoholic or experiences problems due to the use of alcohol. The cost to society is estimated at in excess of $166 billion each year.
There are an estimated 26.8 million COAs in the United States. Preliminary research suggests that over 11 million are under the age of 18.
Children of alcoholics are four times more likely than non-COAs to develop alcoholism.
Genetic factors play a major role in the development of alcoholism. There is an expanding base of literature which strongly supports a heritable basis for alcoholism and a range of family influences that may direct the development of children of alcoholics.
Family interaction patterns also may influence the COA's risk for alcohol abuse. It has been found that families with an alcoholic parent displayed more negative family interaction during problem-solving discussions than in non-alcoholic families.
Almost one-third of any sample of alcoholics has at least one parent who also was or is an alcoholic.
Children of alcoholics are more likely than non-COAs to marry into families in which alcoholism is prevalent.
Parental alcoholism influences adolescent substance use through several different pathways including stress, negative affect and decreased parental monitoring. Negative affect and impaired parental monitoring are associated with adolescent's joining in a peer network that supports drug use behavior.
Source: SAMHSA's National Clearinghouse for Drug and Alcohol Information
Check out our website at: http://members.cox.net/orangecountyadultchildren/
http://www.athealth.com/consumer/disorders/COAFacts.html
Seventy six million Americans, about 43% of the U.S. adult population, have been exposed to alcoholism in the family.
Almost one in five adult Americans (18%) lived with an alcoholic while growing up.
Roughly one in eight American adult drinkers is alcoholic or experiences problems due to the use of alcohol. The cost to society is estimated at in excess of $166 billion each year.
There are an estimated 26.8 million COAs in the United States. Preliminary research suggests that over 11 million are under the age of 18.
Children of alcoholics are four times more likely than non-COAs to develop alcoholism.
Genetic factors play a major role in the development of alcoholism. There is an expanding base of literature which strongly supports a heritable basis for alcoholism and a range of family influences that may direct the development of children of alcoholics.
Family interaction patterns also may influence the COA's risk for alcohol abuse. It has been found that families with an alcoholic parent displayed more negative family interaction during problem-solving discussions than in non-alcoholic families.
Almost one-third of any sample of alcoholics has at least one parent who also was or is an alcoholic.
Children of alcoholics are more likely than non-COAs to marry into families in which alcoholism is prevalent.
Parental alcoholism influences adolescent substance use through several different pathways including stress, negative affect and decreased parental monitoring. Negative affect and impaired parental monitoring are associated with adolescent's joining in a peer network that supports drug use behavior.
Source: SAMHSA's National Clearinghouse for Drug and Alcohol Information
Check out our website at: http://members.cox.net/orangecountyadultchildren/
Wednesday, January 24, 2007
Further Characteristics
A bit of a twist on the "Characteristics" with added insights.
As reprinted from: http://www.thisisawar.com/AddictionAlcoholChild.htm
1. We became isolated and afraid of people and authority figures;
2. We became approval seekers and lost our own identity in the process;
3. We are frightened by angry people and personal criticism;
4. We either became alcoholics, married them, or found another compulsive personality, such as a workaholic, to fulfill our need for and expectation of abandonment;
5. We live life from the viewpoint of helping and seeking victims, and we are attracted by that weakness in our relationships;
6. We have an overdeveloped sense of responsibility, and it is easier for us to be concerned with others rather than with ourselves;
7. We suffer guilt feelings when we stand up for ourselves; instead, we give in to others;
8. We confuse love with pity and tend to "love" people we can pity and rescue;
9. We have suppressed our feelings from our traumatic childhoods and have lost the ability to feel or to honestly express our feelings. Rationalization seems far easier;
10. We judge ourselves harshly and have a very low sense of self-esteem. We sometimes compensate for this sense of inferiority by trying to appear superior;
11. We are dependent personalities who are terrified of abandonment. We will do anything to hold on to a relationship in order not to experience the pain of abandonment;
12. We became para-alcoholic, taking on the characteristics of alcoholism even though we did not pick up the drink;
13. We became compulsive and obsessive in our behavior;
14. We are unknowingly trying to recreate the chaotic lifestyle with which we are familiar;
15. We are afraid of intimacy and have difficulty forming close intimate relationships;
16. We became aware of feelings which seem to separate us from others, and we find ourselves depressed. Depression is endemic in dysfunctional families.
Copyright 2002 Janet Geringer Woititz
Check out our website at: http://members.cox.net/orangecountyadultchildren/
As reprinted from: http://www.thisisawar.com/AddictionAlcoholChild.htm
1. We became isolated and afraid of people and authority figures;
2. We became approval seekers and lost our own identity in the process;
3. We are frightened by angry people and personal criticism;
4. We either became alcoholics, married them, or found another compulsive personality, such as a workaholic, to fulfill our need for and expectation of abandonment;
5. We live life from the viewpoint of helping and seeking victims, and we are attracted by that weakness in our relationships;
6. We have an overdeveloped sense of responsibility, and it is easier for us to be concerned with others rather than with ourselves;
7. We suffer guilt feelings when we stand up for ourselves; instead, we give in to others;
8. We confuse love with pity and tend to "love" people we can pity and rescue;
9. We have suppressed our feelings from our traumatic childhoods and have lost the ability to feel or to honestly express our feelings. Rationalization seems far easier;
10. We judge ourselves harshly and have a very low sense of self-esteem. We sometimes compensate for this sense of inferiority by trying to appear superior;
11. We are dependent personalities who are terrified of abandonment. We will do anything to hold on to a relationship in order not to experience the pain of abandonment;
12. We became para-alcoholic, taking on the characteristics of alcoholism even though we did not pick up the drink;
13. We became compulsive and obsessive in our behavior;
14. We are unknowingly trying to recreate the chaotic lifestyle with which we are familiar;
15. We are afraid of intimacy and have difficulty forming close intimate relationships;
16. We became aware of feelings which seem to separate us from others, and we find ourselves depressed. Depression is endemic in dysfunctional families.
Copyright 2002 Janet Geringer Woititz
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Tuesday, January 16, 2007
How Many COAs Are There?
http://www.coaf.org/researchlinks/numbers.htm
In the January 2000 issue of the American Journal of Public Health, an article appears with new estimates of the number of children of alcoholics. Using data from the 1992 National Longitudinal Alcohol Epidemiological Survey, the NIAAA authors found that 15% of all U.S. children were currently exposed to alcohol abuse and/or dependence in the family (which includes any adults living in the household), and 43% of all children were exposed to someone who, during their lifetime, satisfied a diagnosis of alcohol abuse or dependence.
Assuming that the best estimate lies between these two extremes, it was determined that approximately 1 in 4 children in the US is exposed to alcohol abuse and/or dependence in the family at some point before age 18.
This is just the latest in a long line of studies on this issue. The first estimates of the number of children of alcoholics were developed in 1974 by Booz-Allen and Hamilton, who suggested extrapolating national survey data on problem drinking to the U.S. population and multiplying the resulting estimate of adult problem drinkers by the ratio of adults to children in the general population.
It should also be kept in mind that the data do not include alcoholics who are in the military, institutionalized, homeless, or who may have refused to participate in the survey. Given these caveats, it was estimated that there were approximately 6,600,000 children of alcoholics under the age of 18 years in the U.S. at that time.
Check out our website at:http://members.cox.net/orangecountyadultchildren/
In the January 2000 issue of the American Journal of Public Health, an article appears with new estimates of the number of children of alcoholics. Using data from the 1992 National Longitudinal Alcohol Epidemiological Survey, the NIAAA authors found that 15% of all U.S. children were currently exposed to alcohol abuse and/or dependence in the family (which includes any adults living in the household), and 43% of all children were exposed to someone who, during their lifetime, satisfied a diagnosis of alcohol abuse or dependence.
Assuming that the best estimate lies between these two extremes, it was determined that approximately 1 in 4 children in the US is exposed to alcohol abuse and/or dependence in the family at some point before age 18.
This is just the latest in a long line of studies on this issue. The first estimates of the number of children of alcoholics were developed in 1974 by Booz-Allen and Hamilton, who suggested extrapolating national survey data on problem drinking to the U.S. population and multiplying the resulting estimate of adult problem drinkers by the ratio of adults to children in the general population.
It should also be kept in mind that the data do not include alcoholics who are in the military, institutionalized, homeless, or who may have refused to participate in the survey. Given these caveats, it was estimated that there were approximately 6,600,000 children of alcoholics under the age of 18 years in the U.S. at that time.
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Saturday, January 13, 2007
CHILDREN OF ALCOHOLICS
Excerpts from RESEARCH ON CHILDREN OF ALCOHOLICS
Subject: Children of alcoholics Date: 28 Dec 1994
Copyright 1994 Health ResponseAbility Systems, Collective Work & Database
An estimated 6.6 million children under the age of 18 years live in households with at least one alcoholic parent (1). Current research findings suggest that these children are at risk for a range of cognitive, emotional, and behavioral problems.
In addition, genetic studies indicate that alcoholism tends to run in families and that a genetic vulnerability for alcoholism exists (2,3,4). Yet, some investigators also report that many children from alcoholic homes develop neither psychopathology nor alcoholism.
This Alcohol Alert focuses on three major research questions concerning children of alcoholics (COAs):
1. What contributes to resilience in some COAs?
2. Do COAs differ from children of nonalcoholics (nonCOAs)?
3. Are the differences specifically related to parental alcoholism, or are they similar to characteristics observed in children whose parents have other illnesses?
While research findings suggest that some children suffer negative consequences due to parental alcoholism, a larger proportion of COAs function well and do not develop serious problems.
In a longitudinal study of COAs born on the island of Kauai, Werner (5) reported that, although 41 percent of the children developed serious coping problems by 18 years of age, 59 percent did not develop problems.
These resilient children shared several characteristics that contributed to their success, including the ability to obtain positive attention from other people, adequate communication skills, average intelligence, a caring attitude, a desire to achieve, and a belief in self-help.
Studies comparing COAs and nonCOAs have suggested that, although the two groups differ in a variety of psychosocial areas, differences in cognitive performance are observed most frequently.
Cognitive function in COAs has been examined by many researchers because it is an important element needed for adaptation at all stages of development; it can be measured uniformly across developmental stages; and it often is associated with the symptoms of alcoholism.
Ervin and her colleagues (6) found that Full IQ, performance (a measure of abstract and conceptual reasoning), and verbal scores were lower among a sample of children raised by alcoholic fathers than among children raised by nonalcoholic fathers.
Gabrielli and Mednick (7) reported similar results for verbal and Full IQ tests, but not for performance tests.
In a study comparing COAs and nonCOAs whose families were educated and whose parents lived in the home, Bennett and colleagues (8) found that children from alcoholic families had lower IQ, arithmetic, reading, and verbal scores. Despite the lower scores, however, COAs performed within normal ranges for intelligence tests in each of these studies.
It is important to note that cognitive competence can vary with the instrument used to measure performance as well as with the individual who is evaluating function. Johnson and Rolf (9) compared the academic abilities and cognitive function of COAs and nonCOAs from nondisadvantaged backgrounds and found no differences between the groups.
The investigators noted, however, that the children with alcoholic parents underestimated their own competence. In addition, the mothers of COAs underrated their children's abilities. The mother's and children's perceptions of abilities may affect the children's motivation, self-esteem, and future performance.
School-aged children of alcoholic parents often have academic problems. Academic performance may be a better measure than IQ of the effect of living with an alcoholic parent. School records indicate that COAs experience such academic difficulties as repeating grades, failing to graduate from high school, and requiring referrals to school psychologists (10,11).
Although cognitive deficits in COAs may account, in part, for their poor academic performance, motivational difficulties or the stress of the home environment also may contribute to their problems in school. Studies comparing COAs with nonCOAs also have found that parental alcoholism is linked to a number of psychological disorders in children.
Divorce, parental anxiety or affective disorders, or undesirable changes in the family or in life situations can add to the negative effect of parental alcoholism on children's emotional functioning (12,13). The results of several studies have shown that children from alcoholic families report higher levels of depression and anxiety and exhibit more symptoms of generalized stress (i.e., low self-esteem) than do children from nonalcoholic families (12,13,14,15).
In addition, COAs often express a feeling of lack of control over their environment. A recent study by Rolf and colleagues (16) noted that COAs show more depressive affect than nonCOAs and that their self-reports of depression are measured more frequently on the extreme end of the scale.
Moos and Billings (13) found that the emotional stress of parental drinking on children lessens when parents stop drinking. These investigators assessed emotional problems in children from families of relapsed alcoholics, children from families with a recovering parent, and children from families with no alcohol problem. Although the children of relapsed alcoholics reported higher levels of anxiety and depression than children from the homes with no alcohol problem, emotional functioning was similar among the children of recovering and normal parents.
Finally, children from homes with alcoholic parents often demonstrate behavioral problems. Study findings suggest that these children exhibit such problems as lying, stealing, fighting, truancy, and school behavior problems, and they often are diagnosed as having conduct disorders (17).
Teachers have rated COAs as significantly more overactive and impulsive than nonCOAs (11,18). COAs also appear to be at greater risk for delinquency and school truancy (12,19,20). Several investigators have reported an association between the incidence of diagnosed conduct disorders and parental alcohol abuse (21,22,23). However, other problems associated with alcoholism (e.g., depression among the alcoholic parents and divorce) also may contribute to conduct problems and disorders among COAs.
The alcoholic family's home environment and the manner in which family members interact may contribute to the risk for the problems observed among COAs. Although alcoholic families are a heterogeneous group, some common characteristics have been identified. Families of alcoholics have lower levels of family cohesion, expressiveness, independence, and intellectual orientation and higher levels of conflict compared with nonalcoholic families (13,24,25,26).
Some characteristics, however, are not specific to alcoholic families: Impaired problem-solving ability and hostile communication are observed both in alcoholic families and in families with problems other than alcohol (27). Moreover, the characteristics of families with recovering alcoholic members and of families with no alcoholic members do not differ significantly, suggesting that a parent's continued drinking may be responsible for the disruption of family life in an alcoholic home (13).
The family environment also may affect transmission of alcoholism to COAs. Children with alcoholic parents are less likely to become alcoholics as adults when their parents consistently set and follow through on plans and maintain such rituals as holidays and regular mealtimes (28).
Interestingly, the problems of COAs may not be specific to this population. In a review of research on children whose mothers were schizophrenic, Garmezy (29) reported that, like COAs, these children had cognitive deficits. In particular, they had a limited ability to maintain attention and to perceive relevant stimuli.
Children at high risk for schizophrenia revealed a more negative self-image. The family environment also may influence the risk for schizophrenia; children of schizophrenic parents - whose home environment is turbulent - have an increased risk for developing schizophrenia.
Research on COAs is still in its infancy. Many studies suggest that a variety of differences exist between children of alcoholics and children of nonalcoholics and these differences occur at all ages. However, because of the limitations of the methodology and the inadequate number of comprehensive studies, research findings cannot be generalized to all children who grow up with alcoholic parents.
References
(1) RUSSELL, M.; Henderson, C.; and Blume, S.B. Children of Alcoholics: A Review of the Literature. New York: Children of Alcoholics Foundation, Inc., 1984.
(2) KAIJ, L. Alcoholism in Twins. Studies on the Etiology and Sequels of Abuse of Alcohol. Stockholm: Almqvist & Wiksell Publishers, 1960.
(3) CLONINGER, C.R.; Bohman, M.; and Sigvardsson, S. Inheritance of alcohol abuse. Archives of General Psychiatry 38:861-868, 1981.
(4) GOODWIN, D.W.; Schulsinger, F.; Hermansen, L.; Guze, S.B.; and Winokur, G. Alcohol problems in adoptees raised apart from alcoholic biological parents. Archives of General Psychiatry 28:238-243, 1973.
(5) WERNER, E.E. Resilient offspring of alcoholics: A longitudinal study from birth to age 18. Journal of Studies on Alcohol 47(1):34-40, 1986.
(6) ERVIN, C.S.; Little, R.E.; Streissguth, A.P.; and Beck, D.E. Alcoholic fathering and its relation to child s intellectual development: A pilot investigation. Alcoholism: Clinical and Experimental Research 8(4):362-365, 1984.
(7) GABRIELLI, W.F., JR., & Mednick, S.A. Intellectual performance in children of alcoholics. Journal of Nervous and Mental Disease 171(7):444-447, 1983.
(8) BENNETT, L.A.; Wolin, S.J.; and Reiss, D. Cognitive, behavioral, and emotional problems among school-age children of alcoholic parents. American Journal of Psychiatry 145(2):185-190, 1988.
(9) JOHNSON, J.L., & Rolf, J.E. Cognitive functioning in children from alcoholic and non-alcoholic families. British Journal of Addiction 83:849-857, 1988.
(10) MILLER, D., & Jang, M. Children of alcoholics: A 20-year longitudinal study. Social Work Research & Abstracts 13:23-29, 1977.
(11) KNOP, J.; Teasdale, T.W.; Schulsinger, F.; and Goodwin, D.W. A prospective study of young men at high risk for alcoholism: School behavior and achievement. Journal of Studies on Alcohol 46(4):273-278, 1985.
(12) SCHUCKIT, M.A., & Chiles, J.A. Family history as a diagnostic aid in two samples of adolescents. Journal of Nervous and Mental Disease 166(3):165-176, 1978.
(13) MOOS, R.H., & Billings, A.G. Children of alcoholics during the recovery process: Alcoholic and matched control families. Addictive Behaviors 7:155-163, 1982.
(14) ANDERSON, E., & Quast, W. Young children in alcoholic families: A mental health needs-assessment and an intervention/prevention strategy. Journal of Primary Prevention 3:(3)174-187, 1983.
(15) PREWETT, M.J.; Spence, R.; and Chaknis, M. Attribution of causality by children with alcoholic parents. International Journal of the Addictions 16(2):367-370, 1981.
(16) ROLF, J.E.; Johnson, J.L.; Israel, E.; Baldwin, J.; and Chandra, A. Depressive affect in school-aged children of alcoholics. British Journal of Addiction 83:841-848, 1988.
(17) WEST, M.O., & Prinz, R.J. Parental alcoholism and childhood psychopathology. Psychological Bulletin 102(2):204-218, 1987.
(18) BELL, B., & Cohen, R. The Bristol Social Adjustment Guide: Comparison between the offspring of alcoholic and non-alcoholic mothers. British Journal of Clinical Psychology 20:93-95, 1981.
(19) FINE, E.W.; Yudin, L.W.; Holmes, J.; and Heinemann, S. Behavioral disorders in children with parental alcoholism. Annals of the New York Academy of Sciences 273:507-517, 1976.
(20) RIMMER, J. The children of alcoholics: An exploratory study. Children and Youth Services Review 4:365-373, 1982.
(21) STEINHAUSEN, H.-C.; Gobel, D.; and Nestler, V. Psychopathology in the offspring of alcoholic parents. Journal of the American Academy of Child Psychiatry 23(4):465-471, 1984.
(22) MERIKANGAS, K.R.; Weissman, M.M.; Prusoff, B.A.; Pauls, D.L.; and Leckman, J.F. Depressives with secondary alcoholism: Psychiatric disorders in offspring. Journal of Studies on Alcohol 46(3):199-204, 1985.
(23) STEWART, M.A.; deBlois, C.S.; and Singer, S. Alcoholism and hyperactivity revisited: A preliminary report. In: Galanter, M., ed. Currents in Alcoholism. Volume V. New York: Grune & Stratton, 1979. pp. 349-357.
(24) CLAIR, D., & Genest, M. Variables associated with the adjustment of offspring of alcoholic fathers. Journal of Studies on Alcohol 48(4):345-355, 1986.
(25) FILSTEAD, W.J.; McElfresh, O.; and Anderson, C. Comparing the family environments of alcoholic and "normal" families. Journal of Alcohol and Drug Education 26(2):24-31, 1981.
(26) MOOS, R.H., & Moos, B.S. The process of recovery from alcoholism: Comparing functioning in families of alcoholics and matched control families. Journal of Studies on Alcohol 45(2):111-118, 1984.
(27) BILLINGS, A.G.; Kessler, M.; Gomberg, C.A.; and Weiner, S. Marital conflict resolution of alcoholic and nonalcoholic couples during drinking and non-drinking sessions. Journal of Studies on Alcohol 40(3):183-195, 1979.
(28) WOLIN, S.J.; Bennett, L.A.; Noonan, D.L.; and Teitelbaum, M.A. Disrupted family rituals: A factor in the intergenerational transmission of alcoholism. Journal of Studies on Alcohol 41(3):199-214, 1980.
(29) GARMEZY, N. Children at risk: The search for the antecedents of schizophrenia. Part II: Ongoing research programs, issues, and intervention. Schizophrenia Bulletin 9:55-125, 1974.
ACKNOWLEDGMENTS: The National Institute on Alcohol Abuse and Alcoholism wishes to acknowlege the following individuals who have contributed their time and expertise to the development of the Alcohol Alert series over the past 2 years:
John Allen, Ph.D.; Loran D. Archer; Gerald Brown, M.D.; Fulton Caldwell, Ph.D.; Mary Dufour, M.D., M.P.H.; Michael Eckardt, Ph.D.; Terry Freeman; Richard Fuller, M.D.; Bridget Grant, Ph.D.; Thomas Harford, Ph.D.; Brenda Hewitt; Jeannette Johnson, Ph.D.; Michael J. Lewis, Ph.D.; Markku Linnoila, M.D., Ph.D.; Jane Lockmuller; Diane Miller; John Noble; H. Laurence Ross, Ph.D.; Barbara Smothers, Ph.D.; Fred Stinson, Ph.D.; Cate Timmerman; Ken Warren, Ph.D.; Dianne Welsh; Gerald Williams, D.Ed.; and Terry Zobeck, Ph.D.
Source: NIAAA, ALCOHOL ALERT, No. 9, July 1990
Subject: Children of alcoholics Date: 28 Dec 1994
Copyright 1994 Health ResponseAbility Systems, Collective Work & Database
An estimated 6.6 million children under the age of 18 years live in households with at least one alcoholic parent (1). Current research findings suggest that these children are at risk for a range of cognitive, emotional, and behavioral problems.
In addition, genetic studies indicate that alcoholism tends to run in families and that a genetic vulnerability for alcoholism exists (2,3,4). Yet, some investigators also report that many children from alcoholic homes develop neither psychopathology nor alcoholism.
This Alcohol Alert focuses on three major research questions concerning children of alcoholics (COAs):
1. What contributes to resilience in some COAs?
2. Do COAs differ from children of nonalcoholics (nonCOAs)?
3. Are the differences specifically related to parental alcoholism, or are they similar to characteristics observed in children whose parents have other illnesses?
While research findings suggest that some children suffer negative consequences due to parental alcoholism, a larger proportion of COAs function well and do not develop serious problems.
In a longitudinal study of COAs born on the island of Kauai, Werner (5) reported that, although 41 percent of the children developed serious coping problems by 18 years of age, 59 percent did not develop problems.
These resilient children shared several characteristics that contributed to their success, including the ability to obtain positive attention from other people, adequate communication skills, average intelligence, a caring attitude, a desire to achieve, and a belief in self-help.
Studies comparing COAs and nonCOAs have suggested that, although the two groups differ in a variety of psychosocial areas, differences in cognitive performance are observed most frequently.
Cognitive function in COAs has been examined by many researchers because it is an important element needed for adaptation at all stages of development; it can be measured uniformly across developmental stages; and it often is associated with the symptoms of alcoholism.
Ervin and her colleagues (6) found that Full IQ, performance (a measure of abstract and conceptual reasoning), and verbal scores were lower among a sample of children raised by alcoholic fathers than among children raised by nonalcoholic fathers.
Gabrielli and Mednick (7) reported similar results for verbal and Full IQ tests, but not for performance tests.
In a study comparing COAs and nonCOAs whose families were educated and whose parents lived in the home, Bennett and colleagues (8) found that children from alcoholic families had lower IQ, arithmetic, reading, and verbal scores. Despite the lower scores, however, COAs performed within normal ranges for intelligence tests in each of these studies.
It is important to note that cognitive competence can vary with the instrument used to measure performance as well as with the individual who is evaluating function. Johnson and Rolf (9) compared the academic abilities and cognitive function of COAs and nonCOAs from nondisadvantaged backgrounds and found no differences between the groups.
The investigators noted, however, that the children with alcoholic parents underestimated their own competence. In addition, the mothers of COAs underrated their children's abilities. The mother's and children's perceptions of abilities may affect the children's motivation, self-esteem, and future performance.
School-aged children of alcoholic parents often have academic problems. Academic performance may be a better measure than IQ of the effect of living with an alcoholic parent. School records indicate that COAs experience such academic difficulties as repeating grades, failing to graduate from high school, and requiring referrals to school psychologists (10,11).
Although cognitive deficits in COAs may account, in part, for their poor academic performance, motivational difficulties or the stress of the home environment also may contribute to their problems in school. Studies comparing COAs with nonCOAs also have found that parental alcoholism is linked to a number of psychological disorders in children.
Divorce, parental anxiety or affective disorders, or undesirable changes in the family or in life situations can add to the negative effect of parental alcoholism on children's emotional functioning (12,13). The results of several studies have shown that children from alcoholic families report higher levels of depression and anxiety and exhibit more symptoms of generalized stress (i.e., low self-esteem) than do children from nonalcoholic families (12,13,14,15).
In addition, COAs often express a feeling of lack of control over their environment. A recent study by Rolf and colleagues (16) noted that COAs show more depressive affect than nonCOAs and that their self-reports of depression are measured more frequently on the extreme end of the scale.
Moos and Billings (13) found that the emotional stress of parental drinking on children lessens when parents stop drinking. These investigators assessed emotional problems in children from families of relapsed alcoholics, children from families with a recovering parent, and children from families with no alcohol problem. Although the children of relapsed alcoholics reported higher levels of anxiety and depression than children from the homes with no alcohol problem, emotional functioning was similar among the children of recovering and normal parents.
Finally, children from homes with alcoholic parents often demonstrate behavioral problems. Study findings suggest that these children exhibit such problems as lying, stealing, fighting, truancy, and school behavior problems, and they often are diagnosed as having conduct disorders (17).
Teachers have rated COAs as significantly more overactive and impulsive than nonCOAs (11,18). COAs also appear to be at greater risk for delinquency and school truancy (12,19,20). Several investigators have reported an association between the incidence of diagnosed conduct disorders and parental alcohol abuse (21,22,23). However, other problems associated with alcoholism (e.g., depression among the alcoholic parents and divorce) also may contribute to conduct problems and disorders among COAs.
The alcoholic family's home environment and the manner in which family members interact may contribute to the risk for the problems observed among COAs. Although alcoholic families are a heterogeneous group, some common characteristics have been identified. Families of alcoholics have lower levels of family cohesion, expressiveness, independence, and intellectual orientation and higher levels of conflict compared with nonalcoholic families (13,24,25,26).
Some characteristics, however, are not specific to alcoholic families: Impaired problem-solving ability and hostile communication are observed both in alcoholic families and in families with problems other than alcohol (27). Moreover, the characteristics of families with recovering alcoholic members and of families with no alcoholic members do not differ significantly, suggesting that a parent's continued drinking may be responsible for the disruption of family life in an alcoholic home (13).
The family environment also may affect transmission of alcoholism to COAs. Children with alcoholic parents are less likely to become alcoholics as adults when their parents consistently set and follow through on plans and maintain such rituals as holidays and regular mealtimes (28).
Interestingly, the problems of COAs may not be specific to this population. In a review of research on children whose mothers were schizophrenic, Garmezy (29) reported that, like COAs, these children had cognitive deficits. In particular, they had a limited ability to maintain attention and to perceive relevant stimuli.
Children at high risk for schizophrenia revealed a more negative self-image. The family environment also may influence the risk for schizophrenia; children of schizophrenic parents - whose home environment is turbulent - have an increased risk for developing schizophrenia.
Research on COAs is still in its infancy. Many studies suggest that a variety of differences exist between children of alcoholics and children of nonalcoholics and these differences occur at all ages. However, because of the limitations of the methodology and the inadequate number of comprehensive studies, research findings cannot be generalized to all children who grow up with alcoholic parents.
References
(1) RUSSELL, M.; Henderson, C.; and Blume, S.B. Children of Alcoholics: A Review of the Literature. New York: Children of Alcoholics Foundation, Inc., 1984.
(2) KAIJ, L. Alcoholism in Twins. Studies on the Etiology and Sequels of Abuse of Alcohol. Stockholm: Almqvist & Wiksell Publishers, 1960.
(3) CLONINGER, C.R.; Bohman, M.; and Sigvardsson, S. Inheritance of alcohol abuse. Archives of General Psychiatry 38:861-868, 1981.
(4) GOODWIN, D.W.; Schulsinger, F.; Hermansen, L.; Guze, S.B.; and Winokur, G. Alcohol problems in adoptees raised apart from alcoholic biological parents. Archives of General Psychiatry 28:238-243, 1973.
(5) WERNER, E.E. Resilient offspring of alcoholics: A longitudinal study from birth to age 18. Journal of Studies on Alcohol 47(1):34-40, 1986.
(6) ERVIN, C.S.; Little, R.E.; Streissguth, A.P.; and Beck, D.E. Alcoholic fathering and its relation to child s intellectual development: A pilot investigation. Alcoholism: Clinical and Experimental Research 8(4):362-365, 1984.
(7) GABRIELLI, W.F., JR., & Mednick, S.A. Intellectual performance in children of alcoholics. Journal of Nervous and Mental Disease 171(7):444-447, 1983.
(8) BENNETT, L.A.; Wolin, S.J.; and Reiss, D. Cognitive, behavioral, and emotional problems among school-age children of alcoholic parents. American Journal of Psychiatry 145(2):185-190, 1988.
(9) JOHNSON, J.L., & Rolf, J.E. Cognitive functioning in children from alcoholic and non-alcoholic families. British Journal of Addiction 83:849-857, 1988.
(10) MILLER, D., & Jang, M. Children of alcoholics: A 20-year longitudinal study. Social Work Research & Abstracts 13:23-29, 1977.
(11) KNOP, J.; Teasdale, T.W.; Schulsinger, F.; and Goodwin, D.W. A prospective study of young men at high risk for alcoholism: School behavior and achievement. Journal of Studies on Alcohol 46(4):273-278, 1985.
(12) SCHUCKIT, M.A., & Chiles, J.A. Family history as a diagnostic aid in two samples of adolescents. Journal of Nervous and Mental Disease 166(3):165-176, 1978.
(13) MOOS, R.H., & Billings, A.G. Children of alcoholics during the recovery process: Alcoholic and matched control families. Addictive Behaviors 7:155-163, 1982.
(14) ANDERSON, E., & Quast, W. Young children in alcoholic families: A mental health needs-assessment and an intervention/prevention strategy. Journal of Primary Prevention 3:(3)174-187, 1983.
(15) PREWETT, M.J.; Spence, R.; and Chaknis, M. Attribution of causality by children with alcoholic parents. International Journal of the Addictions 16(2):367-370, 1981.
(16) ROLF, J.E.; Johnson, J.L.; Israel, E.; Baldwin, J.; and Chandra, A. Depressive affect in school-aged children of alcoholics. British Journal of Addiction 83:841-848, 1988.
(17) WEST, M.O., & Prinz, R.J. Parental alcoholism and childhood psychopathology. Psychological Bulletin 102(2):204-218, 1987.
(18) BELL, B., & Cohen, R. The Bristol Social Adjustment Guide: Comparison between the offspring of alcoholic and non-alcoholic mothers. British Journal of Clinical Psychology 20:93-95, 1981.
(19) FINE, E.W.; Yudin, L.W.; Holmes, J.; and Heinemann, S. Behavioral disorders in children with parental alcoholism. Annals of the New York Academy of Sciences 273:507-517, 1976.
(20) RIMMER, J. The children of alcoholics: An exploratory study. Children and Youth Services Review 4:365-373, 1982.
(21) STEINHAUSEN, H.-C.; Gobel, D.; and Nestler, V. Psychopathology in the offspring of alcoholic parents. Journal of the American Academy of Child Psychiatry 23(4):465-471, 1984.
(22) MERIKANGAS, K.R.; Weissman, M.M.; Prusoff, B.A.; Pauls, D.L.; and Leckman, J.F. Depressives with secondary alcoholism: Psychiatric disorders in offspring. Journal of Studies on Alcohol 46(3):199-204, 1985.
(23) STEWART, M.A.; deBlois, C.S.; and Singer, S. Alcoholism and hyperactivity revisited: A preliminary report. In: Galanter, M., ed. Currents in Alcoholism. Volume V. New York: Grune & Stratton, 1979. pp. 349-357.
(24) CLAIR, D., & Genest, M. Variables associated with the adjustment of offspring of alcoholic fathers. Journal of Studies on Alcohol 48(4):345-355, 1986.
(25) FILSTEAD, W.J.; McElfresh, O.; and Anderson, C. Comparing the family environments of alcoholic and "normal" families. Journal of Alcohol and Drug Education 26(2):24-31, 1981.
(26) MOOS, R.H., & Moos, B.S. The process of recovery from alcoholism: Comparing functioning in families of alcoholics and matched control families. Journal of Studies on Alcohol 45(2):111-118, 1984.
(27) BILLINGS, A.G.; Kessler, M.; Gomberg, C.A.; and Weiner, S. Marital conflict resolution of alcoholic and nonalcoholic couples during drinking and non-drinking sessions. Journal of Studies on Alcohol 40(3):183-195, 1979.
(28) WOLIN, S.J.; Bennett, L.A.; Noonan, D.L.; and Teitelbaum, M.A. Disrupted family rituals: A factor in the intergenerational transmission of alcoholism. Journal of Studies on Alcohol 41(3):199-214, 1980.
(29) GARMEZY, N. Children at risk: The search for the antecedents of schizophrenia. Part II: Ongoing research programs, issues, and intervention. Schizophrenia Bulletin 9:55-125, 1974.
ACKNOWLEDGMENTS: The National Institute on Alcohol Abuse and Alcoholism wishes to acknowlege the following individuals who have contributed their time and expertise to the development of the Alcohol Alert series over the past 2 years:
John Allen, Ph.D.; Loran D. Archer; Gerald Brown, M.D.; Fulton Caldwell, Ph.D.; Mary Dufour, M.D., M.P.H.; Michael Eckardt, Ph.D.; Terry Freeman; Richard Fuller, M.D.; Bridget Grant, Ph.D.; Thomas Harford, Ph.D.; Brenda Hewitt; Jeannette Johnson, Ph.D.; Michael J. Lewis, Ph.D.; Markku Linnoila, M.D., Ph.D.; Jane Lockmuller; Diane Miller; John Noble; H. Laurence Ross, Ph.D.; Barbara Smothers, Ph.D.; Fred Stinson, Ph.D.; Cate Timmerman; Ken Warren, Ph.D.; Dianne Welsh; Gerald Williams, D.Ed.; and Terry Zobeck, Ph.D.
Source: NIAAA, ALCOHOL ALERT, No. 9, July 1990
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