Academic journal article Journal of Counseling and Development : JCD

A Model of Depression in Adult Children of Alcoholics and Nonalcoholics. (Research)

Academic journal article Journal of Counseling and Development : JCD

A Model of Depression in Adult Children of Alcoholics and Nonalcoholics. (Research)

Article excerpt

In the last two decades, the knowledge base about the physical and psychological concerns experienced by adult children of alcoholics (ACOAs) has expanded rapidly. Much of the early literature was clinically based and anecdotal in nature. Empirical studies followed (Black, Bucky, & Wilder-Padilla, 1986; Kashubeck & Christensen, 1995; McKenna & Pickens, 1983; Plescia-Pikus, Long-Surer, & Wilson, 1988), which focused on a variety of concerns (e.g., depression, low self-esteem, difficulty with intimate relationships, substance abuse) identified by clinicians working with ACOAs. Among those concerns, depression and decreased self-esteem were frequently identified (Bush, Ballard, & Fremouw, 1995; Domenico & Windle, 1993).

More recently, researchers have begun to question the assumption that all ACOAs are homogeneous in terms of their familial experiences and the psychological effects that may result from these experiences. Although some writers have noted that the earlier findings of distress could be the result of methodological flaws in sample selection (clinical versus nonclinical; Kashubeck & Christensen, 1992; Nardi, 1981; M. O. West & Prinz, 1987), others have observed that the differences in concerns experienced by ACOAs may be the result of the varying range and level of functioning experienced in the family system as a whole (Baker & Williamson, 1989; Hardwick, Hansen, & Bairnsfather, 1995; Seefeldt & Lyon, 1992; Werner & Broida, 1991; Wright & Heppner, 1991). It is likely that alcoholic families can be characterized on a continuum of dysfunction and that there are numerous within-group differences in their environments and experiences. One conceptualization of family environments is through multigenerational family systems theory, which focuses on the concepts of intimacy, triangulation, intimidation, and individuation (Bray, Harvey, & Williamson, 1987). Those differing experiences of family relationships affect later intra-and interpersonal issues for ACOAs.

Parental drinking style is another factor that has been mentioned in the clinical literature as a variable that might account for some of the within-group differences for ACOAs (J. L. Johnson & Roll, 1990). Not all alcoholics exhibit the same affect or behavior during the drinking period. Violent and abusive behavior may be exhibited during drinking. Alternatively, the drinking parent may emotionally or physically withdraw and thus be unavailable to the family. Other drinking behavior is hidden from the family. However, specific behavioral drinking styles have not been defined or studied. Although a few studies (Kashubeck & Christensen, 1995; Stout & Mintz, 1996) have examined the abusive behavior that may occur in the alcoholic family, no investigators have identified patterns of drinking behavior or the relationships between those patterns and psychological outcomes. It is unclear how the varying behavioral expressions of abusive drinking may affect family interactions, intimate relationships, or the offsprings' levels of self-esteem and depression.

Another often-cited problematic area for ACOAs is that of interpersonal relationships (Black, 1981; Woititz, 1985). Yet, with the more recent focus on within-group differences, one should not expect all ACOAs to experience difficulties in this realm either. One concept related to interpersonal relationships that has received recent attention is that of attachment theory. Attachment theory grew out of infant development literature and is based on the premise that the infant's ability to develop a secure emotional bond with the caregiver provides the security necessary for environmental exploration (Ainsworth, Blehar, Waters, & Wall, 1978; Bowlby, 1982) and forms the foundation for the development of later interpersonal relationships. Emotional availability and responsiveness of caregivers are crucial to the formation of a working model of self as worthy of care and of attachment figures as caring and responsive to needs. …

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