Academic journal article Alcohol Health & Research World

Concepts and Issues in COA Research

Academic journal article Alcohol Health & Research World

Concepts and Issues in COA Research

Article excerpt

Estimates of the number of children of alcoholics (COA's) and the prevalence of alcohol use disorders among them can vary widely from study to study depending on research design features such as sample selection, data collection strategies, and assessment methods. Although investigators agree that COA's are at higher risk for developing alcohol use disorders than children of nonalcoholics, problems with alcohol are not an inevitable consequence of COA status. Recent research has identified numerous biological, psychological, and social factors associated with a family history of alcoholism that may play a role in determining whether COA's will develop an alcohol use disorder. The conceptual model presented in this article gives a general overview of how such risk factors can interact with life stressors to influence alcohol-related behavior in COA's. (Subsequent articles in this issue explore some of the specific factors identified in the model in greater depth.) KEY WORDS: AODD (alcohol and other drug dependence); children of alcoholics; epidemiology; study design; sample selection; data collection; identification and screening for AOD use; family AODU (alcohol and other drug use) history; risk factors; causes of AODU; scientific model; literature review

For years common wisdom has fostered the notion that alcoholism runs in families. To a large extent, recent scientific studies have substantiated this concept, although with two important provisos (for reviews, see Sher 1991; West and Prinz 1987; Windle and Searles 1990). First, not all children of alcoholics (COA's) develop alcohol use disorders' or other forms of psychopathology, such as depressive disorders; hence, the manifestation of an alcohol use disorder or other psychopathology is not inevitably associated with COA status. Second, both COA's and children of nonalcoholics (non-COA's) substantially overlap in the frequency with which they engage in the normal (rather than the clinical) range of alcohol use and other problem behaviors (e.g., delinquent activity). Therefore, the expression of alcohol use disorders among COA's is considered to be probabilistic, because it occurs at some certainty level less than 100 percent (e.g., Zucker et al. 1995), and not deterministic (i.e., inevitable). Several important scientific questions must be addressed more fully, however, regarding the pervasiveness of alcohol use disorders among COA's; the identification of major genetic and environmental causes that probabilistically may contribute to the occurrence of these disorders; and the development, application, and evaluation of preventive interventions to ameliorate the frequency and severity of alcohol use disorders and their devastating consequences.

This issue of Alcohol Health & Research World focuses on current knowledge about COA's. In recent years, the number of scientific COA studies has increased dramatically (e.g., Galanter 1991; Sher 1991; Windle and Searles 1990), paving the way for keener insight into the genetic mechanisms and psychosocial processes that contribute to alcohol use disorders among the COA population. Nevertheless, constructive debates among scientists and practitioners coexist with this expanding knowledge base in the ongoing manner that often characterizes the dynamic practice of science. At issue are the relative importance of different etiologic factors (e.g., genetic and environmental), the benefits of alternative COA intervention and treatment strategies, and the advantages of various research and sampling designs. This article first discusses the relative merits and limitations of several study designs in the context of epidemiological issues, then presents a conceptual model that provides a broad perspective on COA functioning. The article concludes with a brief overview of the other articles in this issue, which discuss various factors identified in the conceptual model.

EPIDEMIOLOGICAL ISSUES

Two fundamental, related questions of concern among investigators in the COA field are: (1) how many COA's are there? …

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