Alcoholism, Genetics or Choice?
Clinical symptoms of alcoholism include preoccupation with alcohol, compulsive use of alcohol, and drink seeking behavior. The Center for Disease Control defines alcohol dependency as a chronic disease. The disease symptoms include cravings for alcohol, inability to control drinking and continued use despite recurring psychological, physical, and interpersonal problems. Dependency occurs as a result of long-term abuse. Alcohol abuse is defined as patterned drinking resulting in damage to interpersonal relationships, health, and ability to work (Center for Disease Control and Prevention [CDC], 2010).
Across the lifespan alcoholism impacts individuals and families, below the distinctive features of alcoholism, significant concepts as they relate to alcoholism and critical periods of development affected will be discussed. Controversies will be examined and the impact of the issue on lifespan development.
Description and Distinctive Features
Alcoholism impacts development through nature and nurture. From the development of the fetus through the end of adolescence the presence of at least one parent with alcoholism impacts the likelihood of the child developing conduct and attention disorders. A child of alcoholics risk for development of alcoholism is increased four to ten fold. Causes for the development of alcoholism include environmental as well as genetic factors (Enoch, 2006).
Recent twin studies of approximately 10,000 twin pairs showed genetic disposition at 50% concluding nature and nurture play equal roles (Enoch, 2006). Genetic vulnerability is thought to effect “numerous genes of small to modest effects in many neurotransmitter systems, and signal transduction pathways within the mesolimbic dopamine reward pathway and interacting stress response systems” (Enoch, 2006, p. 194). Additionally, individuals at higher than average risk for developing alcoholism demonstrate impaired cognitive capacity presenting as developmental, attention, and conduct disorders. Onset at early age is frequent in those with behavioral deviancy whereas later age correlates with genetics (Tarter & Vanyukov, 1994). Environmental factors include sexual, emotional, physical abuse, availability of alcohol, parental views on consumption, and peer pressure (Enoch, 2006).
Connection to Concepts
The psychosocial theory by Erikson aids in understanding of alcoholism development. As the individuals progress through stages one to four and resolve the crisis faced successfully development progresses, if at some point in the process the child is prevented from successfully completing a stage and development’s health suffers. As a result, at stage five identities is not achieved. These individuals are considered identity diffused, resulting in difficulty at work, criminal behavior, and possible substance abuse. Research has developed subcategories of identity diffusions to simplify alcoholic tendencies (White, 2000).
Archer and Waterman’s research found people with diffused identities’ display unacceptable behavior beginning in adolescence and continue the behaviors into adulthood. The findings of a Swedish adoption study found two types of alcoholism, further investigating genetics role in alcoholism. “Adoptees that acquired Type I alcoholism had a genetic predisposition along with an environmental exposure to alcohol. Those who acquired Type II alcoholism had alcoholic fathers with the same type of alcoholism and had a risk factor nine times that of normal sons, regardless of environment” (White, 2000, p. 49).
The first critical period for the risk of alcoholism development occurs before the child is born. If the child is exposed to alcohol while still in the womb the risk of alcoholism increases. If the exposure is high the child may develop fetal alcohol syndrome, a condition in which facial deformities and neurodevelomental problems occur sometimes to the levels of mental retardation. At lower levels of fetal alcohol exposure the child develops with a natural desire for alcohol. The developing nervous system becomes aware of ethanol in the amniotic fluid and the olfactory system becomes attuned to the chemosensory attributes. The child delivers with a desire for the taste and smell. In recent studies of rats the rats exposed to alcohol in the womb preferred the taste of alcohol over other liquids. These babies crave alcohol and if given the opportunity will begin drinking prior to adolescence. When these children drink they do not drink socially they begin drinking more than intended and develop into alcoholics within a short time ("Pre-natal alcohol", 2007).
The age of initial consumption affects the likelihood of alcohol dependence later in life. Research compiled in 2008 revealed 50% of children begin drinking by eighth grade. Of the adolescent drinkers, those beginning by 13 increase the risk of developing dependence to alcohol by 38 percent. The risk increases further if the child has a family history of alcoholism. When the adolescent obtains a drivers license consequences for choosing to drink become severe, even deadly. 5,000 people less than 21 die yearly from alcohol-related injuries to include suicide (300), homicide (1,600), and car accidents. To change the age of first exposure influential people to the adolescent, parents, teachers, and schools joining force to monitor, communicate, cooperate, and develop alcohol free opportunities (Meyers, 2008).
Controversies surrounding alcohol consumption and addiction include possible links to childhood Attention Deficit Hyperactivity Disorder and Conduct Disorders. An ongoing longitude study of the controversy has yet to determine if the consumption will lead to abuse or addiction, the mean age of the study was 15 years old (Molina & Pelham, 2003). Other controversies include societal acceptance of alcohol consumption and lack of parental prevention. Raising the legal drinking age is not enough to end all underage drinking. Additionally, the alcohol industry produces fun flavored beverages, similar to soft drinks that are appealing to younger drinkers ("Pre-natal alcohol,” 2007). Another yet heated controversy is whether alcoholism is a disease or a matter of willpower. The basis of disease is the connection to genetics. Many argue alcoholism is a loss of control, suggesting for alcoholics each drink results in drunkenness.
Nature and nurture play equal roles in the development of alcoholism, professionals cannot determine if it is a disease or a vice, and alcoholic behaviors ruin families. If alcoholism is not genetic, unborn children are affected by the mothers drinking. Once the children are born the home and family contributes to the development of alcoholism. An age old problem has resulted in vast research and few concrete conclusions. Researchers determine a 50% likelihood of development of alcoholism as a result of nature and 50% as a result of nurture. The shift should swing toward preventative measures in the form of abstinence training for youth and recovery techniques for the practicing alcoholic.
Molina, B., & Pelham, W. (2003). Childhood predictors of adolescent substance use in a longitudinal study of children with ADHD. Journal of Abnormal Psychology, 112, 497-507. doi: 10.1037/0021-843x.112.3.497