Alcoholism in family systems
Encyclopedia
Alcoholism in family systems refers to the conditions in families that enable alcoholism
, and the effects of alcoholic behavior by one or more family members on the rest of the family. Mental health professionals are increasingly considering alcoholism and addiction
as diseases that flourish in and are enabled by family systems. Family members react to the alcoholic with particular behavioral patterns. They may enable the addiction to continue by shielding the addict from the negative consequences of his actions. Such behaviors are referred to as codependence
. In this way, the alcoholic is said to suffer from the disease of addiction
, whereas the family members suffer from the disease of codependence.
Alcoholism is one of the leading causes of a dysfunctional family
. As of 2001, there were an estimated 26.8 million children of alcoholics (COAs) in the United States, with as many as 11 million of them under than age of 18. Children of addicts have an increased suicide rate and on average have total health care costs 32 percent greater than children of nonalcoholic families.
Adults from alcoholic families experience higher levels of state and trait anxiety
and lower levels of differentiation of self than adults raised in non-alcoholic families. Additionally adult children of alcoholics have lower self-esteem
, excessive feelings of responsibility, difficulties reaching out, higher incidence of depression
, and increased likelihood of becoming alcoholics.Parental alcoholism may affect the fetus even before a child is born. In pregnant women, alcohol is carried to all of the mother’s organs and tissues, including the placenta, where it easily crosses through the membrane separating the maternal and fetal blood systems. When a pregnant woman drinks an alcoholic beverage, the concentration of alcohol in her unborn baby’s bloodstream is the same level as her own. A pregnant woman who consumes alcohol during her pregnancy may give birth to a baby with Fetal Alcohol Syndrome (FAS).
Alcoholism does not have uniform effects on all families. The levels of dysfunction and resiliency of the non-alcoholic adults are important factors in effects on children in the family. Children of untreated alcoholics score lower on measures of family cohesion, intellectual-cultural orientation, active-recreational orientation, and independence. They have higher levels of conflict within the family, and many experience other family members as distant and non-communicative. The cumulative effect of the family dysfunction may affect the children in families with untreated alcoholics' ability to grow in developmentally healthy ways.
COAs perceptions of their parents drinking habits influence their own future drinking patterns and are developed at an early age. Alcohol related expectancies are correlated with parental alcoholism and alcohol abuse among their offspring. Problem solving discussions in families with an alcoholic parent contained more negative family interactions than in families with non-alcoholics parents. Several factors related to parental alcoholism influence COA substance abuse including stress, negative affect and decreased parental monitoring. Impaired parental monitoring and negative affect correlate with COAs associating with peers that support drug use.
After drinking alcohol, sons of alcoholics experience more of the physiological changes associated with pleasurable effects compared with sons of non-alcoholics, although only immediately after drinking.
Compared with non-alcoholic families, alcoholic families demonstrate poorer problem-solving abilities, both among the parents and within the family as a whole. These communication problems many contribute to the escalation of conflicts in alcoholic families. COAs are more likely than non-COAs to be aggressive, impulsive, and engage in disruptive and sensation seeking behaviors.
Alcohol addiction is a complex disease that results from a variety of genetic, social, and environmental influences. Alcoholism affected approximately 4.65 percent of the U.S. population in 2001-2002, producing severe economic, social, and medical ramifications (Grant 2004). Researchers estimate that between 50 and 60 percent of alcoholism risk is determined by genetics (Goldman and Bergen 1998; McGue 1999).This strong genetic component has sparked numerous linkage and association studies investigating the roles of chromosomal regions and genetic variants in determining alcoholism susceptibility.
Exposure was higher among women (46.2 percent) than among men (38.9 percent) and declined with age. Exposure to alcoholism in the family was strongly related to marital status, independent of age: 55.5 percent of separated or divorced adults had been exposed to alcoholism in some family member, compared with 43.5 percent of married, 38.5 percent of never married, and 35.5 percent of widowed persons. Nearly 38 percent of separated or divorced women had been married to an alcoholic, but only about 12 percent of currently married women were married to an alcoholic.
and neglect
by state child protective service agencies. Substance abuse is one of the two largest problems affecting families in the United States, being a factor in nearly four-fifths of reported cases. Alcoholism is more prevalent among child abusing parents. Alcoholism is more strongly correlated to child abuse than depression
and other disorders.
Many children of alcoholics score lower on tests measuring cognitive and verbal skills than non-COAs. Lacking requisite skills to express themselves can impact academic performance, relationships, and job interview
s. The lack of these skills do not, however, imply that COAs are intellectually impaired. COAs are also shown to have difficulty with abstraction and conceptual reasoning, both of which play an important role in problem-solving academically and otherwise.
In her book Adult Children of Alcoholics, Janet G. Woititz describes numerous traits common among adults who had an alcoholic parent. Although not necessarily universal or comprehensive, these traits constitute an adult children of alcoholics syndrome (cf. the work of Wayne Kritsberg).
An analysis of six year-olds with alcohol exposure during the second-trimester of pregnancy showed lower academic performance and problems with reading, spelling, and mathematical skills. 6% of offspring from alcoholic mothers have Fetal Alcohol Syndrome
(FAS). The risk a offspring born to an alcoholic mothers having FAS increases from 6% to 70% if the mother's previous child had FAS.
People diagnosed with FAS have IQs ranging from 20-105 (with a mean of 68), and demonstrate poor concentration and attention skills. FAS causes growth deficits, morphological abnormalities, mental retardation
, and behavioral difficulties. Among adolescents and adults, those with FAS are more likely to have mental health problems, dropping out or be suspended from schools, problems with the law, require assisted living as an adult, and problems with maintaining employment.
Alcoholism
Alcoholism is a broad term for problems with alcohol, and is generally used to mean compulsive and uncontrolled consumption of alcoholic beverages, usually to the detriment of the drinker's health, personal relationships, and social standing...
, and the effects of alcoholic behavior by one or more family members on the rest of the family. Mental health professionals are increasingly considering alcoholism and addiction
Substance dependence
The section about substance dependence in the Diagnostic and Statistical Manual of Mental Disorders does not use the word addiction at all. It explains:...
as diseases that flourish in and are enabled by family systems. Family members react to the alcoholic with particular behavioral patterns. They may enable the addiction to continue by shielding the addict from the negative consequences of his actions. Such behaviors are referred to as codependence
Codependence
Codependency is unhealthy love and a tendency to behave in overly passive or excessively caretaking ways that negatively impact one's relationships and quality of life. It also often involves placing a lower priority on one's own needs, while being excessively preoccupied with the needs of others...
. In this way, the alcoholic is said to suffer from the disease of addiction
Disease model of addiction
The disease model of addiction describes an addiction as a lifelong disease involving biologic and environmental sources of origin. The traditional medical model of disease requires only that an abnormal condition be present that causes discomfort, dysfunction, or distress to the individual...
, whereas the family members suffer from the disease of codependence.
Alcoholism is one of the leading causes of a dysfunctional family
Dysfunctional family
A dysfunctional family is a family in which conflict, misbehavior, and often abuse on the part of individual members occur continually and regularly, leading other members to accommodate such actions. Children sometimes grow up in such families with the understanding that such an arrangement is...
. As of 2001, there were an estimated 26.8 million children of alcoholics (COAs) in the United States, with as many as 11 million of them under than age of 18. Children of addicts have an increased suicide rate and on average have total health care costs 32 percent greater than children of nonalcoholic families.
Adults from alcoholic families experience higher levels of state and trait anxiety
Anxiety
Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...
and lower levels of differentiation of self than adults raised in non-alcoholic families. Additionally adult children of alcoholics have lower self-esteem
Self-esteem
Self-esteem is a term in psychology to reflect a person's overall evaluation or appraisal of his or her own worth. Self-esteem encompasses beliefs and emotions such as triumph, despair, pride and shame: some would distinguish how 'the self-concept is what we think about the self; self-esteem, the...
, excessive feelings of responsibility, difficulties reaching out, higher incidence of depression
Clinical depression
Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities...
, and increased likelihood of becoming alcoholics.Parental alcoholism may affect the fetus even before a child is born. In pregnant women, alcohol is carried to all of the mother’s organs and tissues, including the placenta, where it easily crosses through the membrane separating the maternal and fetal blood systems. When a pregnant woman drinks an alcoholic beverage, the concentration of alcohol in her unborn baby’s bloodstream is the same level as her own. A pregnant woman who consumes alcohol during her pregnancy may give birth to a baby with Fetal Alcohol Syndrome (FAS).
Alcoholism does not have uniform effects on all families. The levels of dysfunction and resiliency of the non-alcoholic adults are important factors in effects on children in the family. Children of untreated alcoholics score lower on measures of family cohesion, intellectual-cultural orientation, active-recreational orientation, and independence. They have higher levels of conflict within the family, and many experience other family members as distant and non-communicative. The cumulative effect of the family dysfunction may affect the children in families with untreated alcoholics' ability to grow in developmentally healthy ways.
Prevalence
Based on the number of children with parents meetings the DSM-III-R criteria for alcohol abuse or alcohol dependents, in 1996 there was an estimated 26.8 million children of alcoholics (COAs) in the United States of which 11 million were under the age of 18. As of 1988, it was estimated 76 million Americans, about 43% of the U.S. adult population, have been exposed to alcoholism or problem drinking in the family, either having grown up with an alcoholic, having an alcoholic blood relative, or marrying an alcoholic. While growing up, nearly one in five adult Americans (18%) lived with an alcoholic. In 1992, it was estimated one in eight adult American drinkers were alcoholics or experienced problems as a consequences of their alcohol use.Familiality
Children of alcoholics (COAs) are more at risk for alcoholism and other drug abuse than children of non-alcoholics. Children of alcoholics are four times more likely than non-COAs to develop alcoholism. Both genetic and environmental factors influence the development of alcoholism in COAS.COAs perceptions of their parents drinking habits influence their own future drinking patterns and are developed at an early age. Alcohol related expectancies are correlated with parental alcoholism and alcohol abuse among their offspring. Problem solving discussions in families with an alcoholic parent contained more negative family interactions than in families with non-alcoholics parents. Several factors related to parental alcoholism influence COA substance abuse including stress, negative affect and decreased parental monitoring. Impaired parental monitoring and negative affect correlate with COAs associating with peers that support drug use.
After drinking alcohol, sons of alcoholics experience more of the physiological changes associated with pleasurable effects compared with sons of non-alcoholics, although only immediately after drinking.
Compared with non-alcoholic families, alcoholic families demonstrate poorer problem-solving abilities, both among the parents and within the family as a whole. These communication problems many contribute to the escalation of conflicts in alcoholic families. COAs are more likely than non-COAs to be aggressive, impulsive, and engage in disruptive and sensation seeking behaviors.
Alcohol addiction is a complex disease that results from a variety of genetic, social, and environmental influences. Alcoholism affected approximately 4.65 percent of the U.S. population in 2001-2002, producing severe economic, social, and medical ramifications (Grant 2004). Researchers estimate that between 50 and 60 percent of alcoholism risk is determined by genetics (Goldman and Bergen 1998; McGue 1999).This strong genetic component has sparked numerous linkage and association studies investigating the roles of chromosomal regions and genetic variants in determining alcoholism susceptibility.
Marital relationships
Alcoholism usually has strong negative effects on marital relationships. Separated and divorced men and women were three times as likely as married men and women to say they had been married to an alcoholic or problem drinker. Almost two-thirds of separated and divorced women, and almost half of separated or divorced men under age 46 have been exposed to alcoholism in the family at some time.Exposure was higher among women (46.2 percent) than among men (38.9 percent) and declined with age. Exposure to alcoholism in the family was strongly related to marital status, independent of age: 55.5 percent of separated or divorced adults had been exposed to alcoholism in some family member, compared with 43.5 percent of married, 38.5 percent of never married, and 35.5 percent of widowed persons. Nearly 38 percent of separated or divorced women had been married to an alcoholic, but only about 12 percent of currently married women were married to an alcoholic.
Prevalence of abuse
Over one million children yearly are confirmed as victims of child abuseChild abuse
Child abuse is the physical, sexual, emotional mistreatment, or neglect of a child. In the United States, the Centers for Disease Control and Prevention and the Department of Children And Families define child maltreatment as any act or series of acts of commission or omission by a parent or...
and neglect
Neglect
Neglect is a passive form of abuse in which a perpetrator is responsible to provide care for a victim who is unable to care for himself or herself, but fails to provide adequate care....
by state child protective service agencies. Substance abuse is one of the two largest problems affecting families in the United States, being a factor in nearly four-fifths of reported cases. Alcoholism is more prevalent among child abusing parents. Alcoholism is more strongly correlated to child abuse than depression
Depression (mood)
Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behaviour, feelings and physical well-being. Depressed people may feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, or restless...
and other disorders.
Correlates
Children of alcoholics exhibit symptoms of depression and anxiety more than children of non-alcoholics. COAs have lower self-esteem than non-COAs from childhood through young adulthood. Children of alcoholics show more symptoms of anxiety, depression, and externalizing behavior disorders than non-COAs. Some of these symptoms include crying, lack of friends, fear of going to school, nightmares, perfectionism, boarding and excessive self-consciousness.Many children of alcoholics score lower on tests measuring cognitive and verbal skills than non-COAs. Lacking requisite skills to express themselves can impact academic performance, relationships, and job interview
Job interview
A job interview is a process in which a potential employee is evaluated by an employer for prospective employment in their company, organization, or firm. During this process, the employer hopes to determine whether or not the applicant is suitable for the job.-Role:A job interview typically...
s. The lack of these skills do not, however, imply that COAs are intellectually impaired. COAs are also shown to have difficulty with abstraction and conceptual reasoning, both of which play an important role in problem-solving academically and otherwise.
In her book Adult Children of Alcoholics, Janet G. Woititz describes numerous traits common among adults who had an alcoholic parent. Although not necessarily universal or comprehensive, these traits constitute an adult children of alcoholics syndrome (cf. the work of Wayne Kritsberg).
Treatment
Suggested practices to mitigate the impact of parental alcoholism on the development of their children include:- Maintaining healthy family traditions and practices, such as vacations, mealtimes, and holidays
- Encouraging COAs to develop consistent, stable, relationships with significant others outside of the family.
- Planning non-drinking activities to compete with alcoholic behaviour and tendencies.
Pregnancy
Prenatal alcohol-related effects can occur with moderate levels of alcohol consumption by non-alcoholic and alcoholic women. Cognitive performance in infants and children is not as impacted by mothers who stopped alcohol consumption early in pregnancy, even if it was resumed after giving birth.An analysis of six year-olds with alcohol exposure during the second-trimester of pregnancy showed lower academic performance and problems with reading, spelling, and mathematical skills. 6% of offspring from alcoholic mothers have Fetal Alcohol Syndrome
Fetal alcohol syndrome
Fetal alcohol syndrome is a pattern of mental and physical defects that can develop in a fetus in association with high levels of alcohol consumption during pregnancy. Current research also implicates other lifestyle choices made by the prospective mother...
(FAS). The risk a offspring born to an alcoholic mothers having FAS increases from 6% to 70% if the mother's previous child had FAS.
People diagnosed with FAS have IQs ranging from 20-105 (with a mean of 68), and demonstrate poor concentration and attention skills. FAS causes growth deficits, morphological abnormalities, mental retardation
Mental retardation
Mental retardation is a generalized disorder appearing before adulthood, characterized by significantly impaired cognitive functioning and deficits in two or more adaptive behaviors...
, and behavioral difficulties. Among adolescents and adults, those with FAS are more likely to have mental health problems, dropping out or be suspended from schools, problems with the law, require assisted living as an adult, and problems with maintaining employment.
See also
- Adult Children of AlcoholicsAdult Children of AlcoholicsAdult Children of Alcoholics is an organization that is intended to provide a forum to individuals who desire to recover from the effects of growing up in an alcoholic or otherwise dysfunctional family. ACA membership has few formal requirements. ACA does not receive any outside economic...
- Al-Anon/AlateenAl-Anon/AlateenAl-Anon/Alateen, known as Al-Anon Family Groups, is an international "fellowship of relatives and friends of alcoholicswho share their experience, strength, and hope in order to solve their common problems." They "help families of alcoholics by practicing the Twelve Steps, by welcoming and giving...
- Concordance (genetics)Concordance (genetics)Concordance as used in genetics usually means the presence of the same trait in both members of a pair of twins. However, the strict definition is the probability that a pair of individuals will both have a certain characteristic, given that one of the pair has the characteristic. For example,...
- Nar-AnonNar-AnonNar-Anon is a twelve-step program for friends and family members of drug addicts. Nar-Anon is complementary to, but separate from, Narcotics Anonymous , analogous to Al-Anon with respect to Alcoholics Anonymous; Nar-Anon's traditions state that it should "always cooperate with Narcotics Anonymous."...
- National Association for Children of AlcoholicsNational Association for Children of AlcoholicsThe National Association for Children of Alcoholics was formed in February 1983 in California, by 20 professionals concerned about the needs of family members of alcoholics...
- Dual diagnosisDual diagnosisThe term dual diagnosis is used to describe the comorbid condition of a person considered to be suffering from a mental illness and a substance abuse problem. There is considerable debate surrounding the appropriateness of the term being used to describe a heterogeneous group of individuals with...
- Dysfunctional familyDysfunctional familyA dysfunctional family is a family in which conflict, misbehavior, and often abuse on the part of individual members occur continually and regularly, leading other members to accommodate such actions. Children sometimes grow up in such families with the understanding that such an arrangement is...
- Self-medicationSelf-medicationSelf-medication is a term used to describe the use of drugs or other self-soothing forms of behavior to treat untreated and often undiagnosed mental distress, stress and anxiety, including mental illnesses and/or psychological trauma...