DePaul University Master’s Entry into Nursing Practice, 2018 The Risk and Resistance Factors Influencing the Propensity Toward Alcoholism Among Children of Alcoholics: An Integrative Review of the Literature DePaul University Master’s Entry into Nursing Practice, 2018 Molly Pierce Background Results Discussion Many of the studies to date have focused on the risks associated with being a child of an alcoholic, and very few focus on their strengths, or resilience. Despite the obvious risks of growing up with a parent who drinks too much, many COAs do not become alcoholics themselves, and many go on to live healthy lives. With the information gained in this research, nurses have the ability to help children discover where they can find their own particular resilience and provide them with what they need to thrive. Currently in the United States there is an estimated 26.8 million children of alcoholics (COAs). It is standard for healthcare professionals to advise COAs to abstain from alcohol in its entirety due of the strong genetic propensity toward addiction. However, research has shown that this predisposition is only responsible for half of the risk of alcoholism. Due to the complex psychological and physiological factors that are unique to each person, there are many COAs who do not become alcoholics despite their adverse environments. Factors that appear to increase the level of risk include family history and genetic predisposition, high family density and comorbid psychopathy, low parental monitoring behavior, addictive/impulsive personality, disrupted family rituals, sense of embarrassment or abuse, high parentification, and alcohol related cognitions. The resistance factors that were found to offset or mitigate risks associated with parental alcoholism include high self-esteem and emotional self- regulation, flexible and optimistic temperament style, social support, positive interpersonal relationships, secure attachment with non-alcoholic parent, and parent-family connectedness. Objective Nursing Implications The identification of risk and risk and resistance factors can contribute to the development of optimal intervention strategies to help COAs, better than simply the knowledge of family drinking patterns. It also gives nurses the ability to quickly intervene with at-risk children and focus on the positive intervention programs. The purpose of this study was to identify the risk and resistance factors that influence the propensity toward alcoholism among children of alcoholics. This information will aid health care professionals in providing the unique and multifaceted care necessary to prevent COAs from succumbing to the negative consequences of growing up with an alcoholic parent. Methods Further Research An integrative literature review guided by Whittemore & Knalf was conducted using online databases including CINAHL Complete, PsychInfo, and PubMed. Thirty studies met the inclusion and exclusion criteria. Resiliency among male versus female COAs Impact of paternal versus maternal alcoholism. Age of initial exposure to parental alcoholism and it’s influence on COA’s development. Implicit and explicit beliefs about alcohol and the potential differences in the way the two types of knowledge influence alcohol use.