1. Alcoholism Who is susceptible and why?

2. Bio/Psycho/Social Model 1) Individual who responds to alcohol in a certain way. Positive reward. 2) Personality characteristics that encourage use. Impulsiveness. 3) Member of social group where –A) pressure to drink. College Fraternity. –B) confusion over drinking ground rules. Drink with meals or drink to get drunk?

3. Physiological factors Biological susceptibility Genetic evidence Family history Children of alcoholics (COA) If father alcoholic, 25% sons affected 5-10% of daughters

4. Genetic evidence Twin studies MZ 100% genes DZ 50% genes Reared together Alcoholism in 55% MZ twins 28% DZ twins

5. Adoption studies Original studies done in Denmark and Sweden. Child adopted out. Father alcoholic: 18% sons affected. Father non-alcoholic: 5% sons affected. Daughters less affected.

6. Males particularly susceptible Male limited. TYPE II alcoholism. More severe, early onset. Many negative consequences. Trouble with law, at school, on job. Environment plays less of a role but can lessen the severity. Adopted COA’s did better than those raised with alcoholic parent.

7. Milieu limited. TYPE 1 All women and 75% of men. Less severe, later onset. May not be treated. Personality factors important. –Reward seekers. Psych dependence. Environment plays key role. Family and social groups. Intoxication as recreation. Good time depends on drinking.

8. What is inherited? High initial tolerance. Different rate of metabolism. Alcohol -> acetaldehyde -> acetate -> CO 2 and H 2 0 COA’s higher levels of acetaldehyde. Metabolize alcohol quicker. Hence higher tolerance

9. Acetaldehyde effects Acetaldehyde may combine with brain chemicals to give opiate-like high Acetaldehyde also toxic to liver and heart. Medical complications

10. Brain response to novelty Brain waves to novel stimuli. P3 waves. Less reaction in alcoholics. And in COA’s before start drinking. Need more stimulation?

11. Psychological characteristics Related to biology? Reward seeking. Impulsive. Easily bored. Risk takers Gregarious Push the limits Act out

12. Social factors Alcoholism high in some cultures: Americans, Swiss, Irish, Poles. Low in others: Chinese, Greeks, Orthodox Jews

13. Alcoholism is low in cultures where Children learn alcohol is a beverage. Served in dilute forms. Abstain okay. Parents model moderate drinking Getting drunk not seen as comical. Everyone knows ground rules.

14. Alcoholism is higher in cultures where No ground rules. Mixed messages from different individuals and groups. Getting drunk okay? Funny? Heavy drinking is encouraged. Drinking a sign of masculinity or adulthood.

15. Media images of alcohol Ireland has highest heavy drinking rates in Europe. Youth bombarded with alcohol ads. Have begun to restrict advertising. Change the culture.