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CORK Bibliography: Children of Alcoholics

59 citations. 2009 to present

Prepared: June 2012

Albrecht W. Re: Maternal smoking, alcohol, and coffee use during pregnancy and son's risk of testicular cancer. (editorial). European Urology 57(2): 357-358, 2010. (4 refs.)

Anda RF; Dong MX; Brown DW; Felitti VJ; Giles WH; Perry GS et al. The relationship of adverse childhood experiences to a history of premature death of family members. BMC Public Health 9: article 106, 2009

Background: To assess the association between adverse childhood experiences (ACEs), including childhood abuse and neglect, and serious household dysfunction, and premature death of a family member. Because ACEs increase the risk for many of the leading causes of death in adults and tend to be familial and intergenerational, we hypothesized that persons who report having more ACEs would be more likely to have family members at risk of premature death. Methods: We used data from 17,337 adult health plan members who completed a survey about 10 types of ACEs and whether a family member died before age 65. The prevalence of family member premature death and its association with ACEs were assessed. Results: Family members of respondents who experienced any type of ACEs were more likely to have elevated prevalence for premature death relative to those of respondents without such experience ( p < 0.01). The highest risk occurred among those who reported having been physically neglected and living with substance abusing or criminal family members during childhood. A powerful graded relationship between the number of ACEs and premature mortality in the family was observed for all age groups, and comparison between groups reporting 0 ACE and >= 4 ACEs yielded an OR of 1.8 (95% Cl, 1.6-2.0). Conclusion: Adverse childhood experiences may be an indicator of a chaotic family environment that results in an increased risk of premature death among family members.

Copyright 2009, BioMed Central

Andreas JB; O'Farrell TJ. Alcoholics Anonymous attendance following 12-step treatment participation as a link between alcohol-dependent fathers' treatment involvement and their children's externalizing problems. Journal of Substance Abuse Treatment 36(1): 87-100, 2009. (55 refs.)

We investigated longitudinal associations between alcohol-dependent fathers' 12-step treatment involvement and their children's internalizing and externalizing problems (N = 125, M-age = 9.8 +/- 3.1), testing the hypotheses that fathers' greater treatment involvement would benefit later child behavior and that this effect would be mediated by fathers' posttreatment behaviors. The initial association was established between fathers' treatment involvement and children's externalizing problems only, whereas Structural Equation Modeling (SEM) results supported mediating hypotheses. Fathers' greater treatment involvement predicted children's lower externalizing problems 12 months later, and fathers' posttreatment behaviors mediated this association. Greater treatment involvement predicted greater posttreatment Alcoholics Anonymous attendance, which in turn predicted greater abstinence. Finally, fathers' abstinence was associated with lower externalizing problems in children. Theoretical and practical implications of these findings are discussed.

Copyright 2009, Elsevier Science

Antolin T; Berman SM; Conner BT; Ozkaragoz TZ; Sheen CL; Ritchie TL et al. D2 dopamine receptor (DRD2) gene, P300, and personality in children of alcoholics. Psychiatry Research 166(2/3): 91-101, 2009. (67 refs.)

The D2 dopamine receptor (DRD2) gene has been associated with alcoholism and other drug use disorders. Reduced P300 amplitude has been noted in individuals with psychiatric disorders. Personality variables are also associated with reduced P300 amplitude. The current study was conducted to determine whether variants of the DRD2 would show differential relationships among P300 amplitude and personality traits. The study consisted of 101 adolescent children of alcoholics; 39 carried the Al+ genotype (Al A1, Al A2) and 62 carried the Al- genotype (A2A2). The Al+ genotype group had higher IQ and Self-Directedness scores than the Al- genotype group. As predicted, the negative relationship between Novelty Seeking and Harm Avoidance was present in A1(-) but not Al+ participants. Additionally, in Al+ but not in Al- participants, there was a negative relationship between Novelty Seeking and Self-Directedness and a positive relationship between P300 amplitude and Cooperativeness. The results suggest that in adolescent children of alcoholics, dopaminergic genetic determinants are critical modifiers of the relationship between neurocognitive and personality endophenotypes proposed as vulnerability markers for substance use disorders.

Copyright 2009, Elsevier Science

Belles S; Budde A; Moesgen D; Klein M. Parental problem drinking predicts implicit alcohol expectancy in adolescents and young adults. Addictive Behaviors 36(11): 1091-1094, 2011. (27 refs.)

The present study aimed to investigate the influence of parental problem drinking on implicit and explicit alcohol expectancy of adolescents and young adults (12-24 years). The study was conducted via the Internet, employing a between-subjects design. We measured alcohol expectancy by means of an Implicit Association Test (IAT) and a self-report questionnaire. A short version of the Children of Alcoholics Screening Test (CAST) was used to measure alcohol-related parental problem behavior. Our results showed that increased CAST-scores were correlated with a stronger implicit association between the concepts alcohol and arousal. In contrast, no such relationship was observed between parental problem drinking and self-reported expectancy of alcohol arousal. These findings provide tentative evidence that an implicit cognitive processing bias is implicated in the intergenerational transmission of addictive behaviors.

Copyright 2011, Elsevier Science

Boyd R; Kresnow MJ; Dellinger AM. Alcohol-Impaired driving and children in the household. Family & Community Health 33(2): 167-174, 2009. (22 refs.)

More children in the United States are killed in motor vehicle crashes annually than by any other Cause; nearly a quarter of these deaths involve alcohol. This study examines the national prevalence of alcohol-impaired driving and riding with an alcohol-impaired driver and the association of these behaviors to having at least 1 child in the household. An estimated 2.5 million adult drivers with children living in their households reported that they had been a recent alcohol-impaired driver. Evidence-based approaches, including mass media campaigns and sobriety checkpoints, continue to be critically important public health activities.

Copyright 2009, Lippincott, Williams & Wlikins

Boynton MH; Arkes J; Hoyle RH. Brief report of a test of differential alcohol risk using sibling attributions of paternal alcoholism. Journal of Studies on Alcohol and Drugs 72(6): 1037-1040, 2011. (31 refs.)

Objective: Parental alcoholism is generally found to be a strong predictor of alcohol misuse. Although the majority of siblings agree on the presence of parental alcohol issues, there is a significant minority who do not. Method: The current study analyzed sibling data from the 1979 National Longitudinal Survey of Youth using multilevel modeling, which accounts for the nested structure of the data. These analyses permitted a test of whether (a) identifying one's father as an alcoholic predicted greater risk of alcohol problems, (b) being from a family whose siblings did not all agree on the presence of paternal alcoholism increased the likelihood of alcohol problems, and (c) risk of alcohol misuse significantly differed among individuals from families in which there was familial disagreement about paternal alcoholism. Results: Results show that individuals who identified their father as an alcoholic were themselves more likely to have alcohol issues as compared with individuals both within and between families who did not identify their father as an alcoholic. Risk was similar for individuals in families in which there was disagreement about paternal alcoholism compared with individuals from families in which everyone agreed on the presence of paternal alcoholism. Moreover, there was not a significant interaction between paternal alcoholism attributions and familial disagreement. Conclusions: Findings indicate that in the case of child reports of paternal alcoholism, the increased risk of alcohol problems holds true regardless of the accuracy of an individual's assessment. These results may be not only because of the impact of paternal alcoholism on a person's alcohol misuse but also because of a person's alcohol problems potentially influencing his or her perceptions of familial alcohol-related behaviors.

Copyright 2011, Alcohol Research Documentation

Brook JS; Saar NS; Brook DW. Developmental pathways from parental substance use to childhood academic achievement. American Journal on Addictions 19(3): 270-276, 2010. (58 refs.)

This cross-sectional study examined the pathways to childhood academic achievement in 209 African American and Puerto Rican children and their mothers. There were three pathways to childhood academic achievement: (a) the mother-child relationship and the child's personality mediated between low parental substance use and childhood academic achievement; (b) the child's personality mediated between high parental education and childhood academic achievement; and (c) there was a direct relationship between the child's gender and childhood academic achievement. Policy and clinical implications suggest the importance of increasing educational opportunities for all parents by providing substance use treatment and self-esteem workshops.

Copyright 2010, Wiley-Blackwell

Brown DW; Anda RF; Tiemeier H; Felitti VJ; Edwards VJ; Croft JB et al. Adverse childhood experiences and the risk of premature mortality. American Journal of Preventive Medicine 37(5): 389-396, 2009. (27 refs.)

Background: Strong, graded relationships between exposure to childhood traumatic stressors and numerous negative health behaviors and outcomes, healthcare utilization, and overall health status inspired the question of whether these adverse childhood experiences (ACEs) are associated with premature death during adulthood. Purpose: This study aims to determine whether ACEs are associated with an increased risk of premature death during adulthood. Methods: Baseline survey data on health behaviors, health status, and exposure to ACEs were collected from 1.7,337 adults aged >18 years during 1995-1997. The ACEs included abuse (emotional, physical, sexual); witnessing domestic violence; parental separation or divorce; and growing up in a household where members were mentally ill, substance abusers, or sent to prison. The ACE score (an integer count of the eight categories of ACEs) was used as a measure of cumulative exposure to traumatic stress during childhood. Deaths were identified during follow-up assessments (between baseline appointment date and December 31, 2006) using mortality records obtained from a search of the National Death Index. Expected years of life lost (YLL) and years of potential life lost (YPLL) were computed using standard methods. The relative risk of death from all causes at age <= 65), cars and at age <= 75 years was estimated across the number of categories of ACEs using multivaribale-adjusted Cox proportional hazards regression. Analysis was conducted during January-February 2009. Results: Overall, 1539 people died during follow-up; the crude death rate was 91.0 per 1000; the age-adjusted rate was 54.7 per 1000. People with six or more ACEs died nearly 20 years earlier on average than those without ACEs (60.6 years, 95% CI = 56.2, 65.1, vs 79.1 years, 95% CI = 78.4, 79.9). Average YLL per death was nearly three times greater among people with six or more ACEs (25.2 years) than those without ACEs (9.2 years). Roughly one third (n = 526) of those who died during follow-up were aged <= 75 years at the time of death, accounting for 4792 YPLL. After multivariable adjustment, adults with six or more ACEs were 1.7 (95% CI = 1.06, 2.83) times more likely to die when aged <= 75 years and 2.4 (95% CI = 1.30, 4.39) times more likely to die when aged <= 65 years. Conclusions: ACEs are associated with an increased risk of premature death, although a graded increase in the risk of premature death was not observed across the number of categories of ACEs. The increase in risk was only partly explained by documented ACE-related health and social problems, suggesting other possible mechanisms by which ACEs may contribute to premature death.

Copyright 2009, Elsevier Science

Buu A; Wang W; Wang J; Puttler LI; Fitzgerald HE; Zucker RA. Changes in women's alcoholic, antisocial, and depressive symptomatology over 12 years: A multilevel network of individual, familial, and neighborhood influences. Development and Psychopathology 23(1, special issue): 325-337, 2011. (87 refs.)

In a sample of 273 adult women and their families, we examined the effects of women's psychopathology history, their social support, their husbands' and children's symptomatology, family stress, and neighborhood environment on their alcohol problems, antisocial behavior, and depression over a 12-year period during their 30s and early 40s. Women's alcohol problems and antisocial behavior decreased but their depression symptoms increased over time. Women's disorder history and their partners' parallel symptomatology were associated with their symptoms. For women's antisocial behavior, their own history of alcoholism and their partners' alcohol problems were also significant risk factors. Higher levels of social support were associated with lower levels of depression in women. Children's externalizing behavior was positively correlated with their mothers' alcohol problems and antisocial behavior, whereas children's internalizing behavior was positively correlated with their mothers' depression. Neighborhood residential instability was associated with higher levels of alcoholic and depressive symptomatology in women. Intervention efforts might target women with young children by improving social support, educational or professional training opportunity, access to family counseling, and neighborhood environment.

Copyright 2011, Cambridge University Press

Carter VB. Factors predicting placement of urban American Indian/Alaskan Natives into out-of-home care. Children and Youth Services Review 32(5): 657-663, 2010. (52 refs.)

American Indian/Alaskan Native children have disproportionately been placed into out-of-home care compared to White children in the child welfare system What were the factors that child protective set vices (CPS) workers considered when deciding to remove a child from the home? Utilizing data from the National Survey of Child and Adolescent Well-Being, this study examined out-of-home care factors for 2215 urban American Indian/Alaskan Native (AI/AN) and White children. In the urban sample, children from White families were younger and were more likely to be investigated for lack of supervision, while AI/AN families were investigated for physical neglect. In the placement regression models, urban AI/AN children came from homes where caregivers had greater alcohol, drug and mental health problems. Decisions by CPS workers to place AI/AN children may have been influenced by racial bias. A CPS system that acknowledges culture and race may reduce overrepresentation in placement. Efforts to work with AI/AN families prior to a child's removal may prove to be beneficial and less expensive.

Copyright 2010, Elsevier Science

Cavazos-Rehg PA; Spitznagel EL; Bucholz KK; Nurnberger J; Edenberg HJ; Kramer JR et al. Predictors of sexual debut at age 16 or younger. Archives of Sexual Behavior 39(3): 664-673, 2010. (52 refs.)

The present study examined the extent to which variables within the self system (i.e., symptoms of alcohol dependence and conduct disorder, gender, race, and metropolitan status) and the familial system (i.e., having an alcohol dependent biological parent or second-degree relative, religious background, educational background of parents, and being born to a teenage mother) were associated with sexual debut at 16 years old or earlier. Participants were 1,054 biological relatives, aged 18-25 years, of alcohol dependent probands who participated in the Collaborative Study on the Genetics of Alcoholism project. Comparison participants (N = 234) without alcohol dependent biological parents were also evaluated. Clinical and sociodemographic variables were assessed by structured, personal interviews. Parental history of alcohol dependence was evaluated by direct interview of parents in most cases and family history in uninterviewed parents. In a multivariate survival analysis, increased risk of becoming sexually active at 16 years of age or earlier was significantly associated with 6 of the 10 predictor variables, including race, one or more alcohol dependence symptoms, and/or one or more conduct disorder symptoms. Having an alcohol dependent biological parent or second-degree relative (e.g., aunt, uncle, or grandparent), educational background of mother, and being born to a teenage mother were also significantly associated with increased risk. These results provide evidence that specific variables in the self and familial systems of influence are important in predicting sexual debut at 16 years old or earlier.

Copyright 2010, Springer

Contractor LFM; Celedonia KL; Cruz M; Douaihy A; Kogan JN; Marin R et al. Mental health services for children of substance abusing parents: Voices from the community. Community Mental Health Journal 48(1): 22-28, 2012. (53 refs.)

This qualitative study explores how to improve services for children of parents with Substance Use Disorders (SUD) with unmet mental health needs. Focus groups were conducted with parents and caregivers to identify perceived barriers to services, including: (1) attitudes and beliefs about mental health care, (2) inadequacies in mental health services, (3) children's ambivalence about treatment, and (4) parental disagreement and lack of involvement. Peer support, afterschool activities, and family counseling were identified as potential improvements. This information can serve as a foundation and guide to develop services for the underserved population of children and adolescents of substance abusing parents.

Copyright 2012, Springer

Coyle JP; Nochajski T; Maguin E; Safyer A; DeWit D; Macdonald S. An exploratory study of the nature of family resilience in families affected by parental alcohol abuse. Journal of Family Issues 30(12): 1606-1623, 2009. (51 refs.)

Resilient families are able to adapt to adversities, but the nature of family resilience is not well understood. This study examines patterns of family functioning that may protect families from the negative impact of alcohol abuse. Naturally occurring patterns of family functioning are identified and associations between these patterns and parenting, current parental alcohol use, recent family stressful events, supportive relationships outside the family, and demographic characteristics are assessed. Cross-sectional data are analyzed from racially diverse American and Canadian families (N = 674) who have at least one parent with an alcohol abuse problem and a child between ages 9 and 12 years. Cluster analyses derived from family functioning indicators are used to identify naturally occurring family patterns. Multivariate assessments evaluated relationships between family functioning clusters and potentially influencing factors. The study results reveal a continuum of family functioning associated with parenting, child's perception of teacher caring, and race.

Copyright 2009, Sage Publications

Dwyer JG. A consitutional birthright: The State, parentage, and the rights of newborn persons. UCLA Law Review 56(4): 755-835, 2009. (75 refs.)

State parentage laws, dictating who a newborn child's first legal parents will be, have been the subject of constitutional challenges in several U.S. Supreme Court and many lower court decisions. All of those decisions, however, have focused on constitutional rights of adults (especially unwed biological fathers) who wish to become, or to avoid becoming, legal parents. Neither courts nor legal scholars have considered whether the children have any constitutional rights that constrain legislatures and courts in deciding which adults will be their legal parents. If a state enacted a parentage law that said, for example, that any child born to a birth mother who already had two children would be placed in a parent-child relationship at birth with applicants for adoption rather than with the birth mother, would that infringe on any constitutional right of the child? Or would the birth mother be the only person with standing to challenge the law? Such a law would be purely hypothetical in the U.S. (though not far from reality in some other parts of the world). But the actual current parentage laws in the United States, which confer legal parent status in almost all instances on biological parents, with no regard for fitness, also have a seriously adverse affect on a subset of children-specifically, children whose birth parents are manifestly unfit to raise children, as evidenced by serious child maltreatment histories, criminal records, substance abuse, mental illness, and/or imprisonment. This Article is the first to consider whether states violate a constitutional right of some children when their parentage laws consign the children to legal relationships with, and into the custody of, adults whom the state knows to be unfit. It identifies opportunities for children's advocates to advance constitutional challenges to state parentage laws as applied to newborn offspring of adults unfit to parent, and it presents a robust legal theory to underwrite such challenges.

Copyright 2009, University of California

Eiden RD; Molnar DS; Colder C; Edwards EP; Leonard KE. A conceptual model predicting internalizing problems in middle childhood among children of alcoholic and nonalcoholic fathers: The role of marital aggression. Journal of Studies on Alcohol and Drugs 70(5): 741-750, 2009. (43 refs.)

Objective: The purpose of this study was to test a conceptual model predicting children's anxiety/depression in middle childhood in a community sample of children with parents who had alcohol problems (n = 112) and those without alcohol problems (n = 101). The conceptual model examined the role of parents' alcohol diagnoses, depression, and antisocial behavior among parents of children ages 12 months to kindergarten age in predicting marital aggression and parental aggravation. Higher levels of marital aggression and parental aggravation were hypothesized to predict children's depression/anxiety within time (18 months to kindergarten age and, prospectively, to age during fourth grade). Method: The sample was recruited front New York State birth records when the children were 12 months old. Assessments were conducted at 12, 18, 24, and 36 months; at kindergarten age; and during fourth grade, Results: Children with alcoholic fathers had higher depression/anxiety scores according to parental reports but not self-reports. Structural equations modeling was largely supportive of the conceptual model. Fathers' alcoholism was associated with higher child anxiety via greater levels of marital aggression among families with alcohol problems. Results also indicated that there was a significant indirect association between parents' depression symptoms and child anxiety via marital aggression. Conclusions: The results highlight the nested nature of risk characteristics in alcoholic families and the important role of marital aggression in predicting children's anxiety/depression. Interventions targeting both parents' alcohol problems and associated marital aggression are likely to provide the dual benefits of improving family interactions and lowering risk of children's internalizing behavior problems.

Copyright 2009, Alcohol Research Documentation

Elgan TH; Leifman H. Children of substance abusing parents: A national survey on policy and practice in Swedish schools. Health Policy 101(1): 29-36, 2011. (34 refs.)

Objectives: This study aims at examining policy and practice within the Swedish school setting pertaining to children of substance abusing parents/caregivers. Methods:A cross-sectional survey, involving a representative sample of randomized schools (n = 443) throughout Sweden was conducted using a self-completed questionnaire. Descriptive analysis was performed including bivariate analysis combined with logistic regression modeling to examine possible correlates between variables. Results: The response rate was 66%, and participants reported that 37% had been trained in issues related to children of substance abusing parents, 33% of the schools had a policy document, and 73% of the schools had identified students with this complex of problems. Whether or not schools identify these students depends upon the occurrence of schools being "compulsory" or "upper secondary", "public" or "independent", the "school size", and respondents' participation in further training, which in turn is associated with the presence of a policy document. Conclusions: It appears as if a policy document does not directly predict whether schools identify students having substance abusing parents. However, it does influence whether respondents have participated in further training, which subsequently predicts the identification of students having substance abusing parents. Implications for policy and practice within the school setting are discussed.

Copyright 2011, Elsevier Science

Embregts PJCM. Residential treatment following outpatient treatment for children with mild to borderline intellectual disabilities: A study of child and family characteristics. Research in Developmental Disabilities 30(5): 1062-1067, 2009

In this study, the question was explored whether children with a mild intellectual disability (MID) who were placed in residential treatment following outpatient treatment differ significantly on child and family characteristics from children with MID and not placed in residential treatment following outpatient treatment. The records of the children were examined with respect to various child and family characteristics. Retrospective case analyses were thus undertaken. The results showed those children placed in residential treatment to have experienced significantly more often a traumatic event than the other children. Those children placed in residential treatment had received significantly fewer months of outpatient treatment than those not placed in residential treatment. Finally, there were significantly more children placed in residential treatment having educationally incapable parents or parents with alcohol/drug problems and/or psychiatric problems than in the other group. The findings are discussed in light of a disturbed balance between the support needs and means of the family which can lead to placement of a child in a residential treatment. The possibilities of a multisystemic model for outpatient treatment are discussed.

Copyright 2009, Elsevier Science

Fortuna JL. Sweet preference, sugar addiction and the familial history of alcohol dependence: Shared neural pathways and genes. Journal of Psychoactive Drugs 42(2): 147-151, 2010. (34 refs.)

Contemporary research has shown that a high number of alcohol-dependent and other drug-dependent individuals have a sweet preference, specifically for foods with a high sucrose concentration. Moreover, both human and animal studies have demonstrated that in some brains the consumption of sugar-rich foods or drinks primes the release of euphoric endorphins and dopamine within the nucleus accumbens, in a manner similar to some drugs of abuse. The neurobiological pathways of drug and "sugar addiction" involve similar neural receptors, neurotransmitters, and hedonic regions in the brain. Craving, tolerance, withdrawal and sensitization have been documented in both human and animal studies. In addition, there appears to be cross sensitization between sugar addiction and narcotic dependence in some individuals. It has also been observed that the biological children of alcoholic parents, particularly alcoholic fathers, are at greater risk to have a strong sweet preference, and this may manifest in some with an eating disorder. In the last two decades research has noted that specific genes may underlie the sweet preference in alcohol- and drug-dependent individuals, as well as in biological children of paternal alcoholics. There also appears to be some common genetic markers between alcohol dependence, bulimia, and obesity, such as the A1 allele gene and the dopamine 2 receptor gene.

Copyright 2010, Haight-Ashbury

Gordh AHVS; Soderpalm B. Healthy subjects with a family history of alcoholism show increased stimulative subjective effects of alcohol. Alcoholism: Clinical and Experimental Research 35(8): 1426-1434, 2011. (55 refs.)

Background: Research has shown that subjects with a family history positive (FHP) of alcoholism are at increased risk for alcoholism and that this group reacts differently to alcohol than family history negative (FHN) subjects. These different levels of sensitivity may make FHP persons more likely to consume alcohol. Here, we tested the hypothesis that subjects FHP for type 1 alcoholism (according to Cloninger) are more sensitive than control subjects to the stimulative, properties of alcohol following a single moderate dose of alcohol. Methods: Fifty-one healthy men and women (22 FHP and 29 FHN) participated in 2 laboratory sessions, in which they consumed a beverage containing ethanol (0.6 g/kg in juice) or placebo (juice alone) in a randomized order. Primary dependent measures were self-report questionnaires of mood states. Results: Subjects with family history of type 1 alcoholism showed increased stimulative responses and an elevated positive mood state after ethanol compared to controls. Conclusions: At this moderate dose, ethanol increased stimulative subjective responses in individuals who were "family history positive." This enhanced sensitivity could motivate to exaggerated drinking and thereby increase the risk for developing alcoholism.

Copyright 2011, Wiley-Blackwell

Gray R. Commentary: Sullivan on the offspring of the female criminal alcoholic. (editorial). International Journal of Epidemiology 40(2): 289-292, 2011. (23 refs.)

Gwynne K; Blick BA; Duffy GM. Pilot evaluation of an early intervention programme for children at risk. Journal of Paediatrics and Child Health 45(3): 118-124, 2009. (51 refs.)

Aim: Children from vulnerable families, where there is social disadvantage, parental mental health problems, substance abuse or domestic violence, are at risk of attention, language, learning and behaviour problems because of poor attachment and lack of stimulation in the early years. Three primary modes of early intervention have been shown to produce sustained improvements in children's health, education and well-being despite these risk factors. This pilot aimed to evaluate the Spilstead Model (SM) of early intervention in Australia, which provides a uniquely integrated model of centre-based care, incorporating all three best-practice approaches. Method: The study targeted all new clients who attended the SM programme over a 12-month period. A battery of standardised clinician and parent-rated measures assessed parent, child and family functioning via pre-post test research design. Results: Results indicated large effect size changes (P < 0.01) in parent/child interaction; reduced parent stress; parental satisfaction; parent confidence; parental capacity; family interactions; child well-being; and total family functioning. A total of 71% of children who presented on initial developmental screening with delays in the clinical range were found to be within the normal range on post-testing; 41% moved from the below average range to scores within the normal range in language development. Parents noted improvements in externalising behaviours of large effect size (1.46). Conclusions: (i) Results were highly positive for both children and parents; (ii) the synergistic nature of the SM may have the potential to maximise outcomes for families via a cumulative programme effect; and (iii) implications for further research were established.

Copyright 2009, Wiley-Blackwell

Haber JR; Bucholz KK; Jacob T; Grant JD; Scherrer JF; Sartor CE et al. Effect of paternal alcohol and drug dependence on offspring conduct disorder: Gene-environment interplay. Journal of Studies on Alcohol and Drugs 71(5): 652-663, 2010. (40 refs.)

Objective: Not only are substance-use disorders and externalizing disorders frequently comorbid, they often co-occur in families across generations. The current study examined the role of genetic and environmental influences in the relationship between paternal histories of drug dependence or alcohol dependence and offspring conduct disorder using an offspring-of-twins design. Method: Participants were male twins (n = 1,774) from the Vietnam Era Twin Registry, their offspring (n = 1,917), and mothers of the offspring (n = 1,202). Twins had a history of drug dependence, alcohol dependence, or neither. Based on the father's and his co-twin's drug-dependence or alcohol-dependence history and zygosity, risk groups were constructed to reflect different levels of genetic and environmental risk that were then used to predict offspring conduct disorder. Results: After controlling for potentially confounding variables, the offspring of men with a history of drug dependence or alcohol dependence had significantly higher rates of conduct disorder, compared with offspring of men without this history. Offspring at higher genetic risk had higher rates of conduct disorder. High-risk offspring at lower environmental risk had lower rates of conduct disorder but only in the case of paternal drug-dependence risk. Lower environmental risk did not influence rates of offspring conduct disorder when the father had an alcohol-dependence history. Conclusions: Genetic risk associated with both paternal drug-dependence and paternal alcohol-dependence histories predicted offspring conduct-disorder risk, but only risk associated with paternal drug-dependence history was mitigated by having a low-risk environment. These results demonstrated a significant gene environment interaction effect.

Copyright 2010, Alcohol Reearch Documentation

Haller MM; Chassin L. The reciprocal influences of perceived risk for alcoholism and alcohol use over time: Evidence for aversive transmission of parental alcoholism. Journal of Studies on Alcohol and Drugs 71(4): 588-596, 2010. (32 refs.)

Objective: This study examined how perceived risk for alcoholism and alcohol use influenced each other over time. We hypothesized an aversive transmission mechanism, by which some children of alcoholics may reduce their drinking because they perceive themselves to be at risk for future alcohol problems because of their parents' alcoholism. Method: Using participants (N = 804, 47% female) from an ongoing longitudinal study of children of alcoholics (e.g., Chassin et al., 1991), we examined the reciprocal prospective relations between perceived risk for alcoholism and drinking across three measurement occasions, and also tested whether perceived risk for alcoholism mediated the effect of perceived parental alcoholism on subsequent drinking. Results: Mediation analyses provided evidence for aversive transmission, in which the effect of perceived parental alcoholism on alcohol use during young adulthood was decreased to the extent that perceived parental alcoholism predicted higher levels of perceived risk for alcoholism during emerging adulthood. Results indicated reciprocal effects between perceived risk for alcoholism and drinking over time, such that higher levels of perceived risk were associated with lower levels of drinking. Results were replicated using both self-report and collateral-report of alcohol use, and using both actual and perceived parental alcoholism. Conclusions: Young adults may avoid drinking when they perceive their parent(s) to be alcoholic, and consequently perceive themselves to be at elevated risk for alcoholism. Given that beliefs about risk for alcoholism are potentially modifiable, increasing self-perceived risk for alcoholism may be one feasible way to reduce the intergenerational transmission of alcohol disorders within families.

Copyright 2010, Alcohol Research Documentation Center

Haller M; Handley E; Chassin L; Bountress K. Developmental cascades: Linking adolescent substance use, affiliation with substance use promoting peers, and academic achievement to adult substance use disorders. Development and Psychopathology 22(4, special issue): 899-916, 2010. (74 refs.)

Using a high-risk community sample (N = 405), the current study examined developmental cascades among substance use, affiliation with substance use promoting peers, and academic achievement over an 18-year period and tested whether these pathways mediated the influence of parental alcoholism on adult alcohol and drug use disorders. Results showed that the influence of parental alcoholism on adult drug disorders was mediated by developmental cascades across all three domains, whereas the influence of parental alcoholism on adult alcohol disorders was mediated through affiliation with substance use promoting peers and persistence in binge drinking. Adolescent drug use had more implications for adult outcomes than did adolescent alcohol use, which was less likely to spill over into other domains of functioning. Findings indicated that adolescent risk factors had indirect rather than unique effects on adult substance use disorders, suggesting that adolescent risk is not immutable and is largely mediated by later influences.

Copyright 2010, Cambridge University Press

Han M; Osterling KL. Characteristics and factors impacting reunification outcomes among Vietnamese immigrant families in the child welfare system. Children and Youth Services Review 34(1): 103-111, 2012. (40 refs.)

Using a mixed methods approach, this study examined reunification processes and outcomes among Vietnamese immigrant families involved in the child welfare system. A quantitative design was used to describe characteristics and reunification outcomes of Vietnamese immigrant children and families who are involved in family reunification services. Qualitative methods were used to explore factors that may influence reunification outcomes among Vietnamese families. The quantitative portion of the study included an exploratory design using administrative data from one county in the Northern California. The quantitative sample (N = 32) included children entering the foster care system for 8 or more days between January 1, 2001 and December 31, 2007 from child welfare administrative data (CWS/CMS) which was merged with eligibility data (CalWIN) in order to obtain parent and child place of birth to determine country of origin. The qualitative study included an exploratory design using interview data from child welfare workers (N = 8) and Vietnamese immigrant parents who had successfully reunified (N = 7). Quantitative results indicated that the most common type of maltreatment leading to entry into care was care-taker absence or incapacity, an abuse category that is often used in cases of parental substance abuse. 53.8% of Vietnamese immigrant children in the quantitative sample reunified with their parents, which is close to the national rate of reunification. Qualitative findings pointed to the importance of the following factors within reunification: acculturation-related issues, parental substance abuse, child welfare worker cultural competency and issues related to service availability and effectiveness. Implications for social work practice and policy are discussed.

Copyright 2012, Elsevier Science

Heitzeg MM; Nigg JT; Yau WYW; Zucker RA; Zubieta JK. Striatal dysfunction marks preexisting risk and medial prefrontal dysfunction is related to problem drinking in children of alcoholics. Biological Psychiatry 68(3): 287-295, 2010. (74 refs.)

Background: Parental alcoholism substantially raises risk for offspring alcoholism, an effect thought to be mediated by a dysregulation in impulse control. Adult alcoholics have alterations in the frontostriatal system involved in regulating impulsive responses. However, it remains controversial whether these alterations reflect preexisting traits predisposing to problem alcohol use or are secondary to alcohol involvement. Methods: Sixty-one 16 to 22 year olds were tested using a go/no-go task during functional magnetic resonance imaging. Forty-one were family history positive (FH+), having at least one parent with a diagnosis of alcohol use disorder (AUD), and 20 were family history negative (FH-). Two FH+ subgroups were created to disentangle alcohol involvement from preexisting risk: the FH+ control group (n = 20) had low alcohol problems, differing from the FH- group only by family history. The FH+ problem group (n = 21) had high alcohol problems. Results: The ventral caudate deactivated during successful inhibition in the FH- but not the FH+ groups, regardless of problem alcohol involvement. Regression analyses showed that ventral caudate deactivation was related to fewer externalizing problems as well as to family history. Orbital and left medial prefrontal regions were deactivated in both the FH- and FH+ control groups but not the FH+ problem group. Activation in these regions was associated with alcohol and other drug use. Conclusions: These findings suggest a preexisting abnormality in ventral striatal function in youth at risk for AUD, which may lead to inappropriate motivational responding, and suggest that with alcohol use, the prefrontal "control" mechanism loses efficiency, further dysregulating the frontostriatal motivational circuitry.

Copyright 2010, Elsevier Science

Hill SY; Tessner KD; McDermott MD. Psychopathology in offspring from families of alcohol dependent female probands: A prospective study. Journal of Psychiatric Research 45(3): 285-294, 2011. (57 refs.)

Background: Despite the importance of understanding the long-term outcome for children of alcohol dependent (AD) women, the available literature is largely based on offspring of AD fathers and few have utilized prospective designs that include child, adolescent and young adult assessments. Multiplex AD families in which multiple cases of AD are present provide an ideal setting for understanding developmental variants of the adult phenotype. Method: Offspring from multiplex AD families identified through the mother or control families were evaluated multiple times during childhood and followed to young adulthood. Familial risk status and the presence of specific child/adolescent disorders were used as predictors of substance use disorder outcome by young adulthood. Results: Offspring who were members of maternal multiplex families had elevated rates of child and young adulthood disorders. High risk offspring of alcohol dependent women were at increased risk for externalizing (Conduct Disorder and ADHD) and internalizing disorders (Major Depressive Disorder (MDD) and Anxiety Disorders). By young adulthood, offspring from these multiplex families had significantly greater odds of developing alcohol abuse or dependence (odds ratio [OR] = 3.63 [CI 1.36-9.641) and drug abuse or dependence (OR = 4.23 [CI 1.73-10.32]). The prospective design of the study revealed that specific childhood disorders (Conduct Disorder, ADHD, MOD) increased the odds of subsequent development of substance use disorder (SLID). Conclusions: Multiplex familial risk for alcohol dependence is a significant predictor of substance use disorders by young adulthood. Familial risk and an earlier childhood disorder may set the stage for later development of SLID.

Copyright 2011, Elsevier Science

Holmila MJ; Itapuisto M; Ilva M. Invisible victims or competent agents: Opinions and ways of coping among children aged 12-18 years with problem drinking parents. Drugs: Education, Prevention and Policy 18(3): 179-186, 2011. (35 refs.)

Aims: The article describes the lives of children with problem drinking parents from children's own perspective, emphasizing their experiences, agency and coping. Methods: The qualitative data were collected with a web-based questionnaire advertised on two children's and adolescents'' help pages. The final sample consisted of 70 volunteers between the ages 12 and 18 years, mostly girls (17%% were boys). Findings: Children with problem drinking parents are a hidden population and neglected by services, which they need. Children have, however, developed their own ways of trying to cope. They also have various practical suggestions and opinions concerning services and the type of help they would find useful. Conclusions: Harms inflicted to children are an important reason for preventing substance misuse. It is also important that children are heard by professionals and authorities dealing with family problems, and that one understands, supports and respects children's own agency and ways of coping. Children's ways of coping can differ from those of the adults. Further studies on children living with problem drinking parents are needed. The study shows that internet can be one way of collecting research data from this otherwise hard-to-reach group.

Copyright 2011, Taylor & Francis

Johnson EC. When a student does not want to be in school: A reading of Paulo Freire through family alcoholism discourse. Qualitative Inquiry 15(7): 1287-1289, 2009. (1 refs.)

As Richardson reminds us, "People make sense of their lives, for the most part, in terms of specific events." The author develops a set of poems based on his autoethnography study on Children of Alcoholics (COA). As the author reads Paulo Freire through alcoholism discourse, he creates a link between COA and his own school experiences. While the author questions his desire for education, he continues to excel in his studies to overcome particular life obstacles. To raise awareness for all educators, his postmodern work attempts to show the dimensions of family alcoholism and how it might impact ones views of their own schooling experience.

Copyright 2009, Sage Publications

Kelley ML; Braitman A; Henson JM; Schroeder V; Ladage J; Gumienny L. Relationships among depressive mood symptoms and parent and peer relations in collegiate children of alcoholics. American Journal of Orthopsychiatry 80(2): 204-212, 2010. (57 refs.)

Relationships among adult children of alcoholics (ACOAs) and parent and peer relations and depressive mood were examined among 136 ACOAs and 436 non-ACOAs. As compared to non-ACOAs, ACOAs reported less positive relationships to mothers, fathers, and peers, and more depressive mood; however, more positive relationships to parents and peers significantly reduced the strength of the association between ACOA categorization and depressive mood. Examination of data from ACOAs alone revealed that maternal alcoholism was related to less positive relationships to their mothers and to their peers; however, paternal alcoholism did not predict the quality of the relationship to fathers, mothers, or peers. Attachment to parents and peers and the gender of the alcohol-abusing parent were associated with depressive symptoms among ACOAs.

Copyright 2010, American Psychological Association

Kelley ML; Pearson MR; Trinh S; Klostermann K; Krakowski K. Maternal and paternal alcoholism and depressive mood in college students: Parental relationships as mediators of ACOA-depressive mood link. Addictive Behaviors 36(7): 700-706, 2011. (60 refs.)

The present study examined whether suspecting one's mother versus father of alcohol abuse was associated with parent-offspring relationships, and the degree to which parent-child relationships were associated with depressive symptoms. As compared to non-ACOAs (n = 288), ACOAs (n = 100) reported more negative parent-child relationships (i.e., greater alienation, poorer communication, less trust, greater emotional longing, and more negative attitudes toward the parent) and increased depressive symptoms on the POMS (McNair, Lorr, & Droppleman, 1992). A closer look revealed that suspected maternal alcohol abuse was associated with more negative mother-child relationships, whereas suspected paternal alcohol abuse was associated with more negative father-child relationships. Both maternal alcohol abuse and paternal alcohol abuse predicted depressive symptoms.

Copyright 2011, Elsevier Science

Klostermann K; Kelley ML. Alcoholism and intimate partner violence: Effects on children's psychosocial adjustment. (review). International Journal of Environmental Research and Public Health 6(12): 3156-3168, 2009. (82 refs.)

It is widely recognized that alcoholism and relationship violence often have serious consequences for adults; however, children living with alcoholic parents are susceptible to the deleterious familial environments these caregivers frequently create. Given the prevalence of IPV among patients entering substance abuse treatment, coupled with the negative familial consequences associated with these types of behavior, this review explores what have been, to this point, two divergent lines of research: (a) the effects of parental alcoholism on children, and (b) the effects of children's exposure to intimate partner violence. In this article, the interrelationship between alcoholism and IPV is examined, with an emphasis on the developmental impact of these behaviors (individually and together) on children living in the home and offers recommendations for future research directions.

Copyright 2009, Molecular Diversity Preservation International-MDPI

Knopik VS; Jacob T; Haber JR; Swenson LP; Howell DN. Paternal alcoholism and offspring ADHD problems: A children of twins design. Twin Research and Human Genetics 12(1): 53-62, 2009. (55 refs.)

Objective: A recent Children-of-Female-Twin design suggests that the association between maternal alcohol use disorder and offspring ADHD is due to a combination of genetic and environmental factors, such as prenatal nicotine exposure. We present here a complementary analysis using a Children-of-Male-Twin design examining the association between paternal alcoholism and offspring attention deficit hyperactivity problems (ADHP). Methods: Children-of-twins design: offspring were classified into 4 groups of varying genetic and environmental risk based on father and co-twin's alcohol dependence status. Results: Univariate results are suggestive of a genetic association between paternal alcohol dependence and broadly defined offspring ADHP. Specifically, offspring of male twins with a history of DSM-III-R alcohol dependence, as well as offspring of non-alcohol dependent monozygotic twins whose co-twin was alcohol dependent, were significantly more likely to exhibit ADHP than control offspring. However, multivariate models show maternal variables independently predicting increased risk for offspring ADHP and significantly decreased support for a genetic mechanism of parent-to-child transmission. Conclusions: In support of earlier work, maternal variables (i.e., maternal ADHD and prenatal exposure) were strongly associated with child ADHP; however, the role of paternal alcohol dependence influences was not definitive. While genetic transmission may be important, the association between paternal alcohol dependence and child ADHP is more likely to be indirect and a result of several pathways.

Copyright 2009, Australian Academy Press

Malone SM; McGue M; Iacono WG. Mothers' maximum drinks ever consumed in 24 hours predicts mental health problems in adolescent offspring. Journal of Child Psychology and Psychiatry 51(9): 1067-1075, 2010. (32 refs.)

Background: The maximum number of alcoholic drinks consumed in a single 24-hr period is an alcoholism-related phenotype with both face and empirical validity. It has been associated with severity of withdrawal symptoms and sensitivity to alcohol, genes implicated in alcohol metabolism, and amplitude of a measure of brain activity associated with externalizing disorders in general. In a previous study we found that the maximum number of drinks fathers had ever consumed in 24 hrs was associated with externalizing behaviors and disorders in preadolescent and adolescent children. The purpose of the present study was to determine whether maternal maximum consumption has similar correlates. Method: We examined associations between maternal maximum consumption and alcohol dependence, respectively, and disruptive disorders and substance-related problems in two large independent population-based cohorts of 17-year-old adolescents. Results: Maximum consumption was associated with conduct disorder, disruptive disorders in general, early substance use and misuse, and substance disorders in adolescent children regardless of sex. Associations were consistent across cohorts, providing internal replication. They also paralleled our previous findings regarding paternal status. They could not be explained by maternal alcohol dependence, effects of drinking during pregnancy, or paternal maximum consumption. They were not simple artifacts of the fact that maximum consumption is a continuous measure while alcohol dependence is dichotomous. Conclusions: Despite deriving from a single question about lifetime behavior, parental maximum consumption appears to reflect vulnerability for mental health problems, especially substance-related ones, more directly than a diagnosis of alcohol dependence.

Copyright 2010, Wiley-Blackwell

Manning V; Best DW; Faulkner N; Titherington E. New estimates of the number of children living with substance misusing parents: Results from UK National Household Surveys. BMC Public Health 9(377), 2009. (38 refs.)

Background: The existing estimates of there being 250,000 - 350,000 children of problem drug users in the UK (ACMD, 2003) and 780,000 - 1.3 million children of adults with an alcohol problem (AHRSE, 2004) are extrapolations of treatment data alone or estimates from other countries, hence updated, local and broader estimates are needed. Methods: The current work identifies profiles where the risk of harm to children could be increased by patterns of parental substance use and generates new estimates following secondary analysis of five UK national household surveys. Results: The Health Survey for England (HSfE) and General Household Survey (GHS) (both 2004) generated consistent estimates - around 30% of children under-16 years (3.3-3.5 million) in the UK lived with at least one binge drinking parent, 8% with at least two binge drinkers and 4% with a lone (binge drinking) parent. The National Psychiatric Morbidity Survey (NPMS) indicated that in 2000, 22% (2.6 million) lived with a hazardous drinker and 6% (705,000) with a dependent drinker. The British Crime Survey (2004) and NPMS (2000) indicated that 8% (up to 978,000) of children lived with an adult who had used illicit drugs within that year, 2% (up to 256,000) with a class A drug user and 7% (up to 873,000) with a class C drug user. Around 335,000 children lived with a drug dependent user, 72,000 with an injecting drug user, 72,000 with a drug user in treatment and 108,000 with an adult who had overdosed. Elevated or cumulative risk of harm may have existed for the 3.6% (around 430,000) children in the UK who lived with a problem drinker who also used drugs and 4% (half a million) where problem drinking co-existed with mental health problems. Stronger indicators of harm emerged from the Scottish Crime Survey (2000), according to which 1% of children (around 12,000 children) had witnessed force being used against an adult in the household by their partner whilst drinking alcohol and 0.6% (almost 6000 children) whilst using drugs. Conclusion: Whilst harm from parental substance use is not inevitable, the number of children living with substance misusing parents exceeds earlier estimates. Widespread patterns of binge drinking and recreational drug use may expose children to sub-optimal care and substance-using role models. Implications for policy, practice and research are discussed.

Copyright 2009, BioMed Central

Maxson RT; Yuma-Guerrero P; von Sternberg K; Lawson KA; Johnson KMK; Brown J et al. Screening for risky alcohol use among caregivers of pediatric trauma patients: A pilot study. Journal of Trauma, Injury, Infection and Critical Care 67(1, Supplement S): S37-S42, 2009. (28 refs.)

Background: Injury is the leading cause of death for children and has been linked to caregiver drinking. Screening and brief intervention for risky drinking has been successful in adult trauma centers but has not been evaluated in caregivers of pediatric trauma patients. The purpose of this study was to investigate a pilot screening process for risky drinking caregivers, to determine rates of risky alcohol use, and to assess potential relationships between risky drinking and child safety behaviors. Methods: Caregivers of pediatric trauma patients were screened by trained injury prevention educators. The screening assessed risky drinking, tobacco and illicit drug use, and child safety behaviors. Data were analyzed using descriptive analysis, frequency comparisons, and univariate logistic regression. Results: Over 7 months, 295 caregivers were screened; 32.5% (n = 96) screened positive for risky alcohol use. For 173 injured children, one caregiver was screened, and for 61 children, two caregivers were screened. In the one-caregiver group, 29% (n = 50) screened positive for risky drinking. For the two-caregiver group, in 18% (n = 11) of the cases, both caregivers screened positive, whereas in 39% (n = 24) only one caregiver screened positive. Males were more likely to screen positive (p < 0.01). Relationships between reported child safety behaviors and risky drinking were of interest, but not statistically significant. Conclusions: The results of our study demonstrate that a substantial number of caregivers of pediatric trauma patients will self-report risky drinking behaviors, and therefore, an opportunity exists for these families to receive the benefits of screening and brief intervention programs in pediatric trauma care settings.

Copyright 2009, Lippincott, Willams & Wilkins

McLaughlin KA; Green JG; Gruber MJ; Sampson NA; Zaslavsky AM; Kessler RC. Childhood adversities and adult psychiatric disorders in the National Comorbidity Survey Replication. II Associations with persistence of DSM-IV Disorders. Archives of General Psychiatry 67(2): 124-132, 2010. (53 refs.)

Context: Although significant associations of childhood adversities (CAs) with adult mental disorders have been widely documented, associations of CAs with onset and persistence of disorders have not been distinguished. This distinction is important for conceptual and practical purposes. Objective: To examine the multivariate associations of 12 retrospectively reported CAs with persistence of adult DSM-IV disorders in the National Comorbidity Survey Replication. Design: Cross-sectional community survey. Setting: Household population in the United States. Participants: Nationally representative sample of 5692 adults. Main Outcome Measures: Recency of episodes was assessed separately for each of 20 lifetime DSM-IV mood, anxiety, disruptive behavior, and substance use disorders in respondents with a lifetime history of these disorders using the Composite International Diagnostic Interview. Predictors of persistence were examined using backward recurrence survival models to predict time since most recent episode controlling for age at onset and time since onset. Results: The CAs involving maladaptive family functioning (parental mental illness, substance use disorder, criminality, family violence, physical and sexual abuse, and neglect) but not other CAs were significantly but modestly related to persistence of mood, substance abuse, and anxiety disorders. Number of maladaptive family functioning CAs had statistically significant, but again substantively modest, subadditive associations with the same outcomes. Exposure to multiple other CAs was significantly associated with persistence of mood and anxiety disorders. Associations remained statistically significant throughout the life course, although the substantive size of associations indicated by simulations showing time to most recent episode would increase by only 1.6% (from a mean of 8.3 years to a mean of 8.4 years) in the absence of CAs. Conclusions: The overall statistically significant associations of CAs with adult DSM-IV/Composite International Diagnostic Interview disorders are due largely to component associations with onsets rather than with persistence, indirectly suggesting that the greatest focus of public health attention on CAs should be aimed at primary rather than secondary prevention.

Copyright 2010, American Medical Association

Morean ME; Corbin WR; Sinha R; O'Malley SS. Parental history of anxiety and alcohol-use disorders and alcohol expectancies as predictors of alcohol-related problems. Journal of Studies on Alcohol and Drugs 70(2): 227-236, 2009. (68 refs.)

Objective: Research has consistently identified a family history of alcoholism as a risk factor for alcohol-related problems, and global positive expectancies have been found to moderate this association. High rates of comorbidity between alcohol use and anxiety disorders suggest that a family history of anxiety disorders may also increase risk. Further, expectations of negative reinforcement (e.g., tension reduction) have been found to moderate the influence of anxiety-related traits. The current study sought to extend previous research by examining the influence of parental history of alcoholism, anxiety disorders, and the combination, as predictors of alcohol-related problems, Expectancies of global positive changes and tension reduction were hypothesized to moderate the influence of parental history of alcoholism and anxiety, respectively. Method: Direct interviews with parents assessed their history of alcoholism and anxiety for 144 offspring (ages 18-32; 53.5% male) creating four groups: those with a parental history of alcoholism (27.80%), anxiety (22.20%), both alcoholism and anxiety (33.30%), and no history of psychopathology (16.70%). Established measures assessed the offsprings' alcohol expectancies, alcohol use, and alcohol-related problems. Results: Although expected interactions between parental alcoholism and global positive expectancies and between parental anxiety and tension-reduction expectancies were not found, global positive expectancies were associated with alcohol-related problems among the group with parental history of both alcoholism and anxiety. Conclusions: The results suggest that the relation between parental history of alcoholism and global positive expectancies observed in previous studies may be strongest among individuals with a comorbid parental history of alcohol and anxiety disorders. Incorporating expectancies into interventions targeting individuals with a comorbid parental history of alcohol and anxiety disorders may have utility.

Copyright 2009, Alcohol Research Documentation Center

Morgan PT; Desai RA; Potenza MN. Gender-related influences of parental alcoholism on the prevalence of psychiatric illnesses: Analysis of the National Epidemiology Survey on alcohol and related conditions. Alcoholism: Clinical and Experimental Research 34(10): 1759-1767, 2010. (37 refs.)

Background: Offspring of individuals with alcoholism are at increased risk for psychiatric illness, but the effects of gender on this risk are not well known. In this study, we tested the hypothesis that the gender of the parent with alcoholism and the gender of offspring affect the association between parental alcoholism and offspring psychiatric illness. Method: We analyzed the National Epidemiology Survey on Alcohol and Related Conditions (NESARC) data to examine the gender-specific prevalence of axis I and axis II disorders in 23,006 male and 17,368 female respondents with and without a history of paternal or maternal alcoholism. Adjusted odds ratios were calculated for the disorders based on gender and presence of maternal or paternal alcoholism. Results: Maternal or paternal alcoholism was associated with a higher prevalence of every disorder examined, regardless of the gender of offspring. Gender-related differences in prevalences were present in nearly all examined disorders, and the association between parental alcoholism and offspring psychiatric disorders was significantly different in men and women. These differences included stronger associations in female offspring of men with alcoholism (alcohol abuse without dependence); in female offspring of women with alcoholism (mania, nicotine dependence, alcohol abuse, and schizoid personality disorder); in male offspring of men with alcoholism (mania); and in male offspring of women with alcoholism (panic disorder). Conclusions: Interactions between gender and parental alcoholism were specific to certain disorders but varied in their effects, and in general female children of women with alcoholism appear at greatest risk for adult psychopathology.

Copyright 2010, Research Society on Alcoholism

Office of Applied Studies, Substance Abuse and Mental Health Administration. The NSDUH Report: Children Living with Substance-Dependent or Substance-Abusing Parents: 2002 to 2007. (April 16, 2009). Rockville MD: Substance Abuse and Mental Health Administration, 2009. (6 refs.)

Parental substance dependence and abuse can have profound effects on children, including child abuse and neglect, injuries and deaths related to motor vehicle accidents, and increased odds that the children will become substance dependent or abusers themselves. Up-to-date estimates of the number of children living with substance-dependent or substance-abusing parents are needed for planning both adult treatment and prevention efforts and programs that support and protect affected children. Summary: Combined data from 2002 to 2007 indicate that over 8.3 million children under 18 years of age (11.9 percent) lived with at least one parent who was dependent on or abused alcohol or an illicit drug during the past year. Of these, almost 7.3 million (10.3 percent) lived with a parent who was dependent on or abused alcohol, and about 2.1 million (3.0 percent) lived with a parent who was dependent on or abused illicit drugs. About 5.4 million children under 18 years of age lived with a father who met the criteria for past year substance dependence or abuse, and 3.4 million lived with a mother who met the criteria.

Public Domain

Ohannessian CM. Does technology use moderate the relationship between parental alcoholism and adolescent alcohol and cigarette use? Addictive Behaviors 34(6-7): 606-609, 2009. (23 refs.)

The primary goals of this study were to examine the associations between technology use and alcohol and cigarette use during adolescence and to explore whether technology use moderates the relationship between parental alcoholism and substance use (alcohol and cigarette use). The sample included 328 14-16 year-old adolescent boys and girls. The adolescents completed a battery of self-report questionnaires which included measures that assessed their substance use, their use of technology, and their parents' alcohol use (including alcoholism). Results indicated that adolescents who had an alcoholic parent reported relatively higher levels of alcohol consumption. Heavier use of technology (particularly text messaging, e-mailing/IMing, and watching television) also was related to earlier and heavier substance use during adolescence. Moreover, these effects tended to be more pronounced in adolescents with an alcoholic parent. Results from this study suggest that high levels of technology use during adolescence may be related to an increased risk of alcohol and cigarette use, particularly for children of alcoholic parents (COAs).

Copyright 2009, Elsevier Science

Ohannessian CM. Media use and adolescent psychological adjustment: An examination of gender differences. Journal of Child and Family Studies 18(5): 582-593, 2009. (55 refs.)

This study examined media use and psychological adjustment (as indicated by depression and anxiety symptomatology) in a sample of 328 14- to 16-year-old adolescents. Primary goals of the study were to explore whether media use differs by gender, whether media use is related to adolescent psychological problems, and whether media use moderates the relationship between parental alcoholism and adolescent psychological adjustment. Adolescents were surveyed in the spring of 2006, and again one year later. Gender differences in media use were observed with boys spending more time playing video games than girls and girls spending more time talking on the phone than boys. Strikingly, none of the types of media examined was associated with depression or anxiety. Moreover, media use acted as a protective factor for boys. Boys who spent relatively more time playing video games and watching television had the lowest levels of anxiety, especially those from alcoholic homes. The opposite pattern emerged for girls.

Copyright 2009, Springer

Ohannessian CM; Hesselbrock VM. A finer examination of the role that negative affect plays in the relationship between paternal alcoholism and the onset of alcohol and marijuana use. Journal of Studies on Alcohol and Drugs 70(3): 400-408, 2009. (48 refs.)

Objective: This study was designed to separately examine the relations between four fundamental components of negative affect (sadness, fear, guilt, and hostility) and the onset of substance use. An additional goal was to examine the potential mediating roles that these components of negative affect play in the relationship between paternal alcoholism and the initiation of substance use. Method: The sample included 200 adolescents ages 15-19 years (62% girls; 68% white: 56% children of alcoholics [COAs]) and their fathers. The adolescents were followed up 5 years later when they were in early adulthood. Participants completed a clinical psychiatric interview and self-report questionnaires that assessed negative affect and substance use. Results: Results from structural equation modeling indicated that higher levels of hostility and lower levels of guilt were associated with earlier substance-use initiation. In addition, hostility played an indirect role in the relationship between paternal alcoholism and the onset of marijuana use, with COAs reporting higher hostility levels than non-COAs and higher hostility predicting earlier marijuana use. Conclusions: These results underscore the importance of separately examining different components of negative affect when investigating the role that negative affect plays in substance use.

Copyright 2009, Alcohol Research Documentation Inc.

Park S; Kim H; Kim H. Relationships between parental alcohol abuse and social support, peer substance abuse risk and social support, and substance abuse risk among South Korean adolescents. Adolescence 43(173): 87-99, 2009. (39 refs.)

This study examined the roles played by parental alcohol abuse and social support, peer substance abuse risk and social support, and substance abuse risk among adolescents in South Korea. Participants were adolescents between the ages of 15 and 22 years (mean, 18), residing in Seoul city and in surrounding Kyung-gi Province. Of 259 participants, 41.3% scored 2 or more on the POSIT scale, which suggested they met the problematic criteria for substance abuse risk. Logistic regression results suggested that the influence of social support on substance abuse risk among adolescents depended on the source of support-parents or peers. These findings need to be considered in the development of intervention programs for adolescents at risk for substance abuse.

Copyright 2009, Libra Publishers

Pearson MR; D'Lima GM; Kelley ML. Maternal and paternal alcohol misuse and alcohol-related outcomes among college students. Substance Use & Misuse 47(6): 708-717, 2012. (48 refs.)

Using a large college student sample (N = 1,095), the present study examined whether the relationship between parental alcohol abuse and offspring alcohol use varied as a function of parent and offspring gender, and whether the relationship to the non-substance-abusing mother or father buffered against the risk associated with being an adult child of an alcoholic (ACOA). Among women, maternal ACOAs (i.e., the mother only was suspected of alcohol misuse) had the greatest risk of problematic alcohol consumption, whereas among men, both parent ACOAs (i.e., both parents were suspected of alcohol misuse) had the greatest risk of problematic alcohol consumption. No support was found for the buffering hypothesis. We discuss implications of our findings and future directions.

Copyright 2012, Informa HealthCare

Piasecki TM; Slutske WS; Wood PK; Hunt-Carter EE. Frequency and correlates of diary-measured hangoverlike experiences in a college sample. Psychology of Addictive Behaviors 24(1): 163-169, 2010. (35 refs.)

A sample of college students, oversampled for smoking (N = 127, 43% smokers), monitored their daily experiences using electronic diaries over 14 days. We examined the frequency and correlates of liberally defined hangoverlike experiences (HLEs) using data from 1,595 person-days (1,325 after abstention from drinking and 270 after drinking, including 125 HLEs). More than 40% of the sample reported at least one HLE, and nearly half of all drinking episodes were followed by HLE. Endorsement of HLE was more likely as the number of drinks increased and was associated with modest elevations of hangover symptoms. Gender did not predict rates of overall HLE endorsement, but male students were less likely than female students to report an HLE after a drinking episode and showed a weaker relation between number of drinks and HLE. Smokers were more likely to report HLE, but there was no evidence that smoking status was associated with increased HLE susceptibility. Self-reported parental alcohol problems were associated with more frequent HLE and incrementally predicted HLE endorsement when number of drinks was covaried. The findings suggest that HLE is a common outcome of college drinking and attest to the feasibility of using electronic diaries to assess its episode- and person-level correlates.

Copyright 2010, Educational Publishing Foundation

Polak KA; Puttler LI; Ilgen MA. The relationship between structural aspects of self-concept and psychosocial adjustment in adolescents from alcoholic families. Substance Use & Misuse 47(7): 827-836, 2012. (57 refs.)

Sixty adolescents from alcoholic families living in two large cities in Poland were examined in 2008 and 2009. Richness, stability, and certainty of their self-concepts, as well as levels of school adjustment, anxiety, and depression, were evaluated using a set of questionnaires. In a series of bivariate analyses, the strongest associations found were between richness of the self-concept and the social withdrawal syndrome, and between stability of the self-concept and depression. Both relationships remained significant, using multiple regression models, after controlling for possible confounding factors. Possible explanations and implications for the findings, as well as the study's limitations, are noted and discussed.

Copyright 2012, Informa Healthcare

Sarkola T; Gissler M; Kahila H; Autti-Ramo I; Halmesmaki E. Early healthcare utilization and welfare interventions among children of mothers with alcohol and substance abuse: A retrospective cohort study. Acta Paediatrica 100(10): 1379-1385, 2011. (23 refs.)

Aim: Early childhood healthcare utilization, mortality and welfare interventions were studied among children of mothers with identified gestational alcohol and/or substance abuse. Methods: Register-based retrospective cohort study. The exposed cohort consisted of 638 children born to 524 women followed up antenatally 1992-2001 at special outpatient clinics in the capital area of Finland. Nonexposed children (n = 1914) born to control women were matched for maternal age, parity, number of foetuses, month of birth and delivery hospital of the index child. Postnatal data of both cohorts were collected from national registers until 2007. Results: The exposed cohort displayed twice the amount of in- and outpatient hospital care episodes compared with nonexposed children. Differences attributable to exposure were found in categories of conditions originating in the perinatal period, mental and behavioural disorders, and nonspecific factors influencing health status and contact with health services. This was reflected in amounts of reimbursements for drugs of the central nervous system, as well as special care allowances and rehabilitation for mental and behavioural disorders. The highest degree of healthcare utilization was observed among exposed children placed in out-of-home care. One-third of these children received outpatient care and one-tenth required inpatient care for a mental and behavioural disorder. No significant differences were found in early mortality. Conclusion: The exposed children displayed significant neonatal and early mental and behavioural healthcare utilization, and need for significant psychosocial support during their first decade of life.

Copyright 2011, Wiley-Blackwell

Sorensen HJ; Manzardo AM; Knop J; Penick EC; Madarasz W; Nickel EJ et al. The contribution of parental alcohol use disorders and other psychiatric illness to the risk of alcohol use disorders in the offspring. Alcoholism: Clinical and Experimental Research 35(7): 1315-1320, 2011. (33 refs.)

Background: Few population-based studies have investigated associations between parental history of alcoholism and the risk of alcoholism in offspring. The aim was to investigate in a large cohort the risk of alcohol use disorders (AUD) in the offspring of parents with or without AUD and with or without hospitalization for other psychiatric disorder (OPD). Methods: Longitudinal birth cohort study included 7,177 men and women born in Copenhagen between October 1959 and December 1961. Cases of AUD were identified in 3 Danish health registers and cases of OPD in the Danish Psychiatric Central Register. Offspring registration with AUD was analyzed in relation to parental registration with AUD and OPD. Covariates were offspring gender and parental social status. Results: Both maternal and paternal registration with AUD significantly predicted offspring risk of AUD (odds ratios 1.96; 95% CI 1.42 to 2.71 and 1.99; 95% CI 1.54 to 2.68, respectively). The association between maternal, but not paternal, OPD and offspring AUD was also significant (odds ratios 1.46; 95% CI 1.15 to 1.86 and 1.26; 95% CI 0.95 to 1.66, respectively). Other predictors were male gender and parental social status. A significant interaction was observed between paternal AUD and offspring gender on offspring AUD, and stratified analyses showed particularly strong associations of both paternal and maternal AUD with offspring AUD in female cohort members. Conclusions: Parental AUD was associated with an increased risk of offspring AUD independent of other significant predictors, such as gender, parental social status, and parental psychiatric hospitalization with other diagnoses. Furthermore, this association appeared to be stronger among female than male offspring. The results suggest that inherited factors related to alcoholism are at least as important in determining the risk of alcoholism among daughters as among sons.

Copyright 2011, Wiley-Blackwell

Tarokh L; Carskadon MA. Sleep electroencephalogram in children with a parental history of alcohol abuse/dependence. Journal of Sleep Research 19(Supplement 1): 165-174, 2010. (51 refs.)

We examined the sleep electroencephalogram (EEG) in 9- and 10-year-old children with (PH+) and without (PH-) a parental history of alcohol abuse/dependence to determine whether sleep disturbances associated with alcohol precede the onset of alcohol use. Participants: slept on a fixed sleep schedule that ensured at least a 10-h time in bed for 1 week before an adaptation and baseline night. Data were collected in a four-bed sleep research laboratory. Thirty healthy boys and girls aged 9 or 10 years were classified as either PH+ or PH- based on DSM-IV criteria applied to structured parental interviews. All-night polysomnography was performed, sleep data were scored visually in 30-s epochs, and EEG power spectra were calculated for each epoch. All-night EEG spectra were calculated for rapid eye movement (REM) and non-REM (NREM) sleep, and cycle-by-cycle spectra were calculated for NREM sleep. The two groups did not differ on any sleep stage variable. All-night analyses revealed normalized power in the delta band and spindle range were lower in PH+ children. Within NREM sleep cycles PH+ children exhibited less normalized power in the delta band and spindle range compared with PH- children. This effect occurred in the first four cycles and was most pronounced in the first sleep cycle of the night. We found no signs of sleep disruption in sleep stages for PH+ children. Sleep EEG spectral differences, however, suggest that certain circuits responsible for 'protecting' sleep may be impaired in PH+ children, which may lead to disrupted sleep later in life.

Copyright 2010, Wiley-Blackwell

Templeton L; Novak C; Wall S. Young people's views on services to help them deal with parental substance misuse. Drugs: Education, Prevention and Policy 18(3): 172-178, 2011. (21 refs.)

Aim: Services for children of parental substance misusers are in their infancy. There is a dearth of research which has heard from children about how they view and benefit from such services. The aim of this article is to present qualitative data from children and young people who have attended three new family-focused services. Methods: As part of the evaluations of three new services for children and families of parental substance misusers, interviews were conducted with young people. Qualitative interview data from 23 young people were thematically analysed. Findings: Young people benefitted through meeting other people and having an opportunity to talk and share experiences, learning about addiction and understanding and controlling their emotions. Their families became safer, healthier and more cohesive. Conclusions: Children living with parental substance misuse need specific support; all three services are excellent examples of service development in this area.

Copyright 2011, Taylor & Francis

Templeton L; Velleman R; Hardy E; Boon S. Young people living with parental alcohol misuse and parental violence: 'No-one has ever asked me how I feel in any of this'. Journal of Substance Use 14(3-4): 139-150, 2009. (30 refs.)

Young people are adversely affected by negative family experiences, but there is a gap in knowledge when the commonly co-existing issues of parental alcohol misuse and parental domestic abuse are considered. Research which talks directly to the young people living in such circumstances is therefore needed. As part of a Europe-wide research study, eight young people aged 12-18 years from five families in England were interviewed about their experiences of living with parental alcohol misuse and violence. Strong links emerged between parental drinking and domestic abuse, with verbal aggression common, and frequent and physical violence less frequent, but of equal concern. The young people had tried and were trying a range of strategies to try and cope with their home environments, and faced an ongoing battle in working out what to do for the best. Support from family, friends, and professionals was discussed, but the young people generally had mixed views about what help they had received and the support that they would have liked. The paper discusses what the findings might mean in terms of the practice and policy response to children living in risky family environments.

Copyright 2009, Informa Healthcare

Torvik FA; Rognmo K; Ask H; Roysamb E; Tambs K. Parental alcohol use and adolescent school adjustment in the general population: Results from the HUNT study. BMC Public Health 11: AR 706, 2011. (58 refs.)

Background: This study investigates the relationship between parental drinking and school adjustment in a total population sample of adolescents, with independent reports from mothers, fathers, and adolescents. As a group, children of alcohol abusers have previously been found to exhibit lowered academic achievement. However, few studies address which parts of school adjustment that may be impaired. Both a genetic approach and social strains predict elevated problem scores in these children. Previous research has had limitations such as only recruiting cases from clinics, relying on single responders for all measures, or incomplete control for comorbid psychopathology. The specific effects of maternal and paternal alcohol use are also understudied. Methods: In a Norwegian county, 88% of the population aged 13-19 years participated in a health survey (N = 8984). Among other variables, adolescents reported on four dimensions of school adjustment, while mothers and fathers reported their own drinking behaviour. Mental distress and other control variables were adjusted for. Multivariate analysis including generalized estimation equations was applied to investigate associations. Results: Compared to children of light drinkers, children of alcohol abusers had moderately elevated attention and conduct problem scores. Maternal alcohol abuse was particularly predictive of such problems. Children of abstainers did significantly better than children of light drinkers. Controlling for adolescent mental distress reduced the association between maternal abuse and attention problems. The associations between parental reported drinking and school adjustment were further reduced when controlling for the children's report of seeing their parents drunk, which itself predicted school adjustment. Controlling for parental mental distress did not reduce the associations. Conclusions: Parental alcohol abuse is an independent risk factor for attention and conduct problems at school. Some of the risk associated with mothers' drinking is likely to be mediated by adolescent mental distress. Despite lowered adjustment on the externalizing dimensions, children of alcohol abusers report that they enjoy being at school as much as other children.

Copyright 2011, Biomed Central Ltd

Vitulano ML; Fite PJ; Rathert J; Gaertner A; Wynn P; Hill R. The influence of neighborhood safety on the relation between caregiver alcohol use and child symptoms of depression. Journal of Substance Use 16(5): 359-366, 2011. (28 refs.)

Objective: To examine the potential moderating effect of neighborhood safety on the caregiver alcohol use and child depression relation. Background: Parental alcohol use is a risk factor for child adjustment outcomes, including depression. However, more research is needed in this area as many children of problem drinkers grow up healthy and well adjusted. Methods: This study examined the potential moderating effect of perceptions of neighborhood safety on the association between caregiver alcohol use and child symptoms of depression in a community sample of 89 children ranging from 9 to 12 years of age (mean = 10.4, SD = 1.1). Results: Findings suggest that for those who viewed their neighborhoods as less safe, caregiver alcohol use was positively related to child depression; however, for those who viewed their neighborhoods as more safe, caregiver alcohol use and child depression were not related. Conclusions: Intervention strategies should target children who reside in unsafe neighborhoods, particularly those exposed to caregiver substance use, as they may be more likely to experience depressive symptoms.

Copyright 2011, Informa Healthcare

Waldron M; Martin NG; Heath AC. Parental alcoholism and offspring behavior problems: Findings in Australian children of twins. Twin Research and Human Genetics 12(5): 433-440, 2009. (47 refs.)

We examine the impact of rearing by an alcoholic parent on risk for child behavior problems using data on 2492 offspring drawn from two ongoing studies of children of female and male same- and opposite-sex twin pairs. Results of regression models predicting child behavior problems from parent and co-twin lifetime history of alcohol use disorder (AUD) provide support for genetic but not environmental transmission of externalizing and a measure of total problem behaviors. Results for internalizing behavior were inconclusive with respect to transmission of risk.

Copyright 2009, Australian Academy Press

Whitbeck LB; Crawford DM. Gestational risks and psychiatric disorders among indigenous adolescents. Community Mental Health Journal 45(1): 62-72, 2009. (69 refs.)

This study reports on the effects maternal prenatal binge drinking, cigarette smoking, drug use, and pregnancy and birth complications on meeting criteria for psychiatric disorders at ages 10-12 and 13-15 years among 546 Indigenous adolescents from a single culture in the northern Midwest and Canada. Adolescent DSM-IV psychiatric disorders were assessed with the Diagnostic Interview Schedule for Children-Revised (DISC-R). Results indicate that maternal behaviors when pregnant have significant effects on adolescent psychiatric disorders even when controlling for age and gender of adolescent, family per capita income, living in a single mother household, and adolescent reports of mother's positive parenting.

Copyright 2009, Springer

Xian H; Scherrer JF; Pergadia ML; Madden PAF; Grant JD; Sartor CE et al. Contribution of parental psychopathology to offspring smoking and nicotine dependence in a genetically informative design. Journal of Studies on Alcohol and Drugs 71(5): 664-673, 2010. (34 refs.)

Objective: It is not known if parental psychiatric disorders have an independent effect on offspring smoking after controlling for genetic and environmental vulnerability to nicotine dependence. We tested if parental alcohol, drug, or conduct disorders; antisocial personality disorder; depression; and anxiety disorders remained significant predictors of offspring smoking initiation, regular smoking, and nicotine dependence before and after adjusting for genetic and environmental risk for nicotine dependence. Method: Data were obtained via semi-structured interviews with 1,107 twin fathers, 1,919 offspring between the ages of 12 and 32, and 1,023 mothers. Genetic and environmental liability for smoking outcomes was defined by paternal and maternal nicotine dependence. Multinomial logistic regression models were computed to estimate the risk for offspring trying cigarettes, regular smoking, and the Fagerstrom Test for Nicotine Dependence (FTND) as a function of parental psychopathology and sociodemographics before and after adjusting for genetic and environmental vulnerability to nicotine dependence. Results: Before adjusting for genetic and environmental risk for nicotine dependence, ever trying cigarettes was associated with maternal depression, regular smoking was associated with maternal alcohol dependence and maternal conduct disorder, and FTND was associated with paternal and maternal conduct disorder and antisocial personality disorder. No parental psychopathology remained significantly associated with regular smoking and FTND after adjusting for genetic and environmental vulnerability to nicotine dependence in a multivariate model. Conclusions: The association between parental psychopathology and offspring smoking outcomes is partly explained by genetic and environmental risk for nicotine dependence. Point estimates suggest a trend for an association between parental antisocial personality disorder and offspring regular smoking and nicotine dependence after adjusting for genetic and environmental vulnerability. Studies in larger samples are warranted.

Copyright 2010, Alcohol Reearch Documentation

Yau WYW; Zubieta JK; Weiland BJ; Samudra PG; Zucker RA; Heitzeg MM. Nucleus accumbens response to incentive stimuli anticipation in children of alcoholics: Relationships with precursive behavioral risk and lifetime alcohol use. Journal of Neuroscience 32(7): 2544-2551, 2012. (46 refs.)

Children of alcoholics (COAs) are at elevated risk to develop alcohol and other substance use disorders. The neurobiological underpinnings of this heightened vulnerability are presently not well understood. This study investigated whether, in humans, COAs have different functioning of the mesolimbic reward circuitry beyond previous substance use confounds and examined potential group differences in neural response in relation to alcohol use and behavioral risk. We studied 20 18- to 22-year-old COAs and 20 controls, developmentally well characterized for substance use and selected to match on sex, age, IQ, lifetime substance use and associated problems, and precursive (ages 12-14 years) externalizing behavioral risk. None met criteria for Diagnostic and Statistical Manual of Mental Disorders IV diagnosis. Neural responses to anticipation of reward and loss were assessed using functional magnetic resonance imaging during a monetary incentive delay task. Overall, COAs showed reduced ventral striatum activation during anticipation of monetary reward and loss compared with controls. However, additional analysis revealed that blunted nucleus accumbens (NAcc) response was only observed in COAs who have not demonstrated any problem drinking behavior. In addition, uniquely in COAs, NAcc activation was positively correlated with precursive externalizing risk, as well as current and lifetime alcohol consumption. These findings suggest a multilevel developmental process whereby lower precursive behavioral risk appears protective of later problem alcohol use in COAs, which is further associated with a blunted NAcc response to incentive anticipation, potentially reflecting a resilience mechanism. Moreover, the results suggest that a close association between motivational responses, alcohol consumption, and behavioral risk may underlie addiction vulnerability in COAs.

Copyright 2012, Society of Neuroscience