Smoke Signals December 1990 page 14
Children of Alcoholics: Are They Different?
An estimated 6.6 million children under the age of 18
years live in households with at least one alcoholic
parent. Current research findings suggest that these
children are at risk for a range of cognitive, emotional,
and behavioral problems. In addition, genetic studies
indicate that alcoholism tends to run in families and that
a genetic vulnerability for alcoholism exists. Yet, some
investigators also report that many children from
alcoholic homes develop neither psychopathology nor
alcoholism. This Alcohol Alert focuses on three major
research questions concerning children of alcoholics
(COAs): 1) What contributes to resilience in sofflQAs;
2) Do COAs differ from children of nonalcoholics
(nonCOAs); and 3) Are the differences specifically
related to parental alcoholism, or are they similar to
characteristics observed in children whose parents have
other illnesses?
Before summarizing the research findings on these
questions, it should be said that many studies of COAs
have been plagued by methodological issues. For
example, the composition of the sample chosen for a
study can affect the study results significantly. Yet,
many COA studies use a biased sample selection of
children in treatment or in trouble. In addition, studies
often are conducted without the benefit of matched
control groups. The absence of control groups makes it
difficult to generalize results from treatment samples to
nontrcatmcnt populations. Children of various ages and
developmental stages frequently are grouped in one
sample, and the developmental differences within the
group are ignored. Another problem is that because few
longitudinal studies have been performed, it is difficult
to know whether the observed problems are impair
ments or are developmental delays. In addition, the
effect of such factors as marital conflict and the severity
of parental drinking on the development of problems
should be considered. All of these limitations can affect
the outcome of the study. The studies cited below are
not free of these methodological problems, but they are
the best that we have.
While research findings suggest that some children
suffer negative consequences due to parental alcoholism,
a larger proportion of COAs function well and do not
develop serious problems. In a longitudinal study of
COAs born on the island of Kauai, Werner reported
that, although 41 percent of the children developed
serious coping problems by 18 years of age, 59 percent
did not develop problems. These resilient children
shared several characteristics that contributed to their
success, including the ability to obtain positive attention
from other people, adequate communication skills,
average intelligence, a caring attitude, a desire to .
achieve, and a belief in self-help.
Studies comparing COAs and nonCOAs have sug
gested that, although the two groups differ in a variety of
psychosocial areas, differences in cognitive performance
are observed most frequently. Cognitive function in
COAs has been examined by many researchers because
it is an important element needed for adaptation at all
stages of development; it can be measured uniformly
across developmental stages; and it often is associated
with the symptoms of alcoholism. Ervin and her
colleagues found that Full IQ, performance (a measure
of abstract and conceptual reasoning), and verbal scores
were lower among a sample of children raised by
alcoholic fathers than among children raised by nonalco
holic fathers. Gabrielli and Mcdnick reported similar
results for verbal and Full IQ tests, but not for perform
ance tests. In a study comparing COAs and non COAs
whose families were educated and whose parents lived
in the home, Bennett and colleagues found that children
from alcoholic families had lower IQ, arithmetic,
reading, and verbal scores. Despite the lower scores,
however, COAs performed within normal ranges for
intelligence tests in each of these studies.
It is important to note that cognitive competence can
vary with the instrument used to measure performance
as well as with the individual who is evaluating function.
Johnson and Rolf compared the academic abilities and
cognitive function of COAs and nonCOAs from nondis
advantaged backgrounds and found no difference
between the groups. The investigators noted, however,
that the children with alcoholic parents underestimated
their own competence. In addition, the mothers of
COAs underrated their children's abilities. The moth
ers' and children's perceptions of abilities may affect the
children's motivation, self-esteem, and future perform
ance. School-aged children of alcoholic parents often have
academic problems. Academic performance may be a
better measure than IQ of the effect of living with an
alcoholic parent. School records indicate that COAs
experience such academic difficulties as repeating
grades, failing to graduate from high school, and
requiring referrals to school psychologists. Although
cognitive deficits in COAs may account, in part, for their
poor academic performance, motivational difficulties or
the stress of the home environment also may contribute
to their problems in school.
Studies comparing COAs with nonCOAs also have
found that parental alcoholism is linked to a number of
psychological disorders in children. Divorce, parental
anxiety or affective disorders, or undesirable changes in
the family or in life situations can add to the negative
effect of parental alcoholism on children's emotional
functioning. .
The results of several studies have shown that children
from alcoholic families report higher levels of depres
sion and anxiety and exhibit more symptoms of general
ized stress (i.e. low self-esteem) than do children from
nonalcoholic families. In addition, COAs often express
a feeling of lack of control over their environment. A
recent study by Rolf and colleagues noted that COAs
show more depressive affect than nonCOAs and that
their self-reports of depression are measured more
frequently on the extreme end of the scale.
Moos and Billings found that the emotional stress of
parental drinking on children lessens when parents stop
drinking. These investigators assessed emotional
problems in children from families of relapsed alcohol
ics, children from families with a recovering parent, and
children from families with no alcohol problem. Al
though the children of relapsed alcoholics reported
higher levels of anxiety and depression than children
from the homes with no alcohol problem, emotional ,
functioning was similar among the children of recover
ing and normal parents.
Finally, children from homes with alcoholic parents
often demonstrate behavioral problems. Study findings
suggest that these children exhibit such problems as
lying, stealing, fighting, truancy, and school behavior
problems, and they often are diagnosed as having
conduct disorders. Teachers have rated COAs as
significantly more overactive and impulsive than non
COAs. COAs also appear to be at greater risk for
delinquency and school truancy. Several investigators
have reported an association between the incidence of
diagnosed conduct disorders and parental alcohol abuse.
However, other problems associated with alcoholism
(e.g. depression among the alcoholic parents and
divorce) also may contribute to conduct problems and
disorders among COAs.
The alcoholic family's home environment and the
manner in which family members interact may contrib
ute to the risk for the problems observed among COAs.
Although alcoholic families are a heterogeneous group,
some common characteristics have been identified.
Families of alcoholics have lower levels of family
cohesion, expressiveness, independence, and intellectual
orientation and higher levels of conflict compared with
nonalcoholic families. Some characteristics, however,
are not specific to alcoholic families: Impaired problem
solving ability and hostile communication arc observed
both in alcoholic families and in families with problems
other than alcohol. Moreover, the characteristics of
families with recovering alcoholic members and of
families with no alcoholic members do not differ
significantly, suggesting that a parent's continued
drinking may be responsible for the disruption of family
life in an alcoholic home.
The family environment also may affect transmission of
alcoholism to COAs. Children with alcoholic parents
arc less likely to become alcoholics as adults when their
parents consistently set and follow through on plans and
maintain such rituals as holidays and regular mealtimes.
Interestingly, the problems of COAs may not be
specific to this population. In a review of research on
children whose mothers were schizophrenic, Garmezy
reported that, like COAs, these children had cognitive
deficits. In particular, they had a limited ability to
maintain attention and to perceive relevant stimuli.
Children at high risk for schizophrenia revealed a more
negative self-image. Jhe family environment also may
influence the risk for schizophrenia; children of schizo
phrenic parents whose home environment is turbulent
- have an increased risk for developing schizophrenia.
Research on COAs is still in its infancy. Many studies
suggest that a variety of differences exist between
children of alcoholics and children of nonalcoholics and
these differences occur at all ages! However, because of
the limitations of the methodology and the inadequate
number of comprehensive studies, research findings
cannot be generalized to all children who grow up with
alcoholic parents.
Alcohol Alert, a publication of the National Institute
on Alcohol Abuse and Alcoholism, provides timely
information on alcohol research and treatment to health
professionals and other interested people. This issue is
the ninth in the scries.
Courtesy of Alcohol Alert.