Children of alcoholics in Spain: from risk to pathology
- 541 Downloads
To identify the possible risk factors and negative outcomes associated with parental alcoholism. A secondary aim was to determine the influence of the family density of alcoholism on children of alcoholics’ (COAs) psychological functioning.
A multisite epidemiological study was conducted in 8 Spanish cities, recruiting a total sample of 371 COAs (whose parents were in contact with alcohol treatment centers and accepted to participate in this study) and 147 controls (from schools in the same localities as COAs). Both groups were 6–17 years old and received a comprehensive evaluation of mental disorders (no symptoms, subclinical symptoms or clinical diagnosis for each disorder; according to DSM-IV criteria); alcohol and other substance use (none, occasional, regular and risky consumption); school achievement (low, middle and high) and other academic performance indicators (WISC-R Information and Arithmetic subtests, school support activities and failed subjects and courses). Lastly, several cognitive functions were measured by the WISC-R Similarities, Block Design and Digit Symbol subtests, the Toulouse-Piéron test and the Stroop test. Logistic regression methods were used to compare both groups and a linear regression model was used to determine the influence of the family density of alcoholism. The following confounding variables were controlled for: age, gender, socio-economic status and family cohesion.
Children of alcoholics’ were twice as likely as controls to present subclinical symptoms and four times more likely than controls to have a definite diagnosis of any mental disorder. More specifically, COAs had a significantly higher risk than controls of attention deficit disorder/hyperactivity, depression, phobias, enuresis and tics. COAs also tended to have more symptoms of generalized anxiety disorder. COAs had worse results on all the cognitive tests used and their risk of low school achievement was nine times higher than that of controls. Family density of alcoholism was significantly related to several psychiatric disorders and to low academic and cognitive performance in these children.
Children of alcoholics’ whose parents are in contact with treatment centers in Spain constitute a target group for selective prevention, as they have a higher risk of different negative outcomes, which mainly include attention disorders and other cognitive deficits, depression and anxiety.
Key wordschildren of alcoholics (COAs) risk factors psychiatric disorders family density of alcoholism prevention
This article and the Socidrogalcohol’s ALFIL Program were supported by the Spanish Government’s National Plan on Drugs. We thank the European Commission for funding ENCARE: the European Network for Children Affected by Risky Environments in the Family (Alcohol-related issues). The ALFIL Program has been integrated into this network (grant agreement SPC 2002481). We are grateful for the contribution to this study made by all the professionals, children and families who participated in the ALFIL Program. Special thanks to Roser Bono and Josefina Castro-Fornieles for her valuable review of the manuscript of this paper and to Lourdes Serrano for her help with the database.
- 16.DGPNSD, Delegación del Gobierno para el Plan Nacional sobre Drogas (2001) Encuesta sobre drogas a población escolar en el año 2000. Madrid. (Spanish Governmental Delegation for the National Plan on Drugs. Survey about drugs to school population in the year 2000) Available at http://www.pnsd.msc.es/
- 18.Díaz R, Ferri MJ (2002) Intervención en poblaciones de riesgo: los hijos de alcohólicos. En Gual A (ed) Monografía sobre alcohol. Adicciones 13(Suppl 2):247–268Google Scholar
- 19.Díaz R, Gual A (1999) ALFIL program: a multicomunity study of children of alcoholics in Spain: effects of familial density of alcoholism on cognitive measures. Alcohol Alcohol 34:445Google Scholar
- 23.Golden CJ (1994) Stroop Test de Colores y Palabras. Madrid: TEA Ediciones. Adapted from the original work published in 1978: Stroop Color and Word TestGoogle Scholar
- 24.Gual A, Díaz R (1999) Alcoholism prevention in children of alcoholics. Alcohol Alcohol 34:440Google Scholar
- 25.Gual A, Díaz R (2001) Children of alcoholics: risk factors and preventive strategies. WHO European ministerial conference on young people and alcohol. Working group: the family, Stockholm, 19–21 FebruaryGoogle Scholar
- 30.Hesselbrock V, Bauer LO, Hesselbrock MN, Gillen R (1991) Neuropsychological factors in individuals at high risk for alcoholism. In: Galanter (ed) Recent developments in alcoholism, 9. Plenum Press, New York, pp 21–40Google Scholar
- 32.Hesselbrock V, Stabenau JR, Hesselbrock MN (1985) Minimal brain dysfunction and neuropsychological test performance in offspring of alcoholics. In: Galanter M (ed) Recent developments in alcoholism, 3. Plenum Press, New York, pp 65–82Google Scholar
- 35.Hilton ME (1991) The demographic distribution of drinking patterns in 1984. In: Clark WB, Hilton ME (eds) Alcohol drinking practices and problems alcohol in America. State University of New York Press, Albany pp 73–101Google Scholar
- 36.Hollinshead AB (1990) Four factor index of social status. Yale University Department of Sociology, New HavenGoogle Scholar
- 38.Hussong AM, Curran PJ, Chassin L (1998) Pathways of risk for accelerated heavy alcohol use among adolescent children of alcoholic parents. J Abnorm Psychol 26:453–466Google Scholar
- 47.Miller WR, Zweben DSW, DiClemente CC, Rychtarik RG (1995) Motivational enhancement therapy manual. In: Mattson ME (ed) National Institute on Alcohol Abuse and Alcoholism. Project MATCH Monograph Series, vol 2. U.S. Goverment Printing Office, MarylandGoogle Scholar
- 48.Moss RH, Moss BS, Tricket EJ (1984) Las escalas de clima social: Familia, trabajo, instituciones penitenciarias y escuela. Madrid: TEA Ediciones. (Adapted from the original of 1974 The social climate scales: family, work, correctional institutions and classroom environmental scales). Consulting Psychologists Press Inc., Palo AltoGoogle Scholar
- 49.Noble EP (1990) Alcoholics fathers and their sons: neurophysiological, electrophysiological, personality and family correlates. In: Begleiter H, Cloninger R (eds) Genetics and biology of alcoholism Banbury report 33. Cold Spring Harbor Laboratory Press, pp 159–174Google Scholar
- 59.Sher KJ (1991) Children of alcoholics. A critical appraisal of theory and research. University of Chicago Press, Chicago and LondonGoogle Scholar
- 63.Tolouse E, Piéron H (1986) Prueba perceptiva y de atención. Madrid: TEA Ediciones (Original work published in 1911: Attention and perception test)Google Scholar
- 66.Wechsler D (1993) Escala de Inteligencia de Wechsler para Niños-Revisada Madrid: TEA Ediciones (Original work published in 1974: WISC-R, Wechsler Intelligence Scale for Children—Revised)Google Scholar
- 67.Wiers RW, Sergeant JA, Gunning WB (1994) Psychological mechanisms of enhanced risk of addiction in children of alcoholics: a dual pathway? Acta Paediatr 404:9–13Google Scholar