Skip to main content
SpringerLink
Log in

Types and Phases of Alcohol Dependence Illness

  • Chapter
Genetics Behavioral Treatment Social Mediators and Prevention Current Concepts in Diagnosis

Part of the book series: Recent Developments in Alcoholism ((RDIA,volume 1))

Abstract

The published data based on retrospective recall support the position that there is a characteristic developmental sequence of clinical signs and symptoms in alcohol dependence illness. These symptoms cluster in three sequential temporal phases: psychological dependence, physiological dependence, and neurological disorganization. Individuals may discontinue alcohol consumption during any phase and are not doomed to complete the sequence. Attempts to develop subtypes of alcohol-dependent individuals are generally based on inadequate samples from nonrepresentative treatment centers, many of whose patients are not alcohol dependent. The proposed essential-reactive, primary-affective, and life-style typologies have very weak support. Studies repeatedly confirm sociopathic, depressed, and anxious subgroups of alcohol dependent patients. However, such classifications have not been able to encompass more than one-half of the treatment populations studied. These concurrent symptom types are more prevalent in publicly operated treatment facilities and are predictive of recovery.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. World Health Organization Expert Committee on Mental Health, Alcoholism Subcommittee: Second Report. WHO Tech Rep Ser No. 48, 1952.

    Google Scholar 

  2. Mann M: New Primer on Alcoholism, ed 2. New York, Holt, Rinehart and Winston, 1968.

    Google Scholar 

  3. Gitlow SE: Alcoholism: A disease, in Bourne PB, Fox R (eds): Alcoholism—Progress in Research and Treatment. New York, Academic Press, 1973, pp 1–9.

    Google Scholar 

  4. Madsen W: The American Alcoholic: The Nature-Nurture Controversies in Alcoholic Research and Therapy. Springfield, Illinois, Charles С Thomas, 1974.

    Google Scholar 

  5. Johnson VE: I’ll Quit Tomorrow. New York, Harper & Row, 1973.

    Google Scholar 

  6. National Council on Alcoholism, Criteria Committee: Criteria for the diagnosis of alcoholism. Am J Psychiatry 129: 132, 1972.

    Google Scholar 

  7. Pattison EM, Sobell MB, Sobell LC: Emerging Concepts of Alcohol Dependence. New York, Springer, 1977.

    Google Scholar 

  8. Jellinek EM: The Disease Concept of Alcoholism. New Haven, Hillhouse Press, 1960.

    Book  Google Scholar 

  9. Jellinek EM: Phases of alcohol addiction. Q J Stud Alcohol 13: 673–684, 1952.

    PubMed  CAS  Google Scholar 

  10. Edwards G, Gross MM, Keller M, et al: Alcohol Related Disabilities, WHO Offset Publication No. 32. Geneva, WHO, 1977.

    Google Scholar 

  11. Edwards G, Gross MM: Alcohol dependence: Provisional description of a clinical syndrome. Br Med J 1: 1058–1061, 1976.

    Article  PubMed  CAS  Google Scholar 

  12. Lender ME: Jellinek’s typology of alcoholism: Some historical antecedents. J Stud Alcohol 40: 361–375, 1979.

    PubMed  CAS  Google Scholar 

  13. Goodwin DW, Crane JB, Guze SB: Alcoholic “blackouts”: A review and clinical study of 10 alcoholics. Am J Psychiatry 126: 191–198, 1969.

    PubMed  CAS  Google Scholar 

  14. Jellinek EM: Phases in the drinking history of alcoholics, analysis of a survey conducted by the Official Organ of Alcoholics Anonymous. Q] Stud Alcohol 7: 1–88, 1946.

    CAS  Google Scholar 

  15. Trice HM, Wahl JR: A rank order analysis of the symptoms of alcoholism. Q J Stud Alcohol 19: 636–648, 1958.

    PubMed  CAS  Google Scholar 

  16. Glatt MM: Drinking habits of English (middle class) alcoholics. Acta Psychiatr Scand 37: 88–113, 1961.

    Article  PubMed  CAS  Google Scholar 

  17. Curlee J: Alcoholic blackouts: Some conflicting evidence. Q J Stud Alcohol 34: 409–413, 1973.

    PubMed  CAS  Google Scholar 

  18. Park P: Developmental ordering of experiences in alcoholism. Q J Stud Alcohol 34: 473–488, 1973.

    PubMed  CAS  Google Scholar 

  19. Kirivanta P: Alcoholism Syndrome in Finland: A Comparative Analysis of the AA Movement, Outpatients in a Clinic and Inmates of the Institutions for the Care of Alcoholics. Helsinki, Finnish Foundation for Alcohol Studies, 1969.

    Google Scholar 

  20. Park P, Whitehead P: Developmental sequences and dimensions of alcoholism. Q J Stud Alcohol 34: 887–904, 1973.

    PubMed  CAS  Google Scholar 

  21. Orford J, Hawker A: Note on the ordering of symptoms in alcohol dependence. Psychol Med] 4: 281–288, 1974.

    CAS  Google Scholar 

  22. Clark WB, Cahalan D: Changes in problem drinking over a four-year span. Addict Behav 1: 251–259, 1979.

    Article  Google Scholar 

  23. Chick J, Duffy JC: Application to the alcohol dependence syndrome of a method of determining the sequential development of symptoms. Psychol Med J 9: 313–319, 1979.

    Article  CAS  Google Scholar 

  24. Barnes GE: The alcoholic personality: A reanalysis of the literature. J Stud Alcohol 40: 571–634, 1979.

    PubMed  CAS  Google Scholar 

  25. Maertzen CA, Monroe JJ, Hill HE: Manual for alcoholic scales of the inventory of habits and attitudes (IHA). Psychol Rep 25: 947–973, 1969.

    Article  Google Scholar 

  26. Pattison EM, Сое R, Doerr HD: Population variation between alcoholism treatment facilities. Int J Addict 8: 199–229, 1973.

    PubMed  CAS  Google Scholar 

  27. Smart RG, Schmidt W, Moss MK: Social class as a determinant of the type and duration of therapy received by alcoholics. Int J Addict 4: 543–556, 1938.

    Google Scholar 

  28. Knight RP: The dynamics and treatment of the chronic alcohol addiction. Bull Menninger Clin 1: 233–250, 1938.

    Google Scholar 

  29. Dale PW, Ebaugh FG: Personality structure with relation to tetraethylthiuran disulfide (Antabuse) therapy of alcoholism. JAMA 146: 314–319, 1951.

    Article  CAS  Google Scholar 

  30. Rudie R, McGaughran L: Differences in developmental experiences, defensiveness, and personality organization between two classes of problem drinkers. J Abnorm Soc Psychol 62: 659–665, 1961.

    Article  PubMed  CAS  Google Scholar 

  31. Sugarman AA, Reilly D, Albahary R: Social competence and the essential-reactive distinction in alcoholism. Arch Gen Psychiatry 12: 552–556, 1965.

    Article  Google Scholar 

  32. Levine J, Zigler E: The essential-reactive distinction in alcoholism: A developmental approach. J Abnorm Psychol 81: 242–249, 1973.

    Article  PubMed  CAS  Google Scholar 

  33. Blum J, Levine J: Maturity, depression, and life events in middle aged alcoholics. Addic Behav 1: 37–45, 1975.

    Article  CAS  Google Scholar 

  34. Pitts FN Jr, Winokur G: Affective disorder. VII. Alcoholism and affective disorder. J Psychiatr Res 4: 246–251, 1943.

    Google Scholar 

  35. Schuilsit M, Pitts FN Jr, Reich T, et al: Alcoholism I: Two types of alcoholism in women. Arch Gen Psychiatry 20: 301–306, 1969.

    Article  Google Scholar 

  36. Winokur G, Reich T, Rimmer J, et al: Alcoholism. III. Diagnosis and psychiatric illness in 259 alcoholic probands. Arch Gen Psychiatry 23: 104–111, 1970.

    Article  PubMed  CAS  Google Scholar 

  37. Winokur G, Rimmer J, Reich T: Alcoholism. IV. Is there more than one type of alcoholism? Br J Psychiatry 118: 525–531, 1971.

    Article  PubMed  CAS  Google Scholar 

  38. Brown MA: Alcoholic profiles on the Minnesota multiphasic. J Clin Psychol 6: 266–269, 1950.

    Article  PubMed  CAS  Google Scholar 

  39. Goss A, Morosco TE: Alcoholism and clinical symptoms. J Abnorm Psychol 74: 682–684, 1969.

    Article  PubMed  CAS  Google Scholar 

  40. Goldstein SG, Linden JD: Multivariate classification of alcoholics by means of the MMPI. J Abnorm Psychol 74: 661–669, 1969.

    Article  PubMed  CAS  Google Scholar 

  41. Mogar RE, Wilson WM, Helm ST: Personality subtypes of male and female alcoholic patients. Int J Addict 5: 99–113, 1970.

    PubMed  CAS  Google Scholar 

  42. Bean KL, Karasievich GO: Psychological test results at three stages of inpatient alcoholism treatment.] Stud Alcohol 36: 838–852, 1975.

    CAS  Google Scholar 

  43. Whitelock PR, Overall JE, Patrick JH: Personality patterns of alcohol abuse in a state hospital population. J Abnorm Psychol 78: 9–16, 1971.

    Article  PubMed  CAS  Google Scholar 

  44. Skinner HA, Jackson DN, Hoffman H: Alcoholic personality types: Identification and correlates. J Abnorm Psychol 83: 658–666, 1974.

    Article  PubMed  CAS  Google Scholar 

  45. Lawlis FG, Ruben SE: 16-PF Study of personality patterns in alcoholics. Q J Stud Alcohol 32: 318–327, 1971.

    PubMed  CAS  Google Scholar 

  46. Nerviano VJ: Common personality patterns among alcoholic males: A multivariate study. J Consult Clin Psychol 44: 104–110, 1976.

    Article  PubMed  CAS  Google Scholar 

  47. Horn JL, Wanberg KW: Symptoms patterns related to excessive use of alcohol. Q J Stud Alcohol 30: 35–58, 1969.

    PubMed  CAS  Google Scholar 

  48. Horn JL, Wanberg KW: Dimensions of perception of background and current situation of alcoholic patients. Q] Stud Alcohol 31: 633–658, 1970.

    CAS  Google Scholar 

  49. Horn JL, Wanberg KW, Adams G: Diagnosis of alcoholism: Factors of drinking background and current conditions in alcoholics. Q J Stud Alcohol 35: 147–175, 1974.

    Google Scholar 

  50. Pokorny AD, Miller BA, Kanas TE, et al: Dimensions of alcoholism. Q J Stud Alcohol 32: 699–705, 1971.

    PubMed  CAS  Google Scholar 

  51. Partington JT, Johnson FG: Personality types among alcoholics. Q J Stud Alcohol 30: 21–24, 1969.

    PubMed  CAS  Google Scholar 

  52. Chandler J, Hensman C, Edwards G: Determinants of what happens to alcoholics. Q J Stud A lcohol 32: 349–363, 1971.

    CAS  Google Scholar 

  53. Evenson RC, Altman H, Sletten IW, et al: Factors in the description and grouping of alcoholics. Am J Psychiatry 130: 49–54, 1973.

    PubMed  CAS  Google Scholar 

  54. Finney JW, Moos RH: Treatment and outcome for empirical subtypes of alcoholic p atients. J Consult Clin Psychol 47: 25–38, 1979.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Mental Hygiene, The Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland, 21205, USA

    Wallace Mandell

  2. Comprehensive Alcoholism Program, The Johns Hopkins Hospital, Baltimore, Maryland, 21205, USA

    Wallace Mandell

Authors
  1. Wallace Mandell
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Albert Einstein College of Medicine, Bronx, New York, USA

    Marc Galanter M.D.

  2. Department of Psychiatry, University of Kansas Medical Center, Kansas City, Kansas, 66103, USA

    Donald W. Goodwin

  3. Department of Psychiatry and Human Behavior, Jefferson Medical College, Thomas Jefferson University, Philadelphia, 19107, Pennsylvania, USA

    Edward Gottheil

  4. Department of Psychiatry, The Neuropsychiatric Institute, Alcohol Research Center, University of California, Los Angeles, California, 90024, USA

    Alfonso Paredes

Rights and permissions

Reprints and permissions

Copyright information

© 1983 Plenum Press, New York

About this chapter

Cite this chapter

Mandell, W. (1983). Types and Phases of Alcohol Dependence Illness. In: Galanter, M., et al. Genetics Behavioral Treatment Social Mediators and Prevention Current Concepts in Diagnosis. Recent Developments in Alcoholism, vol 1. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-3617-4_22

Download citation

  • DOI: https://doi.org/10.1007/978-1-4613-3617-4_22

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-3619-8

  • Online ISBN: 978-1-4613-3617-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation