A Comprehensive Theory of the Pathogenesis of Alcoholism

  • Ulrich Golüke
  • Robert Landeen
  • Dennis Meadows


Measured by the number of meetings and publications on the subject, the current knowledge of alcoholism is substantial and increasing. Yet one finds that the new knowledge, the numerous meetings, and all the federal dollars spent on addressing the problem of alcohol abuse have had an insignificant impact on the prevalence of alcoholism. Recidivism rates are still 30%–70%, and estimated costs of alcohol abuse rose to about $40 billion in 1975 in the United States alone. The frustrating lack of progress can be attributed to the lack of a comprehensive theory of alcoholism. Most theories, or models, of alcoholism are like the descriptions of an elephant by blind people: they capture reality, but only partially.


Alcohol Consumption Stress Ratio Coping Skill Drinking Behavior Comprehensive Theory 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. Alcaron, R. de, 1969, The spread of heroin abuse in a community, Bull. Narcotics 21(3): 17–22.Google Scholar
  2. Allport, F. H., 1955, “Theories of perception and the concept of structure,” Wiley, New York.Google Scholar
  3. Ashby, W. R., 1960, “Design for a brain: The origin of adaptive behavior,” Wiley, New York.CrossRefGoogle Scholar
  4. Bacon, S. D., 1943, Sociology and the problems of alcohol, Q. J. Stud. Alcohol 4:402–445.Google Scholar
  5. Baekeland, F., 1977, Evaluation of treatment methods in chronic alcoholism, in “The biology of alcoholism,” Vol. 5, B. Kissin and H. Begleiter (eds.) Plenum Press, New York, pp. 385–440.CrossRefGoogle Scholar
  6. Bales, R. F., 1946, Cultural differences in rates of alcoholism, Q.J. Stud. Alcohol 6:480–499.Google Scholar
  7. Barry, H., III, 1973, Cross cultural evidence that dependence conflict motivates drunkeness, in “Cross cultural approaches to the study of alcohol,” M. Everett, J. Waddell, and D. Heath (eds.), Mouton, The Hague, pp. 249–263.Google Scholar
  8. Beck, H., 1976, Neuropsychological servosystems, consciousness, and the problem of embodiment, Behav. Sci. 21:139–160.CrossRefGoogle Scholar
  9. Begleiter, H., and Porjesz, B., 1977, Persistance of brain hyperexcitability following chronic alcohol exposure in rats, in “Alcohol intoxication and withdrawal,” Vol. 3b, M. Gross (ed.), Plenum Press, New York, pp. 209–222.Google Scholar
  10. Bejerot, C., and Bejerot, N., 1978, Exposure factors in drug use, abuse, and addiction, in “Basis of addiction,” J. Fishman (ed.), Abakon Verglagsgesellschaft, Berlin, pp. 89–118.Google Scholar
  11. Bejerot, N., 1972, “Addiction, an artifically induced drive,” Thomas, Springfield, Ill.Google Scholar
  12. Bertalanffy, L. von, 1968, “General systems theory,” Braziller, New York.Google Scholar
  13. Bethe, A., Fischer, E., and Goldstein, K., 1931, Die Anpassungsfahigkeit (Plastizitat) des Nevensystems, in “Handbuch der normalen und phatologischen Physiologie,” Vol. 15/2, A. Bethe, G. Bergmann, G. Embden, und A. Ellinger (eds.), Springer, Berlin, pp. 1045–1220.CrossRefGoogle Scholar
  14. Blane, H. T., 1968, “The personality of the alcoholic,” Harper & Row, New York.Google Scholar
  15. Bossell, H., 1977, Orientors of non-routine behavior, in “Concepts and tools of computer-assisted policy analysis,” Vol. 1, H. Bossel (ed.), Birkhauser Verlag, Basel and Stuttgart, pp. 227–265.Google Scholar
  16. Brunswick, E., 1956, Historical and thematic relations of psychology to other sciences, Scientific Monthly 83:151–161.Google Scholar
  17. Bruun, K., Edwards, G., Lumio, M., Makela, K., Pan, L., Popham, R. E., Room, R., Schmidt, W., Skog, O. J., Sulkunen, P., and Osterberg, E., 1975, “Alcohol control policies in public health perspective,” Vol. 25, Finnish Foundation for Alcohol Studies, Helsinki.Google Scholar
  18. Cahalan, D., 1970, “Problem drinkers,” Jossey-Bass, San Francisco.Google Scholar
  19. Cahalan, D., Cisin, I., and Crossley, H., 1969, “American drinking practices: A national survey of drinking behavior and attitudes,” Monographs of the Rutgers Center of Alcohol Studies, No. 6, New Brunswick, N.J.Google Scholar
  20. Cannon, W., 1932, “The wisdom of the body,” Norton, New York.Google Scholar
  21. Cappell, H., 1975, An evaluation of tension models of alcohol consumption, in “Research advances in alcohol and drug problems,” Vol. 2, R. J. Gibbins, Y. Israel, H. Kalant, R. E. Popham, W. Schmidt, and R. G. Smart (eds.), Wiley, New York, pp. 177–209.Google Scholar
  22. Clare, A., 1977, How good is treatment? in “Alcoholism: New knowledge and new responses,” G. Edwards and M. Grant (eds.), Groom Helm, London, pp. 279–289.Google Scholar
  23. Cofer, C. N., and Apple, M. H., 1964, “Motivation: Theory and research,” Wiley, New York.Google Scholar
  24. de Lint, J., and Schmidt, W., 1968, The distribution of alcohol consumption in Ontario, Q. J. Stud. Alcohol 29:968–973.Google Scholar
  25. Dochin, E., 1979, Event related brain potentials: A tool in the study of human information processing, in “Evoked brain potentials and behavior,” H. Begleiter (ed.), Plenum Press, New York, pp. 13–88.Google Scholar
  26. Dole, V. P., 1978, A clinician’s view of addiction, in “The basis of addiction,” J. Fishman (ed.), Abakon Verlagsgesellschaft, Berlin, pp. 37–46.Google Scholar
  27. Edwards, G., 1977, The alcohol dependence syndrome: Usefulness of an Idea, in “Alcoholism: New knowledge and new responses,” G. Edwards and M. Grant (eds.), Croom Helm, London, pp. 136–156.Google Scholar
  28. Edwards, G., 1978, Drugs and the questions that can be asked of epidemiology, in “The basis of addiction,” J. Fishman (ed.), Abakon Verlagsgesellschaft, Berlin, pp. 15–36.Google Scholar
  29. Edwards, G., Orford, J., Egert, S., Guthrie, S., Hawker, A., Hensman, C., Mitcheson, M., Oppenheimer, E., and Taylor, C., 1977, Alcoholism: A controlled trial of “treatment” and “advice,” J. Stud. Alcohol 38:1004–1031.Google Scholar
  30. Festinger, L., 1957, “A theory of cognitive dissonance,” Row Peterson, Evanston, Ill.Google Scholar
  31. Fillmore, K. M., 1974, Drinking and problem drinking in early adulthood and middle age, Q. J. Stud. Alcohol 35:819–840.Google Scholar
  32. Forrester, J. W., 1961, “Industrial dynamics,” MIT Press, Cambridge, Mass.Google Scholar
  33. Foster, R. O., Soeldner, J. S., Tan, M. H., and Guyton, J. R., 1973, Short-term glucose homeostasis in man: A systems dynamics model,J. Dynam. Syst. Measurement Control 1973:308–314.CrossRefGoogle Scholar
  34. Glaser, F. B., Greenberg, S. W., and Barrett, M., 1978, “A system approach to alcohol treatment,” Addiction Research Foundation, Toronto.Google Scholar
  35. Goldberg, L., 1943, Quantitative studies on alcohol tolerance in man, Acta Physiol. Scand. 5(Suppl. 16):5–128.CrossRefGoogle Scholar
  36. Goldstein, D. B., 1977, Temporal patterns of voluntary alcohol intake, in “Alcohol intoxication and withdrawal,” Vol. 3b, M. Gross, (ed.), Plenum Press, New York, pp. 539–546.Google Scholar
  37. Goluke, U., 1980, “A comprehensive theory of the pathogenesis of alcoholism: Appendix,” Resource Policy Center, Thayer School of Engineering, Publication No 252, Hanover, N.H.Google Scholar
  38. Goodman, M., 1974, “Study notes in system dynamics,” Wright-Allen, Cambridge, Mass.Google Scholar
  39. Goodwin, D., 1976, “Is alcoholism hereditary?” Oxford University Press, New York.Google Scholar
  40. Gordis, E., 1976, What is alcoholism research? Ann. Intern. Med. 85:821–823.Google Scholar
  41. Gross, M., 1945, The relation of the pituitary gland to some symptoms of alcoholic intoxication and chronic alcoholism, Q. J. Stud. Alcohol 6:25–35.Google Scholar
  42. Gross, M. (ed.), 1973–1977, “Alcohol intoxication and withdrawal,” 4 Vol., Plenum Press, New York.Google Scholar
  43. Herz, A., and Schulz, R., 1978, Changes in neuronal sensitivity during addictive processes, in “The basis of addiction,” J. Fishman (ed.), Abakon Verlagsgesellschaft, Berlin, pp. 375–394.Google Scholar
  44. Hughes, P. H., and Crawford, G. A., 1972, A contagious disease model for researching and interviewing in heroin epidemics, Arch. Gen. Psychiat. 27:149–155.CrossRefGoogle Scholar
  45. Jellinek, E. M., 1960, “The disease concept of alcoholism,” Hillhouse Press, New Haven, Conn.Google Scholar
  46. Jessor, R., Graves, T. D., Hanson, R. C., and Jessor, S. L., 1968, “Society, personality, and deviant behavior: A study of a tri-ethnic community,” Holt, Rinehart, & Winston, New York.Google Scholar
  47. Johnston, V. S., 1979, Stimuli with biological significance, in “Evoked brain potentials and behavior,” H. Begleiter (ed.), Plenum Press, New York, pp. 1–12.Google Scholar
  48. Kalant, H., 1977, Alcohol withdrawal syndromes in the human: Comparison with animal models, in “Alcohol intoxication and withdrawal,” Vol. 3b, M. Gross (ed.), Plenum Press, New York, pp. 57–64.Google Scholar
  49. Katzper, H., Ryback, R., and Hertzman, M., 1976, “Preliminary aspects of modeling and simulation for understanding alcohol utilization and the effects of regulatory policies,” U.S. Department of Commerce, National Technical Information Service, PB-263 023, Washington.Google Scholar
  50. Kendall, R. E., and Statton, M. C., 1966, The fate of untreated alcoholics, Q. J. Stud. Alcohol 27:22–43.Google Scholar
  51. Keshishian, J. M., 1979, Anatomy of a Burmese beauty secret, National Geographic 155(6):798–801.Google Scholar
  52. Kissin, B., 1974, The pharmacodynamics and natural history of alcoholism, in “The biology of alcoholism,” Vol. 3, B. Kissin and H. Begleiter (eds.), Plenum Press, New York, p. 8.Google Scholar
  53. Kissin, B., 1977a, Medical management of the alcoholic patient, in “The biology of alcoholism,” Vol. 5, B. Kissin and H. Begleiter (eds.), Plenum Press, New York, pp. 53–103.CrossRefGoogle Scholar
  54. Kissin, B., 1977b, Theory and practice in the treatment of alcoholism, in “The biology of alcoholism,” Vol. 5, B. Kissin and H. Begleiter (eds.), Plenum Press, New York, pp. 1–51.CrossRefGoogle Scholar
  55. Kissin, B., 1979, Biological investigations in alcohol research,J. Stud. Alcohol Supplement No. 8,40:146–203.Google Scholar
  56. Kissin, B., and Begleiter, H. (eds.), 1971–1977, “The biology of alcoholism,” 5 vols., Plenum Press, New York.Google Scholar
  57. Kissin, B., and Hankoff, L., 1959, The acute effects of ethyl alcohol on the Funkenstein mecholyl response in male alcoholics, Q.J. Stud. Alcohol 20:696–703.Google Scholar
  58. Kissin, B., Tuchfeld, B. S., Schuckit, M. A., Rosenberg, C. M., Glaser, F. B., and Matcom, A. J., 1977, Comments on “Alcoholism: A controlled trial of’treatment’ and advice,” J. Stud. Alcohol 38:1804–1829.Google Scholar
  59. Klausner, S. Z., Foulks, E. F., and Moore, M. H., 1980, “Social change and the alcohol problem on the Alaskan North Slope,” Center for Research on the Acts of Man, Philadelphia.Google Scholar
  60. Lashley, K., 1929, “Brain mechanisms and intelligence,” University of Chicago Press, Chicago.CrossRefGoogle Scholar
  61. Lazarus, R. S., 1966, “Psychological stress and the coping process,” McGraw-Hill, New-York.Google Scholar
  62. Lederman, S., 1956, “Alcool, alcoolisme, alcoolisation,” Institut National d’études Démographique, Travaux et Documents, Cahier No. 29, Presses Universitaires de France, Paris.Google Scholar
  63. Lemere, F., 1953, What happens to alcoholics? Am. J. Psychiat. 109:674–676.Google Scholar
  64. Levi, L. (ed.), 1972, “Stress and distress in response to psychosocial stimuli,” Pergamon Press, Oxford.Google Scholar
  65. Levin, G., Roberts, E. B., and Hirsch, G. B., 1975, “The persistent poppy,” Ballinger, Cambridge, Mass.Google Scholar
  66. Lieber, C. S., 1977, Metabolism of ethanol, in “Metabolic aspects of alcoholism,” C. S. Lieber (ed.), University Park Press, Baltimore, pp. 1–29.CrossRefGoogle Scholar
  67. Lieber, C. S., and DeCarli, L. M., 1977, Metabolic effects of alcohol on the liver, in “Metabolic aspects of alcoholism,” C. S. Lieber (ed.), University Park Press, Baltimore, pp. 31–79.CrossRefGoogle Scholar
  68. Lumsden, D., 1975, Towards a systems model of stress, in “Stress and anxiety,” Vol. 2, I. G. Sarason and C. D. Spielberger (eds.), Hemisphere, Washington, pp. 191–228.Google Scholar
  69. Martin, W. R., and Jasinski, D. R., 1969, Physiological parameters of morphine dependence in man—Tolerance, early abstinence, protracted abstinence,J. Psychiat. Res. 7:9–17.CrossRefGoogle Scholar
  70. Maslow, A., 1954, “Motivation and personality,” Harper Sc Row, New York.Google Scholar
  71. McClelland, D. C., Davis, W. N., Kalin, R., and Wanner, H. E., 1972, “The drinking man: Alcohol and human motivation,” Free Press, New York.Google Scholar
  72. Meadows, D. L., Behrens, W., III, Meadows, D. H., Naill, R., Randers, J., and Zahn, E., 1974, “Dynamics of growth in a Finite world,” Wright-Allen Press, Cambridge, Mass.Google Scholar
  73. Mechanic, D., 1973, “Politics, medicine, and social science,” Wiley, New York.Google Scholar
  74. Medicine in the Public Interest, 1979, “The effects of alcoholic beverage control laws,” Washington.Google Scholar
  75. Mello, N. K., 1972, Behavioral Studies of Alcoholism, in “The biology of alcoholism,” Vol. 2, B. Kissin and H. Begleiter (eds.), Plenum Press, New York, pp. 219–291.Google Scholar
  76. Mello, N. K., 1976, Some issues in research on the biology of alcoholism, in “Alcohol and alcohol problems,” W. J. Filstead, J. J. Rossi, and M. Keller (eds.), Ballinger, Cambridge, Mass., pp. 167–192.Google Scholar
  77. Menninger, K., 1938, “Man against himself,”, Harcourt, Brace, New York.Google Scholar
  78. Menninger, K., Mayman, M., and Pruyser, P., 1963, “The vital balance,” Viking Press, New York.Google Scholar
  79. Mezey, E., and Tobon, F., 1971, “Rates of ethanol clearance and activities of the ethanol-oxidizing enzymes in chronic alcohol patients,” Gastroenterology 61:707–715.Google Scholar
  80. Miller, G. H., and Agnew, N., 1974, The Ledermann model of alcohol consumption, Q. J. Stud. Alcohol 35:877–898.Google Scholar
  81. Miller, J. G., 1978, “Living systems,” McGraw-Hill, New York.Google Scholar
  82. Miller, W. R., and Caddy, G. R., 1977, “Abstinence and controlled drinking in the treatment of problem drinkers,”J. Stud. Alcohol 38:986–1003.Google Scholar
  83. Myrsten, A. L., 1977, Interaction of alcohol with psychological stress, in “Alcohol intoxication and withdrawal,” Vol. 3b, M. Gross, (ed.), Plenum Press, New York, pp. 319–331.Google Scholar
  84. Naitoh, P., 1972, The effects of alcohol on the autonomic nervous system of humans: Psychophysiological approach, in “The biology of alcoholism,” Vol. 2, B. Kissin and H. Begleiter (eds.), Plenum Press, New York, pp. 367–433.Google Scholar
  85. Okamoto, M., Rosenberg, H. C., and Boisse, N. R., 1977, Barbituate withdrawal in cats, in “Alcohol intoxicavion and withdrawal,” Vol. 3b, M. Gross (ed.), Plenum Press, New York, pp. 25–42.Google Scholar
  86. Oppenheim, A. N., 1976, Towards a social psychology of dependence, in “Drugs and drug dependence,” G. Edwards, M. A. H. Russel, D. Hawks, and M. MacCafferty (eds.), Saxon House, Farnborough, England, pp. 214–221.Google Scholar
  87. Pattison, E. M., 1979, The selection of treatment modalities for the alcoholic patient, in “The diagnosis and treatment of alcoholism,” J. H. Mendelson and N. K. Mello (eds.), McGraw-Hill, New York, pp. 126–227.Google Scholar
  88. Polich, J. M., Armor, D. J., and Braiker, H. B., 1980, “The course of alcoholism: Four years after treatment,” Rand Corporation, R-2433-NIAAA, Santa Monica, Calif.Google Scholar
  89. Pomerleau, O., Pertschuk, M., and Stinnett, J., 1976, A critical examination of some current assumptions in the treatment of alcoholism, J. Stud. Alcohol 37:849–867.Google Scholar
  90. Pribram, K. H., 1971, “Languages of the brain,” Prentice-Hall, Englewood Cliffs, N.J.Google Scholar
  91. Pugh, A., 1976, “Dynamo users manual,” MIT Press, Cambridge, Mass.Google Scholar
  92. Richmond, B., 1977, “Toward a structural theory of cancer,” Massachusetts Institute of Technology, System Dynamics Memorandum D-2718, Cambridge, Mass.Google Scholar
  93. Rix, K. J. B., 1977, “Alcohol and alcoholism,” Eden Press, Montreal.Google Scholar
  94. Roebuck, J. B., and Kessler, R. G. (eds.), 1972, “The etiology of alcoholism,” Thomas, Springfield, Ill.Google Scholar
  95. Roizen, R., Cahalan, D., and Shanks, P., 1978, Spontaneous remission among untreated problem drinkers, in “Longitudinal research on drug use,” D. Kandel (ed.), Hempis-phere Press, Washington, pp. 197–221.Google Scholar
  96. Rutgers, 1979, “The etiology of alcoholism,” J. Carpenter, Principal Investigator, and D. Lester, Scientific Director, National Institute of Alcohol Abuse and Alcoholism Grant No. 1 T50 AA03509–01.Google Scholar
  97. Ryan, C., and Butters, N., 1980, Further evidence for a continuum-of-impairment encompassing male alcoholic Korsakoff patients and chronic alcoholic men, Alc. Clin. Exp. 4:190–198.CrossRefGoogle Scholar
  98. Ryback, R., 1971, The continuum and specificity of the effects of alcohol on memory, Q. J. Stud. Alcohol 32:995–1016.Google Scholar
  99. Salaspuro, M. P., 1971, Influence of ethanol on the metabolism of the pathological liver, in “Biological basis of alcoholism,” Y. Israel and J. Mardones (eds.), Wiley, New York, pp. 163–182.Google Scholar
  100. Sargent, M., 1973, Theory in alcohol studies, in “Cross cultural approaches to the study of alcoholism,” M. Everett, J. Waddel, and D. Heath (eds.), Mouton, The Hague, pp. 342–352.Google Scholar
  101. Seixas, F. A., and Eggelston, S. (eds.), 1973, Alcoholism and the central nervous system, Ann. N. Y.Acad. Sci. 215.Google Scholar
  102. Seixas, F. A., and Galanter, M., 1977–1979, “Currents in alcoholism,” 6 vol., Grune & Stratton, New York.Google Scholar
  103. Selye, H., 1956, “The stress of life,” McGraw-Hill, New York.Google Scholar
  104. Selye, H., 1974, “Stress without distress,” Lippincott, New York.Google Scholar
  105. Smith, C. M., 1978, “Alcoholism: treatment,” Eden Press, Montreal.Google Scholar
  106. Sokolov, E. N., 1963, “Perception and the conditioned reflex,” Pergamon, Oxford.Google Scholar
  107. Steiner, C., 1971, “Games alcoholics play,” Grove, New York.Google Scholar
  108. Strel’chuck, I.V., 1976, “Stages of chronic alcoholism and their correlation with defensive-protective reactions,” Int. J. Ment. Health 5:74–84.Google Scholar
  109. Tarter, R. E., and Sugarman, A., 1976, “Alcoholism: Interdisciplinary approaches to an enduring problem,” Addison-Wesley, Reading, Mass.Google Scholar
  110. Tintera, J. W., and Lovell, H. W., 1949, Endocrine treatment of alcoholism, Geriatrics 4:274–280.Google Scholar
  111. Tokar, J. T., Brunse, A. J., Stefflre, V. J., Napior, D. A., and Sodergren, J. A., 1973, Emotional states and behavioral patterns in alcoholics and nonalcoholics, Q. J. Stud. Alcohol 34:133–143.Google Scholar
  112. Ullman, A. D., 1952, The psychological mechanism of alcohol, Q. J. Stud. Alcohol 13:602–608.Google Scholar
  113. U.S. Department of Health, Education, and Welfare, 1971, National Institute on Alcohol Abuse and Alcoholism, “First special report to the U.S. Congress on alcohol and health,” DHEW Publication No. (ADM) 74–68, Superintendent of Documents, U.S. Government Printing Office, Washington.Google Scholar
  114. U.S. Department of Health, Education, and Welfare, 1974, National Institute on Alcohol Abuse, and Alcoholism, “Second special report to the U.S. Congress on alcohol and health,” DHEW Publication No. (ADM) 75–212, Superintendant of Documents, U.S. Government Prining Office, Washington.Google Scholar
  115. Vaughan, H., 1979, A neurophysiology of mind, in “Evoked brain potentials and behavior,” H. Begleiter (ed.), Plenum Press, New York, pp. 437–446.Google Scholar
  116. Victor, M., Adams, R. D., and Collins, G. H., 1971, “The Wernicke-Korsakoff syndrome,” Davis, Philadelphia.Google Scholar
  117. Vince, M. A., 1949, Rapid response sequences and the psychological refractory period, Br. J. Psychol. 40:23–40.Google Scholar
  118. Vogel-Sprott, M., 1972, Alcoholism and learning, in “The biology of alcoholism,” Vol. 2, B. Kissin and H. Begleiter (eds.), Plenum Press, New York, pp. 485–507.Google Scholar
  119. Wilder, J., 1967, “Stimulus and response: The law of initial value,” John Wright, Bristol, England.Google Scholar
  120. Williams, R. J., 1959, Biochemical individuality and cellular nutrition: Prime factors in alcoholism, Q. J. Stud. Alcohol 20:452–463.Google Scholar

Copyright information

© Plenum Press, New York 1983

Authors and Affiliations

  • Ulrich Golüke
    • 1
  • Robert Landeen
    • 2
  • Dennis Meadows
    • 1
  1. 1.Resource Policy Center, Thayer School of EngineeringDartmouth CollegeHanoverUSA
  2. 2.Department of PsychiatryDartmouth Medical SchoolHanoverUSA

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