The Tridimensional Personality Questionnaire in Males at High and Low Risk for Alcoholism

Cloninger has proposed a tridimensional model as the basis for the classification of personality variants and has developed the Tridimensional Personality Questionnaire (TPQ) as an empirical test of this model. In this study, the TPQ was administered to two groups of young men. One group was comprised of nonalcoholic sons of male alcoholics; the other group consisted of nonalcoholic men with no family history of alcoholism. Since the sons of male alcoholics are considered to be at greater risk to develop alcoholism than the sons of nonalcoholics, it was hypothesized that the two groups would demonstrate differences with regard to one or more personality variants as measured by the TPQ. No statistically significant differences in the three TPQ-subscale scores of the two groups were found.     

The Influence of Both Drinking and Familial Risk Statuses on Cognitive Functioning of Social Drinkers

Problem and nonproblem drinking, college student sons of alcoholics were compared to problem and nonproblem drinking college student sons of nonalcoholic fathers with respect to cognitive functioning. Problem drinkers performed more poorly on two of the four cognitive tasks, Group Embedded Figures and Symbol-Digit Paired Associates Learning Task, thus supporting earlier findings of cognitive deficits in problem drinking nonalcoholics. Additionally, sons of alcoholics tended to perform more poorly than sons of nonalcoholics on the Group Embedded Figures Test. Cognitive performance was not predicted by any of four measures of impulsive/antisocial personality and behavior-preadult antisocial behavior, childhood behavior problems, sensation seeking, and the MacAndrew Alcoholism Scale. The findings of the research pointed to the importance of considering both drinking and familial alcoholism risk statuses in studies of the cognitive performance of nonalcoholics. Further implications and limitations of the findings are discussed.     

Learning achievement in sons of alcoholics

Adolescent sons of alcoholics, equated to sons of nonalcoholics on age, intelligence, and grade level, performed significantly more poorly on a standardized test of educational achievement Family environment and rated behavioral disturbance were not systematically correlated with educational achievement. Upon controlling for the effects of psychopathology, the highest and most numerous correlations were found between neuropsychological performance and educational achievement These findings suggest that cognitive impairment may be associated with the vulnerability for alcoholism.     

The Role of Antisocial, Affective, and Childhood Behavioral Characteristics in Alcoholics' Neuropsychological Performance

Chronic alcoholics demonstrate cognitive deficits when compared with nonalcoholics. These deficits are typically attributed to the direct effects of ethanol and its metabolites on the central nervous system (CNS). There are other factors, however, that differentiate alcoholics from controls, such as personality or behavioral characteristics. These factors may affect neuropsychological performance and thus alter the interpretation of alcoholic cognitive deficits as resulting solely from alcohol's toxic effects. To investigate this question, male and female alcoholics and peer nonalcoholic controls were compared on personality, behavioral, and cognitive measures. Alcoholics had greater numbers of antisocial behaviors, childhood behavioral disorder symptoms (CBD), and affective symptomatology, and had poorer neuropsychological performance than controls. The three personality and behavioral factors were positively intercorrelated with each other, and were negatively related to cognitive performance. The CBD factor proved to be the most consistent predictor of neuropsychological performance for both alcoholics and controls, and males and females. While the behavioral factors differentiated alcoholics from controls and predicted performance, significant differences between the groups in cognitive performance still remained when these factors were taken into account.     

Chronic Tolerance and Sensitization to Alcohol in Sons of Alcoholics

In view of conflicting results concerning differences between sons of alcoholics and sons of nonalcoholics in response to a single alcohol challenge (with a given dose), we exposed these high and low risk groups to several sessions in which they drank alcohol at the same dose in order to measure the development of chronic tolerance or sensitization with repeated doses. Sons of alcoholics and sons of nonalcoholics received a moderate dose of alcohol (0.5 g/kg) in three sessions with alcohol, followed by a placebo session. Sons of alcoholics developed reverse tolerance or chronic sensitization to repeated dosings of alcohol in finger pulse amplitude, while sons of nonalcoholics did not. Sons of alcoholics failed to show chronic tolerance in skin conductance and finger temperature, while sons of alcoholics did show the development of tolerance. Sons of alcoholics demonstrated greater motor activity throughout the sessions, both before and after alcohol. These results indicate that high and low risk groups differ in terms of their developmental adaptation to alcohol, as well as in the temperamental trait of behavioral activity.     

Sons of Alcoholics Report Greater Hangover Symptoms than Sons of Nonalcoholics: A Pilot Study

We investigated alcohol-induced hangovers among college men at high and low risk for alcoholism. Thirteen sons of alcoholics reported significantly (p less than 0.001) greater hangover symptoms in the past year than 25 sons of nonalcoholics. The two groups reported comparable quantity-frequency of recent drinking. To the extent that hangover represents an acute withdrawal syndrome to alcohol, this raises the question of whether sons of alcoholics are "dependence-prone."     

Parental history of alcoholism and problem behaviors in Native-American children and adolescents

BACKGROUND: A positive family history of alcoholism is one of the most consistent and powerful predictors of a person's risk for developing this disorder. This finding has stimulated much research on etiological vulnerability factors and mechanisms by which children of alcoholic parents are at high risk for developing alcohol-related problems. In primarily Euro-American samples, parental alcoholism has been associated with a variety of negative outcomes for children and adolescents, including problematic behavior. Native-American Indians, in addition to high rates of alcoholism and alcohol-related mortality, have the highest prevalence of a positive family history for alcoholism of all ethnic groups in the United States. METHODS: This study used the Achenbach Child Behavior Checklist (CBCL) to evaluate behavioral problems in 96 Mission Indian children and adolescents based on the presence or absence of parental alcohol dependence and sex of the offspring. RESULTS: Consistent with previous research, results indicated a high prevalence of a positive family history of alcoholism in these Native-American youths. Seventy-four percent of the offspring had either one or both parents with alcohol dependence (children of alcoholics). Only 7% had no first- or second-degree alcoholic relatives. Results indicated that sons of alcoholics scored significantly higher on the Total Behavior Problem scale, as well as the Internalizing and Externalizing scales, of the CBCL than sons of nonalcoholics, whereas there were no significant differences in CBCL scores between daughters of alcoholics and daughters of nonalcoholics. It is noteworthy that scores on the CBCL for Mission Indian children of alcoholics were comparable to scores in the published literature of children of alcoholics of other ethnicities. In addition, a relatively low percentage of youths were identified with significant levels of behavioral problems. CONCLUSIONS: These findings suggest that sons of alcoholics of Mission Indian heritage experience more problems than sons of nonalcoholics, but also suggest that Mission Indian children of alcoholics are not more vulnerable to behavioral problems than children of alcoholic parents of other ethnic backgrounds.     

Evidence for impersistence in young male alcoholics

This investigation compared a group of 30-year-old male Veterans Administration inpatient alcoholics with an IQ, age, and education matched comparison group of nonpsychiatric VA outpatients or blue collar employees on three measures of persistence: Matching to Familiar Figures Test (MFFT), Retarded Rotation Test (RRT), and Mirror Tracing (MT). Alcoholics were found to make significantly more errors on the MFFT and MT tasks, but didn't differ significantly from nonalcoholics on the RRT. The alcoholics were also differentiated from the nonalcoholics on an overall index of persistence based on a combination of the three measures. The ramifications of the findings for understanding the etiology of the neuropsychological deficits manifested by alcoholics are discussed.     

Specific Cognitive Impairment in Sons of Early Onset Alcoholics

Cognitive and behavioral functioning in school-aged sons of early onset alcoholics, late onset alcoholics, normal social drinking fathers, and depressed fathers were compared on a battery of neuropsychological measures. Sons of early onset alcoholics performed more poorly than offspring of the normal fathers on tests measuring attention and verbal intellectual capacity, but were not significantly different from sons of late onset alcoholic fathers. Sons of normal and late onset alcoholics were not distinguishable from each other.     

Cognitive Status of Sons of Alcoholic Men

Sons of community dwelling alcoholic, depressed, and normal men were administered a comprehensive battery of neuropsychological tests. A generalized cognitive deficit was not found in the sons of alcoholics. The sons of alcoholics demonstrated greater ataxia than offspring in the two control groups and also performed more poorly on tests measuring visual scanning and attention, planning ability, and impulse control. These findings raise the possibility that an anterior cerebral dysfunction underlies the cognitive deficit observed in children of alcoholics.     

Effects of Alcoholism and Instructional Conditions on Speed/Accuracy Tradeoffs

The speed and accuracy of neuropsychological performance in alcoholics and nonalcoholics were assessed for each item within a four-test computerized battery. Subjects were randomly assigned to one of three instructional conditions: Speed-emphasis instructions, Accuracy-emphasis instructions, or Typical instructions emphasizing speed and accuracy equally. Across conditions, alcoholics were less accurate and took longer to perform than controls. Examining speed and accuracy components separately within each condition, as predicted, the greatest differences in accuracy scores between alcoholics and controls appeared in the Speed-emphasis condition, while the greatest group differences in speed scores appeared in the Accuracy-emphasis condition. The results indicate that the relationships between speed and accuracy are dissimilar between alcoholics and controls; alcoholics exhibit speed/accuracy tradeoffs in that they are unable to adjust performance to meet speed or accuracy demand without suffering substantial compromise in the other aspect of performance. These results have implications for future studies concerning methodological approaches to speed and accuracy assessment and provide support for an information-processing deficit associated with chronic alcohol abuse.     

Personality and Substance Use Disorders: I. Effects of Gender and Alcoholism Subtype

The relationship between alcoholism and self-rated personality was explored in a community-ascertained sample of 303 male and 103 female alcoholics, and 304 male and 770 female nonalcoholics. Alcoholics met DSM-Ill-R lifetime criteria for alcohol dependence; personality was assessed using the Multidimensional Personality Questionnaire. Compared with controls, alcoholics scored significantly higher on all indicators of negative emotionality, and consistently lower on all indicators of constraint. Individual effect sizes were moderate in both the male and female samples. A subsample of severe male alcoholics, identified by cluster analysis, was characterized by relatively early onset of problem drinking and relatively high antisociality and familial loading of problem drinking; they were also more extreme than moderate male alcoholics on negative emotionality and constraint. When taken in aggregate, personality risk appears to be associated with a continuum of alcoholic risk such that individuals extreme in both negative emotionality and behavioral disinhibition have especially high rates of alcoholism.     

The prevalence of gastric autoantibodies in chronic alcoholics.

One hundred fifty alcoholic men and women and 150 age and sex-matched nonalcoholic controls (after exclusion of pernicious anemia and cancer of the stomach) were evaluated for the presence of parietal cell antibodies (PCA). Blocking and binding intrinsic factor antibodies (IFA) were determined in the PCA positive sera. The prevalence and age and sex distribution of PCA in the alcoholics and nonalcoholics was identical. In alcoholics above the age of 60 years, the incidence of PCA, although higher than in those of the younger age group was similar to that in the nonalcoholics of the same age group (in men 6.3 percent and 7.3 percent and in women 7.5 percent and 10.0 percent respectively). Antral gastritis of moderate or severe degree was the frequent lesion in alcoholics. This form of gastritis was not associated with any significant increase in the incidence of PCA. No patients with sera positive for IFA were detected among the 22 PCA positive patients. There is no evidence for humoral derangement of the gastric autoimmunity in chronic alcoholics.     

Alcoholic Cerebellar Degeneration Is Not a Dose-Dependent Phenomenon

Eleven alcoholics with cerebellar degeneration (eight with computerized tomography confirmation of cerebellar atrophy) were matched with nonataxic alcoholics and nonalcoholics. There were no laboratory or physiological markers for ataxia, including hemoglobin A1a + b, red blood cell transketolase, liver function enzymes, and measures of reaction time and hand-eye coordination. Acetaldehyde-modified hemoglobin levels (as hemoglobin A1a + b) did not, as previously reported, distinguish between alcoholics and nonalcoholics. There was 24% less annual alcohol consumption in ataxic alcoholics compared with nonataxic alcoholics, 9% less lifetime consumption in ataxic alcoholics, and 33% less maximal daily intake. The finding that ataxic alcoholics do not have higher alcohol consumption than nonataxic alcoholics suggests that alcoholic cerebellar degeneration is not a dose-dependent phenomenon, and that alcoholics with cerebellar degeneration may have an idiosyncratic sensitivity to the neuronal effects of alcohol.     

Pancreatic secretion in chronic alcoholics

To gain further insight on the effects of alcohol on human pancreatic enzyme secretion, we tested the effects of a 12% (v/v) alcohol solution, wine, and a glucose sclution added to a meal on trypsin output in duodenal aspirate of nonalcoholic volunteers and compared the results to those of chronic alcoholics. Plasma concentrations of gastrin, cholecystokinin, and pancreatic polypeptide were monitored pre-and postprandially. Similar blood alcohol concentrations were determined in nonalcoholics and alcoholics following wine and the alcohol solution. Nonstimulated trypsin output (basal) was higher in alcoholics but not significantly so when compared to nonalcoholics. However postprandial trypsin output, 2014±301 mg/5 hr was significantly greater in alcoholics (P<0.05) compared to nonalcoholics 1271±118 mg/5 hr. Alcohol and wine when added to the meal significantly (P<0.05) inhibited trypsin output in both groups. Basal and postprandial levels of gastrin and cholecystokinin were similar in nonalcoholics and alcoholics. Basal plasma pancreatic polypeptide levels were similar in both groups, but the postprandial increments in pancreatic polypeptide levels observed in nonalcoholics were not observed in alcoholics. We conclude that chronic alcoholics have increased postprandial pancreatic enzyme secretion, and that this secretion, as that of nonalcoholics, can be affected by alcohol or wine. The postprandial hypersecretion of enzymes in alcoholics is not related to increased plasma levels of cholecystokinin or gastrin. It is possible that the impaired release of pancreatic polypeptide may participate in the mechanism for increased pancreatic enzyme secretion in chronic alcoholics.This work was supported by grant AA 07676-01A1 from the Alcohol, Drug Abuse and Mental Health Administration and in part by a grant (GCRC RR-43) from the General Clinical Research Centers Program of the Division of Research Resources, National Institute of Health.     

Echocardiographic abnormalities in chronic asymptomatic alcoholics

Alcohol abuse is a frequent contributor to elevated blood pressure, but the literature is ambiguous about the role of hypertension in producing left ventricular dysfunction. Fifty asymptomatic male alcoholics admitted for detoxification were studied using echocardiograms and systolic time intervals. Alcoholics were separated into Group I (28 with hypertension) and Group II (22 without hypertension). Forty-four patients had analyzable echocardiograms and were compared to 29 nonalcoholics. Group III consisted of 14 nonalcoholics with hypertension. Group IV consisted of 15 normotensive nonalcoholics (controls). The ejection fraction and shortening fraction were reduced in Group I (p less than 0.05). Hypertensive alcoholics had increased left ventricular mass indices but less than hypertensive nonalcoholics. Left ventricular wall stress was compared to mass as an index of ventricular compensation. The wall stress to mass index for hypertensive alcoholics was 1.65 as compared to 1.43 for the controls. Alcoholics without hypertension had a wall stress to mass ratio of 1.54. Hypertensive patients had a reduced wall stress to mass ratio of 1.38 when compared to controls. These data suggest an inappropriate compensatory response to afterload. Alcohol and hypertension combined may be more harmful to left ventricular function than either disease alone.     

Reliability and validity of the quantitative inventory of alcohol disorders (QIAD) and the veracity of self-report by alcoholics

The purpose of this study was to investigate a recently developed instrument for alcoholism severity: The Quantitative Inventory of Alcohol Disorders (QIAD). The primary intention was to demonstrate the reliability and validity of the QIAD as a diagnostic tool within the field of alcoholism. A secondary intention was to examine the veracity of alcoholics self-report on the QIAD and other alcohol-related instruments. The subjects for the experimental group were 25 inpatient alcoholics and their spouses. The control group consisted of 21 nonalcoholics and their spouses. All subjects were administered the QIAD, Michigan Alcoholism Screening Test (MAST), and the Alcohol Severity Rating Scale (ASRS). The alcoholics and partners were given the same tests 5 to 8 days after initial testing. The primary therapists for the alcoholics were asked to rate alcoholism severity for each subject using the ASRS. Pearson product moment correlation coefficients were used for the test-retest reliability procedure. Alcoholics scores on the QIAD, MAST, and ASRS were compared with their spouses scores using a test-retest procedure. Nonalcoholics scores on these instruments were also compared with their spouses' scores. Construct and concurrent validity for the QIAD were tested through comparison of QIAD scores of the alcoholics with their corresponding scores on the MAST and ASRS. t-Tests were used to determine differences between alcoholics and nonalcoholics on all three scales. The results of this investigation supported the position that the QIAD is a reliable and valid instrument for measuring alcoholism severity. The QIAD correlated highly for both the alcoholics and their spouses. The test-retest procedure revealed a high level of correlation. A significant difference was found between the QIAD scores of the alcoholics and nonalcoholics. Construct validity was demonstrated by significant correlations between the alcoholics QIAD and MAST scores, both measuring the extent of alcoholism. The QIAD demonstrated concurrent validity by significantly correlating with alcoholics ASRS ratings. High correlations between alcoholic and spouse scores on the QIAD supported the hypothesis that inpatient alcoholics can produce valid responses to self-report questionnaires.     

Characteristics of Japanese Alcoholics with the Atypical Aldehyde Dehydrogenase 2*2.I. A Comparison of the Genotypes of ALDH2, ADH2, ADH3, and Cytochrome P-4502E1 Between Alcoholics and Nonalcoholics

We examined the genotypes of the aldehyde dehydrogenase (ALDH)-2 , alcohol dehydrogenase (ADH)-2, ADH3 , and P-4502E1 loci of 53 alcoholics and 97 nonalcoholics. All of the subjects fulfilled the DSM-III-R criteria for alcohol dependence. The control group consisted of 97 subjects who were either hospital staff or students. We also compared the frequencies of homozygous ALDH2*1/1 and heterozygous ALDH2*1/2 genotypes in alcoholics. Our study revealed differences in the allelic frequencies of the ALDH2, ADH2 , and ADH3 loci between alcoholics and nonalcoholics. For alcoholics with both homozygous ALDH2*1/1 and heterozygous ALDH2*1/2 genotypes, it was found that ADH2 and ADH3 played important roles. Alcoholics with the heterozygous ALDH2*1/2 genotype showed a significantly higher frequency of ADH2*1/1 than ones with the homozygous ALDH2*1/1 genotype. We assume ADH2*1 plays an important role in the development of alcoholism in alcoholics with the heterozygous ALDH2*1/2 genotype.     

Cognitive impairment in alcoholic and nonalcoholic cirrhotic patients

Cognitive impairment is common in patients with advanced liver disease. It has been suggested that patients with alcoholic liver disease (ALD) have more impaired cognition than nonalcoholics. The objective of this study was to characterize any differences in cognitive functions between alcoholic cirrhotic patients and non-alcoholic cirrhotic patients of similar age, education, and severity of liver disease. We assessed cognitive functions in 117 patients with alcoholic cirrhosis and 163 patients with nonalcoholic cirrhosis using a brief battery of neuropsychological tests. In addition, all patients had standard psychiatric examinations to assess the effect of the disease severity, alcoholism, anxiety, and depression on the test scores. The study showed a higher proportion of patients with cognitive impairment in the alcoholic group. Alcoholics performed poorly in tests of memory and motor speed compared with nonalcoholics, despite similar premorbid IQ and education. Because patients with alcoholic cirrhosis had more severe liver disease (Child-Pugh score 8.5 +/- 2.2 vs. 7.6 +/- 2.2, P =.03) than nonalcoholics, the results were reanalyzed after adjusting for the linear effects of Child-Pugh score on cognitive test scores. We also used two-way analysis of variance to examine the interaction between Child class and alcoholism. Finally, the test scores were compared within each Child class. These analyses revealed no primary or interaction effect of alcoholism and confirmed that the differences in the test scores observed in alcoholics reflect the greater severity of their liver disease. The severity of cognitive impairment is similar in both alcoholic and non-alcoholic cirrhotic patients when adjusted for the severity of liver disease.     

Association of Cerebral Infarction and Chronic Alcoholism: An Autopsy Study

Central nervous system (CNS) infarcts were present at autopsy in 10 of 23 alcoholic patients and in 9 of 36 nonalcoholic patients. There were more males than expected in the infarct population and in the alcoholic population. Male subjects comprised the entire population of alcoholics with infarcts. In addition, a history of alcohol abuse was present in every case of cerebral infarction dying before age 75. The incidence of cardiomegaly was increased among the alcoholics. There were no differences between alcoholics and nonalcoholics in the incidence of diagnosed hypertension, moderate-to-severe coronary atherosclerosis, or adult onset diabetes. However, CNS infarction was more likely to occur at an earlier age in alcoholics than in nonalcoholics. Excessive alcohol consumption may be a risk factor in the premature development of cerebrovascular disease in males.