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Individuals with a family history of alcoholism: Will they too become alcoholics?

April 24, 2006

Those who are male and have behavioral disinhibition have the highest risk of developing alcoholism

- Individuals with a family history of alcoholism (FH+) have a greater risk of developing alcoholism themselves than do persons with no family history.

- FH+ individuals who are male and have behavioral disinhibition may have the greatest risk of developing alcoholism.

- Researchers caution that these combined characteristics indicate a greater probability, not certainty, of developing alcoholism.

Previous research has shown that individuals with a family history of alcoholism (FH+) have a greater risk of developing alcoholism themselves than do persons with no such history (FH-). A study in the May issue of Alcoholism: Clinical & Experimental Research has found that FH+ individuals who are male and have behavioral disinhibition have the greatest risk of developing alcoholism. However, a higher risk does not equate certainty.

"The development of alcoholism among individuals with a family history of alcoholism is about four to eight times more common than it is among individuals with no such family history," said William R. Lovallo, Director of the Behavioral Sciences Laboratories at the Veterans Affairs Medical Center, Oklahoma City and corresponding author for the study. "Although the definition of 'family history' is different according to different researchers, we define it as when either or both of the person's parents have had an alcohol problem."

"Prior research has shown that male gender and behavioral disinhibition are strong predictors of alcohol problems," added Peter R. Finn, professor of psychology at Indiana University, Bloomington. "Behavioral disinhibition reflects a general disposition characterized by an apparent insensitivity to punishment, an increased sensitivity to immediate rewards, a tendency to prefer immediate smaller rewards as opposed to larger long-term rewards, and a failure to consider and inhibit behavior when aversive consequences are likely. Those high in behavioral disinhibition are probably more likely to experiment with substance use earlier, because they are less inhibited by the prospect of negative consequences and less likely to learn to moderate their consumption once they have initiated use. Some research suggests that the presence of a family history of alcoholism amplifies this risk."

For this study, researchers examined the cognitive and behavioral characteristics of 175 male and female nonalcoholic 18- to 30-year-olds (87 FH+, 88 FH-) who were also classified as to their level of behavioral disinhibition using the Sociability scale of the California Personality Inventory. All study participants were given the Stroop Color-Word test, as well as the Iowa Gambling Task.

"The Stroop test examines working memory," explained Lovallo. "Participants first read a list of color words printed in ink that doesn't match the word. Next they recite just the color of the inks, which is much, much harder. The gambling task involves four decks of cards, each containing cards with both a gain and a loss. Participants are able to eventually gauge which two decks are risky - with bigger gains and bigger losses - and which two decks have fewer gains and losses. This allows us to examine their gambling strategy, safe or risky."

Results indicate that FH+ individuals with behavioral disinhibition appear to have working-memory deficits. Furthermore, the male individuals in this group demonstrate an attraction to the rewarding aspects of a risk-taking challenge.

"FH+ subjects with behavioral disinhibition performed more poorly on the Stroop task, which suggests poor inhibitory control," explained Finn. "The FH+ males also pay more attention to rewards when making decisions, as evidenced by results on the Iowa gambling task. This study suggests a potential mechanism - increased attention to gains - that may be responsible, in part, for the increased vulnerability of those with a family history for alcoholism."

"These findings are not secondary or consequential to a history of drinking," added Lovallo, "but reflect the familial and personal characteristics of those subjects at high risk for developing alcoholism. Having the ability to decipher the behavioral characteristics of people who we think are at risk for alcoholism allows us to begin to talk about the process, about brain mechanisms, and how an inherited risk may be expressed through a person's behavior. So, if you come from a family with alcoholism, and you also tend to like to take risks, break rules, etc., which are all part of behavioral disinhibition, you should be aware that you're manifesting some high-risk characteristics. Parents and teachers may also want to be aware of these characteristics."

Alcoholism: Clinical & Experimental Research