ROLE OF SIGNIFICANT OTHERS IN TREATMENT

Brief-TSF includes a ‘Partner Brief-TSF’ program to be used as adjunctive therapy whenever possible when an alcoholic patient is in a relationship.

Partner Brief-TSF can also be applied when the alcoholic is not in treatment.

Like other aspects of Brief-TSF, the partner sessions are focused and aim to meet specific goals.

Partner Brief-TSF is not intended to be used as brief marital or relationship counseling, although one objective of these sessions is to help the patient(s) assess the impact of alcohol abuse on the relationship. Marital therapy may be briefly discussed, and significant others concerns, frustrations, and grievances are validated, but the facilitator also suggests that intensive relationship counseling (along with other therapies such as family therapy or sex therapy) be deferred, at least until the client has completed Brief-TSF and, preferably, 6 months of sobriety.

The Partner Brief-TSF sessions deal with the subjects of enabling and detaching. Both of these concepts have their origins in Al-Anon, a 12-step program similar to AA but for the affected rather than the addicted. A primary goal of the Partner Brief-TSF program is to encourage and briefly facilitate the partner’s use of Al-Anon as a resource for coping with being in a relationship with an alcoholic and also for healing personal wounds that typically derive from that kind of relationship.

Another goal is to assess initially the partner’s use of alcohol or other drugs and make an appropriate referral if necessary. Finally, the goals and objectives of Brief-TSF itself and AA are outlined.

Brief-TSF includes guidelines for handling emergency calls from a partner. The approach emphasizes support and efforts to facilitate the partner’s use of Al-Anon.

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Lesbian Alcoholics were Unloved, Unwanted and Alcoholic had Parents; Social Supports and Lesbian Alcoholics

The purpose of this study was to investigate the relationship between social support and alcoholism among lesbians.

Fifteen lesbian alcoholics and 15 lesbian non-alcoholics were administered a questionnaire covering their childhood and adolescent history, social support systems, history of drinking, and demographic information.

The findings suggested that the alcoholic lesbians’ current support systems were not as disrupted as had been anticipated.

However, the alcoholic lesbians more often reported;

• having had a less supportive childhood and adolescence,
• feeling unloved and unwanted,
• experiencing conflict with adults in their families, and
• having had a parent with a drinking problem.

Social Supports and Lesbian Alcoholics. Rebecca Schilit, W. Mark Clark, and Elizabeth Ann Shallenberger. Affilia 1988; 3; 27.

Alcohol intervention may help.

Women Can Inherit Drinking Problem Too, Study Finds

In the first major twin study to compare genetic and environmental factors that contribute to the risk of alcoholism in both sexes, researchers have found that genetics plays an important role in determining alcohol dependence in women as well as in men. The study contradicts the long-held assumption that a woman’s environment is more likely to influence whether she becomes dependent on alcohol.

The study was conducted by scientists at Washington University School of Medicine in St. Louis and Australian collaborators at the Queensland Institute of Medical Research. It was funded by the U.S. National Institute of Alcoholism and Alcohol Abuse, and the findings were published in a recent issue of the journal Psychological Medicine.

While there is ample evidence for an important genetic influence on alcoholism risk in men, the tie between genetics and alcoholism in women has been uncertain, said the paper’s lead author, Andrew Heath, Ph.D., a professor of psychiatry at Washington University.

The study sought to address this shortcoming. It involved 2,685 pairs of twins, all participants in an adult twin study started in Australia in 1978 and maintained by the Australian National Health and Medical Research Council. The two members of each pair were raised in the same home environment. The study included — for the first time — twins of opposite sex as well as twins that were either both male or both female.

Telephone interviews with the twins were conducted to assess whether the participants had lost control over their drinking, were unable to cut back on drinking or had similar problems with alcohol.

Twins who had an alcoholic identical twin were much more likely to be alcoholic themselves than were twins who had an alcoholic fraternal twin, and this was equally true in women and in men. More surprisingly, men who had an alcoholic twin sister had very high rates of alcoholism.

“If shared environmental factors are of predominant importance in women but genetic influences predominate in men — a commonly held belief — then we would have expected to see very low concordance for alcoholism of unlike-sex twin pairs,” Heath said. “That wasn’t the case.”

The study also found that women with an alcoholic identical (monozygotic) twin sister were six times more likely to be alcohol dependent than other women. Monozygotic twins share the same genetic makeup. Dizygotic, or nonidentical, twins, who are not more alike genetically than ordinary sisters, were only three times more likely to be alcohol dependent if their twin had a drinking problem.

The study also examined whether psychiatric disorders that commonly precede or coexist with alcoholism, such as childhood behavior problems like lying and stealing or depression, were as strongly associated with risk of alcoholism in women as in men.

“It used to be believed that depression predicted increased risk of alcohol problems in women, whereas a history of childhood behavior problems predicted alcoholism risk in men. We found that depression is a potent predictor for alcohol dependence in both men and women,” said Heath. “A history of behavior problems also is as strong a predictor in women than in men — slightly more powerful in women, in fact.”

Heath AC, Bucholz KK, Madden PAF, Dinwiddie SH, Slutske WS, Bierut LJ, Statham DJ, Dunne MP, Whitfield JB, Martin NG. “Genetic and Environmental Contributions to Alcohol Dependence Risk in a National Twin Sample — Consistency of Findings in Women and Men”. Psychological Medicine. 27(6):1381-1396, 1997 November.

Students with a dense family history of alcoholism are most at risk of alcohol-use disorders

This study looks at first-, second- and third-degree relatives instead of just one parent, usually paternal

Not all university students will “mature out” of their heavy-drinking habits.

A new study examines the density of college students’ family history of alcoholism.

This type of measure – looking at first-, second- and third-degree relatives – identified a significant number of at-risk individuals who would have been missed using regular family-history measures.

While many university students tend to “mature out” of heavy-drinking behavior by the time they become young adults, some go on to develop alcohol-use disorders (AUDs). Most genetic research on an individual’s family history of alcoholism (FHA) has looked at the parents’ – usually paternal – alcohol use. New findings indicate that looking at the density of FHA – including first-, second- and third-degree relatives – is much more telling.

Results will be published in the August issue of Alcoholism: Clinical & Experimental Research.

“Using a density measure of FHA can identify a greater number of individuals who may be at risk for developing an alcohol problem,” said Christy Capone. “The greater number of affected relatives … the greater the potential risk of developing an AUD. Ours is the first published study to examine this measure among college students.”

“Family density appears to be a promising method to identify a higher percentage of at-risk individuals,” agreed John Hustad, research associate at Brown University. “For example, in this study, approximately 44 percent of the at-risk participants would have been missed if a typical family-history measure had been used instead of the family-history density approach.”

The study population for this research consisted of 408 undergraduate students (293 females, 115 males) from a northeastern U.S. university who were asked to complete an anonymous survey for course credit during the 2005-2006 academic year.

“Our use of a density measure identified a large proportion of students, about 29 percent, who are at potentially greater risk for development of AUDs based on their report of alcoholism among first- and second-degree relatives,” said Capone. “Our other key finding was the relationship between FHA and other potential risk factors – behavioral undercontrol, age of onset of drinking (AOD), and cigarette use.”

All of these risks factors are inter-related, added Hustad. “First, family-history density was related to AOD, behavioral undercontrol, and current cigarette use which, in turn, are related to alcohol use and/or alcohol-related problems in this sample of college students. Second, behavioral undercontrol was associated with alcohol problems but not the degree of alcohol consumption; this suggests that individuals with a family-history density of AUDs and behavioral undercontrol are more likely to behave irresponsibly when drinking.”

“The importance of identifying these risk factors is the idea that they can be useful markers of at-risk status and can help us to develop appropriate intervention strategies,” said Capone. “Although, given the fact that many students come to college already having experience with alcohol, I believe that preventive interventions should begin early in the high-school years or during the transition from middle school to high school.”

Hustad agreed. “Due to the relationship between earlier AOD and more alcohol-related problems during college, it is clear that education and prevention efforts should begin well before the college years,” he said. “Until that happens, the risk factors identified in this research can be easily implemented in any screening and brief intervention for incoming college students. For example, these results suggest that effective interventions addressing tobacco use may have a positive influence on both smoking and alcohol-related consequences.”

“It is important to remember that not everyone with density of familial alcoholism will go on to develop a long-term problem with alcohol themselves,” said Capone. “Alcohol dependence is a very complex disorder and FHA is but one influence on its development. However, college students who are heavy drinkers and have a greater density of familial alcoholism are certainly at higher risk of continuing to drink in a problematic fashion after the college years.”

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Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism by AA Services Read more about this title…

Simple Screening Can Help Decrease Teen Risk Behaviors

Research shows that adolescents who engage in one form of risky behavior, like drug or alcohol use, are likely to engage in other risky behaviors like self-harm, or having unprotected sex, but often times these behaviors are not discussed during a medical or mental health exam. Now, a new study shows that a simple and brief screening measure called the adolescent risk inventory (ARI) can quickly identify the broad range of risk behaviors found among adolescents.

“This constellation of behavior problems is really the thing we are trying to avoid. So, identifying early that a teen is engaging in a risky behavior may prevent that behavior from being the gateway to further risky behaviors,” says lead author Celia Lescano, PhD with the Bradley Hasbro Children’s Research Center and The Warren Alpert Medical School of Brown University.

This research study appeared in the April 2007 issue of the journal Child Psychiatry and Human Development.

Prior research indicates that teenagers who engage in one risky behavior are more likely to be involved in others and that this has an additive effect. The authors note that risk behaviors among teens are prevalent and can lead to increased morbidity, mortality, and health care costs, so identifying and dealing with problematic issues as they arise can help teens be safer and healthier.

Researchers studied 134 youth ages 12 to 19 with psychiatric disorders. Each study participant was given the adolescent risk inventory (ARI) (a paper and pencil measure). The ARI included questions about sexual history (have you ever been pregnant or been a dad?), self-harm (have you ever attempted suicide?), and attitudes towards acting out (do you break rules for no reason?).

“We found that the ARI is reliable and comprehensive and can be useful in quickly identifying a wide range of teen risk behaviors,” says Lescano.

This is important, the authors say, because when teens are seen for medical and/or mental health care, risk behavior issues are often neglected. Time and relevance are often seen as barriers that prevent providers from obtaining this important information.

“Given that the ARI is brief and broad in it assessment of behaviors, these barriers can be overcome and allow pediatricians, family doctors and mental health professionals to make referrals based on the information they get from the teen,” explains Lescano.

The analyses also provided intriguing data on the relationship between sex risk, psychopathology, and behavior in that abuse or self-harm behaviors were highly predictive of sex risk. This is important because while many clinicians are aware of the sexual risks that aggressive youths take, many are unaware of the association between risky sexual behavior and emotional distress, abuse and self-harm. Behaviors like self-cutting thoughts, suicidal thoughts or attempts, or a history of sexual abuse should alert clinicians to the potential for significant sexual risk, the authors say.

Oftentimes, research programs that target the identified risk behavior can be found in nearby communities or even through the medical or mental health offices in which the teens are being seen.

“Referral to these programs, as well as to mental health professionals to help treat the negative emotions that can precipitate risk behaviors may be useful avenues to decreasing risky behaviors in teens,” says Lescano.

Research report from; Lifespan

Alcoholism is a multigenerational disease as evidenced by this report.

Abstract; To test the hypothesis of a sex-linked factor influencing the occurrence of alcoholism and alcohol abuse, alcoholism or abuse rates were compared for 136 sons of the sons vs 134 sons of the daughters of 75 alcoholics. No substantial difference between the groups of grandsons was found in frequency of officially registered alcoholism or alcohol abuse, or both, which suggests no sex-linked factor is involved. The total sample was also used to calculate the risk of such registration for the grandson; the rate of registration by the grandsons’ fifth decade of life was 43%, approximately three times that of the general male population, and even higher than the equivalent rate in brothers of alcoholics. This result is incompatible with an assumption of a recessive gene being involved in the occurrence of alcoholism, though it fits with the assumption of a dominant gene.

L. Kaij and J. Dock. Grandsons of alcoholics. A test of sex-linked transmission of alcohol abuse. Arch Gen Psychiatry. Vol. 32 No. 11, November 1975.

Research Summary; Women and men appear to have different genetic and environmental risk factors for alcoholism, Reuters reported Jan. 24/2006.

A quartet of new family studies on alcoholism show, for example, that while both sexes are more likely to develop alcoholism if they have a history of aggressive behavior in childhood, women who experienced severe physical punishment in childhood were also at elevated risk, while men were not.

“Clearly, there are some common antecedents (to alcoholism), such as conduct disorder or symptoms, but there are also predictors unique to each gender,” said researcher Aruna Gogineni of the Johns Hopkins University School of Medicine. “These are the kinds of findings that call out for many more studies on women in order to determine how the mechanisms of alcoholic parental risk may differ in men and women.”

Researchers affirmed that children of alcoholics were generally more likely to have alcohol problems themselves, but said that genetic makeup may be more important for men, while environmental factors may have more of an impact on women. For example, one study comparing children of biological and adopted parents with alcoholism found that male children of alcoholics related by blood were more likely to be alcoholics themselves.

The research appears in the February 2006 issue of the journal Alcoholism: Clinical & Experimental Research.

From; Join Together Online

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Psychopathology of Children with Alcohol Dependent Fathers.

SUMMARY; Objective: In this study, we aimed to research cognitive, behavioral and psychopathological differences between children of fathers with alcohol dependency (ACOA’s) and children of fathers without alcohol dependency (non-ACOA’s).

Method of research: A battery of psychological tests was performed on 46 children of 34 alcoholic fathers and 36 children of 34 non-alcoholic fathers, between the ages of 6 and 16 years were evaluated. Two groups were matched with each other on the basis of socioeconomic level of family, age and gender of children.

Results: The findings of this research indicated that children of alcoholic fathers had a higher incidence of psychopathology.

Frequency of DSM-IV Diagnoses in the Study and Control Groups.

Teacher Report collaboration scores were higher in research group.

It was also found that mothers in research group had higher level of psychiatric symptoms.

Conclusion: Alcohol dependent patients are an easily available group for clinicians.

It can be more realistic to treat alcohol dependency as a family disease because of associated psychiatric problems in children and mothers.

In addition to alcohol dependent fathers, including mothers and children in the psychiatric assessment and treatment plans may become a preventive step for the child.

Research report; Sadriye Ebru ÇENGEL KÜLTÜR, M. Fatih ÜNAL, ?eniz ÖZUSTA. Psychopathology of Children with Alcohol Dependent Fathers. Turkish Journal of Psychiatry, 2006; 17(1)

Brief-TSF is designed to include all family members where appropriate

What symptoms of alcoholism does Brief-TSF address?

Many signs and symptoms of alcohol abuse may not be apparent even to a close relative or friend.

However, some can be easily seen and some may be hidden by other symptoms; or denied by the drinker.

The Brief-TSF course describes the signs and symptoms of alcohol abuse and alcoholism and provides ways of uncovering them.

Medical symptoms of alcoholism.

The medical symptoms of alcoholism are;

• Hangovers,
• blackouts,
• injuries,
• lethargy,
• weight gain or loss,
• poor coordination,
• high blood pressure,
• impotence,
• vomiting,
• nausea,
• cirrhosis of the liver,
• pancreas disease,
• brain damage, and
• tolerance to alcohol.

Psychological signs of alcohol dependence.

The psychological symptoms of alcohol dependence are;

• Poor concentration,
• sleep problems,
• cloudy thinking,
• depression,
• anxiety/stress,
• aggression,
• loss of control of drinking and
• denial of the effects of alcohol.

Social aspects of alcohol abuse

The social aspects of alcohol abuse are;

• Difficulties and arguments with family or friends,
• difficulties performing at work or home,
• unemployment,
• withdrawal from friends and social activities,
• legal problems and
• financial insecurity.

Spiritual affects of alcohol addiction.

The spiritual affect of alcohol addiction are;

• Dysthymia or mild chronic depression,
• restlessness,
• irritability,
• discontentment,
• self-centeredness,
• insecurity,
• self-pitying,
• resentful,
• fearful and
• feeling useless.

Partner Brief-TSF

Brief-TSF includes intervention with significant others in an alcohol dependents life. Significant others may be

• partners of alcoholics,
• children of alcoholics,
• adult children of alcoholics,
• parents of alcoholics,
• grand parents of alcoholics and
• work colleagues.

Partner Brief-TSF has similar goals and methods to Brief-TSF. The overall goal is referral of the significant other to Al-anon or Alateen.

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