Concepts and issues in COA research

Estimates of the number of children of alcoholics (COA's) and the prevalence of alcohol use disorders among them can vary widely from study to study depending on research design features such as sample selection, data collection strategies, and assessment methods. Although investigators agree that COA's are at higher risk for developing alcohol use disorders than children of nonalcoholics, problems with alcohol are not an inevitable consequence of COA status. Recent research has identified numerous biological, psychological, and social factors associated with a family history of alcoholism that may play a role in determining whether COA's will develop an alcohol use disorder. The conceptual model presented in this article gives a general overview of how such risk factors can interact with life stressors to influence alcohol-related behavior in COA's. (Subsequent articles in this issue explore some of the specific factors identified in the model in greater depth.).