An examination of selected typologies. Hyperactivity, familial, and antisocial alcoholism

In exploring potential alcoholism typologies, this chapter critically examines findings of adoption, high-risk, and familial alcoholism studies and studies of psychiatric syndromes in alcoholic individuals and their families. The adoption studies revealed that familial alcoholism and childhood conduct disorder and hyperactivity are associated with subsequent alcoholism. However, the relationship between childhood hyperactivity and alcoholism is probably coincidental to the conjoint presence of aggressive and antisocial behaviors in the same individuals. Psychiatric diagnosis and family psychiatric history studies suggest a synergistic relationship between alcoholism and sociopathy. Clinical studies of familial and antisocial alcoholism indicate that both are associated with early onset, more severe alcoholism, and poorer treatment outcome. Both meet clinical criteria for an alcoholism typology, although the evidence is more compelling for antisocial alcoholism. The findings of metabolic, electrophysiological, and neuropsychological differences between high- and low-risk subjects are of potential import, although their present significance is uncertain. Further clinical evaluation of antisocial and familial alcoholism and their relationship to each other is necessary. High risk and familial alcoholism findings may be confounded by the subjects's antisocial characteristics.