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Essential and reactive alcoholism: a review
R D Walker1, M O Howard, P S Walker
1DATSEP, Veterans Administration Medical Center, Seattle, WA 98108, USA.
Journal of Clinical Psychology
|January 1, 1996
Summary
Essential alcoholics show earlier onset and greater severity compared to reactive alcoholics. This distinction impacts achievement, social connections, and neuropsychological function, suggesting potential for tailored treatment approaches.
Area of Science:
- Psychiatry
- Psychology
- Neuroscience
Background:
- Alcoholism is a complex disorder with varying presentations.
- The essential-reactive typology attempts to categorize alcoholics based on distinct characteristics.
- Previous research has explored differences between these subtypes, but a comprehensive review is warranted.
Purpose of the Study:
- To review and synthesize findings on essential and reactive alcoholism.
- To examine the methodological rigor of studies investigating this typology.
- To identify key differences in characteristics between essential and reactive alcoholics.
Main Methods:
- Systematic review of approximately 12 studies published between 1951 and 1992.
- Focus on studies involving hospitalized male alcoholics.
- Analysis of findings related to the Essential-Reactive Alcoholism Questionnaire.
Main Results:
- Essential alcoholics typically exhibit earlier onset and higher severity of alcoholism.
- Essential alcoholics often present with lower educational/occupational achievement and more interpersonal conflict.
- Evidence suggests essential alcoholics have more antisocial behaviors, familial alcoholism, and impaired neuropsychological functioning.
Conclusions:
- The essential-reactive alcoholism distinction is supported by consistent findings across studies.
- Essential alcoholics appear to have a more severe and complex presentation of the disorder.
- Further research should explore the prognostic value and treatment-matching potential of this typology.