Essential and reactive alcoholism: a review

Methodological characteristics and substantive findings of investigations of essential and reactive alcoholics were reviewed. The data base was comprised of approximately 12 studies published between 1951-1992, most of which employed small samples of hospitalized male alcoholics. Psychometric properties of the Essential-Reactive Alcoholism Questionnaire, the instrument generally used to assess the essential-reactive dimensions, rarely were examined. The weight of the evidence suggests that essential alcoholics have earlier onset and greater severity of alcoholism, lower levels of occupational and educational achievement, more interpersonal conflict, fewer long-term friendships, more antisocial attitudes and conduct, greater density of familial alcoholism, more impaired neuropsychological functioning, and lower resting blood pressure than do reactive alcoholics. Research is needed to assess the prognostic utility of the essential-reactive typology and the degree to which the distinction may facilitate patient-treatment matching.