Patterns of Familial Alcoholism, Alcoholism Severity, and Psychopathology
Patterns of Familial Alcoholism, Alcoholism Severity, and Psychopathology
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家族性酗酒的模式、酗酒严重程度和精神病理学
DOI：
10.1097/00005053-198803000-00005
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发表时间：
1988
期刊：
影响因子：
--
通讯作者：
A. Alterman
中科院分区：
文献类型：
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作者：
A. Alterman
酒精中毒严重程度、精神病理/人格和家族酒精中毒程度之间的相互关系使用以下四种家族酒精中毒分类方案进行了检验，每种分类方案区分了三种家族酒精中毒程度：1)传统的，将酗酒者与非父母、非父母和父母的酗酒亲属进行比较；2)直系性，在家庭双方或一方均不酗酒的亚组之间有所区别；3)代际，比较没有、一代或两代家族酗酒的酗酒者；4)定量的，每一级酗酒者得1分，每二级酗酒者得1/2分。研究对象为83名年龄在50岁或以下的男性酗酒退伍军人管理局住院病人。使用酒精使用量表、各种酒精相关症状和行为以及实验室值来评估酒精中毒的严重程度/模式。采用MMPI、精神病态状态量表、Mac-Andrew酗酒量表、儿童问题行为问卷和诊断为反社会人格障碍（ASP）的患者比例来测量精神病理/人格。令人惊讶的是，在酒精中毒的严重程度/模式上很少有亚组差异。只有治疗时的年龄和非酒精性药物的使用与家族性酒精中毒的增加有关。另一方面，儿童时期的行为问题，特别是反社会行为和ASP诊断被发现与家族酗酒程度的增加有关。在两代和双系酗酒者中，ASP的诊断最为明显，而在传统分类中，家族酗酒程度的增加与ASP无关。双系家族性酗酒者也表现出反映特征性障碍的MMPI谱。在研究的变量中，线性分类似乎是最敏感的，而常规方案对微分最不敏感。这些发现强调了家族性酒精中毒研究的二分法的局限性。本文讨论了两种解释ASP在双系和两代家族性酗酒者中高发的原因——性格谱系障碍假说与ASP的独立传播假说。
The interrelationships among the severity of alcoholism, psychopathology/personality, and the degree of familial alcoholism were examined using the following four familial alcoholism classification schemes, which each differentiated three degrees of familial alcoholism: 1) conventional, compared alcoholics with no, nonparental, and parental alcoholic relatives; 2) lineality, distinguished between subgroups with alcoholism in neither, one, or both sides of their family; 3) generational, compared alcoholics having no, one, or two generations of familial alcoholism; 4) quantitative, credited one point for each first-degree and 1/2 point for each second-degree alcoholic relative. The subjects were 83 male alcoholic Veterans Administration inpatients 50 years of age or under. The Alcohol Use Inventory, various alcohol-related symptoms and behaviors, and laboratory values were used to evaluate the severity/pattern of alcoholism. Psychopathology/personality were measured by the MMPI, the Psychopathic State Inventory, the Mac-Andrew Alcoholism Scale, the Childhood Problem Behaviors Questionnaire, and the percentage of patients with an antisocial personality disorder (ASP) diagnosis. Surprisingly few subgroup differences were revealed in the severity/pattern of alcoholism. Only age at time of treatment and use of nonalcoholic drugs were associated with increasing familial alcoholism. On the other hand, childhood behavior problems, particularly antisocial behavior, and an ASP diagnosis were found to be associated with an increasing degree of familial alcoholism. The diagnosis of ASP was most apparent in the two-generational and bilineal alcoholics, while an increased degree of familial alcoholism was not associated with ASP for the conventional classification. Bilineal familial alcoholics also exhibited an MMPI profile reflective of a characterological disorder. The lineality classification appeared to be the most sensitive and the conventional scheme the least sensitive to differentiations in the variables studied. These findings underline the limitations of dichotomous classifications for the study of familial alcoholism. Two explanations for the high prevalence of ASP in bilineal and two-generational familial alcoholics are discussed—the character spectrum disorder hypothesis vs. the independent transmission of ASP.