¶ … exist between alcoholism as a learned behavior (rather than as a condition arising from any genetic predisposition) and self-esteem. This research is based upon the assumption that there is a direct connection between self-esteem and learned behaviors: While a person's self-esteem may of course be affected by inherited conditions (such as a birth defect) it is much more likely to be affected by conditions that the person believes that he or she has control over. Thus, to the extent that alcoholism is a learned behavior and to the extent that alcoholics believe that their condition is a learned behavior they are likely to suffer from lowered self-esteem for as long as they continue to drink. Our attitudes about alcoholism have changed dramatically over the last fifty years as our conception of the condition - which causes so much harm and so much grief to so many people, including both the alcoholics themselves and to others - as one that was a matter of complete free will to a question of genetics. That pendulum is slowly swinging back now to viewing alcoholism as a learned behavior, although there is little doubt that there is some element of genetic predisposition to the condition. This research proposes to answer the question of whether the learned aspects of alcoholism are more significant than the genetic elements of it and, if so, how this fact should affect the way in which social workers treat alcoholics and their families.

While it might not seem - to either the alcoholic or those people in his or her circle who are affected by the alcoholics' drinking - that it makes much of a difference as to whether the causes of alcoholism are genetic, learned, or a combination of the two, there are important repercussions in terms of treatment depending upon whether the disease is viewed as inherited or learned. It does little good at all to lecture someone on better eating habits if that's individual's diabetes is caused by genetics. It does a world of good if it is caused by learned behavior. The picture becomes substantially more complicated when there is a mixture of genetic and learned behavioral elements involved.

This research, drawing from the recent work of a number of other researchers, argues that because alcoholism is in large measure a learned behavior it has a substantial negative effect upon the self-esteem of alcoholics who blame themselves for their drinking and - understanding the harm that they are doing to themselves and to those around them - suffer from lowered self-esteem. This would not be the case if the condition were an entirely genetic one: People understand that Tay-Sachs disease has a terrible effect on those around them but they do not suffer a loss of self-esteem because they realize that the condition is in no way linked to voluntary behavior.

The problem statement for this research is thus: If alcoholism is recognized as a learned behavior, what are the effects of alcoholism on self-esteem and how can social workers use learning theories to help alcoholics to become sober? This statement requires us to define several key terms.

Alcoholism: For the purpose of this study alcoholism is defined as a condition that is characterized by drinking of alcoholic beverages that is both habitual (at least two drinks a day) and excessive in that this drinking directly harms the individual physically, psychologically, professionally or socially.

Learned Behavior: Behavior that is acquired through watching the behavior of others and by a Pavlovian system of conditioned response (i.e. A drink produces feelings of pleasure in the individual who drinks more to reproduce those same feelings)

Innate Behavior: This is synonymous with genetically determined behavior. Ascribed behavior is behavior over which we do not have total conscious control. (For example, breathing is an innate behavior. We can stop breathing, but we will only pass out and begin to breathe again. Breathing is not entirely regulatable by the conscious mind.) Genetically-based behaviors may be modified to a much lesser degree than learned behavior

Sober: The state of being no longer physically dependent upon alcohol and of being able to function free of its effects. (For some people this might include some drinking).

Literature Review number of researchers have investigated the question of whether or not alcoholism has a genetic component and, if so, how powerful that component is. This literature review thus looks first at some of the most recent research in this area. In general researchers have found that there is a genetic element to alcoholism but that this element is not as important as the learned-behavior element of alcoholism. After examining the ways in which alcoholism has been determined...

We are likely to consider learned behavior vis-a-vis beneficial behaviors: We learn to speak our native language, we learn to do calculus, we learn to play tennis. But research such as that performed by Dawes etal (1999) reinforces the fact that even highly dysfunctional behavior can be learned. Our human brains are programmed to allow us to learn, and there may be some evolutionary bias towards our learning things that are beneficial to our overall survival, but if so this is a slight bias indeed. The ability to learn that is central to our ability to function successfully as human beings cannot be separated from our human ability to learn how to perform actions that are harmful to us. We can learn to take drugs (including alcohol) as easily as we can learn to drive a car.
Our ability to learn to do things that are harmful to us is not doubt exacerbated when there are genetic elements to that form of learned behavior, which may well explain why alcoholism and drug addiction, which are certainly harmful behaviors, are also so widespread. It is difficult for individuals to struggle against the simultaneous pressures of genetics and our human inclination to copy what we see around us.

Hommer etal (2001) suggests that there are indeed genetic elements to alcoholism, although not in an obviously straightforward way (i.e. there is no single gene for alcohol addition). (This research is backed up by other research on addiction such as Atrens [2001] work on nicotine.)

Although the evidence for alcohol neurotoxicity as the cause of gender differences in brain volume among alcoholics is not conclusive, it is stronger than the evidence for pre-alcoholism differences. No studies have examined the brain volumes of children at risk for alcoholism before they begin drinking, and no longitudinal imaging studies of individuals at risk for alcoholism have been conducted. Although there is no direct evidence of smaller brain volumes among individuals at risk for alcoholism, there is evidence that emotional trauma during childhood is associated with smaller intracranial volume and brain volume. Since alcoholic women report a higher rate of emotional trauma during childhood than alcoholic men, it is possible that this could contribute to differences in prealcoholism brain volume. However, we have found that the presence or absence of posttraumatic stress disorder does not influence hippocampal volume among alcoholic women. Further studies are needed to understand the effects of emotional trauma on the developing brain and the adult brain. Genetic influences also may affect pre-alcoholism brain volume.

LeMarquand etal (1999), on the other hand, found a direct genetic component for alcoholism in at least some people. As noted above, however, it is important to recognize that simply because there is (or may be) a genetic element to alcoholism this does not also mean that there is not a strong element of learned behavior.

A substantial proportion of the vulnerability to alcoholism is believed to be genetically mediated, particularly in early-onset, male-limited, type-2 alcoholism. Human and primate studies suggest a significant genetic component in 5-HT-related measures. Additionally, mice with genetic alterations affecting serotonergic neurotransmission show increased aggression and alcohol intake. Environmental factors may also be important. Early stressors lead to greater developmental declines in CSF 5-HIAA in monkeys than in unstressed animals. The extent to which low 5-HT function contributes to the genetic risk for alcoholism remains to be determined. The present results suggest that reduced central nervous system 5-HT function may account for some of the behavioral problems of impulse control that characterize individuals with a multigenerational paternal family history of alcoholism. Whether the propensity for disinhibited behavior after acute tryptophan depletion may help predict future outcome (alcoholism or impulsive behavior or both) remains to be investigated.

Mehrabian (2001) found that the genetic component is likely to be higher when alcoholism is comorbid with other conditions such as depression:

Review of the relevant literature indicates a substantial positive relation between depression and alcohol abuse or dependence (e.g., Merikangas & Gelernter, 1990). A large-scale twin study of women suggests…