Alcohol Addiction and Family Dynamics: A Research Study

Introduction

With alcohol addiction posing major health and social problems in the United States, and the family remaining the basic social unit, the effects of alcohol addiction by a family member on the functioning of that social unit are of paramount importance. Understanding this disruption may lead to better ways to mitigate the effects of addiction on the social components of the problem. The central question is: when alcohol addiction is discovered or recognized in a family member living in the household, in what ways are the family dynamics — the interrelationships and methods of communication — altered? Some information was also developed regarding which family member is most likely to feel the effects caused by another member's addiction.

Information was obtained from two groups with long and deep experience dealing with the social disruptions of alcohol addiction: Alcoholics Anonymous and Al-Anon, the family and significant-other organization allied with Alcoholics Anonymous. Questionnaires were provided to leaders of these organizations, whose assistance was requested in developing the data. Because of the higher-power-based nature of the organizations, the information, though anonymous, was considered reliable. The findings were expected to demonstrate significant areas of negative impact on family dynamics resulting from a member's alcohol addiction.

Several researchers have adequately documented that the social and health costs of alcohol use and abuse in the United States represent a staggering figure. Because of this, interest in the availability of alcohol and in strategies to affect that availability have risen, as has interest in the development of intervention strategies — although these have also been found to have little influence on alcohol use (Gorman et al. 1998, 661). Dozens of studies have examined various aspects of alcohol use, many aimed at finding causal relationships between alcohol use and abuse and an array of factors, from genetic predisposition to parental attitudes toward drinking. A few are included here, notably those of Bennette et al. (1999), Johnson & Pandina (1991), and Costa et al. (1999). Some of these studies have investigated whether youthful alcohol abuse moderates with age, and if so, why and how.

Studies have also been conducted to determine what sort of intervention works best for abusers of all ages. Included here are notes concerning the work of Beattie (2001) and Schuckit & Smith (2000).

All of these studies skirt one of the issues that might be considered central to the problems of alcohol in a society that views the family as its foundation: the effect of alcohol addiction on the family unit. A few studies have touched on aspects of that question, including those of Friedemann (1996) and Gorman et al. (1998).

The aim of this study is to determine whether alcohol addiction alters family dynamics. In order to do that, it is necessary to obtain information from families that have experienced the development of alcohol addiction in one or more members. Several problems are inherent in locating this study population. First, while it may appear that alcohol addiction has suddenly begun, it may in fact merely have been recognized after existing for some time. If that were the case, it would be difficult to attribute any change in family dynamics to the onset of alcohol addiction versus its recognition. Second, while it is possible to obtain public records regarding arrests for alcohol-based criminal activity, this type of information does not contribute directly to an understanding of the effects of addiction on family dynamics. Third, there are a set of variables that may alter the precise effect of alcohol addiction on family dynamics. For example, would the dynamics be altered differently — or at all — if the mother were the addict? Or the father? Or a son, a daughter? Two children? A residential grandparent? Is there a difference in effects if the addicted family member does not live in the household, and if so, is the effect mitigated? These may, however, be issues for further study.

Purpose of the Study

The current research question is: when alcohol addiction is discovered or recognized in a family member living in the household, in what ways are the family dynamics — the interrelationships and methods of communication — altered?

The study will also investigate the degree of disruption depending on whether the addicted family member is a parent, a child, or another relative. In addition, it will examine whether the addicted family member is aware that his or her addiction affects the family, and what he or she believes that effect entails. There will be no attempt to assess what the addicted family member or any other family member believes is the correct course of action to mitigate the effects or cope with the addiction itself.

Once the extent and parameters of the effects of alcohol addiction on family dynamics are described, it will be possible to begin finding effective remedies for the expected negative disruptions, which in turn may help ameliorate the acknowledged serious social — if not health — costs of alcohol addiction to U.S. society.

Literature Review

While there has been considerable research on many aspects of alcohol addiction, a few areas are most pertinent to the current investigation concerning the effect of alcohol abuse on family dynamics. The most relevant areas are: attitudes toward alcohol use and abuse, causative factors, treatment effectiveness, youth drinking, and alcohol and violence. Following are brief notations regarding important studies in each of those areas.

An important aspect of the current study concerns the interaction between family members in a household containing a member addicted to alcohol. Parents, as important facilitators of the socialization and discipline of children, can influence offspring's behavior both by instruction and by example — or, as Johnson & Pandina call it, by modeling actions as well as defining norms (1991, 71+). In addition, parents can provide positive attachment (Johnson & Pandina 1991, 71+). On the other hand, "a link between parental alcohol, cigarette, and other drug use with substance use by the child has been established" (Johnson & Pandina 1991, 71+).

Herd tackled a similar concept in a study comparing the influence of parental drinking attitudes and behavior on the drinking patterns of both Black and White adults in the United States, hypothesizing that parents are critical as a source of influence on drinking behavior, as well as for imparting moral values and normative codes (Herd 1994, 353+). Most research until that point had been conducted with samples that included few or no Black respondents (Herd 1994, 353+).

Additional findings noted that parenting style can affect problem behavior; children whose parents did not provide love, warmth, and closeness demonstrated increased levels of substance abuse, delinquency, and poor coping strategies, according to Johnson & Pandina (1991, 71+). For purposes of the current study, it may be assumed that parents who are addicted to alcohol would have impaired abilities to provide these nurturing actions.

However, Johnson & Pandina found that while parental alcohol use was important in a child's choice to use alcohol as a coping mechanism, that influence was secondary to general parenting styles when other problematic outcomes were examined (1991, 71+). In other words, it may not be possible to assume that alcohol automatically impairs a parent's nurturing capacity to the degree hypothesized. Herd also noted that Black respondents in her study demonstrated a more conservative profile of parental drinking attitudes and behaviors, which she thought "might stem from the ambivalent and often negative socio-cultural climate surrounding alcohol use among blacks described in previous ethnographic and historical studies" (Herd 1994, 353+).

Schuckit & Smith investigated alcohol use and abuse in terms of genetic and environmental factors, noting that those two factors were almost equally responsible (2000, 287). They were particularly interested in the level of response (LR) to alcohol, and noted that LR has been shown to predict alcohol problems, abuse, or dependence. A lower LR is predictive of later addiction and is essentially unaffected by six other life domains they investigated as possible precursors or deterrents (Schuckit & Smith 2000, 287).

While the Schuckit & Smith study focused primarily on determining the most cogent correlation between response to alcohol and later addiction, a study by Chermack et al. investigated the relationship between family history of alcoholism, family history of violence, and the effect of childhood conduct problems on substance abuse. This more sociologically oriented study found that a family history of violence (FHV) and a family history of substance abuse (FHA) were important risk factors for developing abuse problems. Most cogent for the current investigation is their finding that "women were more impacted by family background variables (both FHA and FHV) in terms of adult problems with alcohol, drugs and violence (for men, family background variables were associated only with adult problems with drugs and violence)" (Chermack et al. 2000, 845).

Beattie found that information concerning the magnitude of the relationship between interpersonal factors and drinking outcomes was inconsistent. Beattie's study investigated that relationship, providing a review and synthesis of findings from prior research examining the correlation between alcoholism treatment outcomes and social relationships (Beattie 2001, 518). Beattie's approach came from the opposite end of the spectrum from the current investigation: Beattie examined the role of social relationships on treatment outcomes, whereas this study investigates the effect of drinking on social relationships. Beattie noted that "a better understanding of the role of social relationships in treated populations during the course of treatment and recovery or relapse may help to clarify how treatment can better utilize clients' social relationships to maximize treatment effectiveness" (Beattie 2001, 518).

Especially interesting are Beattie's findings that the association between drinking treatment outcomes varied depending on the particular social relationship involved, and that "the effect of social relationships on drinking outcomes is variable, inconsistent and weak" (Beattie 2001, 518). For Beattie, "social relationships involve social ties to one or more individuals in a person's environment" (Beattie 2001, 518), whereas the arguably stronger ties of family are being investigated here.

Closer in some ways to the current investigation was the work of Friedemann, who examined the perception of family functioning among rehabilitating inner-city substance abusers and one of their family members (1996, 123+). Alcoholics Anonymous and Al-Anon, which provided the subjects for that study, define substance abuse as a "disease of the mind, body, and spirit" and view it as "a genetic and environmental disease… manifested as a complex syndrome that touches every area of a person's life, as well as family and friends" (Friedemann 1996, 123+). Friedemann also cited projects showing that family involvement was one of the most important factors influencing recovery.

A study investigating youth drinking that relied on responses from mothers of adolescents revealed that "families of adolescents with alcohol use disorders functioned less well than did families of adolescents with other mental disorders, whereas by adolescent reports these groups were not significantly different" (Clark et al. 1998, 81). This finding is suggestive regarding the possible need to weight questionnaire answers in the current study. Also relevant is Clark's finding that "alcohol use disorders are thought to reflect systemic family problems by many clinicians and theorists" (Clark et al. 1998, 81). Those authors also reported that adolescents in treatment for alcohol use disorders were observed to come from disrupted, violent, or otherwise dysfunctional families; the same study had obtained ratings of family cohesion and adaptability from the adolescent, mother, father, and therapist (Clark et al. 1998, 81). "Adolescents in the two groups with high alcohol and drug consumption perceived lower family cohesion and flexibility, as measured by the FACES II, compared with adolescents in the abstinent comparison group" (Clark et al. 1998, 86).

Bennette's study of problem drinking from young adulthood to adulthood showed that "youth-limited problem drinkers reported greater parental permissiveness, and showed more problem behaviors and escape reasons for use than did developmentally-persistent problem drinkers" (Bennette 1999, 605) — another commentary on possible familial effects of alcohol addiction, at least when the addiction involves a young family member. Costa et al. (1999) showed that young problem drinkers, regardless of family conditions, were more likely to become problem drinkers later in life.

Perhaps one of the most severe consequences of alcohol addiction within a family concerns violence. Gorman et al. accepted as a premise that alcohol contributes to violent behavior and investigated what effect the easy availability of alcohol had on incidences of violence. They noted that "according to the New Jersey Uniform Crime Reports, alcohol is 'involved' in 3 to 4 of every 10 domestic violence offenses" (Gorman et al. 1998, 661), which is supportive of the hypothesis being investigated in this paper. The CDC has similarly documented the link between alcohol use and intimate partner violence, reinforcing the importance of understanding how addiction affects the household environment.