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Release: Aug. 23, 1999

UI study links parental alcoholism to kids' specific behavioral problems

IOWA CITY, Iowa -- For several decades, parental alcoholism has been associated with increased psychiatric or behavioral problems in children. Current University of Iowa Health Care research suggests that children of alcohol-dependent parents are at greater risk for several different types of childhood psychiatric disorders. The study also showed that when a parent has both alcoholism and antisocial personality disorder (ASPD), the alcoholism seems to contribute more to a child's behavioral difficulties.

"Probably the worst type of alcoholism involves those who drink and who also have aggressive behavioral problems," said Samuel Kuperman, M.D., UI associate professor of psychiatry and lead investigator. "However, our research showed that in families with alcoholism and antisocial personality disorder, the children's psychiatric problems are related more to the parents' alcoholism than to the ASPD."

People with antisocial personality disorder are prone to getting into fights, have difficulty holding down jobs or putting down roots, tend to be promiscuous, violate general societal rules, and are at increased risk for suicide attempts.

The UI study is part of an ongoing, six-site collaborative study on the genetics of alcoholism. Kuperman and colleagues at the UI and Washington University analyzed interviews of 463 children ages 7 to 17 and their biological parents, making it the largest investigation of its kind to date. The study also investigated more psychiatric diagnoses than previous related investigations have.

The investigators found that parental alcoholism increases the likelihood of childhood ADHD, conduct disorder and overanxious disorder. The combination of parental alcoholism and antisocial personality disorder puts children at greater risk for oppositional defiant disorder.

Conduct disorder involves aggression, defiance of authority, getting into trouble with the law and blaming others for one's own problems. Some 40 percent of children with conduct disorder will develop ASPD. Oppositional defiant disorder is less severe than conduct disorder in that it does not involve physical aggression or legal mishaps.

The researchers also found that boys tended to have more problems with the three disruptive disorders known as ADHD, conduct disorder and oppositional defiant disorder. Girls showed more anxiety problems such as separation anxiety. Older children tended to have more conduct disorder problems than younger children, which had been suspected in the past but never demonstrated.

"We originally looked for a genetic link between the parents' alcohol-dependence and the children's disruptive disorders," Kuperman said. "We could not find a specific connection because the elements are so intertwined. You can't separate what is familial and what is genetic.

"It may be that these children are predisposed to having some sort of problem, and that at different ages and in different genders the disorders are expressed differently," he said.

The researchers also found that dysfunctional family interactions between the parents and the children were also associated with increased risks for the development of conduct disorder, alcohol abuse and marijuana abuse in the children.

"The study made us wonder: If family relations can be improved, can these symptoms be improved?" Kuperman said. "But this begs the question of which comes first. Bad kids can bring out the worst in parents, and bad parents can bring out the worst in kids. It works both ways."

Kuperman said the findings are already helping the researchers investigate whether certain behaviors such as ADHD precede alcoholism.

In this particular study, children of alcohol-dependent parents did not appear to be at increased risk for developing alcoholism. However, Kuperman said the lack of correlation most likely reflects the child participants' average age of 12.

"It's pretty rare for children to begin drinking below the age of 13," he said, "but by age 17 about 10 percent of children in families with alcoholism are abusing alcohol themselves."

Kuperman, the only child psychiatrist on the research team, said that compared to participants in previous studies, the study's participants were more representative of alcohol-dependent families in the general population. Instead of recruiting families only through alcohol treatment programs or child psychiatry clinics, the researchers included extended families of up to four generations.

"We had the advantage of looking not just at the sickest people who have alcohol-related diagnoses, but entire families," he said. "We saw a spread of problems, and did not just study families who had parents in treatment for alcoholism."

Kuperman said the researchers greatly appreciated the effort the families made to participate in the study and fill out questionnaires, which took six to eight hours to complete.

The findings were published in a recent issue of the Journal of the American Academy of Child and Adolescent Psychiatry.

The other institutions involved in the Collaborative Study on the Genetics of Alcoholism are the State University of New York at Brooklyn, the University of Connecticut at Farmington, Indiana University in Indianapolis, Washington University in St. Louis, and the University of California at San Diego. The collaborative study is funded by grants from the National Institute on Alcohol Abuse and Alcoholism.