Alterman A I
Veterans Administration Medical Center, Philadelphia, Pennsylvania 19104.
J Nerv Ment Dis. 1988 Mar;176(3):167-75. doi: 10.1097/00005053-198803000-00005.
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 MacAndrew 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.(ABSTRACT TRUNCATED AT 250 WORDS)
使用以下四种家族性酒精中毒分类方案,研究了酒精中毒严重程度、精神病理学/人格与家族性酒精中毒程度之间的相互关系,每种方案都区分了三个家族性酒精中毒程度:1)传统型,将酗酒者与无酗酒亲属、非父母酗酒亲属和父母酗酒亲属进行比较;2)直系型,区分家族中无酗酒者、一方有酗酒者或双方有酗酒者的亚组;3)代际型,比较无家族性酒精中毒、有一代家族性酒精中毒或有两代家族性酒精中毒的酗酒者;4)定量型,对每位一级酗酒亲属计1分,对每位二级酗酒亲属计0.5分。研究对象为83名年龄在50岁及以下的男性退伍军人管理局酗酒住院患者。使用酒精使用量表、各种与酒精相关的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。通过明尼苏达多相人格调查表、精神病态状态量表、麦安德鲁酒精中毒量表、儿童问题行为问卷以及反社会人格障碍(ASP)诊断患者的百分比来测量精神病理学/人格。令人惊讶的是,在酒精中毒的严重程度/模式方面几乎没有发现亚组差异。只有治疗时的年龄和非酒精药物的使用与家族性酒精中毒程度的增加有关。另一方面,发现儿童行为问题,尤其是反社会行为,以及ASP诊断与家族性酒精中毒程度的增加有关。ASP诊断在两代和双亲酗酒者中最为明显,而对于传统分类,家族性酒精中毒程度的增加与ASP无关。双亲家族性酗酒者还表现出反映性格障碍的明尼苏达多相人格调查表剖面图。(摘要截选至250字)