Transcript Chapter One: Shaping Your Health

Chapter Four:
Etiology
of
Alcohol
Dependence
public health model
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Agent: alcohol
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Host: the individual
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Environment:
family
community
culture
the agent: alcohol
Effects inviting use
 depressant drug
 diminution of inhibition/relaxation
 speed of action
Socially accepted and widely available
the host
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Multiple theories advanced
Nature versus nurture
 Nature = genetic make-up
 Nurture = individual’s circumstances
 Dilemma: separating these factors
research models
Twin and adoption studies
 Studies of nonalcoholic blood relatives
 Genetic marker studies
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findings suggesting role of
heredity in alcoholism
1.
Epidemiological studies: alcoholism runs
in families
2.
If one twin alcoholic, more common in an
identical twin than a fraternal twin
3.
Studies of step-siblings
“alcoholic home” vs. alcoholic parent
4.
Animal studies: such as “ drinking rats”
what is inherited ?
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Less sensitivity to acute effects
handle alcohol “too well”
Greater sense of relaxation with alcohol
Neuropsychological differences
Differences in metabolism
Differences in brain chemistry
neurotransmitters
the individual
1.
Early psychological approaches
1. application of personality theories
2. “alcoholic personality” not supported
2.
Current approaches
1. core psychological needs
2. learning theory
3. role of temperament
4. stressful events
individual factors:
temperament
Traits exist on continuum
Traits can predispose or be protective
 Cognitive structure
 Harm avoidance
 Impulsivity
 Playfulness
 Sensation seeking
environmental factors
Cultural orientation: defines acceptable and
unacceptable use
cultural orientation
 abstinence
 ritual use
 convivial use
 utilitarian use
characteristics
drinking not accepted
clear rules for drinking
drinking within social life
personal discretion
international comparisons
rank
country
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2.
3.
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7.
8.
>25
Luxembourg
Ireland
Portugal
France
Germany
Czech Republic
Romania
Spain
United States
total (liters)
12.2
11.6
11.0
10.7
10.6
10.5
10.3
9.9
6.6
[ 1999, per capita consumption absolute alcohol ]
Environmental factors
drinking styles & problems
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Norms also influence rates of problems
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Rates of problems associated with —
 solitary drinking
 over-permissive norms
 tolerating drunkenness
 tolerating negative consequences
 absence of ritualized use
environment: drinking
styles & problems
(cont)
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tolerating negative consequences
drinking separate from meals
absence of child socialization todrinking
drinking with strangers
drinking pursued as recreation
drinking concentrated in young males
culture stressing individualism, selfreliance, achievement
environment:
legal approaches
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Among most potent influences
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laws to limit access
hours of sales, drinking age
tax structure
restrictions on advertising
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cross-cultural comparison
Countries vary in legal drinking age
 Within countries, further variations
depending on
type of beverage
location
separate or with meals
 Europe: legal age ranges from 15 to 20 yrs.
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current social issues in US
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health insurance coverage
host liability
role of harm reduction
drinking as recreational activity
(college campus, among young adults)
limitations on advertising