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...as conduct disorder, oppositional disorder, delinquency, and attention deficit disorder (Earls, Reich, Jung, & Cloninger, 1988; Kuperman, Schlosser, Lidral, & Reich, 1999; Merikangas & Avenevoli, 2000; Reich, Earls, Frankel, & Shayka, 1993, Sher, 1991) and for the development of internalizing problems such as depression and anxiety (Bennett, Wolin, & Reiss, 1988; Chassin, Pitts, DeLucia, & Todd, 1999; Reich et al., 1993). In addition, research has indicated that COAs are more likely to experience substance abuse problems in comparison to non-COAs (Chassin et al., 1999; Goodwin, 1988; Russell, Cooper, & Frone, 1990).
Although prior research has consistently indicated that COAs are at an increased risk for these problems, the majority of studies that have examined the relationship between parental alcoholism and COA adjustment have not systematically examined the potential effects of comorbid psychopathology in parents. This is a serious limitation of the COA literature because many studies have shown that comorbid psychiatric problems such as depression, anxiety, drug dependence, and antisocial personality disorder frequently occur among both community dwelling and treated alcoholics (Hill & Hruska, 1992; Kessler et al., 1994; Penick et al., 1994; Sher, Walitzer, Wood, & Brent, 1991; Tarter, 1988; Windle & Searles, 1990). For example, it is estimated that 47% of alcoholics from the community have a comorbid psychiatric diagnosis (Helzer & Pryzbeck, 1988). According to the Epidemiological Catchment Area survey, the most common comorbid diagnoses are drug dependence, antisocial personality disorder (ASPD), and mania (Helzer & Pryzbeck, 1988). Studies examining clinical samples of alcoholics have found even higher rates of comorbid psychopathology. For example, in a clinical sample of alcoholics, Hesselbrock, Meyer, and Keener (1985) found that 77% of the hospitalized alcoholics in their study met the diagnostic criteria for an additional psychiatric disorder, with approximately one half of the alcoholic women and one third of the alcoholic men meeting the criteria for major depression and about one fifth of the alcoholic women and one half of the alcoholic men meeting the criteria for ASPD.
Because the majority of alcoholics typically have at least one additional lifetime psychiatric disorder, the potential influence of comorbid psychopathology needs to be considered when examining the relationship between parental alcoholism and psychological adjustment in their offspring. It cannot simply be assumed that psychological problems among COAs are due to parental alcoholism because the parents of COAs also are likely to experience depression, anxiety, drug dependence, or antisocial personality disorder (ASPD). These disorders may be as influential, or even more influential than parental alcoholism, on the offsprings' psychological adjustment. Research has shown that parental ASPD may be a particularly important confound in the relationship between parental alcoholism and COA adjustment (Chassin, Rogosch, & Barrera, 1991; Moss, Baron, Hardie, & Vanyukov, 2001). For example, Puttler et al. (1998) found that children who had alcoholic fathers with ASPD exhibited significantly more behavioral problems than children who had alcoholic fathers without ASPD.
A handful of studies have taken parental comorbid psychopathology into account when examining the relationship between parental alcoholism and COA adjustment. For example, in a study conducted by Neff (1994), adults were classified as having a parent with alcoholism only, mental illness only, both problems, or neither problem. No significant differences in psychological distress (as indicated by self-reported levels of depression, anxiety, and somatization) or drinking patterns (e.g., quantity, frequency) were found when the parental alcoholism only group was compared to the control group. In fact, for men, no significant differences were found across the four groups. In contrast, women in the parental mental illness only group and the parental mental illness and alcoholism group reported higher levels of depression in comparison to the control group.
In another study, Giunta and Compas (1994) compared 25-35 year-old adult women whose parents abused alcohol only, were psychiatric distressed only, both abused alcohol and were psychiatrically distressed, or had neither problem. The psychological adjustment of the daughters did not differ significantly across the groups. Similar to the Neff study (1994), these results indicate that women who had fathers who abused alcohol but who were not psychiatrically distressed did not differ significantly from women whose fathers had no psychopathology. However, different patterns of results were observed across the two studies when the parental comorbid psychopathology group was compared to the other groups. More specifically, in the Neff study, although differences were not observed for men, women who had parents with alcohol problems and comorbid psychopathology reported significantly higher levels of depressive symptomatology in comparison to those who had parents with no psychopathology. In contrast, in the Giunta and Compas study (which included women only), no differences in psychological adjustment were found between the parental comorbidity group and the other groups (including the no parental psychopathology group). These differences may be due to differences in sampling (e.g., Giunta & Compas only included 25-35 year-old adult Caucasian women in their study, whereas Neff included an ethnically diverse sample of 20-60 year-old adult men and women), methodology (e.g., the manner in which the subgroups were defined), and differences in outcomes assessed (Giunta & Compas used more global measures of psychological adjustment than Neff).
It should be noted that both studies also were limited in several respects. For example, in both studies, psychiatric disorders were considered together, potentially masking the effect that specific disorders may have on offspring adjustment. In addition, both studies relied on self-report measures of psychopathology. Moreover, parental alcoholism and mental illness were assessed with single self-report items in the Neff study. Finally, the Giunta and Compas sample was restricted to highly educated Caucasian young adult women, limiting the external validity of the results. Nevertheless, both studies make an important contribution to the literature because parental comorbid psychopathology was considered in their design. The present study was designed to extend the findings from these studies by addressing the noted limitations.
Jacob and Leonard (1986) used a different approach for taking potential effects of parental comorbid psychopathology into account when examining offspring of alcoholic parents. More specifically, they controlled for comorbid parental psychopathology by excluding parents with additional psychiatric diagnoses. In their study of 10-18 year-old community adolescents, the psychosocial functioning of children of alcoholic fathers (COAs), children of depressed fathers (CODs), and a control group of adolescents was compared. The fathers in this study were screened to ensure that they did not have additional psychopathology. When externalizing behaviors (as reported by both parents and teachers) were compared across the groups for boys, no significant differences were found. Similar results were found for girls when teacher reports of externalizing problem behaviors were examined; that is, COAs and CODs did not have higher levels of externalizing behaviors in comparison to controls. However, when parents' reports of externalizing behaviors were examined for girls, CODs were found to have the highest levels of externalizing behaviors, followed by COAs. Although these results are intriguing, this study included only intact families and most of the fathers were employed. In addition, only paternal alcoholism and paternal depression were assessed. Finally, it is likely that excluding individuals with comorbid psychiatric problems compromises the generalizability of the results, given that many alcoholics have comorbid psychological problems. Nonetheless, consistent with the Neff (1994) and Giunta and Compas (1994) studies, these results (especially the results for boys) indicate that once parental comorbid psychopathology is considered, COAs and CODs may be quite similar to controls in their psychosocial adjustment. Findings for girls also suggest that CODs may be at a greater risk for problem behaviors such as externalizing problems than are COAs. These findings highlight the need to consider parental comorbid depression when examining the relationship between parental alcoholism and COA adjustment.
To summarize, results from all of these studies suggest that individuals who have parents with alcohol abuse/dependence only may be similar in their psychosocial functioning to those who have parents with no psychopathology. Findings from the Neff study also indicate that individuals who have parents with alcohol abuse/dependence and comorbid psychopathology may be at an increased risk for psychological problems. However, as noted, these studies were limited in several respects. Therefore, the primary goal of this study was to build upon this work and to examine the relationship between parental alcoholism and offspring psychopathology systematically by addressing the limitations of prior studies.
Most studies examining COAs have focused on paternal alcoholism or have not distinguished between paternal or maternal alcoholism. However, research conducted by Hill and colleagues (Hill & Hruska, 1992; Hill & Muka, 1996) has suggested that the gender of the alcoholic within the family may affect the child's adjustment. More specifically, in their studies, high-risk offspring from female alcoholic families were found to be at an increased risk for psychopathology (Hill & Muka, 1996), whereas high-risk offspring from male alcoholic families were not (Hill & Hruska, 1992). Although these findings are intriguing, the focus of Hill and colleagues' studies was on family history/density of alcoholism and not parental alcoholism per se. Therefore, many of the alcoholics in the high-risk families were aunts, uncles, or grandparents, and not necessarily parents of the children. In contrast to Hill and colleagues' findings, Chassin and colleagues (Chassin, Curran, Hussong, & Colder, 1997) and Ohannessian and Hesselbrock (1994) found paternal alcoholism, but not maternal alcoholism, to be significantly related to substance use in the offspring. Both of these studies focused on subclinical substance use variables. One goal of the present investigation was to extend these...
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