Methodological characteristics and substantive findings of investigati
ons of essential and reactive alcoholics were reviewed. The data base
was comprised of approximately 12 studies published between 1951-1992,
most of which employed small samples of hospitalized male alcoholics.
Psychometric properties of the Essential-Reactive Alcoholism Question
naire, the instrument generally used to assess the essential-reactive
dimensions, rarely were examined. The weight of the evidence suggests
that essential alcoholics have earlier onset and greater severity of a
lcoholism, lower levels of occupational and educational achievement, m
ore interpersonal conflict, fewer long-term friendships, more antisoci
al attitudes and conduct, greater density of familial alcoholism, more
impaired neuropsychological functioning, and lower resting blood pres
sure than do reactive alcoholics. Research is needed to assess the pro
gnostic utility of the essential-reactive typology and the degree to w
hich the distinction may facilitate patient-treatment matching.