MODELS OF TREATMENT SEEKING FOR ALCOHOLISM - THE ROLE OF GENES AND ENVIRONMENT

We investigated the relative influence of genes and environment on the decision to seek treatment for alcoholism under three models of healt h care utilization. Lifetime alcohol dependence and two measures of tr eatment seeking for alcohol problems were determined from a 1992 telep hone administration of the Diagnostic Interview Schedule. Data were an alyzed from 1,864 monozygotic and 1,492 dizygotic male twin respondent s from the Vietnam Era Twin Registry. Genetic and environmental contri butions to the decision to seek treatment for alcoholism were assessed under competing models for the relationship between genetic influence s on alcoholism risk and genetic influences on treatment seeking among those who became alcoholics. Under the best-fitting model, genetic in fluence accounted for 41% of the variance in treatment seeking and 55% of the liability for alcoholism. Shared environment explained none of the variance in liability for alcoholism, but 40% of the variance in treatment seeking. The severity of alcoholism alone is an inadequate m odel of treatment seeking, because decisions to seek alcohol treatment are also influenced by substantial genetic and or shared environmenta l factors unrelated to the determinants of alcoholism.