Correlates of unpredicted outcomes in sons of alcoholics and controls

Objective: Several risk factors for alcohol abuse and dependence have been identified, including a family history of the disorder and a low response t o alcohol. However, not everyone with these attributes develops an alcohol use disorder and some alcoholics have neither characteristic. This article evaluates factors that might have contributed to unexpected outcomes, in a prospective study of sons of alcoholics and controls. Method: 411 men with complete data at baseline (Time I or TI) and at 15-year (Time 15 or T15) fo llow-ups were studied using the level of response (LR) to alcohol, the fami ly history (FH) of alcoholism, and additional alcohol and drug-related expe riences at T1, T15 data included the development of alcohol abuse or depend ence, along with the 15-year functioning in six domains for the subject, as well as the characteristics of his spouse. The men were divided into group s based on the presence of two major risk factors, low LR and FH, after con trolling for several other characteristics, including antisocial personalit y disorder. Results: Rates of alcohol use disorders increased across Group 1 (family history negative [FHN] and no low LR), Group 2 (either family his tory positive [FHP] or low LR, but not both) and Group 3 (both FHP and low LR). After controlling for FH and LR for Group 1, only T1 drinking quantity and T15 positive alcohol expectancies related to a diagnosis, but explaine d only 12% of the variance. The results improved to R-2'S of 0.26 and 0.36 for Groups 2 and 3, with additional predictors including the TI history of alcohol problems and T15 measures of poor coping mechanisms, higher drinkin g in the environment and less nurturance in the social support system. Conc lusions: Procedures aimed at discouraging earlier heavier drinking, alterin g attitudes toward alcohol early in life, teaching appropriate coping metho ds and developing support systems might help individuals carrying multiple risk factors to become more resilient.