Term Paper: Exist Between Alcoholism

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[. . .] g., Merikangas & Gelernter, 1990). A large-scale twin study of women suggests that the substantial co-morbidity between major depression and alcoholism is also a result of genetic factors that contribute to both disorders (Kendler, Heath, Neale, Kessler, & Eaves, 1993).

Aside from showing a shared variance between depression and alcoholism, studies also have shown a possible causal link in the relation between the two to account for part of that variance....Overall, then, findings show that alcohol abuse and dependence on alcohol can be major predisposing factors to depression.

Tomer (2001), on the other hand, suggests that while alcoholism is certainly not rational (i.e. goes against the best interests of the actor in many cases) this does not mean that it is not learned behavior.

There is a widespread belief that addiction, such as alcohol or drug addiction, is a physiological disease. Phelps and Nourse (1986, pp. 7-8), for example, state that "Addictiveness -- the capacity to become an addict to anything -- is a built-in physiological state, something you are born with. Either you are born addictive or you are born nonaddictive." Thus, in their view, the capacity for addiction is a genetic flaw related to carbohydrate metabolism. The research of leading authorities on addictive behavior such as Stanton Peele does not support this view; neither does the model developed here.

Tomer's model has especially relevance for social work because it stresses the importance of an individual's acquiring traits that will allow him or her to act both in terms of self-interest and the common good:

propose a concept of rationality that is essentially the same as the quality Aristotle called virtue (Thomson, 1953). A virtuous person, according to Aristotle, is one who, because of having acquired good habits, regularly makes right choices, choices that leave one with no regrets and that contribute to one's happiness (Adler, 1978, p. 101). An important aspect of virtue is the quality of temperance which consists of "habitually resisting the temptation to overindulge in pleasures of all sorts." Moreover, temperance "enables us to resist what appears to be good in the short run for the sake of what is really good for us in the long run" (p. 103). Virtue requires a mean between excess and deficiency in actions and passions. Quite clearly, addiction is not temperate; therefore, it is not virtuous, and, I would argue, neither is it rational. Rationality in this sense is associated with wisdom and reason, neither of which could be associated with addiction.

Other researchers have also developed findings with important practical and ethical implications for social work vis-a-vis alcoholism, including Rowe & Liddle (2003) who have found that there is a substantial reduction in alcoholism and its related violence with the use of behavioral therapy. (This does not mean that behavioral therapy cannot also be used to help with conditions that have genetic elements):

In 1995, Liddle and Dakof reported that the development of the subspecialty of family-based treatment for adult drug abuse was unfortunately limited. In their review of this area, they concluded that "potential routes of investigation have been neglected (e.g., marital therapy approaches, although present in the alcoholism area, are virtually absent in the drug abuse field); promising lines of work have not been expanded or sustained (e.g., the work of Stanton & Todd, 1982); and the very definition of family therapy for adult addicts has not gone beyond initial conceptualizations" (p. 518). The most encouraging support for family therapy with adult addicts at that time was the program of research of Stanton and colleagues. Stanton and Todd (1982) reported that an innovative and integrative structural-strategic family therapy model reduced drug use more effectively than a family movie condition and standard drug counseling, although no differences were found on vocational or educational functioning. In a subsequent study, this research group showed that a home detoxification program was more effective than standard detoxification for substance abusers (Stanton, 1985).

Running through this research, as through the rest of the research that is being reviewed here is an insistence on addressing the issue of alcoholism as a complex one that in all likelihood includes genetic, behavioral, social and psychological elements.

While most populations seem to be more subject to learned elements of alcoholism than genetic ones, this is may not true for some groups, such as American Indians. However the current state of research is not clear on such issues and more work certainly needs to be done in this subfield, as Akins (2003) notes:

Higher rates of alcohol consumption and problems related to its use among Indians have raised the possibility of a "firewater gene," which supposedly makes individuals of Indian ancestry especially vulnerable to alcoholism and extreme behavior when under the influence (Leland, 1976; Mail & Johnson, 1993). As Duran and Duran note "The myth of the drunken Indian has persisted in this country from colonial times to the present" (1995, p. 95). Indeed, a belief held by many white Americans and American Indians alike is that Indians are "naturally" predisposed to drunkenness and that binge drinking is the "Indian way" of drinking (Caetano, Clark, & Tam, 1998). However, while higher patterns of alcohol use and differences in patterns of consumption may exist for Indians, there is no evidence in the literature to suggest an increased physiological or psychological reactivity to alcohol by Indians as compared to other racial/ethnic groups (Garcia-Andrade, Wall, & Ehlers, 1997; May, 1982).... Given the problems in studies attempting to discover a genetic link to Indian alcohol use, it is likely that studies that examine the cultural, economic, and social circumstances of American Indians may be more successful in explaining their higher rates of substance use.

The correlation between race and alcoholism may simply reflect the correlation between alcoholism and environmental factors (including stress) that Sandler (2001) and Schuckit etal (2001) found:

Several hypotheses have been proposed to explain why a low LR to alcohol might be related to a higher alcoholism risk (6, 7). First, individuals who live in a heavy drinking environment and who seek the same level of intoxication as their peers could be more likely to consume prodigious amounts of alcohol as they search for the effects experienced by those around them. This repeated heavy intake of ethanol could both contribute to subsequent acquired tolerance and increase the probability of spending more time with heavy-drinking friends. Second, for many people the ability to regularly control the intake of alcohol might result from behaviors learned as one compares internal feelings of intoxication with the amount of beverage consumed, a paradigm in which individuals who require much larger volumes of alcohol to have an effect might have more difficulty in adjusting their drinking behaviors to avoid intense drunkenness. In either of these instances, one might predict that the more intense the level of drinking in the surrounding environment, the greater the potential for alcohol-related problems for individuals with a low LR. One such environment could occur among young individuals serving in the military services.

All of these models - which balance genetic elements of alcoholism with learned ones, rely on concepts drawn from social learning theory models. The basic ideas expressed in social learning theory are relatively straightforward; however, scholars have developed highly elaborated models to explain exactly how people learn to respond to complicated social stimuli within their individual environments of complex social systems. The social learning models that inform the kind of model cited above in established a learned element to alcoholism are in turn based upon well-established models of learning including primarily Pavlovian and operant conditioning (or learning). Although these two forms of learning or conditioning (i.e. Pavlovian and operant) are usually classified as different types of learning, it may in fact be more accurate to define them as two different perspectives on the same type of learning, each of which has equally informed the type of social learning model that we are addressing here.

We may most easily see these basic models of learning have implications for the treatment of alcoholism as a learned behavior by beginning with a definition of each of these forms of learning. The model of Pavlovian learning is one of the most famous paradigms in psychology: It is hard to imagine that there is anyone who has not heard the story of how Pavlov taught his dog to associate the sound of a ringing bell, and indeed taught him this so convincingly that after a while his dogs would salivate in anticipation of eating - even when there was only a ringing bell and no food.

Pavlovian learning always works along these lines: An individual (whether a human or a member of a different species) is subjected to a certain stimulus and responds consistently to that stimulus. Pavlovian learning is usually divided into two subtypes, although arguably one of these is not learning at all.

Pavlovian Learning makes use of various types of stimuli and responses to those stimuli. A conditioned stimulus is one that… [END OF PREVIEW]

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