Research challenges assumptions about adult children of alcoholics

THE BALTIMORE EVENING SUN

MANY POPULAR assumptions about children of alcoholics are being questioned by new research, posing a challenge to the hugely popular therapy movement directed at them and other "adult children" of problem families.

Although proponents of the movement say they have scientific support for their views, critics are unconvinced.

The therapy is based on the idea that the childhood experiences of "adult children of alcoholics," or "ACOAs," have left them with unique emotional patterns and problems.

These include, for example, feeling different from others, putting up a false front, being reluctant to stand up for themselves and failing to enjoy life as much as they would like.

But a new study has found that most people feel this way. The researchers charge that these and other basic beliefs of the ACOA movement are so vague or true of so many people that almost everyone identifies with them.

In short, they are so universal that they are devoid of therapeutic usefulness. These researchers say these statements, which seem more specific than they are, are similar to those used by fortune tellers or astrologers; they call them "Barnum statements," after the huckster P.T. Barnum.

Proponents of the movement concede that more research is needed on the adult children of alcoholics. But they say scientists studying the transmission of alcoholism from generation to generation have ignored the clinical experience of therapists who treat children of alcoholics.

"Only recently has there begun to be research directed by the ACOA outlook," said Dr. Claudia Black, a psychologist who is director of a treatment center for children of alcoholics in Cerritos, Calif.

The proponents cite positive results from a new study, one of the few designed specifically to test a major idea of the movement, that children of alcoholics are drawn to help partners who exploit them.

"The reason there's not yet enough research on adult children of alcoholics is that academics have focused on things like the role of genetics in alcoholism, or on the 20 percent of children of alcoholics who have the worst problems and so can be easily studied because they are in a hospital or in jail," said Dr. Black, who has written several books on the subject.

But many researchers remain skeptical. "Most of the beliefs popularized by the ACOA movement have never been tested scientifically," said Dr. Kenneth Sher, a psychologist at the University of Missouri, who is the author of "Children of Alcoholics: A Critical Appraisal of Theory and Research," published last year by the University of Chicago Press.

It was Dr. Sher, with Mary Beth Logue, a graduate student, who conducted a recent study to test whether basic tenets of the ACOA movement owed their appeal to their being Barnum statements.

First they combed the popular literature to identify key propositions about the traits of children of alcoholics. They then used an experimental ruse to test whether those traits would be seen as better fitting themselves by 112 sons and daughters of alcoholics than by 112 men and women whose parents were not alcoholics.

The participants, all college students, were recruited for what they were told was the validation of a newly developed personality test. After responding to questions in the test, the students were shown a personality profile that was purportedly based on their answers.

The profiles were actually either from popular descriptions of the traits of children of alcoholics or statements taken from previous research on the Barnum effect, such as, "You have some personality weaknesses."

About two-thirds of the men and women said the descriptions fit them well, regardless of whether the statements were from the list of traits of adult children of alcoholics or from the known Barnum statements. Results of the study will be published later this year in Professional Psychology.

"A lot of people resonate with the popular descriptions of children of alcoholics because they are universal truths or vague enough," Dr. Sher said. But, he added, because these personality traits do not distinguish children of alcoholics from most other people, they have little use in making diagnoses or specifying what kind of treatment would be most effective.

"It's a legitimate concern that some clinical claims about adult children of alcoholics are so broad they seem to apply to everyone," said Dr. Timmen Cermak, a psychiatrist at Genesis, a San Francisco treatment center that specializes in the problems of adult children of alcoholics.

"But whenever there is a new clinicalentity, like child abuse, you have to focus on the most general truths to raise public awareness; then you can start looking at the complexities," added Dr. Cermak, whose book, "Evaluating and Treating Adult Children of Alcoholics" (Johnson Institute), was published last year.

"There's another way to see it," said Luvon Roberson, director of public information at the Children of Alcoholics Foundation in New York City, commenting on Sher's study. Those people who are not children of alcoholics who agree with the statements "may simply be from other kinds of dysfunctional families," she added.

One of the few direct experimental tests of concepts from the popular ACOA movement seems to support the idea that people who are children of alcoholics are vulnerable to manipulation by self-centered partners.

The study involved 48 women, half of whom had a parent who was alcoholic. This experiment also involved a ruse: The BTC experimenter, a young man, had a confederate, a young woman who pretended to be a participant as each group of four went through the procedure.

At one point the male experimenter left the room, pretending to have to get some missing forms. While he was gone, the confederate told the group that he used to go out with her roommate.

Then, for half the groups, the confederate added that the experimenter was "the neatest guy," who used to help her roommate with everything from homework to laundry. For the other half she said, instead, that the experimenter was "the biggest jerk," who "used" her roommate "for everything from doing his homework to doing the laundry."

When the experimenter returned, he claimed to need volunteers to help him on another project, and asked the women if they would be willing to help him on it. When the experimenter was described as "a jerk," daughters of alcoholics volunteered twice as much time helping him as did women who did not have an alcoholic parent.

"Frankly, I was very surprised the results were as strong as they were," said Dr. Jeff Greenberg, a psychologist at the University of Arizona, who did the study with a graduate student, Sue Lyons.

Indeed, in the article reporting their study they refer to co-dependency, the theory that children of alcoholics are drawn to mates who share destructive traits with their own parents, as "the chic neurosis of our time." They note that the theory has been largely ignored by scientists studying children of alcoholics.

"Before we did the study I would have thought the Barnum effect explained away the whole ACOA model, but now I think there's at least a grain of truth to it," said Dr. Greenberg, who published the results in the December issue of the Journal of Personality and Social Psychology.

Greenberg believes the study reveals in at least some children of alcoholics what the psychoanalyst Karen Horney called "morbid dependency," in which children who have had an exploitative, manipulative parent learn to get love by meeting that parent's self-centered demands.

As adults they "get the same warm feelings when they meet the demands of a manipulative partner," he said.

Eliminating this "co-dependency" is a major part of the movement. In fact, critics of the movement say co-dependency plays too large a role.

"The adult children of alcoholics movement has looked to a simple construct, co-dependency, to explain everything," said Dr. Ralph Tarter, a psychologist in the psychiatry department at the University of Pittsburgh medical school, who has done extensive studies of the children of alcoholics.

"It just doesn't fit with most of what we know scientifically. It's ideology, not fact."

"In our own research," he said, "we find differences between children of alcoholics and others on personality traits like aggressiveness and impulsivity in boys, but not dependency."

One widespread belief about alcoholism, that it is largely a genetic disorder, was dealt a blow this month by research on 356 patients in treatment for alcoholism and their twins. The study found that environmental factors are far stronger than genes in alcoholism in women, and in men who develop drinking problems in adulthood.

There was a strong genetic influence only among men who developed drinking problems before the age of 20, according to a report by Matt McGue, a psychologist at the University of Minnesota, in the February issue of the Journal of Abnormal Psychology.

Dozens of studies have shown that this group of "early onset" alcoholics are more likely to be hyperactive, have learning problems, get in trouble with the law as teen-agers and use street drugs.

Still, "most children of alcoholics end up having a good social adjustment," Tarter said.

"Even these troubled children of alcoholics have few common, unifying psychological factors that set them apart from anyone else who has had a disadvantaged childhood. That's where the evidence departs from the ideology of the movement."

But Dr. Sher said children of alcoholics had greater impulsivity, rebelliousness, a propensity to take risks, low self-esteem and a tendency to depression, especially in women, according to evidence from dozens of studies reviewed by him.

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