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STRATEGIES OF RESEARCH INTO THE ETIOLOGY OF ALCOHOLISM

Historically, studies of alcoholism, like their counterparts in the study of related pathological processes, have been primarily cross-sectional rather than longitudinal and have focused on identifying discernible psychological correlates of alcoholism rather than on whether these characteristics antedate the onset of adult patterns of problem drinking. Despite the volume of research devoted to the study of adult alcoholics, there appears to be far less agreement about the constituency of the alcoholic personality than one might reasonably expect. The lion’s share of this work has been largely anecdotal and, as Sanford has pointed carefully controlled experimental studies of alcoholic patients have been relatively rare. Syme14 concluded his recent review of the psychological test literature regarding alcoholism by stating that it contained nothing of value and that if the question, “What is the alcoholic personality?” were asked, there would bz no answer. While other readings of this same literature have been less pessimistic (i.e., Gromberg3), it is probably fair to conclude that the composite psychological portrait of the alcoholic sketched by available studies is a largely undecipherable admixture of cause and effect from which no sharp profile emerges. Even if the psychological picture of the adult alcoholic were clearer than it appears to be, such clarity would not necessarily contribute to our understanding of the etiology of alcoholism. As Robins and colleagues1° point out, any effort to reconstruct events that may have led to the occurrence of a disease by studying persons who currently suffer from it runs the risk of confounding causes and effects. Knowing where an individual is at any point in time does not, obviously, tell one how he got there. In the absence of evidence concerning the antecedents of alcohol addiction several writers6 have stressed the need for longitudinal studies in order to trace the connection between adult drinking patterns and early personality characteristics that antedated the onset of drinking behavior. While there is usually agreement about the general utility of such longitudinal studies, it is typically a good deal more difficult to obtain a consensus about the precise methodological format required to fill this prescription. In contrast to studies that make no such claims, research characterized as longitudinal typically shares an expanded time perspective and often little else. The single generalizable requirement of such studies appears to be that information about the same group of people be collected at two or more points in time. Beyond this single restriction there are a great variety of options as to whether the researcher personally collects the materials from the subjects at one or more points in time, whether any of these data points antedate the onset of symptoms, or whether the same or different subjects are considered at all points in time.” A recent methodological paper by Garmezy’ proposes a typology of these various research strategies. In what follows, an attempt will be made to transport this typology into the literature on the etiology of alcoholism; to cite, when available, studies that typify these alternate strategies; and to speculate about the poential payoff of methodologies that have not as yet been employed.