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Encyclopedia of Psychology Alan E. Kazdin, PhD, Editor-in-Chief

ALCOHOLICS ANONYMOUS

Jung had treated an alcoholic member of the Oxford Group who also was in contact with early AA members. Jung told his patient that curing alcoholism was hopeless from the point of view of medicine, but that a spiritual transformation might hold the key to recovery. Bill W. experienced such a spiritual transformation during a hospitalization in 1934, and he interpreted its meaning in light of William James’s Varieties of Religious Experience (1902/1985), so James’s pragmatism was also absorbed into AA. For example James’s concept that acting and behaving in a new way could produce corresponding feelings and views of the self is also endorsed in AA, as reflected in organizational slogans such as “Bring the body and the mind will follow” and “Fake it until you make it.”

ALCOHOLISM

According to diagnostic criteria from the DSM-Ill, alcoholism is the second most prevalent psychiatric syndrome in the adult population, with lifetime and past-year rates of 13.8% and 6.3%, respectively.

In the ECA study, the lifetime prevalence of alcohol abuse or dependence in males was sixfold greater than in females (i.e., 23.8% versus 4%). At the time of the survey, 9% of males and 2% of adult females had met criteria for alcohol abuse or dependence during the past six months, and 5% of men and 0.9% of women met criteria during the past 30 days.

The average relative risk of alcoholism in adoptees with a family history of alcoholism is 2.4 for males and 2.8 for females. An adoptee is 2.5 times more likely to develop alcoholism if a biological parent has alcoholism, irrespective of exposure to the alcoholic parent.

Thus, the majority of the family, twin, and adoption studies have implicated genetic factors in the development of alcoholism, although genes explain less than half of the variability in alcoholism.

Clinical and epidemiologic studies have revealed that alcoholism and depression are inextricably linked (Regier et al.. 1990: Kessler et al., 1997). Whereas 32% of the general population meets criteria for an additional diagnosis, 47% of alcoholics meet criteria for a second diagnosis. Alcoholism is specifically associated with antisocial personality, drug abuse dependence, nicotine dependence, mania, schizophrenia, anxiety states such as panic disorder and social phobia, and major depression. Recent international collaborative studies have revealed that despite large variation in the magnitude of alcoholism, patterns of comorbidity are virtually identical across the world (Merikangas, Dierker, & Szatmari, 1998a).

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