The Types of Alcoholics

Types of Alcoholics

Understanding the different types of alcoholics is essential in recognizing the heterogeneity within the problem of alcoholism. Over the years, researchers and clinicians have developed various typologies to better understand the etiology of alcoholism, improve treatment, and advance the theoretical framework surrounding alcoholism and its consequences.

Alcoholism Typologies Overview

The history of alcoholism typology can be divided into three periods: the prescientific period, the Jellinek era, and the post-Jellinek era. During the prescientific period, physicians developed numerous typologies based on clinical observation, anecdotal evidence, and intuition. E.M. Jellinek made significant contributions by creating the first scientific typology, which was developed into a comprehensive theory of alcoholism as a disease. Since then, typologies have been derived from empirical research data.

Typologies have evolved from single defining characteristics, such as gender or family history of alcoholism, to multidimensional classification schemes that better explain the differences among alcoholics. These typologies aim to capture the diverse characteristics and drinking patterns observed in individuals with alcoholism.

Characteristics of Alcoholics

Alcoholics differ in many personal and drinking-related characteristics. These characteristics include drinking patterns, type of dependence, genetic predisposition, personality traits, and antecedent psychiatric disorders. By recognizing and understanding these differences, it becomes possible to tailor treatment approaches to meet the unique needs of individuals with alcoholism [1].

Research has shown that alcoholic subtypes defined by single dimensions can be differentiated in predictable ways on various other dimensions. This supports the development of typological criteria beyond gender to better explain the differences among alcoholics.

To provide a comprehensive understanding of alcoholism typologies, it is important to consider the subtypes identified by organizations such as the National Institute of Health (NIH). These subtypes include:

1. Young Adult: Typically, individuals in this subtype develop alcohol dependence at a young age and do not have a significant family history of alcoholism. Co-occurring mental health conditions and substance abuse disorders may also be present [2].
2. Functional: Individuals in the functional subtype tend to be middle-aged and well-educated. They may have stable jobs and families, and their alcohol use may not have significant negative consequences in their daily functioning.
3. Intermediate Familial: This subtype is characterized by a family history of alcoholism, early onset of alcohol dependence, and a higher likelihood of co-occurring mental health conditions. Individuals in this subtype may also have a history of substance abuse disorders.
4. Young Antisocial: Individuals in this subtype often have a history of conduct disorder and antisocial behavior. They may engage in impulsive and risky behaviors, including substance abuse. Co-occurring mental health conditions and substance abuse disorders are also common in this subtype.
5. Chronic Severe: This subtype is characterized by individuals with a long history of alcohol dependence, multiple failed attempts at sobriety, and significant physical and mental health challenges. They may also experience social and economic instability.

Understanding the various types and subtypes of alcoholics helps professionals develop targeted interventions and support systems to address the specific needs of individuals struggling with alcoholism. It is important to note that each individual's journey with alcoholism is unique, and treatment approaches should be tailored accordingly.

Behavioral Traits of Alcoholics

Understanding the behavioral traits of individuals struggling with alcoholism is crucial in recognizing and addressing the issue. While each person's experience with alcoholism may vary, there are common characteristics that can help identify the problem. Here are a few behavioral traits often associated with alcoholics:

Prioritizing Alcohol

One of the prominent signs of alcoholism is the prioritization of alcohol above other aspects of life. As a physical dependency on alcohol develops, individuals may feel compelled to continue drinking, even at the expense of their personal relationships, work, or other responsibilities. Some signs of prioritizing alcohol may include avoiding events or occasions without alcohol, suggesting plans that involve drinking, and displaying irritability when access to alcohol is delayed.

Placing Blame on Others

Many alcoholics exhibit a tendency to place blame on others for their unhealthy behavior or the circumstances that lead to their alcohol abuse. This behavior can manifest in blaming coworkers, housemates, partners, or relatives for their need to turn to alcohol as a coping mechanism. By shifting the blame onto others, alcoholics may attempt to absolve themselves of responsibility for their drinking habits.

Making Frequent Excuses

Individuals with alcoholic tendencies often make frequent excuses to justify their excessive drinking. They may attribute their alcohol consumption to a tough week at work, relationship problems, or any other occasion that provides a rationalization for their behavior. Making excuses becomes a way to downplay the severity of their alcohol abuse and avoid facing the consequences of their actions.

Drinking Uncontrollably

One of the clear indications of alcoholism is the inability to control or stop drinking. Alcoholics often consume alcohol well beyond their limits, indicating a physical and psychological urge to continue drinking due to dependency. This lack of control over their alcohol consumption can lead to detrimental consequences in various areas of their life, including relationships, work, and overall well-being.

Struggling Financially

Financial struggles can also be a sign of alcoholism. Frequent alcohol purchases, consumption at bars or social events, and being intoxicated at work can lead to financial instability. Alcoholics may face challenges in managing their finances due to their prioritization of alcohol. The financial burden of alcohol consumption can result in accumulating debt, loss of employment, or other negative consequences.

Recognizing these behavioral traits in oneself or someone else is an important step towards understanding and addressing alcoholism. If you or someone you know exhibits these signs, it is crucial to seek professional help and support to overcome the challenges associated with alcohol addiction.

Factors Influencing Alcoholism

Alcoholism is a complex disorder influenced by various factors, including genetic predisposition, personality traits, and impulsivity and disinhibition. Understanding these factors can provide insights into the development and progression of alcohol use disorder (AUD).

Genetic Predisposition

Genetics play a significant role in alcoholism, with research indicating that approximately 40% of the genetic variation in alcohol dependence can be attributed to genetic variance in behavioral undercontrol. Individuals with a family history of alcoholism are at a higher risk of developing AUD themselves. Specific genes and their interactions contribute to the susceptibility to alcoholism, although the precise mechanisms are still being explored.

Personality Traits

Personality traits have been linked to alcohol involvement, with certain traits demonstrating a consistent association. Traits related to impulsivity and disinhibition show a robust and consistent relation with alcohol involvement. However, all Five-Factor traits have been shown to correspond, to varying degrees of consistency, to alcohol use and outcomes. Personality can influence substance use both distally, through factors like peer group norms, and proximally, through decision-making processes. Individuals with certain personality traits may be more prone to alcohol misuse.

Impulsivity and Disinhibition

Impulsivity and disinhibition are traits that have a strong association with alcohol involvement. Individuals with high levels of impulsivity and disinhibition may be more likely to engage in risky behaviors, including excessive alcohol consumption [4]. These traits can lead to impulsive decision-making, reduced inhibition, and difficulties in controlling alcohol intake. However, it's important to note that while impulsivity and disinhibition are significant factors, other personality traits also contribute to the development of AUD.

Understanding the factors that influence alcoholism is crucial in developing effective prevention, intervention, and treatment strategies. By recognizing the role of genetic predisposition, personality traits, and impulsivity/disinhibition, healthcare professionals can provide tailored support to individuals struggling with alcohol use disorder. It is important to address these factors in a comprehensive approach to support individuals in their journey towards recovery.

Alcohol Use Disorder (AUD)

Alcohol Use Disorder (AUD) is a chronic condition characterized by the inability to control or stop drinking despite negative consequences. Health care professionals use criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), to assess AUD. The severity of AUD is based on the number of criteria a person meets, which determines the appropriate treatment approach. The severity levels of AUD are classified as mild, moderate, or severe.

Severity Levels of AUD

The severity of AUD is determined by the number of criteria met based on the individual's symptoms. The criteria include various aspects related to alcohol consumption, such as the inability to control drinking, experiencing withdrawal symptoms when attempting to quit, and neglecting important responsibilities due to alcohol use. The severity levels are as follows:

Severity LevelCriteria MetMild2-3 criteriaModerate4-5 criteriaSevere6 or more criteria

Understanding the severity level of AUD is crucial in developing an appropriate treatment plan and providing the necessary support to individuals seeking help.

Treatment Options for AUD

Treating AUD often requires a comprehensive approach that combines medical interventions, behavioral treatments, and support groups. The goal is to help individuals stop or reduce their drinking and prevent a return to alcohol use.

Medications

Several medications have been approved by the U.S. Food and Drug Administration (FDA) to aid in the treatment of AUD. These medications can be used alone or in combination with other treatments. The approved medications include:

• Naltrexone: Helps reduce cravings and the pleasurable effects of alcohol.
• Acamprosate: Aids in maintaining abstinence and reducing alcohol cravings.
• Disulfiram: Creates an unpleasant reaction when alcohol is consumed, serving as a deterrent to drinking.

Behavioral Treatments

Behavioral treatments for AUD focus on modifying drinking behavior and building motivation to prevent relapse. Some common behavioral treatments include:

• Brief interventions: Short counseling sessions that provide education and support for individuals with AUD.
• Reinforcement approaches: Utilize rewards and incentives to encourage individuals to abstain from alcohol.
• Mindfulness-based therapies: Incorporate mindfulness techniques to develop awareness of triggers and coping strategies.

Mutual-Support Groups

Mutual-support groups, such as Alcoholics Anonymous (AA), provide peer support for individuals seeking to stop or reduce their drinking. These groups can be combined with medications and behavioral treatments to offer an added layer of support and encouragement.

Understanding the severity levels of AUD and the available treatment options is essential in addressing the complex nature of alcohol use disorder. A personalized approach that considers the individual's specific needs and circumstances is crucial for successful treatment outcomes.

Alcoholism Typologies

Alcoholism is a complex disorder that can manifest in various ways. Understanding the different typologies of alcoholics can help provide insights into the nature of alcohol addiction and guide appropriate treatment approaches. In this section, we will explore two primary typologies of alcoholism: Type I and Type II.

Type I Alcoholics

Type I alcoholism, also known as late-onset alcoholism, typically affects both men and women. It often emerges later in life after years of heavy drinking. Type I alcoholics may exhibit either a mild or severe form of alcohol addiction.

Genetic predisposition plays a significant role in Type I alcoholism, along with environmental factors. Individuals with Type I alcoholism tend to have a later onset of alcohol use disorder (AUD) and may have experienced a longer period of heavy drinking before developing addiction.

Type II Alcoholics

Type II alcoholism, also referred to as early-onset alcoholism, primarily affects sons of male alcoholics and often begins during adolescence or early adulthood. This typology is characterized by moderate severity and is commonly associated with criminal behavior.

Compared to Type I alcoholism, Type II alcoholism is influenced only weakly by environmental factors, with a stronger genetic predisposition [6]. Personality traits such as harm avoidance and novelty seeking differ between Type I and Type II alcoholics. Neurophysiological markers, such as activity levels of the enzyme monoamine oxidase (MAO) and serotonin levels in the brain, also vary between these two typologies.

Additionally, differences in patterns of electrical brain waves, specifically in the amplitude of the P300 component of the electroencephalogram (EEG) waveform, have been observed between Type I and Type II alcoholics.

Understanding the distinctions between Type I and Type II alcoholism can aid in tailoring treatment strategies and interventions for individuals struggling with alcohol addiction. It is important to consider the unique characteristics and underlying factors associated with each typology to provide targeted support and help those affected by alcoholism on their path to recovery.

Subtypes of Alcoholics

Understanding the different subtypes of alcoholics is crucial in comprehending the diverse manifestations of alcoholism. These subtypes shed light on the varying patterns of alcohol consumption and associated characteristics. Let's explore the five subtypes: Young Adult Subtype, Functional Subtype, Intermediate Familial Subtype, Young Antisocial Subtype, and Chronic Severe Subtype.

Young Adult Subtype

Approximately 31.5% of alcoholics fall into the Young Adult Subtype category. This group tends to initiate alcohol consumption at an early age, around 19 years old, and develop alcohol dependence by the age of 24. The Young Adult Subtype has moderate rates of other substance abuse disorders and often has family members with alcoholism. Within this group, males are 2.5 times more likely than females to be affected [2].

Functional Subtype

Comprising 19.5% of alcoholics, the Functional Subtype is primarily observed in middle-aged individuals, around 41 years old. They typically begin drinking later, around 18 years old, and develop alcohol dependence later, around the age of 37. This group exhibits moderate rates of depression but lower rates of most other co-occurring disorders. Notably, the Functional Subtype has the highest levels of education and income among all types of alcoholics, with approximately 60% being male.

Intermediate Familial Subtype

The Intermediate Familial Subtype consists of 18.8% of alcoholics. Individuals in this subtype tend to start drinking at a younger age, around 17, and develop alcohol dependence earlier, around the age of 32. They have a higher likelihood of having immediate family members with alcoholism and are more prone to various mental health conditions. The Intermediate Familial Subtype also exhibits high rates of addiction to substances such as cigarettes, marijuana, and cocaine.

Young Antisocial Subtype

The Young Antisocial Subtype represents 21.1% of alcoholics and is characterized by early initiation of alcohol consumption, typically around 15 years old, and early development of alcohol dependence at around 18 years old. Over 50% of this subtype exhibits traits of antisocial personality disorder and has high rates of other substance abuse disorders. They often have the lowest levels of education, employment, and income among the subtypes.

Chronic Severe Subtype

The Chronic Severe Subtype encompasses the smallest percentage of alcoholics at 9.2%. Individuals in this subtype start drinking at an early age, around 15 years old, and develop alcohol dependence at an intermediate age, around 29 years old. This group has the highest rates of various mental health conditions and substance abuse disorders. Interestingly, they are also the most likely to seek help for their alcoholism, with approximately two-thirds having sought assistance at some point.

Understanding the different subtypes of alcoholics allows for a more comprehensive approach to addressing the complexities of alcoholism. Recognizing these subtypes can aid in the development of targeted interventions and personalized treatment plans to better support individuals dealing with alcohol use disorder.

References

• [1]: https://www.ncbi.nlm.nih.gov
• ‍[2]: https://www.addictioncenter.com
• ‍[3]: https://freebythesea.com
• ‍[4]: https://www.ncbi.nlm.nih.gov
• ‍[5]: https://www.niaaa.nih.gov
• ‍[6]: https://www.ncbi.nlm.nih.gov