Skip to main content
Journal of Studies on Alcohol and Drugs logoLink to Journal of Studies on Alcohol and Drugs
. 2008 Nov;69(6):941–950. doi: 10.15288/jsad.2008.69.941

Relationship Functioning Among Adult Children of Alcoholics*

Jill N Kearns-Bodkin 1,, Kenneth E Leonard 1,
PMCID: PMC2583382  PMID: 18925353

Abstract

Objective:

The purpose of the current research was to examine the impact of both maternal and paternal alcoholism on the relationship functioning of husbands and wives over the early years of marriage.

Method:

Couples (N = 634) were assessed at the time of marriage, and again at their first, second, and fourth anniversaries. Husbands and wives completed separate, self-administered questionnaires at home.

Results:

Results of separate repeated measures analyses of covariance revealed that, for both husbands and wives, the appraisal of their marital relationship was associated with alcoholism in the opposite gender parent. That is, for husbands, alcoholism in the mother was associated with lower marital satisfaction across the 4 years of marriage. For wives, alcoholism in the father was related to lower marital intimacy. Husbands' physical aggression was influenced by mother's and father's alcoholism; high levels of physical aggression were present among men with alcoholic mothers and nonalcoholic fathers. Interestingly, wives' experience of husband's aggression was also highest among women with alcoholic mothers and nonalcoholic fathers. Wives also reported engaging in high levels of physical aggression when they had an alcoholic mother and a nonalcoholic father, but this effect was restricted to the early part of the marriage. Finally, parental alcoholism was associated with both husbands' and wives' attachment representations.

Conclusions:

The present findings suggest that children raised in alcoholic families may carry the problematic effects of their early family environment into their adult romantic relationships.


Research indicates that children of alcoholics (COAs) are at increased risk for a variety of negative outcomes, including substance abuse, antisocial behavior, mood disorders (e.g., depression and anxiety), academic underachievement, low self-esteem, and relational difficul-ties (e.g., Beesley and Stoltenberg, 2002; Chassin et al., 2002; Dawson, 2000; Harter, 2000; Jackson et al., 2000; Johnson and Leff, 1999). Perhaps one of the most common, yet controversial, claims made with regard to adult COAs (ACOAs) is that they experience significant difficulties with interpersonal functioning, particularly with the establishment and maintenance of intimate relationships (e.g., Larsen, 1985; Seixas and Youcha, 1985; Woititz, 1985), possibly because of the parenting practices of alcoholic parents. For example, Woititz (1985) has noted that alcoholic parents are often inconsistent with the affection they give their children, vacillating between demonstrations of love and warmth at certain times and rejection at other times. As a result, COAs learn from an early age not to trust people and experience persistent fears of abandonment. Thus, although ACOAs may desire love and intimacy, they are likely to be afraid that relationships in their adult lives will be as hurtful as their early relationships (Wood, 1987).

These contentions about the occurrence and source of problems with intimate relationships in ACOAs are consistent with theoretical approaches to and empirical observations of the development of attachment in relationships. More specifically, attachment theory proposes that, through repeated interactions with the primary caregiver, children form internal representations or “working models” of both the self and of the attachment figure (Bowlby, 1969). Children who experience available and responsive attachment figures will likely develop expectations that they are worthy of love and support and that others are generally trustworthy and available (secure attachment). Alternatively, children who do not have responsive attachment figures will develop expectations that they are not worthy of the love and support of others and that people are generally unreliable and rejecting (insecure attachment). Moreover, several studies suggest that these working models of relationships between the infant and the caregiver are internalized early on, and that these working models result in differential patterns of specific representations regarding the self and others in their adult relationships (Belsky and Pensky, 1988; Ricks, 1985; Rutter, 1998).

Several studies based on attachment theory have, in fact, found a greater proportion of insecure attachment styles among ACOAs, mirroring the findings with respect to infant COAs (Eiden et al., 2002; Eiden and Leonard, 1996). For instance, Latty-Mann (1991) examined the attachment styles of a convenience sample of college students and found that self-identified ACOAs fell into predominately insecure classification patterns whereas the control participants were more securely attached. Similarly, Held (1991) found that non-COAs most often identified with secure bonding patterns both in childhood relationships with parents and adult relationships, whereas ACOAs most often identified with insecure bonding patterns. Research also suggests that the adult attachment insecurity ACOAs experience is mediated, at least in part, by parenting behaviors (e.g., Beesley and Stoltenberg, 2002; Kelley et al., 2005).

A few studies have also examined the relationship functioning of ACOAs more specifically. Parker and Harford (1988) used a representative sample of 1,772 adults in the United States to examine the impact of parental alcoholism on alcohol-related problems, marital disruption, and depressive symptoms in ACOAs. Their results showed that having a parental history of alcoholism placed both sons and daughters at risk for later divorce or separation. Domenico and Windle (1993) found increased marital conflict, decreased marital satisfaction, and decreased family cohesion among female ACOAs in a middle-aged community sample. Using the data from the National Survey of Families and Households, Watt (2002) reported that children raised in alcoholic families were less likely to marry, more likely to be unhappy in their marriage, and more likely to divorce, even after controlling for parental divorce.

Thus, although there is some evidence suggesting that parental alcoholism is associated with insecure attachment patterns and relationship difficulties in adulthood, this research is limited in several ways. First, most research has focused on children of alcoholic fathers and relatively little is known about the impact of maternal alcoholism on relationships. The few studies that have examined the gender of the alcoholic parent suggest that there may be differential impacts of parental alcoholism on male versus female children, raising the important issue of considering the gender of the ACOA in conjunction with the gender of the alcoholic parent (e.g., Bradley and Schneider, 1990; Mutzell, 1995; Stout and Mintz, 1996).

A further limitation is that most of the available studies have relied primarily on clinical rather than community samples. However, most individuals with alcohol-use disorders do not seek treatment, and such individuals are considerably different from those who are currently in treatment (Hingston et al., 1980, 1992; Vaillant, 1983). Of the studies that have used nonclinical samples, most are of college students, who may represent a more resilient subset of the ACOA population (Sher et al., 1991). In addition, some effects of parental alcoholism may not become apparent until the ACOA establishes a more committed relationship and/or becomes a parent himself/herself. Thus, studies of college-age ACOAs may underpredict risk and dysfunction and may also have limited generalizability to community samples of young adults (Senchak et al., 1995).

In the current study, we used a longitudinal design to examine the impact of both maternal and paternal alcoholism on the attachment representations and relationship functioning of both husbands and wives over the early years of marriage, a critical developmental period (Huston and Houts, 1998). This study investigated the following research questions: Are there differences among ACOAs with an alcoholic mother, ACOAs with an alcoholic father, ACOAs with both an alcoholic mother and an alcoholic father, and non-COAs in terms of their (1) attachment representations, (2) marital satisfaction and marital intimacy, and (3) reports of psychological and physical aggression over the first 4 years of marriage? Because only a few studies have taken into account the gender of the alcoholic parent, and these studies did not examine the variables we are examining, only research questions (vs directional hypotheses) were posed in the current investigation.

Method

Participants

Couples (N = 634) were participating in the Adult Development Study, a six-wave longitudinal study of marriage and alcohol involvement. Couples who indicated that the marriage was the first marriage for both husband and wife and who were both 18 years of age or older, English-speaking, and literate were eligible for the study. The current analyses are based on self-report data obtained from couple members at the time of marriage (Wave 1) and at their first (Wave 2), second (Wave 3), and fourth (Wave 4) anniversaries. Data collection for Waves 5 (7th anniversary) and 6 (9th anniversary) is currently in progress.

At the time of marriage, the average ages (mean [SD]) of the husbands and wives were 28.7 (6.3) and 26.8 (5.8) years, respectively. The majority of husbands (59%) and wives (62%) were white. A fairly large percentage of the sample was black (husbands: 33%; wives: 31%). There were very small percentages of Hispanic (husbands: 4%; wives: 4%), Asian (husbands: 1%; wives: 1%), and Native American (husbands: 1%; wives: 1%) participants. The remaining participants indicated ‘other’ as their race (husbands: 1%; wives: 1%). Approximately 8% of the husbands and 6% of the wives did not graduate from high school; 25% of husbands and 25% of wives did not receive any education beyond high school. About 39% of husbands and 40% of wives were college graduates. Thirty-eight percent of the husbands and 43% of the wives were parents at the time of marriage. Almost 70% of the couples were living together before marriage, but many of these couples had cohabitated for only a short period before marriage. The cohabiters were together an average of 30.9 (36.8) months; the median was 18.0 months.

Procedures

Over a 3-year period spanning 1996-1999, couples were recruited at the city hall for a brief (5-10 minute), paid ($10) interview after applying for a marriage license. The interview focused on basic sociodemographic factors, family and relationship factors, and drinking characteristics. For couples (n = 62) who were interested but unable to be interviewed at city hall because of time constraints, a phone interview was conducted at a later time. Less than 8.0% of the first-time marriage applicants approached declined to participate. In total, 970 eligible couples were interviewed.

After the interview, couples were asked to participate in the longitudinal study. Husbands and wives who agreed to participate were given identical questionnaires to complete at home and asked to return them in separate postage-paid envelopes. They were asked to complete the materials privately within 2 weeks and to not discuss the contents until both had returned the packets. Each spouse was paid $40 for participation. Only 7.2% (n = 70) of the eligible couples declined to participate in the longitudinal study. There were no significant differences in most sociodemographic attributes between those who refused and those who agreed to participate. Women in couples who agreed were, however, more likely to have children than those in couples who refused (p < .01). Also, couples who agreed to participate had lower incomes (p < .01) than couples who refused.

Complete Wave 1 data were collected for both husband and wife for 71.5% (N = 634) of the 887 eligible couples recruited into the longitudinal study (thirteen of the 900 couples that agreed to participate in the study did not marry). Couples who completed the questionnaires at Wave 1 were more likely to be living together than couples who did not complete the questionnaires (70% vs 62%, respectively, p < .05) and were more likely to be white (husbands: χ2 = 3.35, 1 df, p < .05, n = 887; wives: χ2 = 4.33, 1 df, p < .05, n = 887).

Around the time of the couple's first, second, and fourth anniversaries, couple members were mailed questionnaire packets similar to those they had completed at the time of marriage. Procedures were identical to those used at the first assessment. As with the first assessment, they were asked to complete the questionnaires and return them in the postage-paid envelopes. We retained 91%, 85%, and 81% of wives and 86%, 79%, and 71% of husbands at Waves 2, 3, and 4, respectively. Husbands and wives who did not participate in the fourth assessment did not differ on any sociodemo-graphic variables compared with husbands and wives who did complete the fourth assessment.

Measures

Family history of alcoholism.

Maternal and paternal history of alcoholism was assessed at Wave 1 using a version of the Family History-Research Diagnostic Criteria (FH-RDC; Andreasen et al., 1977) as modified by Domenico and Windle (1993). A biological parent was categorized as having a history of alcoholism if the participant reported that the parent ever had a serious problem with drinking and had experienced at least one of five alcohol-related problems (e.g., legal problems, health problems, marital or family problems, work problems). Although there is significant correspondence and a very high specificity between FH-RDC for alcoholism and diagnoses based on direct interviews of the actual relatives, overall levels of sensitivity are moderate and the reports are not entirely unbiased (Andreasen et al., 1986; Roy et al., 1994). Consequently, although we refer to this as a family history of alcoholism, this should be interpreted as the presence of significant alcohol problems in the affected parent rather than an indication that all of them would meet current diagnostic criteria for alcohol dependence.

Marital satisfaction.

Marital satisfaction was assessed with the Marital Adjustment Test (MAT; Locke and Wallace, 1959). The MAT is a 16-item scale designed to be an index of overall satisfaction with the marital relationship. The test has been shown to possess adequate reliability and good criterion-related validity (see Cohen, 1985; Freeston and Plechaty, 1997). This instrument does not assess marital conflict per se, and therefore is used only as a normative index of overall marital satisfaction. Higher MAT scores (range, 2-158) indicate a more well-adjusted marital relationship. Scores of 100 or higher are typically interpreted as indicative of nondistressed marriages. In the current study, Cronbach's α for husbands and wives ranged from .69 to .91 across the four assessments.

Marital intimacy.

The Personal Assessment of Intimacy in Relationships scale (PAIR; Schaefer and Olson, 1981) was used to assess marital intimacy. The PAIR measures the expected versus realized degree of intimacy in romantic relationships in terms of five conceptually relevant domains. For the current study, four of the five domains (social, emotional, sexual, and recreational intimacy) were assessed with the realized version of this measure. Using a scale ranging from 1 (strongly disagree) to 5 (strongly agree), participants indicated the extent to which they believed each statement characterized their current relationship. A total mean score was computed from the 24 items, with higher scores indicating greater intimacy. Reliability and construct and convergent validity have been demonstrated through previous research (Moore et al., 1998). In the present study, Cronbach's α for husbands and wives ranged from .88 to .94 across the four assessments.

Physical aggression.

The physical assault subscale of the Conflict Tactics Scale – Revised (CTS-2; Straus et al., 1996) was used to assess partner physical aggression. Respondents reported the number of times in the past year that they and their partners engaged in 12 physically aggressive behaviors (e.g., pushed or shoved, slapped, choked) during a disagreement. The following response options were included: 0 = zero times, 1 = 1 time, 2 = 2 times, 3 = 3-5 times, 4 = 6-10 times, 5 = 11-19 times, 6 = 20 or more times. Consistent with the scoring criteria outlined by Straus (Straus and Douglas, 2004; Straus et al., 1996, 1998), values of 3 through 6 were recoded to reflect the midpoints of each response option (3 = 4, 4 = 8, 5 = 15, 6 = 25). These 12 items were then summed to indicate the total number of aggressive behaviors over the past year. To control for the underreporting of violence, a combined score representing the maximum of self-report and partner report of aggression served as the measure of physical aggression for both husbands and wives. Numerous studies have provided evidence for the reliability and validity of the CTS-2 (see Straus, 2007, for a review). Reliability estimates (Cronbach's α) in the current study ranged from .86 to .94 across husband and wife reports of their own and their partner's aggression over the four waves.

Psychological aggression.

Psychological aggression was assessed with the Test of Negative Social Exchange (TENSE; Ruehlman and Karoly, 1991), an 18-item scale assessing the frequency of unpleasant social interactions over the past month, including items such as “making fun of me,” “took me for granted,” “lost his or her temper with me,” “nagged me,” and “yelled at me.” These items, which are normally rated with respect to “how often the people in their lives” engaged in the behaviors, were modified for the present study to refer to the frequency that the spouse engaged in these behaviors over the past month (i.e., husbands and wives provided reports of how often their partner engaged in each form of psychological aggression). Response options ranged from 1 (not at all) to 5 (about every day). The TENSE has been shown to possess good test-retest reliability, internal consistency, and convergent and divergent validity (Ruehlman and Karoly, 1991). In the present study, α coefficients ranged from .87 to .95 for husband and wife reports of partner behavior across the four assessments.

Attachment.

Using a dimensionalized form of Bartholomew's Relationships Questionnaire (Bartholomew and Horowitz, 1991), respondents rated on a scale ranging from 1 (not at all like me) to 7 (very much like me) the degree to which a brief description of each of four attachment styles (secure, preoccupied, fearful, dismissing) corresponded to their general relationship style. From this measure, two facets of attachment were computed: positive view of the self and positive view of others. According to Griffin and Bartholomew (1994), the secure style reflects a positive view of the self and a positive view of others, the dismissing style reflects a positive view of the self and a negative view of others, the preoccupied style reflects a negative view of the self and a positive view of others, and the fearful style reflects a negative view of the self and a negative view of others. Thus, in accordance with this approach, the extent to which participants held positive views of the self was computed by summing participants' ratings on the positive self styles and then subtracting their ratings on the negative self styles. Similarly, the extent to which participants held positive views of others was computed by summing their ratings on the positive other styles and then subtracting their ratings on the negative other styles. The construct validity of the self and other model attachment dimensions has been well established (see Diehl et al., 1998; Griffin and Bartholmew, 1994).

Covariates.

A number of demographic variables were included in the analyses. Spouse-specific covariates were age (in years), race/ethnicity (1 = white; 0 = other racial/ethnic group), parental status at marriage (1 = yes; 0 = no), and highest level of education (range, 1 [less than eighth grade] to 8 [master's, doctoral, other postgraduate degree]). We also included the length of time the couple lived together (in months) before marriage as a covariate.

Results

Descriptive and preliminary analyses

Overall, 27% (n = 171) of husbands reported that their mother (n = 19; 3%), father (n = 127; 20%), or both mother and father (n = 25; 4%) met FH-RDC criteria for alcoholism. Nearly three fourths (73%) of husbands indicated that neither parent was an alcoholic. For wives, 33% (n = 208) reported that their mother (n = 38; 6%), father (n = 137; 22%), or both (n = 33; 5%) met diagnostic criteria for alcoholism, while 67% (n = 426) of wives indicated that neither parent was an alcoholic. Preliminary analyses were conducted to examine whether there were differences between the four ACOA groups (only mother alcoholic, only father alcoholic, both parents alcoholic, neither parent alcoholic) with regard to sociodemographic characteristics. All analyses were conducted using the SPSS for Windows software package (Version 15.0.1.1; SPSS Inc., Chicago, IL). Results of univariate analyses of variance (ANOVAs) and chi-square analyses indicated that no group differences existed between the groups in age or race for either husbands or wives. There were, however, significant differences with regard to parental status at the time of marriage: Husbands and wives were less likely to have children if either the mother was an alcoholic or both parents were alcoholic. In addition, wives with maternal alcoholism lived with their partners for a longer period before marriage compared with wives with no history of parental alcoholism. Finally, husbands with both maternal and paternal alcoholism were less likely to have attended college.

Maternal and paternal alcoholism and relationship functioning

Separate repeated-measures analyses of covariance (ANCOVAs) were conducted for husbands and wives to examine the relationship between both maternal and paternal alcoholism and relationship functioning from the time of marriage through the couples' fourth anniversary. Maternal and paternal alcoholism (yes/no) were included as between-subjects factors, and Wave (Wave 1, Wave 2, Wave 3, and Wave 4) was included as the repeated-measures factor. Separate ANCOVAs were conducted for each dependent measure. All main effects, two-way interactions, and three-way interactions were examined. Post hoc comparisons were performed using the Sidak (1967) adjustment for multiple comparisons. All analyses were conducted using the SPSS for Windows software package (Version 15.0.1.1).

For husbands, a significant main effect of Wave was observed for marital satisfaction (F = 12.35, 3/1,182 df, p < .001), marital intimacy (F = 4.13, 3/1,149 df, p < .01), psychological aggression (F = 3.18, 3/1,146 df, p < .05), and husband-to-wife physical aggression (F = 2.69, 3/1,404 df, p < .05). Husbands' marital satisfaction and marital intimacy declined significantly from the time of marriage to the first anniversary but then remained stable across the remaining assessments. No significant differences were found on the post hoc comparison tests for husbands' psychological aggression or husband-to-wife physical aggression. For wives, a significant main effect of Wave was observed for marital satisfaction (F = 3.85, 3/1,365 df, p < .01), husband-to-wife physical aggression (F = 6.96, 3/1,401 df, p < .001), and wife-to-husband physical aggression (F = 3.80, 3/1,401 df, p < .05). Wives' marital satisfaction decreased from the time of marriage to the first anniversary but then stabilized across the remaining assessments. Both husband-to-wife and wife-to-husband physical aggression increased from the time of marriage to the first anniversary but then returned to a level comparable to that observed at the first assessment. There were no significant two-way interactions between Wave and either maternal or paternal alcoholism.

For both husbands and wives, the appraisal of the marital relationship was associated with alcoholism in the opposite gender parent. That is, for husbands, there was a significant main effect of maternal alcoholism on marital satisfaction (F = 4.77, 1/394 df, p < .05), such that the husbands with a history of maternal alcoholism reported lower marital satisfaction (mean [SE] = 100.38 [4.22]) across the 4 years of marriage when compared with husbands without a history of maternal alcoholism (mean = 110.02 [1.26]). For wives, there was a marginally significant main effect of paternal alcoholism on marital intimacy (F = 3.36, 1/439 df, p = .07); wives with a history of paternal alcoholism reported lower levels of marital intimacy (mean = 3.64 [0.06]) across the first 4 years of marriage when compared with wives without a history of paternal alcoholism (mean = 3.79 [0.06]). No other significant main effects or interactions were observed with regard to husbands' or wives' marital satisfaction or marital intimacy. Both the cell and marginal means for these analyses are presented in Table 1.

Table 1.

Husbands' and wives' relationship functioning, by paternal and maternal alcoholism collapsed across waves, mean (SE)

Husbands
Wives
Mother alcoholic Mother not alcoholic Marginal means Mother alcoholic Mother not alcoholic Marginal means
Marital satisfaction
 Father alcoholic 98.12 (5.37) 108.29 (2.25) 103.21 (2.91) 103.17 (4.33) 107.97 (2.16) 105.57 (2.43)
 Father not alcoholic 102.64 (6.43) 111.74 (1.16) 107.19 (3.26) 109.09 (4.35) 112.30 (1.21) 110.69 (2.25)
 Marginal means 100.38 (4.22)a 110.02 (1.26)b 106.13 (3.09) 110.13 (1.23)
Marital intimacy
 Father alcoholic 3.47 (0.13) 3.62 (0.05) 3.55 (0.07) 3.61 (0.11) 3.67 (0.05) 3.64 (0.06)a
 Father not alcoholic 3.59 (0.15) 3.73 (0.03) 3.66 (0.08) 3.79 (0.11) 3.80 (0.03) 3.79 (0.06)b
 Marginal means 3.53 (0.10) 3.68 (0.03) 3.70 (0.08) 3.74 (0.03)
Positive view of self
 Father alcoholic −0.28 (0.82) 1.38 (0.34) 0.55 (0.45)a 0.33 (0.73) 0.72 (0.36) 0.52 (0.41)
 Father not alcoholic 1.57 (1.00) 2.09 (0.17) 1.83 (0.51)b −0.38 (0.73) 0.98 (0.20) 0.30 (0.34)
 Marginal means 0.65 (0.65) 1.74 (0.19) −0.03 (0.52) 0.85 (0.20)
Positive view of others
 Father alcoholic −0.93 (0.93) −0.76 (0.39) −0.85 (0.51)a −0.56 (0.66) 0.48 (0.32) −0.52 (0.37)
 Father not alcoholic 1.29 (1.14) 0.15 (0.20) 0.72 (0.58)b −0.44 (0.66) 0.02 (0.18) −0.21 (0.34)
 Marginal means 0.18 (0.74) −0.31 (0.22) −0.50 (0.47) −0.23 (0.19)

Note: Marginal means with different superscripts are significantly different at p < .06.

Although there were no significant main effects of parental alcoholism on physical aggression, several interaction effects were observed. Significant two-way interactions were observed between maternal and paternal alcoholism for both husbands' physical aggression (F = 4.47, 1/468 df, p < .05) and wives' experience of husband's physical aggression (F = 4.53, 1/467 df, p < .05). Specifically, when the husband's mother was an alcoholic, husbands engaged in higher levels of aggression when the husband's father was not an alcoholic (see Figure 1). For wives, when no paternal alcoholism was present, wives experienced greater aggression when they had an alcoholic mother (see Figure 2). In addition, a significant three-way interaction was observed between maternal alcoholism, paternal alcoholism, and wave for wives' physical aggression (F = 2.85, 3/1,401 df, p < .05): Wives reported engaging in high levels of physical aggression in the early part of marriage (i.e., at the time of marriage and at the first anniversary) when they had a maternal history of alcoholism, but only when the father was not an alcoholic. No other significant main effects or interactions were observed for either husband-to-wife physical aggression or wife-to-husband physical aggression. In addition, no significant effects were observed for either husbands or wives with regard to the impact of parental alcoholism on psychological aggression.

Figure 1.

Figure 1

Husband-to-wife physical aggression collapsed across waves, by husbands' paternal and maternal alcoholism; n = 477

Figure 2.

Figure 2

Husband-to-wife physical aggression collapsed across waves, by wives' paternal and maternal alcoholism; n = 476.

Finally, there was a significant main effect of paternal alcoholism on husbands' views of others (F = 4.26, 1/382 df, p < .05; Table 1). Husbands with a history of paternal alcoholism held more negative views about others as being responsive and available (mean = -0.85 [0.51]) than did husbands without a paternal history of alcoholism (mean = 0.72 [0.58]). There was also a marginally significant main effect of paternal alcoholism on husbands' views of the self (F = 3.65, 1/382 df, p =.06): Husbands with an alcoholic father generally held less positive views about the self (mean = 0.55 [0.45]) than did husbands without an alcoholic father (mean = 1.83 [0.51]). Although no main effects of parental alcoholism were observed on either wives' views of the self or of others, a significant three-way interaction was observed for wives' views of others (F = 2.62, 3/1,341 df, p < .05): Wives with an alcoholic mother initially reported the most positive views of others. By the first anniversary, however, their views of others became the most negative of the three ACOA groups, before stabilizing across the remaining assessments. Although the other three ACOA groups initially reported less positive views of others, their views remained stable across the four assessments.

Discussion

The results of the present study suggest that there are relationship difficulties among ACOAs across the early years of marriage but that these depend on the gender of the alcoholic parent and the gender of the ACOA. This pattern was most clearly observed in the appraisal of their marital relationship. Specifically, for both men and women, their appraisal was associated with alcoholism in the opposite gender parent. That is, for husbands, maternal alcoholism was associated with lower marital satisfaction across the 4 years of marriage, whereas for wives paternal alcoholism was related to lower marital intimacy. Consistent with a social learning perspective, several researchers have argued that the parental relationship is one way that adolescents learn about romantic relationships and that children often emulate the behaviors that they see their parents demonstrate in their own romantic relationships (e.g., Kinsfogel and Grych, 2004; O'Leary and Cascardi, 1998; Sanders et al., 1999). For instance, if adolescents observe that their parents are emotionally unavailable with one another, or unable to resolve conflicts, then they may be more likely to exhibit similar characteristics both in the home and in other social arenas (Emery, 1982; Reese-Weber and Bertle-Haring, 1998).

Moreover, some research suggests that the opposite-gender parent plays a particularly important role in the child's development of appropriate relationship skills (Hetherington, 1967; Mussen and Rutherford, 1963). For instance, several researchers have argued that daughters' acquisition of feminine behavior and the specific skills involved in interacting with males is at least partly based on learning experiences and reinforcements received during early interactions with the father (Hetherington, 1967; Mussen and Rutherford, 1963). For example, in a study examining the effects of father absence on adolescent girls, Hetherington (1972) found that father absence was associated with an inability to interact appropriately with men. She proposed that the lack of opportunity for constructive interaction with a loving, attentive father results in apprehension and inadequate skills in relating to men. The present findings suggest that both sons and daughters may look toward the opposite-gender parent for information about how to interact with members of the opposite gender in their adult relationships. When the opposite gender parent is an alcoholic, it is likely that the child lacks an adequate model for learning how to engage in these opposite gender interactions.

Whereas the appraisal of the marital relationship seemed to be impacted most by alcoholism in the opposite gender parent, husbands' and wives' physical aggression was influenced by both maternal and paternal alcoholism. Specifically, the highest levels of husband-to-wife physical aggression were present among men with alcoholic mothers and nonalcoholic fathers. Interestingly, wives' experience of husband aggression was also highest among women with alcoholic mothers and nonalcoholic fathers. In addition, wives also reported engaging in high levels of physical aggression when they had an alcoholic mother and a nonalcoholic father, although this effect was restricted to the early part of the marriage.

One possible explanation is that families with alcoholic mothers and nonalcoholic fathers may have very high levels of conflict and aggression. Many investigators have suggested that women's drinking is more closely linked to marital and family functioning than is men's (Curlee, 1967; Gomberg, 1976; Jacob and Seilhamer, 1991; Perodeau, 1984). It has been reported that wives are more likely to cite marital and family difficulties as their cause of drinking (Beckman, 1975; Lisansky, 1957), to develop drinking problems after marriage (Noel et al., 1991), to drink at home (Wanberg and Horn, 1970), and to have less tolerant partners who are more likely to end the marriage (Corrigan, 1980; Dahlgren, 1979; Williams and Klerman, 1984). Given the research demonstrating that experiencing or witnessing violence in one's family of origin increases the likelihood of experiencing violence in one's future intimate relationships (Jackson, 1996; Kalmuss, 1984; Straus et al., 1980), it is possible that the link between maternal alcoholism and partner aggression observed in the current study may be the result of greater marital conflict in families with maternal alcoholism compared with paternal alcoholism.

Somewhat surprisingly, the current findings showed that husbands and wives with both alcoholic mothers and alcoholic fathers did not report significantly greater aggression than the other ACOA groups. At first glance, it might seem that these individuals would be the most likely to have observed partner violence in their parents and therefore, the most likely to exhibit aggressive behavior. Several studies, however, have shown that similarity of alcohol use between husbands and wives is associated with less conflictual marital behavior when compared with couples whose alcohol use is dissimilar (Homish and Leonard, 2007; Leadley et al., 1999; Mudar et al., 2001; Roberts and Leonard, 1998). Mudar et al. (2001) found that couples reporting a discrepant pattern of alcohol use at the time of marriage had lower levels of marital satisfaction compared with couples where both partners drank or neither partner drank. In longitudinal analyses of the same data, Homish and Leonard (2007) found that, after controlling for heavy drinking, discrepancies in husbands' and wives' heavy drinking predicted decreased marital satisfaction over time. Taken together, these findings suggest that, although both parents may have been alcoholics, it is possible that the overall family environment was less conflictual for these children compared with children where the parents had discrepant drinking patterns.

Finally, consistent with prior research, the current study provided evidence that parental alcoholism impacts both husband's and wife's attachment representations. For husbands, a history of paternal alcoholism was associated with less positive views about the self as being worthy of love and support and less positive views of others as generally being trustworthy and available. For wives, no effects were found with regard to views of the self, but an interesting pattern of results was observed for wives' views of others. At the time of marriage, wives with a maternal history of alcoholism actually reported the most positive views of others as being trustworthy and available, compared with the other ACOA groups. By the first anniversary, however, their views of others had declined significantly, becoming the most negative of the four groups. Although the other ACOA groups (father alcoholic, neither parent alcoholic, both parents alcoholic) initially reported less positive views of others compared with the mother alcoholic group, their views remained stable across the four assessments. In contrast to the findings for marital satisfaction and intimacy, however, it appears that husbands and wives attachment representations were impacted most strongly by the same gender parent. Future research is needed to better understand the mechanism involved in these influence processes.

Although there are a number of important strengths of the current research, there are several limitations of the study that should be considered. First, the focus on couples over the first 4 years of marriage defines a specific, developmental transition. Whether parental alcoholism has comparable effects on husbands and wives beyond the “honeymoon phase” is unknown. It is also important to note that the current findings may not generalize to couples who are cohabitating but are not legally married. Given that ACOAs are more likely to have never been married, to be currently cohabitating, and/or to be divorced than non-COAs (Watt, 2002), further research is needed to examine the impact of parental alcoholism on the relationship functioning of these couples.

It is also important to note that, although the current findings suggest that ACOAs are at an increased risk for relationship dysfunction, it is not clear what factors specifically cause these negative outcomes. For instance, the observed relationships between parental alcoholism and relationship dysfunction may be partially the result of mediating variables such as the level of functioning of the family of origin (e.g., parenting practices), presence of childhood physical or sexual abuse, and depression or alcoholism of the ACOA. Additional research is necessary to better understand the processes that contribute to problems in the relationship functioning of ACOAs.

An additional limitation of the current study was the use of self-report measures to assess family history of alcoholism. It would be beneficial for future research to obtain information from collateral informants (e.g., spouse, siblings) to corroborate reports of family history of alcoholism. Moreover, the current study could not address the potential influence of the severity of parental alcoholism on relationship dysfunction. It should also be noted that because of the relatively small number of participants in the ACOA groups (particularly the mother-only alcoholic group for husbands), we were unable to examine the interactive effect of husbands' and wives' parental alcoholism. It will be important for future research to examine the impact of parental alcoholism on relationship functioning using the couple as the unit of analysis. One final limitation to this study must be noted. A significant number of couples did not return their questionnaires at Wave 1, and there were some differences between couples who completed the initial assessment and those who did not. Although this is an important limitation, it should be noted that our recruitment and retention rates compare favorably with other studies of newly married couples (e.g., Huston and Houts, 1998; Veroff et al., 1998).

Despite these limitations, this study provides important insight into the impact of parental alcoholism on the relationship functioning of ACOAs. Of importance, the current findings suggest that children raised in alcoholic families may carry the problematic effects of their early family environment into their adult romantic relationships. Moreover, the present findings indicate that ACOAs are not a homogenous sample. Rather, the impact of parental alcoholism on relational functioning seems to be dependent on the gender of the ACOA, the gender of the alcoholic parent, and the specific relationship variable under investigation.

Footnotes

*

This research was supported by National Institute on Alcohol Abuse and Alcoholism grant R37-AA09922 awarded to Kenneth E. Leonard.

References

  1. Andreasen NC, Endicott J, Spitzer RL, Winokur G. The family history method using diagnostic criteria: Reliability and validity. Arch. Gen. Psychiat. 1977;34:1229–1235. doi: 10.1001/archpsyc.1977.01770220111013. [DOI] [PubMed] [Google Scholar]
  2. Andreasen NC, Rice J, Endicott J, Reich T, Coryell W. The family history approach to diagnosis. Arch. Gen. Psychiat. 1986;43:421–429. doi: 10.1001/archpsyc.1986.01800050019002. [DOI] [PubMed] [Google Scholar]
  3. Bartholomew K, Horowitz LM. Attachment styles among young adults: A test of a four-category model. J. Pers. Social Psychol. 1991;61:226–244. doi: 10.1037//0022-3514.61.2.226. [DOI] [PubMed] [Google Scholar]
  4. Beckman LJ. Women alcoholics: A review of social and psychological studies. J. Stud. Alcohol. 1975;36:797–824. doi: 10.15288/jsa.1975.36.797. [DOI] [PubMed] [Google Scholar]
  5. Beesley D, Stoltenberg CD. Control, attachment style, and relationship satisfaction among adult children of alcoholics. J. Ment. Hlth Counsel. 2002;24:281–298. [Google Scholar]
  6. Belsky J, Pensky E. Developmental history, personality, and family relationships: Toward an emergent family system. In: Hinde RA, Stevenson-Hinde J, editors. Relationships Within Families: Mutual Influences. New York: Oxford Univ. Press; 1988. pp. 193–217. [Google Scholar]
  7. Bowlby J. Attachment and Loss, Vol. 1: Attachment. , New York: Basic Books; 1969. [Google Scholar]
  8. Bradley LJ, Schneider HG. Interpersonal trust, self-disclosure and control in adult children of alcoholics. Psychol. Rep. 1990;67:731–737. doi: 10.2466/pr0.1990.67.3.731. [DOI] [PubMed] [Google Scholar]
  9. Chassin L, Pitts SC, Prost J. Binge drinking trajectories from adolescence to emerging adulthood in a high-risk sample: Predictors and substance abuse outcomes. J. Cons. Clin. Psychol. 2002;70:67–78. [PubMed] [Google Scholar]
  10. Cohen PM. The Locke Marital Adjustment Scale and the Dyadic Adjustment Scale. Amer. J. Fam. Ther. 1985;13:66–71. [Google Scholar]
  11. Corrigan EM. Alcoholic Women in Treatment. New York: Oxford Univ. Press; 1980. [Google Scholar]
  12. Curlee J. Alcoholic women: Some consideration for further research. Bull. Menninger Clin. 1967;31:154–163. [PubMed] [Google Scholar]
  13. Dahlgren L. Female alcoholics: IV. Marital situation and husbands. Acta Psychiat. Scand. 1979;59:59–69. doi: 10.1111/j.1600-0447.1979.tb06947.x. [DOI] [PubMed] [Google Scholar]
  14. Dawson DA. The link between family history and early onset alcoholism: Earlier initiation of drinking or more rapid development of dependence? J. Stud. Alcohol. 2000;61:637–646. doi: 10.15288/jsa.2000.61.637. [DOI] [PubMed] [Google Scholar]
  15. Diehl M, Elnick AB, Bourbeau LS, Labouvie-Vief G. Adult attachment styles: Their relations to family context and personality. J. Pers. Social Psychol. 1998;74:1656–1669. doi: 10.1037//0022-3514.74.6.1656. [DOI] [PubMed] [Google Scholar]
  16. Domenico D, Windle M. Intrapersonal and interpersonal functioning among middle-aged female adult children of alcoholics. J. Cons. Clin. Psychol. 1993;61:659–666. doi: 10.1037//0022-006x.61.4.659. [DOI] [PubMed] [Google Scholar]
  17. Eiden RD, Edwards EP, Leonard KE. Mother-infant and father-infant attachment among alcoholic families. Devel. Psychopathol. 2002;14:253–278. doi: 10.1017/s0954579402002043. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Eiden RD, Leonard KE. Paternal alcohol use and the mother-infant relationship. Devel. Psychopathol. 1996;8:307–323. [Google Scholar]
  19. Emery RE. Interparental conflict and the children of discord and divorce. Psychol. Bull. 1982;92:310–330. [PubMed] [Google Scholar]
  20. Freeston MH, Plechaty M. Reconsiderations of the Locke-Wallace Marital Adjustment Test: Is it still relevant for the 1990s? Psychol. Rep. 1997;81:419–434. doi: 10.2466/pr0.1997.81.2.419. [DOI] [PubMed] [Google Scholar]
  21. Gomberg ES. The female alcoholic. In: Tarter RE, Sugerman AA, editors. Alcoholism: Interdisciplinary Approaches to an Enduring Problem. Reading, MA: Addison-Wesley; 1976. pp. 603–636. [Google Scholar]
  22. Griffin DW, Bartholomew K. Models of the self and other: Fundamental dimensions underlying measures of adult attachment. J. Pers. Social Psychol. 1994;67:430–445. [Google Scholar]
  23. Harter SL. Psychosocial adjustment of adult children of alcoholics: A review of the recent empirical literature. Clin. Psychol. Rev. 2000;20:311–337. doi: 10.1016/s0272-7358(98)00084-1. [DOI] [PubMed] [Google Scholar]
  24. Held SC. Relational Psychopathologies of Adult Children of Alcoholics. San Francisco, CA: United States International University; 1990. Ph.D. dissertation, Dissertation Abstracts International - B 51/08, p. 4033, Publication No. AAT 9026962, February 1991. [Google Scholar]
  25. Hetherington EM. The effects of familial variables on sex typing, on parent-child similarity, and on imitation in children. Minn. Sympos. Child Psychol. 1967;1:82–107. [Google Scholar]
  26. Hetherington EM. Effects of father absence on personality development in adolescent daughters. Devel. Psychol. 1972;7:313–326. [Google Scholar]
  27. Hingson R, Mangione T, Meyers AR, Scotch N. Seeking help for drinking problems: A Study in the Boston metropolitan area. J. Stud. Alcohol. 1982;43:273–288. doi: 10.15288/jsa.1982.43.273. [DOI] [PubMed] [Google Scholar]
  28. Hingson R, Scotch N, Day N, Culbert A. Recognizing and seeking help for drinking problems: A study in the Boston metropolitan area. J. Stud. Alcohol. 1980;41:1102–1117. doi: 10.15288/jsa.1980.41.1102. [DOI] [PubMed] [Google Scholar]
  29. Homish GG, Leonard KE. The drinking partnership and marital satisfaction: The longitudinal influence of discrepant drinking. J. Cons. Clin. Psychol. 2007;75:43–51. doi: 10.1037/0022-006X.75.1.43. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Huston TL, Houts RM. The psychological infrastructure of courtship and marriage: The role of personality and compatibility in romantic relationships. In: Bradbury TN, editor. The Developmental Course of Marital Dysfunction. New York: Cambridge Univ. Press; 1998. pp. 114–151. [Google Scholar]
  31. Jackson NA. Observational experiences of intrapersonal conflict and teenage victimization: A comparative study among spouses and cohabitators. J. Fam. Viol. 1996;11:191–203. [Google Scholar]
  32. Jackson KM, Sher KJ, Wood PK. Trajectories of concurrent substance use disorders: A developmental, typological approach to comorbidity. Alcsm Clin. Exp. Res. 2000;24:902–913. [PubMed] [Google Scholar]
  33. Jacob T, Seilhamer RA. Alcoholism and the family. In: Pittman DJ, White HR, editors. Society, Culture, and Drinking Patterns Reexamined. New Brunswick, NJ: Rutgers Center of Alcohol Studies; 1991. pp. 613–630. [Google Scholar]
  34. Johnson JL, Leff M. Children of substance abusers: Overview of research findings. Pediatrics. 1999;103(5 Pt 2):1085–1099. [PubMed] [Google Scholar]
  35. Kalmuss D. The intergenerational transmission of marital aggression. J. Marr. Fam. 1984;46:11–19. [Google Scholar]
  36. Kelley ML, Nair V, Rawlings T, Cash TF, Steer K, Fals-Stew-Art W. Retrospective reports of parenting received in their families of origin: Relationships to adult attachment in adult children of alcoholics. Addict. Behav. 2005;30:1479–1495. doi: 10.1016/j.addbeh.2005.03.005. [DOI] [PubMed] [Google Scholar]
  37. Kinsfogel KM, Grych JH. Interparental conflict and adolescent dating relationships: Integrating cognitive, emotional, and peer influences. J. Fam. Psychol. 2004;18:505–515. doi: 10.1037/0893-3200.18.3.505. [DOI] [PubMed] [Google Scholar]
  38. Larsen E. Race against yesterday: The ups & downs of intimacy for ACOAs. Focus Fam. Chem. Depend. 1985;8:10–44. [Google Scholar]
  39. Latty-Mann H. An Intergenerational Approach to Studying the Influence of Family of Origin Dynamics on the Etiology of Adult Romantic Attachment Styles—With Special Focus on Adult Children of Alcoholics (ACoAs) Columbia, SC: University of South Carolina; 1991. Ph.D. dissertation, Dissertation Abstracts International - B 52/06, p. 3324, Publication No. AAT 9126074, December 1991. [Google Scholar]
  40. Leadley K, Clark CL, Caetano R. Couples' drinking patterns, intimate partner violence, and alcohol-related partnership problems. J. Subst. Abuse. 1999;11:253–263. doi: 10.1016/s0899-3289(00)00025-0. [DOI] [PubMed] [Google Scholar]
  41. Lisansky E. Alcoholism in women: Social and psychological concomitants: I. Social history data. Q.J. Stud. Alcohol. 1957;18:588–623. [PubMed] [Google Scholar]
  42. Locke HJ, Wallace KM. Short marital-adjustment and prediction test: Their reliability and validity. Marr. Fam. Liv. 1959;21:251–255. [Google Scholar]
  43. Moore KA, McCabe MP, Stockdale JE. Factor analysis of the Personal Assessment of Intimacy in Relationships Scale (PAIR): Engagement, communication and shared friendships. Sex. Marital Ther. 1998;13:361–368. [Google Scholar]
  44. Mudar P, Leonard KE, Soltysinski K. Discrepant substance use and marital functioning in newlywed couples. J. Cons. Clin. Psychol. 2001;69:130–134. doi: 10.1037//0022-006x.69.1.130. [DOI] [PubMed] [Google Scholar]
  45. Mussen P, Rutherford E. Parent-child relations and parental personality in relation to young children's sex-role preferences. Child Devel. 1963;34:589–607. doi: 10.1111/j.1467-8624.1963.tb05949.x. [DOI] [PubMed] [Google Scholar]
  46. Mutzell S. Are children of alcoholic mothers more psychologically damaged compared with children of mothers from the general population? Early Child Devel. Care. 1995;109:159–173. [Google Scholar]
  47. Noel NE, McCrady BS, Stout RL, Fisher-Nelson H. Gender differences in marital functioning of male and female alcoholics. Fam. Dynam. Addict. Q. 1991;1:31–38. [Google Scholar]
  48. O'leary KD, Cascardi M. Physical aggression in marriage: A developmental analysis. In: Bradbury TN, editor. The Developmental Course of Marital Dysfunction. New York: Cambridge Univ. Press; 1998. pp. 343–374. [Google Scholar]
  49. Parker DA, Harford TC. Alcohol-related problems, marital disruption and depressive symptoms among adult children of alcohol abusers in the United States. J. Stud. Alcohol. 1988;49:306–313. doi: 10.15288/jsa.1988.49.306. [DOI] [PubMed] [Google Scholar]
  50. Perodeau GM. Married alcoholic women: A review. J. Drug Issues. 1984;14:703–719. [Google Scholar]
  51. Reese-Weber M, Bartle-Haring S. Conflict resolution styles in family subsystems and adolescent romantic relationships. J. Youth Adolesc. 1998;27:735–752. [Google Scholar]
  52. Ricks MH. The social transmission of parental behavior: Attachment across generations. Monogr. Soc. Res. Child Devel. 1985;50(1-2):211–227. [Google Scholar]
  53. Roberts LJ, Leonard KE. An empirical typology of drinking partnerships and their relationship to marital functioning and drinking consequences. J. Marr. Fam. 1998;60:515–526. [Google Scholar]
  54. Roy M-A, Walsh D, Prescott CA, Kendler KS. Biases in the diagnosis of alcoholism by the family history method. Alcsm Clin. Exp. Res. 1994;18:845–851. doi: 10.1111/j.1530-0277.1994.tb00049.x. [DOI] [PubMed] [Google Scholar]
  55. Ruehlman LS, Karoly P. With a little flack from my friends: Development and preliminary validation of the Test of Negative Social Exchange (TENSE) Psychol. Assess. 1991;3:97–104. [Google Scholar]
  56. Rutter M. Functions and consequences of relationships: Some psychopathological considerations. In: Hinde RA, Stevenson-Hinde J, editors. Relationships Within Families: Mutual Influences. New York: Oxford Univ. Press; 1988. pp. 332–353. [Google Scholar]
  57. Sanders MR, Halford WK, Behrens BC. Parental divorce and premarital couple communication. J. Fam. Psychol. 1999;13:60–74. [Google Scholar]
  58. Schaefer MT, Olson DH. Assessing intimacy: The Pair inventory. J. Marital Fam. Ther. 1981;7:47–60. [Google Scholar]
  59. Seixas JS, Youcha G. Children of alcoholism: A Survivor's Manual. New York: Crown; 1985. [Google Scholar]
  60. Senchak M, Leonard KE, Greene BW, Carroll A. Comparisons of adult children of alcoholic, divorced, and control parents in four outcome domains. Psychol. Addict. Behav. 1995;9:147–156. [Google Scholar]
  61. Sher KJ. Psychological characteristics of children of alcoholics: Overview of research methods and findings. In: Galanter M, editor. Recent Developments in Alcoholism, Vol. 9: Children of Alcoholics. New York: Plenum Press; 1991. pp. 301–326. [PubMed] [Google Scholar]
  62. Sidak Z. Rectangular confidence regions for the means of multivariate normal distributions. J. Amer. Stat. Assn. 1967;62:626–633. [Google Scholar]
  63. Stout ML, Mintz LB. Differences among nonclinical college women with alcoholic mothers, alcoholic fathers, and nonalcoholic parents. J. Counsel. Psychol. 1996;43:466–472. [Google Scholar]
  64. Straus MA. Conflict Tactics Scales. In: Jackson NA, editor. Encyclopedia of Domestic Violence. New York: Routledge; 2007. pp. 190–197. [Google Scholar]
  65. Straus MA, Douglas EM. A short form of the Revised Conflict Tactics Scales, and typologies for severity and mutuality. Viol. Vict. 2004;19:507–520. doi: 10.1891/vivi.19.5.507.63686. [DOI] [PubMed] [Google Scholar]
  66. Straus MA, Gelles RJ, Steinmetz SK. Behind Closed Doors: Violence in the American Family. Garden City, NY: Anchor Press/Doubleday; 1980. [Google Scholar]
  67. Straus MA, Hamby SL, Boney-McCoy S, Sugarman DB. The Revised Conflict Tactics Scale (CTS2): Development and preliminary psychometric data. J. Fam. Issues. 1996;17:283–316. [Google Scholar]
  68. Straus MA, Hamby SL, Finkelhor D, Moore DW, Runyan D. Identification of child maltreatment with the parent-child Conflict Tactics Scales: Development and psychometric data for a national sample of American parents. Child Abuse Negl. 1998;22:249–270. doi: 10.1016/s0145-2134(97)00174-9. [DOI] [PubMed] [Google Scholar]
  69. Vaillant GE. The Natural History of Alcoholism. Cambridge, MA: Harvard Univ. Press; 1983. [Google Scholar]
  70. Veroff J, Douvan E, Orbuch TL, Acitelli LK. Happiness in stable marriages: The early years. In: Bradbury TN, editor. The Developmental Course of Marital Dysfunction. New York: Cambridge Univ. Press; 1998. pp. 152–179. [Google Scholar]
  71. Wanberg KW, Horn JL. Alcoholism symptom patterns of men and women: A comparative study. Q.J. Stud. Alcohol. 1970;31:40–61. [PubMed] [Google Scholar]
  72. Watt TT. Marital and cohabiting relationships of adult children of alcoholics: Evidence from the National Survey of Family and Households. J. Fam. Issues. 2002;23:246–265. [Google Scholar]
  73. Williams CN, Klerman LV. Female alcohol abuse: Its effects on the family. In: Wilsnack SC, Beckman LJ, editors. Alcohol Problems in Women: Antecedents, Consequences, and Intervention. New York: Guilford Press; 1984. pp. 280–312. [Google Scholar]
  74. Woititz JG. Struggle for Intimacy. Deerfield Beach, FL: Health Communications; 1985. [Google Scholar]
  75. Wood BL. Children of Alcoholism: The Struggle for Self and Intimacy in Adult Life. New York: New York Univ. Press; 1987. [Google Scholar]

Articles from Journal of Studies on Alcohol and Drugs are provided here courtesy of Rutgers University. Center of Alcohol Studies

RESOURCES