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Replication of the Stockholm Adoption Study of Alcoholism: Confirmatory Cross-Fostering Analysis

Replication of the Stockholm Adoption Study of Alcoholism: Confirmatory Cross-Fostering Analysis Abstract Background: Two forms of alcoholism with distinct clinical features and mode of inheritance were first distinguished in the Stockholm Adoption Study. This involved a large sample of children born in Stockholm, Sweden, who were adopted at an early age and reared by nonrelatives. Type 1 alcoholism had adult onset and rapid progression of dependence without criminality, whereas type 2 had teenage onset of recurrent social and legal problems from alcohol abuse. Methods: A replication study was carried out with 577 men and 660 women born in Gothenburg, Sweden, and adopted at an early age by nonrelatives. The genetic and environmental backgrounds of the adoptees were classified by the exact procedures calibrated by discriminant analysis in the original study. Results: Both type 2 and severe type 1 alcoholism were confirmed as independently heritable forms of alcoholism in male adoptees. The lifetime risk of severe alcoholism was increased 4-fold in adopted men with both genetic and environmental risk factors characteristic of type 1 alcoholism compared with the others (11.4% vs 3.0%). Neither genetic nor environmental risk factors for type 1 alcoholism by themselves were sufficient to cause alcoholism. In contrast, the risk of type 2 alcoholism was increased 6-fold in adopted sons with a type 2 genetic background compared with others, regardless of their postnatal environment (10.7% vs 2.0%). The sons with a type 2 genetic background in the replication sample had no excess of type 1 alcoholism, and vice versa. There was no increased risk of mild abuse in adopted men regardless of their genetic or environmental background. Conclusion: Type 1 and type 2 alcoholism are clinically distinct forms of alcoholism with causes that are independent but not mutually exclusive. References 1. Cloninger CR, Bohman M, Sigvardsson S. Inheritance of alcohol abuse: cross-fostering analysis of adopted men . Arch Gen Psychiatry . 1981;38:861-868.Crossref 2. Bohman M, Sigvardsson S, Cloninger CR. Maternal inheritance of alcohol abuse: cross-fostering analysis of adopted women . Arch Gen Psychiatry . 1981;38:965-969.Crossref 3. Cloninger CR, Bohman M, Sigvardsson S, von Knorring A-L. Psychopathology in adopted-out children of alcoholics: the Stockholm Adoption Study . Recent Dev Alcohol . 1985;3:37-51. 4. Bohman M, Cloninger CR, von Knorring A-L, Sigvardsson S. An adoption study of somatoform disorders, III: cross-fostering analysis and genetic relationship to alcoholism and criminality . Arch Gen Psychiatry . 1984;41:872-878.Crossref 5. Roe A, Burks B. Adult adjustment of foster children of alcoholic and psychotic parentage and the influence of the foster home . In: Memoirs of the Section on Alcohol Studies . New Haven, Conn: Yale University; 1945. 6. Goodwin DW, Schulsinger F, Moeller N, Hermansen L, Winokur G, Guze SB. Drinking problems in adopted and non-adopted sons of alcoholics . Arch Gen Psychiatry . 1974;31:164-169.Crossref 7. Kaij L. Alcoholism in Twins: Studies on the Etiology and Sequels of Abuse of Alcohol . Stockholm, Sweden: Almqvist & Wiksell; 1960. 8. Kaij L. Biases in a Swedish social register of alcoholics . Soc Psychiatry . 1970;5:216-218.Crossref 9. Ojesjo L. Prevalence of known and hidden alcoholism in the revisited Lundby population . Soc Psychiatry . 1980;15:81-90.Crossref 10. Committee on Nomenclature and Statistics, American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Third Edition . Washington, DC: American Psychiatric Association; 1980. 11. Searles JS. The role of genetics in the pathogenesis of alcoholism . J Abnorm Psychol . 1988;97:153-167.Crossref 12. Murray RM, Clifford CA, Gurling HMD. Twin and adoption studies: how good is the evidence for a genetic role? Recent Dev Alcohol . 1983;1:25-48. 13. Littrell J. The Swedish studies of the adopted children of alcoholics . J Stud Alcohol . 1988;49:491-515. 14. Gilligan SB, Reich T, Cloninger CR. Etiologic heterogeneity in alcoholism . Genet Epidemiol . 1987;4:395-414.Crossref 15. Gilligan SB, Reich T, Cloninger CR. Alcohol-related symptoms in heterogeneous families of hospitalized alcoholics . Alcohol Clin Exp Res . 1988;12:671-678.Crossref 16. Cloninger CR, Sigvardsson S, von Knorring A-L, Bohman M. The Swedish studies of the adopted children of alcoholics: reply to Littrell . J Stud Alcohol . 1988;49:516-521. 17. Babor TF, Hofmann M, DelBoca FK, Hesselbrock V, Meyer RE, Dolinsky ZS, Rounsaville B. Types of alcoholics, I: evidence for an empirically derived typology based on indicators of vulnerability and severity . Arch Gen Psychiatry . 1992;49:599-608.Crossref 18. Nordstrom G, Berglund M. Different patterns of successful long-term adjustment in genetically defined subtypes of alcoholics . Alcohol Alcohol . 1987; (suppl 1) :401-405. 19. Litt MD, Babor TF, DelBoca FK, Kadden RM, Cooney NL. Types of alcoholics, II: application of an empirically derived typology to treatment matching . Arch Gen Psychiatry . 1992;49:609-614.Crossref 20. Von Knorring L, von Knorring A-L, Smigan L, Lindberg U, Edholm M. Personality traits in subtypes of alcoholics . J Stud Alcohol . 1987;48:523-527. 21. Cloninger CR. Neurogenetic adaptive mechanisms in alcoholism . Science . 1987;236:410-416.Crossref 22. Von Knorring A-L, Bohman M, von Knorring L, Oreland L. Platelet MAO activity as a biological marker in subgroups of alcoholism . Acta Psychiatr Scand . 1987;72:51-58.Crossref 23. Sigvardsson S. Alcohol Abuse and Criminality: A Cross-fostering Study of Gene-Environment Interaction. Umeå, Sweden: Umeå University; 1982. Dissertation. 24. SPSS Inc. Statistical Package for the Social Sciences for Personal Computers (SPSS/PC): Version 4.0. Chicago, Ill: SPSS Inc; 1989. 25. SAS Institute Inc. SAS Technical Report P-229, SAS/STATSoftware: Changes and Enhancements, Release 6.07. Cary, NC: SAS Institute Inc; 1992. 26. Cloninger CR, Sigvardsson S, Bohman M (1988). Childhood personality predicts alcohol abuse in young adults . Alcohol Clin Exp Res . 1988;12:494-505.Crossref 27. Cloninger CR, Sigvardsson S, Przybeck TR, Svrakic DM. Personality antecedents of alcoholism in a national area probability sample . Eur Arch Psychiatry Clin Neurosci . 1995;245:239-244.Crossref 28. Cloninger CR. A systematic method for clinical description and classification of personality variants . Arch Gen Psychiatry . 1987;44:573-588.Crossref 29. Sigvardsson S, Bohman M, Cloninger CR. Structure and stability of childhood personality: prediction of later social adjustment . J Child Psychol Psychiatry . 1987;38:929-946.Crossref 30. Tremblay RE, Pihl RO, Vitaro F, Dobkin PL. Predicting early onset of male antisocial behavior from preschool behavior . Arch Gen Psychiatry . 1994;54:732-739.Crossref 31. Wills TA, Vaccaro D, McNamara G. Novelty seeking, risk taking, and related constructs as predictors of adolescent substance use: an application of Cloninger's theory . J Subst Abuse . 1994;6:1-20.Crossref 32. Heath AC, Cloninger CR, Martin NG. Testing a model for the genetic structure of personality: a comparison of the personality systems of Cloninger and Eysenck . J Pers Soc Psychol . 1994;66:762-775.Crossref 33. Svrakic NM, Svrakic DM, Cloninger CR. A general quantitative theory of personality: fundamentals of a self-organizing psychobiological complex . Dev Psychopathol . 1996;8:247-272.Crossref 34. Stallings MC, Hewitt JK, Cloninger CR, Heath AC, Eaves LJ. Genetic and environmental structure of the Tridimensional Personality Questionnaire: three or four primary temperament dimensions? J Pers Soc Psychol . In press. 35. Cloninger CR, Przybeck TR, Svrakic DM. The Tridimensional Personality Questionnaire: U.S. normative data . Psychol Rep . 1991;69:1047-1057.Crossref 36. Svrakic DM, Whitehead C, Przybeck TR, Cloninger CR. Differential diagnosis of personality disorders by the seven-factor model of temperament and character . Arch Gen Psychiatry . 1993;50:991-999.Crossref 37. Cloninger CR. A unified biosocial theory of personality and its role in the development of anxiety states . Psychiatr Dev . 1986;3:167-226. 38. Cloninger CR, Svrakic DM, Przybeck TR. A psychobiological model of temperament and character . Arch Gen Psychiatry . 1993;50:975-989.Crossref 39. Cloninger CR. The psychobiology of social cooperation . Nat Med . 1995;1:623-625.Crossref 40. Cloninger CR, Adolfsson R, Svrakic NM. Mapping genes for human personality . Nat Genet . 1996;12:3-4.Crossref 41. Pickens RW, Svikis DS, McGue M, Lykken DT, Heston LL, Clayton PJ. Heterogeneity in the inheritance of alcoholism: a study of male and female twins . Arch Gen Psychiatry . 1991;48:19-28.Crossref 42. Kendler KS, Neale M, Heath AC, Kessler RC, Eaves LJ. A twin-family study of alcoholism in women . Am J Psychiatry . 1994;151:707-715. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Replication of the Stockholm Adoption Study of Alcoholism: Confirmatory Cross-Fostering Analysis

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American Medical Association
Copyright
Copyright © 1996 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1996.01830080033007
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Abstract

Abstract Background: Two forms of alcoholism with distinct clinical features and mode of inheritance were first distinguished in the Stockholm Adoption Study. This involved a large sample of children born in Stockholm, Sweden, who were adopted at an early age and reared by nonrelatives. Type 1 alcoholism had adult onset and rapid progression of dependence without criminality, whereas type 2 had teenage onset of recurrent social and legal problems from alcohol abuse. Methods: A replication study was carried out with 577 men and 660 women born in Gothenburg, Sweden, and adopted at an early age by nonrelatives. The genetic and environmental backgrounds of the adoptees were classified by the exact procedures calibrated by discriminant analysis in the original study. Results: Both type 2 and severe type 1 alcoholism were confirmed as independently heritable forms of alcoholism in male adoptees. The lifetime risk of severe alcoholism was increased 4-fold in adopted men with both genetic and environmental risk factors characteristic of type 1 alcoholism compared with the others (11.4% vs 3.0%). Neither genetic nor environmental risk factors for type 1 alcoholism by themselves were sufficient to cause alcoholism. In contrast, the risk of type 2 alcoholism was increased 6-fold in adopted sons with a type 2 genetic background compared with others, regardless of their postnatal environment (10.7% vs 2.0%). The sons with a type 2 genetic background in the replication sample had no excess of type 1 alcoholism, and vice versa. There was no increased risk of mild abuse in adopted men regardless of their genetic or environmental background. Conclusion: Type 1 and type 2 alcoholism are clinically distinct forms of alcoholism with causes that are independent but not mutually exclusive. References 1. Cloninger CR, Bohman M, Sigvardsson S. Inheritance of alcohol abuse: cross-fostering analysis of adopted men . Arch Gen Psychiatry . 1981;38:861-868.Crossref 2. Bohman M, Sigvardsson S, Cloninger CR. Maternal inheritance of alcohol abuse: cross-fostering analysis of adopted women . Arch Gen Psychiatry . 1981;38:965-969.Crossref 3. Cloninger CR, Bohman M, Sigvardsson S, von Knorring A-L. Psychopathology in adopted-out children of alcoholics: the Stockholm Adoption Study . Recent Dev Alcohol . 1985;3:37-51. 4. Bohman M, Cloninger CR, von Knorring A-L, Sigvardsson S. An adoption study of somatoform disorders, III: cross-fostering analysis and genetic relationship to alcoholism and criminality . Arch Gen Psychiatry . 1984;41:872-878.Crossref 5. Roe A, Burks B. Adult adjustment of foster children of alcoholic and psychotic parentage and the influence of the foster home . In: Memoirs of the Section on Alcohol Studies . New Haven, Conn: Yale University; 1945. 6. Goodwin DW, Schulsinger F, Moeller N, Hermansen L, Winokur G, Guze SB. Drinking problems in adopted and non-adopted sons of alcoholics . Arch Gen Psychiatry . 1974;31:164-169.Crossref 7. Kaij L. Alcoholism in Twins: Studies on the Etiology and Sequels of Abuse of Alcohol . Stockholm, Sweden: Almqvist & Wiksell; 1960. 8. Kaij L. Biases in a Swedish social register of alcoholics . Soc Psychiatry . 1970;5:216-218.Crossref 9. Ojesjo L. Prevalence of known and hidden alcoholism in the revisited Lundby population . Soc Psychiatry . 1980;15:81-90.Crossref 10. Committee on Nomenclature and Statistics, American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Third Edition . Washington, DC: American Psychiatric Association; 1980. 11. Searles JS. The role of genetics in the pathogenesis of alcoholism . J Abnorm Psychol . 1988;97:153-167.Crossref 12. Murray RM, Clifford CA, Gurling HMD. Twin and adoption studies: how good is the evidence for a genetic role? Recent Dev Alcohol . 1983;1:25-48. 13. Littrell J. The Swedish studies of the adopted children of alcoholics . J Stud Alcohol . 1988;49:491-515. 14. Gilligan SB, Reich T, Cloninger CR. Etiologic heterogeneity in alcoholism . Genet Epidemiol . 1987;4:395-414.Crossref 15. Gilligan SB, Reich T, Cloninger CR. Alcohol-related symptoms in heterogeneous families of hospitalized alcoholics . Alcohol Clin Exp Res . 1988;12:671-678.Crossref 16. Cloninger CR, Sigvardsson S, von Knorring A-L, Bohman M. The Swedish studies of the adopted children of alcoholics: reply to Littrell . J Stud Alcohol . 1988;49:516-521. 17. Babor TF, Hofmann M, DelBoca FK, Hesselbrock V, Meyer RE, Dolinsky ZS, Rounsaville B. Types of alcoholics, I: evidence for an empirically derived typology based on indicators of vulnerability and severity . Arch Gen Psychiatry . 1992;49:599-608.Crossref 18. Nordstrom G, Berglund M. Different patterns of successful long-term adjustment in genetically defined subtypes of alcoholics . Alcohol Alcohol . 1987; (suppl 1) :401-405. 19. Litt MD, Babor TF, DelBoca FK, Kadden RM, Cooney NL. Types of alcoholics, II: application of an empirically derived typology to treatment matching . Arch Gen Psychiatry . 1992;49:609-614.Crossref 20. Von Knorring L, von Knorring A-L, Smigan L, Lindberg U, Edholm M. Personality traits in subtypes of alcoholics . J Stud Alcohol . 1987;48:523-527. 21. Cloninger CR. Neurogenetic adaptive mechanisms in alcoholism . Science . 1987;236:410-416.Crossref 22. Von Knorring A-L, Bohman M, von Knorring L, Oreland L. Platelet MAO activity as a biological marker in subgroups of alcoholism . Acta Psychiatr Scand . 1987;72:51-58.Crossref 23. Sigvardsson S. Alcohol Abuse and Criminality: A Cross-fostering Study of Gene-Environment Interaction. Umeå, Sweden: Umeå University; 1982. Dissertation. 24. SPSS Inc. Statistical Package for the Social Sciences for Personal Computers (SPSS/PC): Version 4.0. Chicago, Ill: SPSS Inc; 1989. 25. SAS Institute Inc. SAS Technical Report P-229, SAS/STATSoftware: Changes and Enhancements, Release 6.07. Cary, NC: SAS Institute Inc; 1992. 26. Cloninger CR, Sigvardsson S, Bohman M (1988). Childhood personality predicts alcohol abuse in young adults . Alcohol Clin Exp Res . 1988;12:494-505.Crossref 27. Cloninger CR, Sigvardsson S, Przybeck TR, Svrakic DM. Personality antecedents of alcoholism in a national area probability sample . Eur Arch Psychiatry Clin Neurosci . 1995;245:239-244.Crossref 28. Cloninger CR. A systematic method for clinical description and classification of personality variants . Arch Gen Psychiatry . 1987;44:573-588.Crossref 29. Sigvardsson S, Bohman M, Cloninger CR. Structure and stability of childhood personality: prediction of later social adjustment . J Child Psychol Psychiatry . 1987;38:929-946.Crossref 30. Tremblay RE, Pihl RO, Vitaro F, Dobkin PL. Predicting early onset of male antisocial behavior from preschool behavior . Arch Gen Psychiatry . 1994;54:732-739.Crossref 31. Wills TA, Vaccaro D, McNamara G. Novelty seeking, risk taking, and related constructs as predictors of adolescent substance use: an application of Cloninger's theory . J Subst Abuse . 1994;6:1-20.Crossref 32. Heath AC, Cloninger CR, Martin NG. Testing a model for the genetic structure of personality: a comparison of the personality systems of Cloninger and Eysenck . J Pers Soc Psychol . 1994;66:762-775.Crossref 33. Svrakic NM, Svrakic DM, Cloninger CR. A general quantitative theory of personality: fundamentals of a self-organizing psychobiological complex . Dev Psychopathol . 1996;8:247-272.Crossref 34. Stallings MC, Hewitt JK, Cloninger CR, Heath AC, Eaves LJ. Genetic and environmental structure of the Tridimensional Personality Questionnaire: three or four primary temperament dimensions? J Pers Soc Psychol . In press. 35. Cloninger CR, Przybeck TR, Svrakic DM. The Tridimensional Personality Questionnaire: U.S. normative data . Psychol Rep . 1991;69:1047-1057.Crossref 36. Svrakic DM, Whitehead C, Przybeck TR, Cloninger CR. Differential diagnosis of personality disorders by the seven-factor model of temperament and character . Arch Gen Psychiatry . 1993;50:991-999.Crossref 37. Cloninger CR. A unified biosocial theory of personality and its role in the development of anxiety states . Psychiatr Dev . 1986;3:167-226. 38. Cloninger CR, Svrakic DM, Przybeck TR. A psychobiological model of temperament and character . Arch Gen Psychiatry . 1993;50:975-989.Crossref 39. Cloninger CR. The psychobiology of social cooperation . Nat Med . 1995;1:623-625.Crossref 40. Cloninger CR, Adolfsson R, Svrakic NM. Mapping genes for human personality . Nat Genet . 1996;12:3-4.Crossref 41. Pickens RW, Svikis DS, McGue M, Lykken DT, Heston LL, Clayton PJ. Heterogeneity in the inheritance of alcoholism: a study of male and female twins . Arch Gen Psychiatry . 1991;48:19-28.Crossref 42. Kendler KS, Neale M, Heath AC, Kessler RC, Eaves LJ. A twin-family study of alcoholism in women . Am J Psychiatry . 1994;151:707-715.

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Aug 1, 1996

References