The child is a father to man...

Risk and Resilience, adults who were the children of problem drinkers,
by Richard Velleman and Jim Orford.
Harwood Academic Publishers

As the title of this book implies there are two ways to view the consequences of problem drinking on children We can focus on the increased risk of negative outcomes for offspring of problem drinkers compared to children whose parents do not have a drink problem. Alternatively we can focus on their resilience and on the fact that the majority of offspring of problem drinking parents do not experience the negative outcomes despite their increase in risk, on their resilience. For example, offspring of parents with drinking problems are at increased risk of excessive alcohol and other drug use as young adults, but only a minority are affected in this way.

This book reports results from a study of young adults in the South-West of England who had a parent who was a problem drinker, The sample consisted of 164 offspring of problem drinkers aged 16-35 and a comparison group of 80 matched for age and sex. The subjects were volunteers recruited from variety of sources either through advertising (media, firms, colleges) or agencies (health, social services, self-help groups). The authors find that the offspring of problem drinkers are at risk of a range of emotional, conduct, educational, and friendship problems in childhood and adolescence, whilst they are living at home. Such results have been widely reported by other studies, but this study suggests that it is only those children who experience disharmonious relationships within he family who are at greater risk.

The main conclusion of this study is that despite negative outcomes in childhood, many offspring of problem drinkers escaped negative consequences in early adulthood. Contrary to expectation, it was not the case that the offspring had poorer mental health as young adults or reported greater anxiety or dissatisfaction with life than the comparison group. Their lives on average were no less stable than those in the comparison group in terms of home, close relationships, friendships work or education, although they were more likely to have left home at an earlier age and to smoke or drink heavily themselves.

From the qualitative information given by those interviewed, the authors studied the characteristics of those who have shown resilience in the face of a stressful childhood with a problem drinking parent. In these cases the protective factors include external social support from schools or extended family members, a career, and above all a supportive adult relationship.

Without detracting from the importance of the negative impact of the experience of being brought up by a problem drinker, this book focuses on the variety of outcomes for such children, the coping mechanisms they employ and the positive aspects of their adult lives. Children are resourceful in their capacity for survival and indeed can gain strength from such adverse experiences in their formative years. As one subject says, "It's all part of the learning process". Indeed an awareness of the problems that alcohol abuse can bring to family members can itself become a protective factor against future transmission. One question that remains is whether the coping mechanisms that children employ have their cost in later, middle life.

Margaret Ely

Margaret Ely is a researcher with the MRC National Survey for Health and Development, Department of Epidemiology and Public Health, University College London Medical School.