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Purpose: Evidence shows that parental alcohol problems are associated with increased risk for early trauma and for alcohol problems in offspring (e.g., Anda et al., 2002). There is little research to date on the influence of early trauma and parental help-seeking and treatment for alcohol problems on help-seeking, treatment, and treatment outcome among offspring. Using data from a family study of alcohol dependence, we examined the associations of early trauma and parental help-seeking and treatment with offspring help-seeking and treatment and offspring treatment outcome.
Method: Data are from the Collaborative study for the Genetics of Alcoholism (COGA), a high-risk family study of alcohol dependence conducted at six centers around the United States. Probands were recruited from treatment settings and were required to have at least two first-degree relatives available for study. All subjects were assessed for alcohol dependence using the Semi-Structured Assessment for the Genetics of Alcoholism (Bucholz et al., 1994), which also included items about help-seeking, treatment utilization, alcohol use. Items on childhood physical and sexual abuse were included at only 2 COGA sites. We use data from 551 siblings of probands (59% female) and 207 probands (29% female) who participated in the trauma section of the interview. Information about parental help-seeking and treatment was taken from interviews directly with parents. All regressions included controls for proband status and gender and standard errors were corrected for familial clustering.
Results: Parental treatment for alcohol problems and early trauma were each associated with more help-seeking and treatment among offspring in univariate models, but early trauma outweighed the influence of parental treatment in mulivariate models. Parental help-seeking had no association with offspring help-seeking or treatment. Individuals who participated in self-help programs like Alcoholics Anonymous, either as the sole treatment method or combined with professional treatment, maintained longer periods of continuous abstinence from alcohol and had fewer relapses than individuals with no treatment or with professional treatment only. Early trauma moderated the influence of professional + self-help treatment such that individuals with histories of early trauma had more relapses and shorter periods of continuous abstinence than individuals without trauma histories. Parental help-seeking and treatment had no association with offspring treatment outcome.
Conclusions: In families at high risk for alcohol dependence, early trauma predicts treatment and moderates treatment outcome, while parental help-seeking and treatment have no or only minimal influence. Future research should account for age at parental help-seeking, since earlier age at parental help-seeking might be associated with a change in the early family environment (e.g., trauma), and with earlier help-seeking or more successful treatment outcome in offspring.