Alcoholism And The Family

323 Pages·1992·10.16 MB·English

by  Satoru Saitoh

The 4th International Symposium of
the Psychiatric Research Institute of Tokyo
ALCOHOLISM
AND
THE FAMILY
Copyrighted Material
The 4th International Symposium
of the Psychiatric Research Institute of Tokyo
Place: Sasagawa Kinen Kaikan
Date: November 21 and 22, 1989
Executive Director: Tsuyoshi ISHII, M.D.
Director, Psychiatric Research Institute of Tokyo
2-1-8 Kamikitazawa, Setagaya-ku, Tokyo 156, Japan
Phone: [phone]
Coordinator: Nobukatsu KATOH, M.D.
Director, Matsuzawa Hospital
2-1-1 Kamikitazawa, Setagaya-ku, Tokyo 156, Japan
Phone: [phone]
Satoru SAITOH, M.D.
Head, Department of Sociopathology
The Psychiatric Research Institute of Tokyo
Organizing Committee: (The Psychiatric Research Institute of Tokyo)
Masato UNO, Director of Research
Shigeo KOSUGI, Director of Administration
Shinsaku KOYANAGI, Director of Technical Division
Kazuya YOSHIMATSU, Head, Department of Social
Psychiatry
Takashi MOROJI, Head, Department of Psychophar-
macology
Shohei OKABE, Head, Department of Clinical Psy
chology
Kenji KOSAKA, Head, Department of Neuropathology
Ken KADOTA, Head, Department of Neurochemistry
Yuji NAKATANI, Department of Sociopathology
Sponsoring Institute: The Psychiatric Research Institute of Tokyo (Tokyo,
Japan)
Copyrighted Material
The 4th International Symposium of
the Psychiatric Research Institute of Tokyo
ALCOHOLISM
AND
THE FAMILY
Edited by
SATORU SAITOH, M.D.
PETER STEINGLASS, M.D.
MARC A. SCHUCKIT, M.D.
Seiwa Shoten, Publishers Brunner/Mazel, Publishers
Tokyo New York
Copyrighted Material
Library of Congress Cataloging-in-Publication Data
Tōkyō-to Seishin Igaku Sōgō Kenkyūjo. International Symposium (4th: 1989: Tokyo,
Japan)
Alcoholism and family / the 4th International Symposium of the Psychiatric
Research Institute of Tokyo; edited by Satoru Saitoh, Peter Steinglass, and Marc
A. Schuckit.
p. cm.
Includes bibliographical references.
Includes index.
ISBN 0-87630-626-1
1. Alcoholism—Congresses. 2. Family—Mental health—congresses.
3. Family psychotherapy—Congresses. I. Saito, Satoru. II. Steinglass,
Peter. III. Schuckit, Marc Alan. IV. Title.
[DNLM: 1. Alcoholism—congresses. 2. family—congresses. 3. Family
Therapy—congresses. WM 274 T646a 1989]
RC563.2.T64 1989
616.86T—dc20
DNLM/DLC 90-2644
for Library of Congress CIP
Japanese edition Copyright © 1989 by Psychiatric Research
Institute of Tokyo
U.S. edition Copyright© 1992 by Psychiatric Research
Institute of Tokyo
All rights reserved. No part of this book may be
reproduced by any process whatsoever without
the written permission of the copyright owners.
Published by
Seiwa Shoten Publishers
1-2-5 Kamitakaido, Suginami-ku
Tokyo, Japan
In collaboration with
BRUNNER/MAZEL, INC.
19 Union Square West
New York, New York 10003
Copyrighted Material
CONTENTS
Preface vii
Contributors viii
Introduction xi
I. GENETIC FACTORS OF ALCOHOLISM 1
1. Alcoholism, A Familial Disorder: Genetic Aspects 3
by Marc A. Schuckit, M.D.
2. CNV of Substance Use Patients with Alcoholic Father 13
by Michihiko Nakamura, M.D.; Kyoko Nishihara,
M.D.; Kiyoshi Nagano, M.D.; Satoru Saitoh, M.D.
3. Drinking Behavior and Lifestyles in Twins 24
by Akio Asaka, M.D.
PART I: Discussion 48
II. GENETIC FACTORS OF ALCOHOLISM:
CLINICAL ASPECTS 57
4. Steps Towards a Classification of Alcoholism: Lessons from
Adoption Studies 59
by Michael Bohman, M.D.; Robert C. Cloninger, M.D.;
Sören Sigvardsson, Ph.D.; Anne-Liis von Knorring,
M.D.
5. Prospective Evidence for the Effects of Environment upon
Alcoholism 71
by George E. Vailiant, M.D.
6. Genetic Polymorphism of Aldehyde Dehydrogenase in
Orientals as a Genetic Marker of a High-Risk
Group of Alcoholism 84
by Shoji Harada, M.D.
PART II: Discussion 90
III. ALCOHOLIC FAMILIES AND MENTAL HEALTH 95
7. International Perspectives on Alcoholism and the Family:
An Overview of WHO Activities 97
by Marcus Grant, Ph.D.
8. The Results of a Survey on Counseling at Public Health
Centers in Tokyo 117
by Eiichi Senoh, M.D.; Sayoko Nobuta, M.A.
V
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vi Alcoholism and the Family
9. Alcoholism and the Native American Family 127
by James O. Whittaker, Ph.D.; Sandra J. Whittaker,
M.A.
PART III: Discussion 140
IV. ALCOHOLISM AND FAMILY MODELS 153
10. Family Systems Approaches to the Alcoholic Family:
Research Findings and Their Clinical Applications
155
by Peter Steinglass, M.D.
11. Therapeutic Control and Therapeutic Impasse: Therapists
"Hitting Bottom" with an Alcoholic Family ... 172
by Naoki Nomura, Ph.D.; Mitsuhiro Ichikawa, M.D.
12. A Cultural Approach to Conceptualizing Alcohol and the
Family 187
by Genevieve M. Ames, Ph.D.
13. Marriage Patterns of Females from Alcoholic Families in
Japan 203
by Satoru Saitoh, M.D.; Anthony Dalby, C.Q.S.W.;
Kiyoshi Nagano, M.D.; Ichiro Tezuka, B.A.; Yuji
Noguchi, Ph.D.
PART IV: Discussion 221
V. THERAPEUTIC APPROACHES TO
THE ALCOHOLIC FAMILY 229
14. Our Experiences in Family Therapy 231
by Motoi Hayashida, M.D., Sc. D.
15. Treatment of Psychiatric Illness in Adolescents with Alco
holic Parents 241
by Kenji Suzuki, M.D.; Hiroaki Kohno, M.D.
16. Therapeutic Effects of Counseling on Wives of Alcoholics 254
by Michio Takemura, M.D.; Yuko Endo, B.A.
17. Psychotherapeutic Treatment of Alcoholic Families: Broad-
Spectrum Intervention 266
by Kazumi Nishio, Ph.D.
18. Effects of Family Alcoholism 272
by Claudia Black, M.S.W., Ph.D.
PART V: Discussion 282
Name Index 297
Subject Index 302
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PREFACE
The science of the etiology and treatment of alcoholism has made notable
progress in recent years. Since the early 1970s there have been growing in
roads made concerning the relevance of hereditary factors in alcoholism. This
has led to the presentation of various innovative hypotheses in this field. In
conjunction with this there has been much discussion and study of the "al
coholic personality" and its possible characteristics. These may be considered
the "longitudinal aspects" linked to the transmission of alcoholism.
However, there is yet another vital area, which may be considered the
"horizontal aspect," i.e., the way in which communication patterns within
the family, or their cultural backgrounds, contribute to both the maintenance
of family homeostasis and the possibility of the intergenerational transmis
sion of alcoholism. These studies have not only revealed the so¬
cio/interactional dynamics of the alcoholic family in both their "wet" and
"dry" stages, but also offered significant implications for family treatment
of the alcoholic family.
In Japan the problem of alcoholism had received only scant attention up
to the mid-1970s, when the issue of housewives' alcoholism in the home hit
the headlines. Nowadays, the Japanese cannot afford to ignore drinking
problems within their society. The pure alcohol equivalent consumed annu
ally by adults in Japan amounts to an average 6-7 liters per capita; 2-3%
of adults are estimated to be alcoholics, with a present male/female ratio
of 10:1.
This international symposium, sponsored by the Psychiatric Research In
stitute of Tokyo on November 21-22, 1989, brought together researchers en
gaged in both of the above areas, in order to create an open forum for both
the exchange of new information and to act as a catalyst stimulating further
innovative studies in this field.
Tsuyoshi Ishii
Director, Psychiatric Research Institute of Tokyo
Executive Director of the International Symposium
Nobukatsu Katoh
Director, Tokyo Metropolitan Matsuzawa Hospital
Head of the International Symposium Committee
Satoru Saitoh
Head, Department of Sociopathology Psychiatric Research Institute of Tokyo
Secretariat Director
vii
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CONTRIBUTORS
AMES, Genevieve M., Ph.D. GRANT, Marcus, Ph.D.
Study Director and Senior Research Scientist Senior Scientist
Prevention Research Center Division of Mental Health
Pacific Institute for Research and Evaluation WHO
2532 Durant Avenue 1211 Geneva
Berkeley, CA 94704 27 - Switzerland
U.S.A.
HARADA, Shoji, M.D.
ASAKA, Akio, M.D. Institute of Community Medicine
Professor University of Tsukuba
Yamanashi Medical College Tennodai, Tsukuba
1110 Shimokato Tamaho-cho Ibaraki 305
Nakakoma-gun, Yamanashi 409-38 Japan
Japan
HAYASHIDA, Motoi, M.D. Sc.D.
BLACK, Claudia, M.S.W., Ph.D. Philadelphia V.A. Medical Center
1590 South Coast Hwy University of Pennsylvania
Suite #17 Philadelphia, PA 19104
Laguna Beach, CA 92651 U.S.A.
U.S.A.
ICHIKAWA, Mitsuhiro, M.D.
BOHMAN, Michael, M.D. Narimasu Kohsei Hospital
Professor 1-19-1 Misono
The Department of Child and Youth Psychiatry Itabashi-ku
Ume University, S-901 87 Ume , Sweden Tokyo 175
Japan
CLONINGER, Robert C, M.D.
The Departments of Psychiatry and Genetics ISHII, Tsuyoshi, M.D.
Washington University School of Medicine and Director
Jewish Hospital Psychiatric Research Institute of Tokyo
216 South Kingshighway Blvd. 2-1-8 Kamikitazawa, Setagaya-ku
St. Louis, MO 63130 Tokyo 156
U.S.A. Japan
DALBY, Anthony, C.Q.S.W. KATOH, Nobukatsu, M.D.
Department of Sociopathology Director
Psychiatric Research Institute of Tokyo Metropolitan Matsuzawa Hospital
2-1-8 Kamikitazawa, Setagaya-ku 2-1-1 Kamikitazawa, Setagaya-ku
Tokyo 156 Tokyo 156
Japan Japan
ENDO, Yuko, B.A. VON KNORRING, Anne-Liis, M.D.
Chief The Department of Child and Youth Psychiatry
Harajuku Counseling Room Umed University
Affiliated to the Clinical Institute on Addiction S-901 87 Umed
Problems (CIAP) Sweden
4-30-2 Jingu-mae
Shibuya-ku
Tokyo 150
Japan
viii
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Contributors ix
KOHNO, Hiroaki, M.D. NOGUCHI, Yuji, Ph.D.
Director Department of Sociology
National Institute on Alcoholism Tokyo Metropolitan Institute of Gerontology
National Kurihama Hospital 35-2, Sakae-cho
2769 Nobi Itabashi-ku
Yokosuka-shi 239 Tokyo 173
Japan Japan
NAGANO, Kiyoshi, M.D. NOMURA, Naoki, Ph.D.
Department of Sociopathology Department of Sociopathology
Psychiatric Research Institute of Tokyo Psychiatric Research Institute of Tokyo
2-1-8 Kamikitazawa, Setagaya-ku 2-1-8 Kamikitazawa, Setagaya-ku
Tokyo 156 Tokyo 156
Japan Japan
NAKAMURA, Michihiko, M.D. SAITOH, Satoru, M.D.
Associate Professor Head, Department of Sociopathology
Department of Psychiatry Psychiatric Research Institute of Tokyo
Kyoto Prefectural University of Medicine 2-1-8 Kamikitazawa, Setagaya-ku
465 Kajii-cho Tokyo 156
Kawaramachi dori Japan
Hirokoji agaru
Kamigyo-ku SCHUCKIT, Marc A., M.D.
Kyoto 602 Director
Japan Alcohol Research Center
San Diego Veterans Affairs Medical Center and
NISHIHARA, Kyoko, M.D. Professor of Psychiatry
Department of Psychophysiology University of California, San Diego, School of
Psychiatric Research Institute of Tokyo Medicine
2-1-8 Kamikitazawa San Diego, CA 92161
Setagaya-ku U.S.A.
Tokyo 156
Japan SENOH, Eiichi, M.D.
Hasegawa Hospital
NISHIO, Kazumi, Ph.D. 2-20-36 Ohsawa
Santa Rosa Institute Mitaka-shi
2455 Bennett Valley Road Tokyo 181
Santa Rosa, CA 95404 Japan
U.S.A.
SIGVARDSSON, Soren, Ph.D.
NOBUTA, Sayoko, M.A. The Department of Child and Youth Psychiatry
Harajuku Counseling Room Ume University
Affiliated to the Clinical Institute on Addiction S-901 87 Umea
Problems (CIAP) Sweden
4-30-2 Jingu-mae
Shibuya-ku STEINGLASS, Peter, M.D.
Tokyo 150 Director
Japan Ackerman Institute for Family Therapy
149 E. 78th Street
New York, NY 10021
U.S.A.
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