Typology of alcoholism and its impact on the course of treatment of alcoholic outpatients

Paul W. O'Neil (1993)

An examination into the field of alcoholism reveals a paucity of research into typology and the course of alcoholism treatment. Furthermore, there is a lack of studies which include outpatients and females. The purpose of this study was to investigate the effect of the type of alcoholism on the course of outpatient alcoholism treatment. Specifically, two types of alcoholism as formulated by Cloninger (1987), and Cloninger, Bohman, and Sigvardsson (1981) were examined. Type I is characterized by a late onset of alcoholism, with little or no previous treatment attempts, parental alcoholism, and no history of antisocial behavior. Type II, conversely, is described as having an early onset of alcoholism, previous treatments, father only alcoholism, and antisocial tendencies. It is believed that if the heterogeneity of alcoholism as manifested in the different types could be discerned, this would impact the course of treatment. The following hypotheses were formulated: Type I alcoholics would be abstinent more often than Type II alcoholics; Type I alcoholics would lapse less than Type II alcoholics; Type I alcoholics would relapse less than Type II alcoholics; Type I alcoholics would remain in treatment longer than Type II alcoholics. In order to test these hypotheses, a sample of 64 outpatients' records were examined. The Appleton Drug/Alcohol Data Base and the Michigan Alcoholism Screening Test (MAST) were the instruments used. The hypotheses, however, were not supported. This was primarily due to subject characteristics that differed from the literature defined typology. The implications of this study will be to highlight the importance of typology and heterogeneity of alcoholism which the author believes will lead to a more insightful and efficacious treatment of alcoholism. In addition, the reasons why the hypotheses were not supported and ideas for future research are also discussed.