Cognitive Impairment in Children of Alcoholics

ing • Adopted COAʼs have poorer ability (Ref. 1) and Planning • Alcoholic COAʼs (vs. FHN alcoholics) have poorer ability (Refs. 1,3,4) • Generally, COA-FHN differences are relatively small but are present (Refs. 2–4) 1The findings are presented for COAʼs compared with family history-negative subjects except where indicated. SOURCES: References (1) Tarter et al. 1990; (2) Sher 1991; (3) Pihl et al. 1990a; (4) Hesselbrock et al. 1991. Despite the general patterns described above, inconsistencies exist among individ­ ual studies in the findings of cognitive deficits of COA’s. These inconsistencies may be due in part to differences in subjects used. For example, the subjects’ early use of alcohol, coexisting psychological and medical condi­ tions, and family histories sometimes are documented inadequately. Subjects may be misclassified as COA’s or FHN’s because they either do not know relevant information about their families’ drinking histories or are not forthcoming with it (Schuckit et al. 1995). Subgroups of COA’s—for example, males or females—within risk categories also must be considered. Finally, the selection of sub­ jects may affect study outcome: Recruiting subjects among university students likely excludes COA’s or SOMA’s with severe cognitive deficits (e.g., Sher et al. 1991). The test measures employed to assess cognitive functions also may contribute to inconsistencies or misinterpretations of study results. Many cognitive/neuropsychological tests assess only very general mental skills. These skills, in turn, require several separate underlying skills, which may not be distin­ guishable in the general tests. Thus, a subject may have one very specific cognitive deficit— for example, poor concentration skills— which affects his or her responses on a variety of tests that require concentration as well as other abilities. Consequently, the subject appears to have far­ranging deficits when in fact only one skill is impaired. Future studies therefore should assess not only general mental abilities but also more specific cogni­ tive functions.