Type I and Type II Alcoholism: An Update

A number of alcoholism1 ty­ ative contributions of genetic and en­ coholic: Environmental factors also pologies have been developed vironmental factors to the individual’s play a role in establishing a person’s during the past one­and­a­half susceptibility for developing the disease susceptibility to alcoholism (Kaij 1960). centuries. Equally diverse are the fac­ (Cloninger et al. 1981). The two sub­ To investigate the relative contributions tors used to distinguish between differ­ types identified in this typology are of genetic and environmental factors to ent alcoholism subtypes within these called type I (milieu­limited) and type the development of alcoholism in more various typologies. These factors in­ II (male­limited) alcoholism. detail, Cloninger and colleagues (1981) clude personality characteristics, co­ This article reviews the findings of studied a sample of 862 male Swedish existing psychiatric disorders, gender, the Stockholm adoption study on which adoptees. This study population com­ and alcohol consumption patterns (for this typology was based and summarizes prised all sons born to single women in review, see the article by Babor, pp. characteristics of both type I and type Stockholm, Sweden, between 1930 and 6–14.). One frequently cited typology II alcoholics as identified in these and 1949 whose fathers were known and resulted from a study of alcoholism and subsequent analyses. Finally, the article who were adopted by nonrelatives at other relevant characteristics in a large presents data from a recent replication of an early age. The investigation also number of Swedish adoptees and their the Stockholm adoption study in a dif­ biological and adoptive parents. This ferent population of Swedish adoptees. C. ROBERT CLONINGER, M.D., is Wallace typology distinguishes alcoholics ac­ Renard Professor of Psychiatry and cording to the inheritance patterns of Genetics and director of the Center their alcoholism (i.e., whether the in­ THE STOCKHOLM for Psychobiology of Personality at volved genes are passed on primarily ADOPTION STUDY the Washington University School of from father to son or from both parents Medicine, St. Louis, Missouri. SÖREN For many years scientists have known to both sons and daughters) and the rel­ SIGVARDSSON, PH.D., is associate pro­ that alcoholism tends to run in families, fessor in the Department of Social Med­ suggesting that inherited characteristics icine and MICHAEL BOHMAN, M.D., is 1The use of the terms “alcoholism” and “alcohol abuse” play a role in its development (Amark frequently overlaps in the alcoholism literature; there­ professor emeritus in the Department fore, the terms are used in this article as they were 1951). Genetic factors alone, however, of Child and Youth Psychiatry, Uni­ used in the original studies cited. cannot determine who becomes an al­ versity of Umeå, Umeå, Sweden.