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From the President of the Research Society on Alcoholism On behalf
of the Research Society on Alcoholism, I am pleased to introduce
this thirteenth volume of Recent Developments in Alcoholism about
alcohol and violence. Current concepts are presented in
well-organized sections that - cus on epidemiology, neurobiology,
psychology, and family issues. It is - coming increasingly clear
that age, gender, socioeconomic circumstances, and genetics affect
aggressive behavior and vulnerability to alcoholism. This v- ume
contains up-to-date discussions of these issues. Indeed, the
information presented here will help all alcohol researchers to
identify biological and social factors that contribute to the
comorbidity of alcoholism and aggression. The editors and associate
editors should be congratulated for bringing toge- er such
important information. This volume will be a valuable resource for
investigators and therapists alike. Ivan Diamond M. D. , Ph. D.
President, Research Society on Alcoholism From the President of the
American Society of Addiction Medicine The American Society of
Addiction Medicine is honored to continue its - sponsorship with
the Research Society on Alcoholism of Recent Developmen ts in
Alcoholism. The topic of alcohol and violence is a particularly
timely one, given the growing number of studies that are examining
the relationship between the two. These studies are consistent with
the hypothesis that al- hol can increase aggression and contribute
to both domestic and criminal violence. Intoxicating blood levels
of alcohol have been found to be especially prevalent in those
injured in fights and assaults.
The first three volumes of this series have dealt with materials
which generally justify the title, The Biology of Alcoholism. This
is only remotely true of the present volume, Social Aspects of
Alcoholism, or of the final volume to come, Treatment and
Rehabilitation. Except for small portions of the treatment section
which involve pharmacotherapy, much of these last two volumes deals
with the psychological aspects of alcoholism and still more with
the social. It is interesting to review the evolution of this new
pattern over the past seven years, a pattern which, had it existed
initially, would have resulted, if not in a dif ferent format, at
least in a different title. Our initial selection of areas to be
covered was influenced by our desire to present as "hard" data as
possible, in an attempt to lend a greater aura of scientific rigor
to a field which was generally considered as "soft. " When we
completed our review of this material in volumes 1-3, we recognized
that what we might have gained in rigor, we had more than lost in
completeness. These volumes presented a picture of a biological
disease syndrome for which the remedies and preventive measures
were presumably also biological. And yet, most workers in the field
readily accept the significant contributions of psychological and
social factors to the pathogenesis and treatment of alcoholism."
The first three volumes of this series have dealt with materials
which generally justify the title, The Biology of Alcoholism. This
is only remotely true of the present volume, Social Aspects of
Alcoholism, or of the final volume to come, Treatment and
Rehabilitation. Except for small portions of the treatment section
which involve pharmacotherapy, much of these last two volumes deals
with the psychological aspects of alcoholism and still more with
the social. It is interesting to review the evolution of this new
pattern over the past seven years, a pattern which, had it existed
initially, would have resulted, if not in a dif ferent format, at
least in a different title. Our initial selection of areas to be
covered was influenced by our desire to present as "hard" data as
possible, in an attempt to lend a greater aura of scientific rigor
to a field which was generally considered as "soft. " When we
completed our review of this material in volumes 1-3, we recognized
that what we might have gained in rigor, we had more than lost in
completeness. These volumes presented a picture of a biological
disease syndrome for which the remedies and preventive measures
were presumably also biological. And yet, most workers in the field
readily accept the significant contributions of psychological and
social factors to the pathogenesis and treatment of alcoholism."
From the President of the Research Society on Alcoholism On behalf
of the Research Society on Alcoholism, I am pleased to introduce
this thirteenth volume of Recent Developments in Alcoholism about
alcohol and violence. Current concepts are presented in
well-organized sections that - cus on epidemiology, neurobiology,
psychology, and family issues. It is - coming increasingly clear
that age, gender, socioeconomic circumstances, and genetics affect
aggressive behavior and vulnerability to alcoholism. This v- ume
contains up-to-date discussions of these issues. Indeed, the
information presented here will help all alcohol researchers to
identify biological and social factors that contribute to the
comorbidity of alcoholism and aggression. The editors and associate
editors should be congratulated for bringing toge- er such
important information. This volume will be a valuable resource for
investigators and therapists alike. Ivan Diamond M. D. , Ph. D.
President, Research Society on Alcoholism From the President of the
American Society of Addiction Medicine The American Society of
Addiction Medicine is honored to continue its - sponsorship with
the Research Society on Alcoholism of Recent Developmen ts in
Alcoholism. The topic of alcohol and violence is a particularly
timely one, given the growing number of studies that are examining
the relationship between the two. These studies are consistent with
the hypothesis that al- hol can increase aggression and contribute
to both domestic and criminal violence. Intoxicating blood levels
of alcohol have been found to be especially prevalent in those
injured in fights and assaults.
The previous volume, The Pathogenesis of Alcoholism: Psychosocial
Factors, attempted to describe the interaction of biological,
psychological, and social factors that lead to the initiation and
perpetuation of alcoholism. The preface to that volume presented
our particular view of the bio-. psycho-social interaction as a
progressive process in which earlier developments produce new
pathogenetic mechanisms, which in turn lead to still other cyclical
feedback activities. Although influences from each of the three
phenomenologic levels are at work during each stage of the clinical
course, it would appear that social factors are most significant in
the early phase, psychological factors at the intermediate level,
and biological ones toward the end. These differences are only
relative, however, for influences of all three types surely are
operative during all stages of the syndrome. This appears to be
particularly true for the biological parameters of activity. Don
Goodwin (1976), who has supplied much of the data that support the
role of hereditary factors in alcoholism, is wont to say that all
living behavior is biological-by definition. The operational
evidence for this is perhaps more evident in alcoholism than in
other syndromes. For example, the general social indifference of
many Asians to alcohol may reflect the presence of an atypical
isoenzyme of alcohol dehydrogenase rather than some independently
derived cultural norm.
This volume is the second in "The Downstate Series of Research in
Psychiatry." It is aseries devoted to the presentation of sig
nificant research with relevance for both clinicians and
researchers in the multiple subfields of psychiatry. This book
focuses on the interactions between psychic phenomena and physical
processes as studied by evoked brain potentials. It presents
material concerned with physiological and psychological unifying
processes, as weIl as research concerning technology and methods of
obtaining meaningful measurements. As such it is representative of
biological psychiatry at its best. Thus, it represents another step
in new directions in psychiatric research but not an unanticipated
direction. Scientific investigation into the human psyche took an
unex pected turn when Sigmund Freud in the last part of the 19th
Century turned his attention from neurological concerns to those of
psychol ogy. His first attempts at explanations as noted in the
"project," included a heavy emphasis on the biological substrate of
behavior."
In this volume, the third of our series, the emphasis has shifted
from the theoretical and experimental to the more clinical and
practical aspects of alcoholism. Where, in the earlier volumes,
more attention was directed to animal than human studies, in this
volume, almost all material deals with the human condition. The
clinical manifestations of alcoholism may be divided into two major
aspects, that of the disease itself and that of its complications.
This separation is to some extent artificial since, in a sense, the
natural history of the disease is a function of the development of
certain complicating mechanisms. These mechanisms in turn either
become part and parcel of the underlying condition -alcoholism-or
give rise to a new set of clinical variables characterized as
"medical complications. " At this point, the dichotomy becomes
real. The disease alcoholism tends to be seen as a distinct
psychosocial entity and to be treated with psychosocial techniques.
The "medical complications" are more clearly envisioned as being
within the legitimate domain of medical practice and are treated by
physicians who often tend to ignore the underlying alcoholism. The
"patient" is sometimes lost in between. The major thrust of this
volume is an attempt to describe the mechanisms of alcoholism as
they are now known, in such a way as to establish a continuum
between the disease alcoholism and its "medical complications.
Alcoholism is a uniquely human condition. Although some forms of
alcohol dependence can be induced experimentally in a variety of
laboratory animals, the complete spectrum of alcoholism with all of
its physical, psychological, and social implications occurs only in
man. The special quality of this relationship becomes more
significant when one considers that the manifestations of most
physical disease syndromes in animals and man are more similar than
they are different. The uniqueness of alcoholism lies in the fact
that it is one of the few physical diseases which reflects at all
levels the problems of individuals coping with the complexities of
human society. In order to present a more coherent picture of these
complex relationships, we have attempted to impose a logical
sequence upon the material. This sequence lies along a dual
parameter-from the physical to the social and from the theor etical
to the empirical. Consequently, it was natural for the first volume
in this series to deal with biochemistry, the most basic and
physical aspect of the inter action of alcohol and man. It is
equally natural for this, the second volume, to deal with
physiology and behavior, for these levels of phenomenology-partic
ularly the latter-are already more empirical and psychological in
their mani festations. Finally, the third volume, clinical
pathology, describes the disease itself, with all of the medical
and social implications carried in the word "alcoholism.
This volume provides an in-depth look at the genetic influences
that contribute to the development of alcoholism. Part I:
Epidemiologic Studies contains five chapters that examine the
various approaches employed in the study of the genetics of
alcoholism. It provides a historical perspective and details all
the essentials of this subject. Part II: Selective Breeding Studies
highlights the results of research involving the selective breeding
of rodents. This type of research has produced homogenous strains
exhibiting specific behavioral responses considered significant in
the development and maintenance of alcohol dependence. The studies
presented in Part III: Phenotypic Studies investigate and analyze
phenotypic markers that serve as correlates to the genotypic
determinants of alcoholism. Through its broad scope, this volume
provides for the first time a panoramic view of the knowledge
available on the hereditary influences of alcoholism.
This is a comprehensive review of the pharmacological effects of alcohol and the mechanisms underlying the pathogenesis of alcoholism. The book draws on general pharmacology, neuropharmacology, and alcohol studies to explore its theme. The second volume in the ALCOHOL AND ALCOHOLISM series, it focuses on the pharmacologic mechanisms underlying the development of alcoholism. The first section on basic pharmacology is concerned with those aspects that are common to all of alcohol's effects. These include pharmacokinetics, general metabolism, and cross-tolerance. The second section on neuropharmacology describes the effects of alcohol on various brain functions, including circulation and metabolism. The third section provides an in-depth review of the neurobiology of physical dependence, withdrawal, and physiological tolerance. The book as a whole gives a comprehensive and authoritative picture of the complex pharmacologic actions of alcohol, particularly on the nervous system. For clinicians and researchers in the field of alcohol and alcoholism, it will serve as a fundamental reference.
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