The Natural History of Alcoholism Revisited
This text, first published in 1983, examines the questions of whether alcoholism is a symptom or a disease, whether it is progressive, whether alcoholics differ from others before the onset of their alcoholism, and whether alcoholics can safely drink. Based on an evaluation of more than 600 individuals followed for over 40 years, Vaillant's original study offered new and authoritative answers to all of these questions. In this updated version Vaillant returns to the same subjects with the perspective gained from 15 years of further follow-up. Alcoholics who had been studied to age 50 in the earlier book have now reached age 65 and beyond, and Vaillant reassesses current knowledge of alcoholism in light of both their experiences and the many new studies of the disease by other researchers. The result is a sharper focus on the nature and course of this disorder as well as a sounder foundation for the assessment of various treatments. This book was awarded the biennial Jellinek Memorial Fund prize for the best research on alcohol abuse in the world.
- Hardback | 462 pages
- 168.1 x 241.8 x 27.9mm | 712.15g
- 27 Jun 1995
- HARVARD UNIVERSITY PRESS
- Cambridge, Mass, United States
- 2nd Revised edition
- 14 line illustrations, 82 tables
In alcoholism research, where one side regularly parades a new study and the other then vilifies it, Dr. Vaillant's work can be cited approvingly by both. Not since Jellinek's "The Disease Concept of Alcoholism," published in 1960, has there been a wiser, more comprehensive book on alcoholism. -- Donald Goodwin, M.D. "American Journal of Psychiatry" ï¿½Aï¿½ remarkable achievement...For anyone who teaches courses or conducts research on alcohol problems and for practitioners who work with alcohol-dependent clients, this book is essential. -- C. Aaron McNeece "Social Work" Important and thought-provoking...Anybody who reads this journal should read this book if they have not done so already...In the detail of its arguments as much as in the wealth of its data, this book goes beyond simplistic theories about alcoholism to paint a picture of a diverse, often highly distressing, disorder. -- Richard Hammersley, Ph.D. "Journal of Studies on Alcohol" This is an excellent review and update of past and current thinking about alcoholism. The author uses the full text of his original outstanding work published in 1983 as the background for a presentation of all the research and clinical experience that has taken place in the ensuing almost 15 years. The result is a clear picture of how the thinking in the alcoholism field has progressed, which controversies have been more or less resolved, and where the new clinical developments are heading. -- William E. Flynn, M.D. "Academic Medicine" Vaillant addresses a number of important issues and questions, which are core prerequisites for achieving more precise knowledge about the causes and consequences of alcohol abuse and dependence...These important issues have been reexamined in a thoughtful and scholarly manner. Dr. Vaillant has added new survey data and information to his current text, and he has also expanded and revised his original interpretations. New and original material is based upon scientific information acquired since publication of the original report...This is an outstanding and highly recommended text for medical students and medical educators. It will be especially helpful to practitioners in virtually every field of medicine who treat patients with alcohol-related problems. -- Jack H. Mendelson, M.D. "Journal of the American Medical Association" [A] remarkable achievement...For anyone who teaches courses or conducts research on alcohol problems and for practitioners who work with alcohol-dependent clients, this book is essential. -- C. Aaron McNeece "Social Work" "The Natural History of Alcoholism Revisited" is a revised and updated version of [what] was, and still is, regarded as a classic and certainly broke new ground during the 1980s...The new text provides an update based on developments over the past 15 years; and its importance again derives from the fact that almost all the alcohol abusers identified in the first version have been followed up for an additional 15 years to make 50 years in all. It goes without saying that 50-year follow-up studies are few and far between...Vaillant's 50-year follow-up now stands as a milestone within the addiction literature...It is required reading...The data are beautifully presented and described and the conclusions eminently reasonable. -- John B. Davies "Times Higher Educational Supplement"
Table of contents
The Problem; The Problem Revisited; The Seven Questions; The Questions Revisited. Part 1 What is Alcoholism?: Is Alcoholism a Unitary Disorder?, Empirical Evidence; The Etiology of Alcoholism - Cultural Factors, Genetic Factors, Genetic Factors Revisited, Childhood Environment, Personality and Premorbid Emotional Stability, Anxiety and Alcohol Abuse, Anxiety and Alcohol Abuse Revisited, Depression and Alcohol Abuse, Depression and Alcohol Abuse Revisited, Sociopathy and Alcohol Abuse Revisited, A Case Example, Other Etiological Factors, Conclusions; The Natural History of Alcoholism - Alcoholism in Women Revisited, Patterns of Alcohol Use among the Core City and College Men, Groups IV and V Revisited, Comparison of the College and Core City Samples to a U.S. Sample, Prevalence of Alcohol Abuse Revisited, Patterns of Alcohol Abuse and Mental Health, Patterns of Alcohol Abuse and Physical Health, Coronary Heart Disease Revisited, The Safe Limits of Alcohol Consumption, The Natural History of Treated and Untreated Alcoholism, The Natural History of Alcoholism Revisited, The Core City Sample, The Core City Sample Revisited, Is Alcoholism a "Progressive Disease"?, Table 3.9 Revisited, A Multifaceted Disease, Progression Revisited, The Problem of the Atypical Alcoholic, The Natural History of Treated Alcoholism, Alcoholism and Morbidity, Mortality Revisited, Hypertension and Alcohol Abuse, Prognosis, Habit Addiction, and Relapse. Part 2 Patterns of Recovery: Paths into Abstinence - Definition of Abstinence, 'Abstinence" Revisited, Etiology of Abstinence, Stable Abstinence Revisited, The Relationship of Alcoholics Anonymous to Abstinence, Alcoholics Anonymous Revisited, The Consequences of Abstinence, The Consequences of Abstinence Revisited; Return to Asymptomatic Drinking - Asymptomatic Drinking Revisited, Case Histories, Return to Controlled Drinking Revisited, Social Environment, Behavioural Training Revisited, Conclusion. Part 3 Methodology: The Sample - The College Sample, The Core City Sample, Comparison of the Two Samples; The Measures - Childhood Premorbid Variables, Midlife Outcome Variables, Attrition, Limitations. Part 4 Lessons for Treatment: The Doctor's Dilemma - The Clinic Sample as an Illustration of the Dilemma, Natural Healing Forces in Alcoholism, Resolution of the Dilemma, Alcoholism Treatment Revisited; Suggestions for Would-Be Helpers - Pharmacotherapy and Psychotherapy Revisited, Additional Guidelines; Summing Up - Alcoholism: Symptom or Disease?, Symptom or Disease Revisited, Is Alcoholism a Progressive Disease?, Are Alcoholics Premorbidly Different?, Is the Cure Worse Than the Disease?, Can "Real" Alcoholics Ever Safely Drink Again?, Abstinence versus Controlled Drinking Revisited, Which Clinic Treatments Help?, Clinic Treatment Revisted, Behavioural Approaches Revisited, Is Recovery through AA the Exception or the Rule?, A Final Reminder. Appendix: