A social casework contribution to understanding alcoholism.

This article describes a 40-year longitudinal study of alcoholism including the etiology of, progression of, and recovery from the disease. The findings are paralleled with similar studies conducted by social work professionals. The capacity of a longitudinal study to elucidate alcoholism and the recovery process is underscored. The etiological hypothesis that views alcoholism primarily as a symptom of psychological instability is questioned.

Vulnerability to schizophrenia. Prediction of adult schizophrenia using childhood information.

Forty years ago, Glueck and Glueck studied a group of Boston Inner city children to discover factors relating to delinquency. Detailed information was obtained on 1,000 boys aged 10 to 17 years, 500 "delinquents" and 500 "nondelinquent controls." In follow-up studies of this group, we have found that 24 have a diagnosis of adult schizophrenia. We matched these 24 with 48, who had a nonschizophrenic outcome, on the basis of IQ, ethnicity, age at interview, and original Glueck grouping (delinquent or control). The 72 childhood records were then examined on a blind basis by Independent raters looking for predetermined "indicators of vulnerability to schizophrenia." The total indicator scores were able to differentiate schizophrenic outcome from nonschizophrenic outcome at highly significant levels. A number of the individual indicators were likewise able to predict outcome. Prediction was improved when subjects with the lowest IQs (less than 85) were excluded from consideration.

Prospective study of alcoholism treatment. Eight-year follow-up.

One hundred patients admitted for alcohol withdrawal were followed for eight years. At the eight year mark, 25 percent had achieved stable abstinence of three years' duration or more, and 29 percent had died. Only 26 percent experienced continued serious problems with alcohol. Premorbid social stability and sustained abstinence made independent contributions to good psychosocial outcome at eight years. Premorbid social stability and Alcoholics Anonymous attendance made independent contributions to sustained abstinence. Review of these data and other major longitudinal studies suggests that factors other than professionally organized treatment per se exert substantial effect upon long-term outcome.

Natural history of male alcoholism. IV. Paths to recovery.

Four hundred inner-city men were prospectively studied from age 14 until age 47. Of these men, 110 met our research criteria for alcohol abuse; 49 of them achieved at least a year of abstinence. Paradoxically, stable abstinence was associated with severity of alcohol abuse. Abstinence was also associated with finding substitute dependencies, new relationships, "behavior modification," and religious or Alcoholics Anonymous involvement. Clinic treatment and good premorbid adjustment were not predictive of abstinence. Eighteen men were able to return successfully to problem-free drinking. Such men had previously manifested only a few symptoms of alcohol abuse.

Natural history of male psychological health: IX. Empirical evidence for Erikson's model of the life cycle.

The authors examine Erikson's model of the life cycle by reviewing two 40-year prospective studies, one of 392 men from high-crime core-city neighborhoods and the other of 94 successful college students. The empirically defined developmental stage of each man at age 47 and many other facets of each man's life course were rated by judges blind to other data. The studies identified a well-defined, career consolidation stage that falls between Erikson's stages of intimacy and generativity. The results support three hypotheses. First, the stages of men's life cycle must be passed through sequentially; failure to master one stage usually precludes mastery of subsequent stages. Second, the age at which a given stage is mastered varies enormously. Third, the stage attained by middle life appears quite independent of childhood social class or education, although adult maturation is correlated with whether childhood was conducive to basic trust, autonomy, and initiative.