Protecting against long term harm

Risk factors involved in long term harm

The previous section identified the effects of parental alcohol misuse on children. A key issue is where the effects on children lead to long term harm.

It used to be thought that most children, in families where at least one parent misused alcohol, would always suffer long term harm. This was based on accounts from adults who already did have problems. Clearly, if the only adults who one talks to are ones who already have problems, one will conclude that there is a high risk for all those childhood and transitional problems to be carried on to adulthood.

From the 1980s, researchers started to look at a more widespread cross-section of adults whose parents had alcohol misuse problems and the studies set out below found that the risk had been overstated:

In one study 250 young people were interviewed. Their ages were split evenly between 16 and 35, 2/3 of whom had one or more parents with a serious alcohol problem; 1/3 of whom (drawn from the same sources) who did not. Certainly, there were adults who did seem badly affected, but:

- there were many who did not seem to be so badly affected, even if they had had problems in childhood and adolescence
- and much less so if they did not have childhood problems.

Even the ones who were affected, generally had no worse problems than did other people of the same age, even though these other people attributed their problems to different causes.

In 1999, a pilot follow-up of the original ‘offspring’ sample of 164 children of problem drinkers contacted around a fifth of that group and re-interviewed them. 34 interviews were conducted at length, approximately 18 years after their last interview in the early 1980s, with interviewees now aged 35-54 years.

Preliminary analysis suggests that these adults are still experiencing difficulties as a result of their childhood experiences. A detailed examination of eight interviews of women who had a problem drinking father drew the following conclusions:

there was a long-term impact of their father’s drinking
they felt isolated, lacking in support and emotionally alone in their childhood
their experiences continued to affect their relationship with their parents in adulthood, and also impacted on their ability to form close relationships with other people
if the woman was the oldest child, she had tried to adopt a responsible, caring role towards other siblings. This did not always have the desired effect of solving their problems and making them feel better
most are aware of the disruption that the drinking has brought upon their lives and some have taken steps to get over problems and form positive bonding relationships, eg with a partner or their children.

But irrespective of whether the problems continue into adulthood, most children have a bad time of it when they are children. Whilst never pleasant for children, the things that can make the child’s experience even worse and increase the risk of long term harm include:

violence: even if it is not directed at the child
marital conflict: the major concern of the child
separation, divorce and parent loss
inconsistency and ambivalence in parenting

These things lead to greater unpredictability, which leads to many other difficulties:

a deteriorating parent-child relationship
diminishing feelings of self-esteem
feelings of exclusion
social isolation

There are also some elements which are directly related to alcohol misuse which make things worse:

if both parents have an alcohol problem
if the problem drinking occurs in the home