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A commonly cited alcoholism typology, the type ! type II typology, was developed from the findings of a study of Swedish adoptees and their biological and adoptive parents. Type I alcoholism affects both men and women, requires the presence of a genetic as well as an environmental predisposition, commences later in life after years of heavy drinking, and can take on either a mild or severe form. Type ll alcoholism, in contrast, affects mainly sons of male alcoholics, is influenced only weakly by environmental factors, often begins during adolescence or early adulthood, is characterized by moderate severity, and usually is associated with criminal behavior. Additional studies have demonstrated that type I and type II alcoholics also differ in characteristic personality traits (e.g., harm avoidance and novelty seeking) as well as in certain neurophysiological markers. A replication study with a second group of Swedish adoptees has confirmed many of the findings of the original adoption study.
KEY WORDS: AOD dependence; disorder classification; Cloninger s typology; adoption study; Sweden; comparative study; hereditary factors; environmental factors; personality trait; criminality; age
A vast number of alcoholisml typologies have been developed during the past one-and-a-half centuries. Equally diverse are the factors used to distinguish between different alcoholism subtypes within these various typologies. These factors include personality characteristics, coexisting psychiatric disorders, gender, and alcohol consumption patterns (for review, see the article by Babor, pp. 6-14.). One frequently cited typology resulted from a study of alcoholism and other relevant characteristics in a large number of Swedish adoptees and their biological and adoptive parents. This typology distinguishes alcoholics according to the inheritance patterns of their alcoholism (i.e., whether the involved genes are passed on primarily from father to son or from both parents to both sons and daughters) and the relative contributions of genetic and environmental factors to the individual's susceptibility for developing the disease (Cloninger et al. 1981). The two subtypes identified in this typology are called type I (milieu-limited) and type II (male-limited) alcoholism.
This article reviews the findings of the Stockholm adoption study on which this typology was based and summarizes characteristics of both type I and type II alcoholics as identified in these and subsequent analyses. Finally, the article presents data from a recent replication of the Stockholm adoption...