Assessing and tracking family histories of alcoholism.

OBJECTIVE: This study sought to (1) determine the rates of family history of alcoholism among a community sample, using both specific questions and structured interviews, (2) document conversions from negative (FH-) to positive (FH+) alcoholism diagnoses among parents and grandparents of subjects, and (3) investigate the concordance between interview and questionnaire methods in assessing alcoholism in family members. METHOD: Information concerning alcoholism among relatives of a sample of 1,201 (620 female) probands was gathered longitudinally over a 13-year period, spanning adolescence into adulthood. At Times 1 through 3 of the study, information was gleaned from personal interviews with subjects, medical health forms and information from subjects' parents, which was used to determine a "best estimate diagnosis." At Time 4, the Family History Research Diagnostic Criteria (FH-RDC) interview was used. RESULTS: The number of subjects having an alcoholic relative increased at each test time with the largest rise occurring at Time 4. Over 80% of subjects whose parent converted to FH+ at Time 4 had previously described that parent as a heavy or problem drinker. CONCLUSIONS: The higher than previously seen escalation in FH+ status occurring at Time 4 is speculated to be the result of one or more of the following: an actual increase in the number of relatives becoming alcoholic, a newfound awareness on the part of probands about alcohol-related problems, the fact that a global judgment or single behavior observation provides an inadequate indication of familial alcoholism, or that the FH-RDC may include a more global measure of "alcohol-related problems" or "problem drinking."