Are There Really Type A and Type B Alcoholics?
Addiction specialists and researchers know that alcoholism does not manifest in the same way in all affected individuals. In the 1990s, a researcher named Thomas F. Babor proposed a classification system that divides alcoholics into two main groups, known as Type A alcoholics and Type B alcoholics, based on several underlying criteria. In a study published in May 2014 in the journal Drug and Alcohol Dependence, researchers from the Public Health Institute and the University of California, San Francisco used data drawn from a nationwide project called the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to help determine if Type A and Type B alcoholics exist in real life.
Alcoholism is the commonly used term for the combination of a physical dependence on the continued consumption of alcoholic beverages and a number of damaging internal and behavioral changes that typically accompany alcohol dependence. Alcohol dependence and alcoholism are so closely associated that doctors and other health professionals commonly use the two terms interchangeably. Prior to 2013, the American Psychiatric Association viewed alcoholism/alcohol dependence as distinctly separate from the dysfunctional behavioral patterns found in some people who abuse alcohol but don’t have a physical need to consume alcoholic beverages. However, in May 2013 the organization created a single diagnostic category, called alcohol use disorder, in recognition of the fact that the symptoms of alcoholism and non-dependent abuse often coexist to one degree or another.
Type A and Type B Alcoholism
Alcoholism is not strictly linked to a definitive, underlying cause or group of causes. Instead, the condition may stem from a combination of factors that differs substantially from person to person. Broadly speaking, some of these factors have a primarily hereditary component that may include complex interactions between a large number of genes in any given individual. Other factors have a primarily environmental component that can include one or more of a wide range of personal, family-related, social, cultural or ecological influences. The classification system proposed by Dr. Babor separates cases of alcoholism primarily associated with hereditary factors from cases of alcoholism primarily associated with environmental factors. Environment-based forms of alcoholism fall under the heading of Type A alcoholism, which typically arises later in life. Genetics-based forms of alcoholism fall under the heading of Type B alcoholism, which typically arises fairly early in life. Babor’s theory also holds that Type B alcoholism tends to have a greater adverse impact than Type A alcoholism.
Do the Types Really Exist?
The National Epidemiologic Survey on Alcohol and Related Conditions was conducted in the early 2000s in order to give public health officials a better understanding of the nationwide impact of problematic alcohol consumption, as well as a better understanding of the issues that can simultaneously appear in individuals affected by alcohol-based issues. In the study published in Drug and Alcohol Dependence, the University of California and Public Health Institute researchers used information gathered from 1,172 NESARC participants to determine if it’s really possible to divide people affected by alcoholism along the lines of Dr. Babor’s Type A/Type B scheme. They also sought to determine if use of the scheme can help doctors and public health officials predict which individuals will develop a diagnosable case of alcoholism in the future.
After reviewing the data, the researchers concluded that real-world cases of alcoholism do indeed fit fairly well into a Type A/Type B arrangement. Specifically, they found that, in comparison to people roughly classifiable as Type A alcoholics, Type B alcoholics have more severe forms of alcohol-related problems. The researchers also found that Type B alcoholics are more likely to have coexisting issues with their physical and mental health, as well as coexisting issues with other forms of substance use/abuse. In addition, when they don’t receive appropriate interventions, people affected by Type B factors have a 100 percent greater chance of developing diagnosable alcoholism within three years. When they do receive appropriate interventions, people affected by Type B factors still have higher chances of developing a diagnosable case of drug addiction and drinking alcohol in excessive amounts.
Significance and Considerations
The authors of the study published in Drug and Alcohol Dependence concluded that the Type A/Type B theory of alcoholism adequately describes the impact of the condition in the general U.S. population. They believe that the development of widespread treatments targeted at Type B traits could substantially help affected individuals during alcoholism recovery. They also believe that widespread Type B screenings could help prevent the onset of alcoholism in large numbers of people.
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