title: Children of alcoholics in Spain: from risk to pathology. Results from the ALFIL program.
abstract: OBJECTIVE
  To identify the possible risk factors and negative outcomes associated with parental alcoholism. A secondary aim was to determine the influence of the family density of alcoholism on children of alcoholics' (COAs) psychological functioning.
  
  
  METHODS
  A multisite epidemiological study was conducted in 8 Spanish cities, recruiting a total sample of 371 COAs (whose parents were in contact with alcohol treatment centers and accepted to participate in this study) and 147 controls (from schools in the same localities as COAs). Both groups were 6-17 years old and received a comprehensive evaluation of mental disorders (no symptoms, subclinical symptoms or clinical diagnosis for each disorder; according to DSM-IV criteria); alcohol and other substance use (none, occasional, regular and risky consumption); school achievement (low, middle and high) and other academic performance indicators (WISC-R Information and Arithmetic subtests, school support activities and failed subjects and courses). Lastly, several cognitive functions were measured by the WISC-R Similarities, Block Design and Digit Symbol subtests, the Toulouse-Piéron test and the Stroop test. Logistic regression methods were used to compare both groups and a linear regression model was used to determine the influence of the family density of alcoholism. The following confounding variables were controlled for: age, gender, socio-economic status and family cohesion.
  
  
  RESULTS
  Children of alcoholics' were twice as likely as controls to present subclinical symptoms and four times more likely than controls to have a definite diagnosis of any mental disorder. More specifically, COAs had a significantly higher risk than controls of attention deficit disorder/hyperactivity, depression, phobias, enuresis and tics. COAs also tended to have more symptoms of generalized anxiety disorder. COAs had worse results on all the cognitive tests used and their risk of low school achievement was nine times higher than that of controls. Family density of alcoholism was significantly related to several psychiatric disorders and to low academic and cognitive performance in these children.
  
  
  CONCLUSIONS
  Children of alcoholics' whose parents are in contact with treatment centers in Spain constitute a target group for selective prevention, as they have a higher risk of different negative outcomes, which mainly include attention disorders and other cognitive deficits, depression and anxiety.
authors.affiliation: Dept. of Child and Adolescent Psychiatry and Psychology, Hospital Clínic, Villarroel, 170, 08036 Barcelona, Spain. diaz@clinic.ub.es
authors.forename: Rosa
authors.initials: R
authors.lastname: Díaz
authors.forename: Antoni
authors.initials: A
authors.lastname: Gual
authors.forename: Montse
authors.initials: M
authors.lastname: García
authors.forename: Jaume
authors.initials: J
authors.lastname: Arnau
authors.forename: Francisco
authors.initials: F
authors.lastname: Pascual
authors.forename: Bartolomé
authors.initials: B
authors.lastname: Cañuelo
authors.forename: Gabriel
authors.initials: G
authors.lastname: Rubio
authors.forename: Yolanda
authors.initials: Y
authors.lastname: de Dios
authors.forename: M Carmen
authors.initials: MC
authors.lastname: Fernández-Eire
authors.forename: Raquel
authors.initials: R
authors.lastname: Valdés
authors.forename: Isabel
authors.initials: I
authors.lastname: Garbayo
mesh_terms: D000124:Achievement; D000293:Adolescent; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology*; D002648:Child; D016241:Child of Impaired Parents / Q000706:statistics & numerical data*; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D009483:Neuropsychological Tests; D015995:Prevalence; D016730:Program Development; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology