Understanding alcoholism can come from the highly technical area of neuroimaging, which provides a window into the neurobiology underlying the clinical observations that have been made over the years.
Another “low tech” source of knowledge comes from a unique long-term study of alcoholism, which has been in progress for 74 years. For many years, the director of this study was Dr. George Vaillant, who published the results of this study as they evolved in three books: The Natural History of Alcoholism (1983), Natural History of Alcoholism Revisited (1995), and most recently, Triumphs of Experience (2012).
When The Natural History of Alcoholism was first published, it was considered an important contribution to understanding alcoholism. Vaillant examined critical questions about understanding alcoholism.
- Who becomes alcoholic?
- What are indicators early on?
- What are the predictors?
- Should abstinence be the goal?
- Is it possible to return to “social drinking”?
Based on an evaluation of more than 600 individuals, Vaillant’s monumental study offered insightful answers to all of these questions for understanding alcoholism. I particularly value Vaillant’s dedication to the data that he collects and analyzes. He attempts to avoid the kind of distortions to conclusions that can result from an attachment to ideology. He begins his book with the quote, “The follow up is the great exposer of truth, the rock upon which fine theories are wrecked.”
Vaillant was true to his word in that he would publish new data as the study progressed and was very specific about how his conclusions in previous publications had been either confirmed or proved to be erroneous. With the recent publication of Triumphs of Experience, we may have seen the last chapter on this study, whose subjects if still alive are in their 90s. In next week’s blog, I will detail some of the specific findings that has helped with understanding alcoholism.
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