Profiling and Labeling Adult Children of Alcoholics: Acceptance of the ACOA Profile and the Barnum Effect
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Profiling and Labeling Adult Children of Alcoholics: Acceptance of the ACOA Profile and the Barnum Effect

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A meta-analysis of the current literature regarding Adult Children of Alcoholics

A meta-analysis of the current literature regarding Adult Children of Alcoholics

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Profiling and Labeling Adult Children of Alcoholics: Acceptance of the ACOA Profile and the Barnum Effect Profiling and Labeling Adult Children of Alcoholics: Acceptance of the ACOA Profile and the Barnum Effect Document Transcript

  • Running head: ADULT CHILDREN OF ALCOHOLICS 1Profiling and Labeling Adult Children of Alcoholics:Acceptance of the ACOA Profile and the Barnum EffectJessica L.MasonUniversity of Virginia
  • ADULT CHILDREN OF ALCOHOLICS 2Profiling and Labeling Adult Children of Alcoholics:Acceptance of the ACOA Profile and the Barnum EffectSubstance abuse affects not only the individual using, but alsothose around him or her.In general, parents’ behavior affects their children. What happens when one or both parents havea history of substance abuse? Do adult children of alcoholics (ACOAs) exhibit a particular arrayof symptoms that allows them to be classified into a specific group? Common descriptorsgrouped together and listed as a symptom profile of ACOAs include:Low self-esteem, shame and guilt, tendency to assume too much responsibility for othersat certain times and too little at other times, need for approval from others, difficultieswith intimacy, excessive loyalty to others, feelings of powerlessness, [and] problems withimpulse control. (Lilienfeld, Lynn, Ruscio & Beyerstein, 2010, p. 192)At first glance, this picture of symptoms may seem to immediately fit those who may havegrown up with one or both parents as alcoholics. However, this is due not to the validity of thesymptom profile, but to the fact that the symptom profile is vague enough to describe a largeportion of the population, and a portion who happen to be adult children of alcoholics. Thisphenomenon, where something seems to fit one group of people when it really fits many, iscalled the Barnum effect, and can be observed when personality descriptions are tailored to fitthe patient vie their triviality. These statements carry high confidence because of the high baserates of the characteristic in the population, even if the statement itself is inherently invalid(Meehl, 1956). This effect can be observed in situations such as monthly horoscopes,fortunetellers, or tarot card readers. According to Fichten and Sunerton (1983), acceptance ofBarnum statements can be affected by factors including the generality of the statements, highbase rates already existing in the population, the supposed individualization of the descriptions,
  • ADULT CHILDREN OF ALCOHOLICS 3and the descriptions’ favorability. As long as the statement made is vague, but the personreading it believes it has been tailored specifically to him or her, the statement should (and willbe) accepted by the reader.Therefore, the distinctive profile of symptoms that seems to fit all adult children ofalcoholics does actually fit them, but only because it fits everyone else as well. The profiles thathave been created that claim to diagnose ACOAs as such are ineffective, as individuals exist whoare ACOAs but show none of the symptoms listed on the profile, and similarly, individuals whoare not ACOAs can exhibit one or many of the listed symptoms. In addition, research shows thatindividuals with parents who had other psychological disorders exhibit traits similar to those ofACOAs.Current literature comparing ACOAs to control groups as well as ACOAs to children ofindividuals with other psychological disorders supports the notion that the ACOA label isincorrect, and should not be used.Acceptance of the ProfileIf the ACOA profile fits more than just adult children of alcoholics, why are people soinclined to believe that the list of symptoms designates adult children of alcoholics as a distinctsubset of the population? Individuals who are not ACOAs have no reason to look at the symptomoutline for those who are, so they remain unaware that the list of symptoms fit them just as well.Those readers who are adult children of alcoholics acknowledge the symptoms as fitting theirpersonalities, because they recognize the symptoms listed as things they have experiencedbefore, and the acceptance of ideas that are congruent with one’s beliefs is favored by bothanalytic and intuitive processing, as long as there are no contradictory elements within themessage that may challenge current knowledge, and the message is easily processed(Lewandowsky, Ecker, Seifert, Schwarz & Cook, 2012). Access to media sources could also be View slide
  • ADULT CHILDREN OF ALCOHOLICS 4a cause of the widespread acceptance of the ACOA symptom profile. For anyone looking forinformation on the subject, a quick Google search for ―adult children of alcoholics‖ returns over1,850,000 results, most of which contain the erroneous ―symptom profile‖ already mentioned, orsome variant thereof. With so much misinformation readily available, someone who grew upwith one or more alcoholic parents may search online for a solution or explanation fortheirstruggle with self-esteem, approval, or intimacy may come across a list of symptoms thatincludes everything they’ve been dealing with, and the website states that all of these problemsstem from the alcoholic parent. These catchall diagnoses are easily accepted perhaps becauseit’s easier to blame someone else for one’s problems than totake the time find fault with oneself.As previously mentioned, however, someone with these same symptoms who did not grow upwith one or more alcoholic may search online and encounter the exact same webpage, butdismiss it because everything fits their particular situation, except the presence of an alcoholicparent. These characteristics should not be listed as symptoms, but as descriptors of a largeportion of people, including those who grew up with one or more parents who abused alcohol.The list of symptoms describes adult children of alcoholics, but does not define them.Literature ReviewMany studies have attempted to determine whether this specific set of symptoms defining―adult children of alcoholics‖ truly exists. Some of the research was conducted comparingACOAs to non-ACOAs, some compared ACOAs to children of individuals with other diagnosedpsychological disorders, and some looked only at ACOAs. However, the overarching consensusbetween all of the research is that ACOA as a label is useful only for describing adult children ofalcoholics, and has no real diagnostic significance.ACOAs and Individuals with Adverse Childhood Events View slide
  • ADULT CHILDREN OF ALCOHOLICS 5Fineran, Laux, Seymour, and Thomas (2010) compared four groups of college students;those who had one alcohol dependent parent, those who experienced an adverse childhood event,those with an alcohol dependent parent who had also experienced an adverse childhood event,and those who denied any adverse childhood events. The researchers evaluated the usingparameters supposedly unique to ACOAs in an attempt to ascertain which of three theories –ACOA, Barnum effect, or Chaos (adverse childhood events create traits similar to ACOA traits)– offered the best explanations for the findings present in ACOA literature. Of the three ACOAtraits that were selected and evaluated in the study, (social desirability, resistance to change, andimpulsiveness) no differences surfaced between the four groups. In addition, the studycontradicted the findings of Christofferson and Soothill (2003) and did not find any evidence tosupport the claim that ACOAs show a greater propensity for alcohol abuse. Between the fourgroups, no statistically significant difference in level of alcohol consumptionemerged. Thesefindings support the idea that the ACOA profile is simply a manifestation of the Barnum effect,and the symptoms listed in the profile are not specific to only adult children of alcoholics, sincestudents with both only an adverse childhood event and students with no adverse childhoodevents and no alcoholic parent displayed any psychological or physiological differences whencompared to the ACOAs also in the study.The Condition of ACOAs and the Effect of Family HistoryWhile Fineran et al. (2010) failed to uncover any links between parental alcohol abuseand later child alcohol abuse, Jacob, Windle, Seilhamer, and Bost (1999), focusing solely onadult children of alcoholics, did find a pattern. The study aimed to investigate the drinking,psychiatric, and psychosocial condition of ACOAs, as well as find any moderators regardingfamily history that describe the effect of parental alcoholism on ACOAs. The results of the
  • ADULT CHILDREN OF ALCOHOLICS 6study indicated, according to the researchers, that ACOAs were differentiable from controlgroups as far as alcohol and other drug abuse were concerned. In addition, they found that―personality characteristics associated with externalizing, undercontrolled behavior, and thatfamily-of-origin social class moderated nondrinking outcomes among COAs‖(Jacob et al., 1999,p. 14). Their results claimed that ACOAs did have higher levels of alcohol and other drugabuse, and that their personalities were easily identifiable when compared to non-ACOAs; twoclaims that are refuted by Fineran et al. (2010). The two studies are completely at odds.However, since Fineral et al. (2010) compared ACOAs to non-ACOAs, their results are morerepresentative of the population as a whole. Jacob et al. (1999) focused solely on ACOAs, andso it is highly likely that the apparent ease of identifying ACOAs from non-ACOAs is due to theBarnum effect – the profile was tailored specifically to describe ACOAs, so they confirm that itdescribes them.Parental Alcoholism as a Risk FactorHall and Webster (2007) claim, ―Growing up in an alcoholic home does not necessarilymean an individual will develop problems, but it does serve as a very real and significant riskfactor‖ (p. 494). The difference here lays in these two similar but distinct ideas: first, thatparental alcoholism causes alcoholism in the child, and second, that parental alcoholism maylead the child to engage in activities that may lead to alcoholism later in life. Claiming directcausation is inadvisable when it comes to alcoholism, since:The factors intertwined with alcoholism are highly complex and interact in amultiplicative fashion. It goes well beyond a simple stimulus-response framework orantecedent-behavior-consequence paradigm. The stimuli are complex and often unclear,
  • ADULT CHILDREN OF ALCOHOLICS 7the antecedents have multiple cues and there is no consistent and clear rules that can beincorporated.‖ (Hall & Webster, 2007, p. 507)It would be simple to say that parental alcoholism causes child alcoholism, however it is notcorrect to claim that parental alcoholism is a sure sign of alcoholism developing in the childrenlater in life.A study conducted on college-aged adult children of alcoholics investigated therelationship between coping style and depressive mood symptoms in both ACOAs and non-ACOAs (Klostermann et al., 2011). The results of the study suggested that ACOAs reportedmore avoidant coping behaviors than non-ACOAs (avoidant coping behaviors included thosesuch as smoking and drinking). However, the researchers stated that their study was limited,mainly because it relied exclusively on the participants’ self-reports, from parental alcohol abuseto personal depressive mood state and coping behavior. In this instance, the children’s views oftheir alcoholic parents, coupled with the unreliability of memory (especially memories ofchildhood) may have skewed the reports of just how alcohol-abusive the parent was. In addition,the researchers mentioned, ―participants who experience depressive symptoms may be lessaccurate in their assessment of coping strategies,‖ since those depressive symptoms may affecttheir general assessment of themselves as well as those strategies (Klostermann et al., 2011, p.1166). The researchers stated that no causal relationships could be established betweencategorization as an ACOA or non-ACOA, depressive symptoms, and coping strategies. Thisstudy’s findings support the idea that although ACOAs may exhibit a certain set of symptoms,not all ACOAs exhibit said symptoms, and therefore the idea of a specific list of symptoms beingused to define ACOAs as a subgroup in the population is faulty. This study could be more
  • ADULT CHILDREN OF ALCOHOLICS 8successful with the use of more objective ways to determine coping strategies, depressive mood,and especially history of parental alcohol abuse.ACOA as a LabelLogue, Sher, and Frensch (1992) conducted a meta-analysis of the clinical literatureregarding ACOAs, followed by a study of their own, and made several pertinent discoveries.They first claimed that the ACOA label is problematic, since it implies maladaptive andpathological characteristics (Burk & Sher, 1998). The practice of labeling ACOAs as suchtherefore could cause ACOAs to believe that they show these specific maladaptive orpathological characteristics. However, misdiagnosis as an ACOA could be harmful and possiblylead to further problems down the line; diagnosed ―ACOAs‖ may exhibit the previously listedsymptoms because they feel they are supposed to exhibit them as a result of their parents’alcohol abuse, not because they are actually experiencing them. In addition, the reported effectsof drinking in parents of ACOAs are so widely varied that it suggests that there is no singlesymptom picturethat applies to ACOAs as a group (Russell, Henderson, & Blume, 1985). Thereis no one set of symptoms that applies to, and only to, ACOAs. Finally, the ACOA label doesnot differentiate between ACOAs and those coming from a family with one or more memberssuffering from disorders such as depression (Jacob & Leonard, 1986). The similarity betweenACOAs and adult children of individuals with other psychological disorders is of paramountimportance – substance abuse in general in parents may lead to the aforementioned ACOAprofile just as much as abuse of specifically alcohol does.The Barnum Effect in Personality Assessments of ACOAsLogue et al. (1992) also attributes the acceptance of ACOA profiles, once more, to theBarnum effect. As previously stated, Barnum profiles are accurate for large numbers of the
  • ADULT CHILDREN OF ALCOHOLICS 9population, but are not relevant because they are not specific enough to provide any differentialinformation for specific groups of people. The study compares descriptions of ACOAs toBarnum profiles: they are vague, they describe two extremes (for example, being either tooworried or not worried enough about others), they describe traits generally seen as favored ordesirable, and they list traits that already have high base rates in the population. Therefore,labeling of ACOAs as such should be avoided, since the act of labeling has no proven positiveeffect on those labeled, and the method of labeling is inherently flawed.In addition to a meta-analysis, Logue et al. (1992) conducted a study in which fourgroups of college students – female ACOAs, female non-ACOAs, male ACOAs, and male non-ACOAs – were first given lengthy personality assessment, using questionnaires containing theMarlowe-Crowne Social Desirability Scale (Crowne & Marlowe, 1960) and Rotter’s (1996)Internal-External Locus of Control Scale. After the initial personality assessment, the subjectswere given one of four possible personality profiles that there were told was generated based ontheir answers to the initial assessment. The second assessment was randomly assigned; theresearchers did not actually base the assignment off of the initial assessment. Each profilecontained six statements, aggregated from either Barnum or ACOA profiles. The results showeda high rate of acceptance of the ACOA profiles for both the ACOA subjects and the non-ACOAsubjects. 71% of ACOAs and 63% of non-ACOAs rated the ACOA profiles as describingthemselves ―very well‖ or better. In addition, 71% of subjects rated the profiles they were givenas describing themselves ―very well‖ or better, even though the profiles they were given were inno way correlated to the results on the previous personality assessment, nor were they correlatedto the subjects’ family history. The researchers concluded, ―statements that are found to behighly acceptable as descriptors of ACOAs, but which are also vague, double-headed, or of high
  • ADULT CHILDREN OF ALCOHOLICS 10base rate in the general population, may not be valid personality descriptions of ACOAs‖(Logue,et al., 1992, p. 231).DiscussionBased on the studies reviewed, the idea that ―adult children of alcoholics display adistinct profile of symptoms‖ is completely false. The list of symptoms has descriptors that areeither far too vague – a tendency to assume too much responsibility for others at times and toolittle at other times describes all points in time, except those rare moments in which one assumesexactly the right amount of responsibility for others – or with exceedingly high base rates in thegeneral population – one could argue that a ―need for approval from others‖ is part of the humancondition. An adult who is also the child of an alcoholic may look at the profile and agree that itdescribes them, but an adult who is not the child of an alcoholic may also agree that the profiledescribes them as well. There needs to be a clear distinction between what describes adultchildren of alcoholics (which many of the symptom profiles so) and what defines adult childrenof alcoholics, since many of them come from complex situations and may exhibit differentphysiological or psychological symptoms stemming from parental alcohol abuse. Lumpingeveryone whose parents abused alcohol into one group and putting a label on them may also bedangerous. Sher (1997) states that generalizations should not be made without carefulforethought; although the research shows that children of alcoholics (COAs) are at a higher risk(compared to non-COAs) for psychological disorders, a small proportion of COAs are actuallyaffected by those disorders, excluding substance abuse disorders. Therefore, labeling ACOAswith a particular symptom picture and diagnosis is counterproductive, and overgeneralizationswhen labeling this population may do more harm than good.
  • ADULT CHILDREN OF ALCOHOLICS 11The overgeneralizations of ACOAs may have the potential to be harmful, but the idea oflabeling a specific group of people due to their family history can be a viable option in someinstances. If a label is helpful, or if it ―identifies a pathological state in need of professionalattention, acceptance of it may serve as the entree into treatment. In clinical populations, labelsmay suggest treatment approaches and prognosis‖ (Logue et al., 1992, p. 226). As an example,the diagnosis of depression can help individuals affected by the disorder to find a treatment planthat works for them, whether it be medication, therapy, or a combination of both; this treatmentshould then lead to a better long-term prognosis as far as the patient’s physical and mental healthare concerned.Taking all of the aforementioned into consideration, the conclusion is clear: labelingadult children of alcoholics with the ―ACOA‖ label and assigning a specific list of symptoms tothat label as defining characteristics of the group is incorrect. Although some studies haveshown that ACOAs are more susceptible to alcoholism or other drug use later in life, the list ofpsychological problems first presented has not been proven to be applicable to all ACOAs, andin fact those traits also applicable to members of the general population. This widespreadacceptance of the list of symptoms as accurate is due to the Barnum effect; either the generalvagueness of the statements on the profile or the high base rate of occurrence in the populationmakes them seem valid when in reality, they are not.
  • ADULT CHILDREN OF ALCOHOLICS 12ReferencesBurk, J. P., & Sher, K. J. (1988). The "forgotten children" revisited: Neglected areas of COAresearch. Clinical Psychology Review, 8, 285-302.Christoffersen, M. N., & Soothill, K. (2003). The long-term consequences of parental alcoholabuse: A cohort study of children in Denmark. Journal of Substance AbuseTreatment, 25, 107-116.Crowne, D. P., & Marlowe, D. (1960). A new scale of social desirability independent ofpsychopathology. Journal of Consulting Psychology, 24, 349-354.Hall, C. W., & Webster, R. E. (2007). Risk factors among adult children of alcoholics.International Journal of Behavioral Consultation and Therapy, 3(4), 494-511.Fichten, C. S., & Sunerton, B. (1983). Popular horoscopes and the "Barnum effect‖. TheJournal of Psychology, 114, 123-134.Fineran, K., Laux, J. M., Seymour, J., & Thomas, T. (2010). The Barnum effect and chaostheory: Exploring college student ACOA traits. Journal of College StudentPsychotherapy, 24, 17-31. DOI: 10.1080/87568220903400096Jacob, T., Windle, M., Seilhamer, R. A., & Bost, J. (1999). Adult children of alcoholics:Drinking, psychiatric, and psychosocial status. Psychology of AddictiveBehaviors, 13(1), 3-21.Jacob, T., & Leonard, K. (1986). Psychological functioning in children of alcoholic fathers,depressed fathers, and control fathers. Journal of Studies on Alcohol, 47, 373-380Klostermann, K., Chen, R., Kelley, M. L., Schroeder, V. M., Braitman, A. L., & Mignone, T.(2011). Coping behavior and depressive symptoms in adult children of alcoholics.Substance Use & Misuse, 46, 1162-1168. DOI: 10.3109/10826080903452546
  • ADULT CHILDREN OF ALCOHOLICS 13Lewandowsky, S., Ecker, U. K. H., Seifert, C. M., Schwarz, N., & Cook, J. (2012).Misinformation and its correction: continued influence and successful debiasing.Psychological Science in the Public Interest, 13(3), 106-131. DOI:10.1177/1529100612451018Lilienfeld, S. O., Lynn, S. J., Ruscio, J., & Beyerstein, B. L. (2010). 50 great myths ofpopular psychology, shattering widespread misconceptions about human behavior. (1sted., pp. 192-195). West Sussex: Blackwell Publishing.Logue, M. B., Sher, K. J., & Frensch, P. A. (1992). Purported characteristics of adult childrenof alcoholics: A possible "Barnum effect". Professional Psychology: Research andPractice, 23(3), 226-232.Meehl, P. E., (1956). Wanted—A good cookbook. American Psychologist, 11, 263-272.Rotter, J. B. (1966). Generalized expectancies for internal versus external control ofreinforcement. Psychological Monographs: General and Applies, 80, 1-28.Russell, M., Henderson, C., & Blume, S. B. (1985). Children of alcoholics: A review of theliterature. New York: Children of Alcoholics FoundationSher, K. J. (1997). Psychological characteristics of children of alcoholics. Alcohol Health &Research World, 21(3), 247-254.