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Studies indicate that sons of alcoholics (SOAs) differfrom sons of nonalcoholics (non-SOAs) on a range ofphysiological activity measures, and the differences

appear to be related to the SOAs increased vulnerability todeveloping alcohol problems. Researchers hope that investi-gating such differences will offer insights into the factors thatmay be responsible for SOAs higher risk for alcohol abuse.

This article summarizes the major findings on differentialphysiological responses from studies conducted to date.

Unfortunately, most of these studies examine physiologicalactivity only in SOAs and exclude daughters of alcoholics.

The reason typically given for this exclusion is that somedata suggest that sons, but not daughters, of alcoholics are atelevated risk for alcoholism.1 Nonetheless, it is encouragingthat the National Institute on Alcohol Abuse and Alcoholism(NIAAA) now funds studies on children of alcoholics only ifthe research design includes both sons and daughters.

Studies of SOAs usually assess physiological responses,such as brain wave (electroencephalographic [EEG]) activity,2

autonomic nervous system3 responses (e.g., heart rate or per-spiration), body sway,4 and hormone levels, in reaction to threegeneral scenarios: (1) nonstressful, resting conditions; (2)stressful conditions; and (3) after drinking alcohol. AlthoughSOAs are not a homogeneous population, certain physiologi-cal responses often characterize them. This article reviewsresearch findings for each of these three distinct scenarios.

PHYSIOLOGICAL ACTIVITY OF SOASIN

NONSTRESSFUL

, RESTING

CONDITIONS

The overall picture emerging from studies of physiologicalresponses under nonstressful, resting conditions indicatesthat compared with non-SOAs, SOAs experience a greaterpreponderance of high-frequency EEG activity and increasedautonomic reactivity in response to nonstressful stimuli,such as hearing a simple tone over headphones. Both ofthese general results suggest a higher level of anxiety ortension in SOAs compared with non-SOAs. Because stud-ies in this area are somewhat inconsistent, however, findingsshould be interpreted cautiously (Finn in press).

Several studies report that SOAs exhibit higher levels

of high-frequency EEG activity than do non-SOAs (for a

review, see Finn in press). For example, Gabrielli andcolleagues (1982) observed that preadolescent sons ofalcoholic fathers experienced a greater percentage of high-frequency EEG activity compared with non-SOAs.Similar patterns of increased high-frequency EEG activityhave been reported in adult SOAs (Ehlers and Schuckit1991), alcoholics (Gabrielli et al. 1982), and their relatives(Pollock et al. 1995). Although the precise meaning ofthese results is unclear, higher levels of high-frequency

1The term alcoholism as used in this article refers to the specific criteriafor a psychiatric diagnosis of alcohol dependence or abuse given in theAmerican Psychiatric AssociationsDiagnostic and Statistical Manual of

Mental Disorders, Fourth Edition. The term alcoholic refers to aperson who meets these criteria.

PETERR. FINN, PH.D., is an associate professor of psychol-

ogy and director of the Clinical Science Training Programand ALICIAJUSTUS is director of the Biobehavioral AlcoholResearch Laboratory in the Department of Psychology atIndiana University, Bloomington, Indiana.

Support for this work was provided by NIAAA grants1R01AA10120 and P50AA07611.

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PHYSIOLOGICAL RESPONSES IN

SONS OF ALCOHOLICS

Peter R. Finn, Ph.D., and Alicia Justus

Researchers have differentiated sons of alcoholics(SOAs) from sons of nonalcoholics (non-SOAs) onvarious measures of physiological activity that appearto be related to the SOAs increased vulnerability todeveloping alcohol problems. This article summarizesmajor findings in the literature and discusses theimplications of risk-related physiological characteristicsfor the future development of alcohol problems.SOAs tend to show signs of physiological activityassociated with anxiety states, such as increased heartrate in response to stressful stimuli. Studies alsodemonstrate that SOAs differ greatly from non-SOAsin their response to alcohol. Drinking alcoholdramatically reduces SOAs reactivity to both stressfuland nonstressful stimuli. Additionally, SOAs appear tobe less sensitive to alcohols intoxicating andimpairing effects. However, studies also suggest thatsome SOAs may experience more of alcoholsrewarding effects for a brief period after drinking.Increased stress-dampening and reduced responsivenessto alcohols negative effects also appear to predict thedevelopment of future alcohol problems and mayreflect important vulnerabilities in SOAs.

KEY WORDS

:children of alcoholics; son; physiological stress;psychological stress; AOD use susceptibility; riskfactors; hereditary factors; electroencephalography;autonomic nervous system; behavioral and mentaldisorder; skin; AODE (alcohol and other drug effects);cortisol; adrenocorticotropic hormone; heart function;AOD intoxication; AOD tolerance; AOD impairment;reinforcement; endorphin; amounts of AOD use; AODsensitivity; comparative study; literature review


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EEG activity have been associated with elevated levels ofanxiety (Gabrielli et al. 1982).

The majority of studies report no differences betweenSOAs and non-SOAs when assessing autonomic activityat baseline (i.e., before presentation of a stimulus). How-ever, studies examining autonomic responses to nonstress-

ful stimuli suggest that at least some SOAs are more reactiveto such stimuli (Finn et al. 1990; cf. Finn in press). SOAshave been found to perspire more (i.e., have greater skinconductance) than non-SOAs in response to nonstressfultones presented over headphones at a loudness level similarto that of a passing car (Finn et al. 1990). In addition,SOAs often continue to respond to these types of toneslonger than do non-SOAs (i.e., SOAs are slower to habit-uate). Similar patterns of increased reactivity and longerhabituation to nonstressful stimuli have been observed inpeople with anxiety disorders, suggesting that this patternof physiological response in SOAs may indicate a propen-

sity toward anxiety-related problems.

PHYSIOLOGICAL ACTIVITY OF SOASIN STRESSFUL CONDITIONS

Several studies measuring autonomic nervous system activi-ty indicate that SOAs with anxious tendencies react strong-ly (i.e., they are hyperreactive) to stressful stimuli, such asreceiving a mildly painful electric shock (for a review, seeFinn in press). For example, Finn and colleagues (1990)reported that compared with non-SOAs, young adult SOAsages 18 to 25 show higher heart rates and greater vein con-

striction (i.e., vasoconstriction) in the hand while awaiting

an electric shock, as illustrated in figure 1. These patterns ofincreased heart rate and vasoconstriction are classic manifes-tations of a typical cardiovascular response to stress, sug-gesting that the SOAs in this study were more stressed bythe prospect of receiving an electric shock than were thenon-SOAs. Increased heart rate reactivity to stress also has

been reported in adolescent SOAs during performance of amental arithmetic task (Harden and Pihl 1995). Anxioustraits (e.g., nervousness and excessive worrying) and a fami-ly history of anxiety disorders appear to be related to in-creased stress-induced cardiovascular reactivity in SOAs(Finn in press; Harden and Pihl 1995). In theory, this patternof hyperreactivity in SOAs may make them more vulnera-ble to using alcohol excessively to self-medicate in an effortto reduce their high levels of stress reactivity (Finn et al.1990). This theory is especially appealing given the fact thatSOAs appear to show increased sensitivity to alcoholsstress-reducing effects, as discussed in the next section.

Some SOAs exhibit high levels of antisocial traits andgenerally disruptive behavior (Finn et al. 1997). Researchsuggests that these SOAs may actually be less responsivethan non-SOAs to the threat of negative events such as apainful electric shock. Finn and colleagues (1994) found thatcompared with non-SOAs, some SOAs show weaker skinconductance responses to tones that are followed by electricshocks. This pattern of low reactivity to the threat of painalso has been found in psychopathic (i.e., antisocial) individ-uals (cf. Finn in press). Theoretically, people who do notbecome upset (i.e., are not reactive) about impending nega-tive events are less likely to inhibit behaviors that often leadto negative consequences. Finn (in press) speculates that

SOAs who are underreactive to the threat of punishmentmay not learn from their mistakes as readily as do non-

SOAs and thus seem more likely to experience alcohol-related problems, such as missing work, failing an exam, orbeing arrested for driving while intoxicated (Finn et al.1997). Before firm conclusions can be made about the asso-ciation between antisocial behavior and physiological activi-ty in SOAs, however, more research is required to replicateand extend the findings of Finn and colleagues (1994).

PHYSIOLOGICAL ACTIVITY OF SOASAFTER DRINKING ALCOHOL

By far, the majority of studies examining physiologicalactivity in SOAs examine the effects of alcohol on variousmeasures of physiological functioning. These studiesreveal three major results:

SOAs show smaller cardiovascular reactions to stressthan do non-SOAs after consuming moderate to highdoses of alcohol (i.e., three to four drinks);

Compared with non-SOAs, SOAs experience lessbody sway and weaker hormone responses to alcoholwhen assessed during resting conditions; and

2EEG activity consists of brain waves that typically vary in frequencyfrom 0.5 to 30 cycles per second (hertz [Hz]). Lower frequencies general-ly are thought to indicate lower arousal or a lower level of activation inthe cerebral cortex, whereas higher frequencies are thought to reflectincreased activation. High-frequency EEG activity, which is often re-ferred to as beta activity, includes relatively small (i.e., low-amplitude)brain waves varying from 12 to 30 Hz in frequency. (Some researchersalso include frequencies between 10 and 12 Hz in this category.) Low-frequency EEG activity, also referred to as slow alpha activity, includesbrain waves varying from 8 to 10 Hz. Low-frequency alpha waves alsohave a much larger amplitude than high-frequency beta waves. Relax-ation and meditation have been found to increase the amount of slowalpha activity. Studies also suggest that reductions or deficits in slow

alpha activity are associated with greater brain activation and anxietystates (cf. Finn in press).

3The autonomic branch of the nervous system helps regulate basic bodyfunctions, including heart activity, digestion, sweating, and respiration. Inthreatening, emergency, or stressful circumstances, the autonomic ner-vous system increases some of the physiological processes it controls(e.g., heart rate, sweating, and constriction of the veins in the extremities)to prepare the body for fight or flight coping responses.

4Body sway reflects the extent to which a persons body moves back andforth or side to side when he or she is asked to stand perfectly straight ona level platform. Body sway is measured in terms of the degree theplatform tilts if a person shifts his or her weight slightly off center. Inmost people, alcohol seriously impairs the ability to maintain balance(i.e., psychomotor impairment), as evidenced by increased body sway.

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After drinking alcohol, SOAs also experience more ofthe physiological changes associated with pleasurableeffects compared with non-SOAs, although only imme-diately after drinking.

Researchers disagree on the interpretation of some ofthese results (e.g., SOAs reduced cardiovascular response

to stress after drinking alcohol). Current theories suggestthat SOAs may demonstrate enhanced responsiveness toalcohol as their blood alcohol levels rise just after drinkingbut reduced responsiveness after blood alcohol levels beginto decline as they sober up.

Alcohols Effect on Cardiac Reactivity

Many studies have reported that SOAs show a substantialdecrease in stress reactions on measures of both cardiacactivity (e.g., Finn et al. 1990; Conrod et al. 1995) andmuscle tension (Conrod et al. 1995; Finn et al. 1990) afterdrinking alcohol. Following the consumption of three to

four drinks of alcohol, which results in blood alcohol levelsbetween 0.075 and 0.13 percent, SOAs seem to be calmand undisturbed when faced with significant stressors, suchas electric shock. In contrast, non-SOAs demonstrate onlymodest decreases in stress reactions after drinking. Figure 2displays a typical pattern of cardiac reactivity to stress inSOAs and non-SOAs after they drink alcoholic beverages.Comparison of figures 1 and 2 illustrates the dramatic re-duction in reactivity in SOAs before and after drinking incontrast with the relatively minor reduction in non-SOAs.

Finn and colleagues (1990) also found that SOAs weresignificantly less reactive to nonstressful stimuli after drink-

ing alcohol. Thus, the general pattern of reduced reactivityafter drinking may predispose SOAs to consume alcoholexcessively to help them cope, especially in stressful situa-tions (Finn in press). In fact, recent data suggest that increased

sensitivity to the stress-reducing effects of alcohol can predicthigher levels of alcohol consumption (Finn in press).

Alcohols Effect on Body Swayand Hormone Responses

In addition to studies suggesting that SOAs are moresensitive to alcohols stress-reducing effects, another bodyof literature indicates that SOAs may be more tolerantthan non-SOAs to alcohols intoxicating effects. SOAs,when matched with non-SOAs exhibiting the same drink-ing patterns, consistently report being less intoxicated thannon-SOAs after consuming the same amount of alcohol

(see, for example, OMalley and Maisto 1985; Schuckit etal. 1996). SOAs also appear to be significantly less im-paired on measures of body sway than non-SOAs afterdrinking two to three alcoholic beverages (see, for exam-ple, Schuckit et al. 1996).

Schuckit and colleagues (1996) also found that SOAsproduce less cortisol than non-SOAs do after drinking twoto three drinks (figure 3), as well as less adrenocorticotropichormone (ACTH). The typical increases in cortisol andACTH that occur after drinking reflect alcohols effect onspecific brain areas controlling the release of these hor-mones and perhaps also a mild stress response to the

0

5

10

15

nSOAsSOAs0

5

10

15

20

25

30

nSOAsSOAs

Heart Rate Vasoconstriction

IncreaseOv

erBaseline

(beatspe

rminute)

DegreeofVasoconstriction

(units

)

Figure 1 Stress reactivity when sober. Sons of alcoholics

(SOAs) and sons of nonalcoholics (nSOAs)

differ in their response to electric shock in

measures of heart rate (left) and vasoconstriction

in the hand (right). SOAs experienced both a

higher increase in heart rate and a greater

degree of vasoconstriction compared with

nSOAs, indicating a higher stress level.

NOTE: Blood vessel constriction (i.e., vasoconstriction) is

measured in arbitrary analog digital computer measurement units.

SOURCE: Finn et al. 1990.

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0

5

10

15

0

5

10

15

20

25

30

nSOAsSOAs nSOAsSOAs

Heart Rate Vasoconstriction

IncreaseOv

erBaseline

(beatspe

rminute)

DegreeofVaso

constriction

(units

)

Figure 2 Stress reactivity after drinking. Increases in

heart rate (left) and vasoconstriction (right) in

response to electric shock were measured in

sons of alcoholics (SOAs) and sons of non-

alcoholics (nSOAs) after they consumed two to

three alcoholic beverages. Compared with

nSOAs, SOAs experienced a smaller increase

in both measures, indicating a lower degree ofstress reactivity. A comparison of these results

with those shown in figure 1 reveals a dramatic

drop in stress reactivity in SOAs after drinking.

NOTE: Blood vessel constriction (i.e., vasoconstriction) is

measured in arbitrary analog digital computer measurement units.

SOURCE: Finn et al. 1990.


4/5230 ALCOHOL HEALTH & RESEARCH WORLD

presence of alcohol as a toxin in the system. The results ofSchuckit and colleagues suggest that SOAs simply have

reduced central nervous system responses to alcohol. Theseresults replicate findings from an earlier study (see Schuckit1995) using a different sample of SOAs and non-SOAsmatched for drinking habits. Both studies imply that SOAsdrinking the same amount over a similar period of time asnon-SOAs appear either to be more innately tolerant tocertain alcohol effects or to develop tolerance more rapidly.

Furthermore, research indicates that the increased toler-ance of SOAs represents a significant risk factor for de-veloping alcohol problems. Schuckit (1995) notes that aweaker response to alcohol at age 20 (i.e., a need to drinkmore alcohol to experience an effect) is a strong predictorof alcohol problems at age 28. Similar results have beenreported by Volavka and colleagues (1996), who showedthat smaller changes in EEG activity (i.e., increased toler-ance) after youth in late adolescence consumed two tothree drinks was associated with more alcohol problemsand consumption 10 years later.

Why should increased innate tolerance lead to alcoholproblems? The basic theory is that people learn to regulatetheir drinking by monitoring alcohols effects on their levelof functioning, then adjust their intake based on the effectsthey experience. Typically, a person stops or at least slowsdown the rate of drinking when he or she begins to feelimpaired. The experience of being impaired or intoxicated

thus serves as a feedback mechanism that contributes to theregulation of alcohol intake. Failure to experience the nor-mal impairing effects of alcohol, however, may lead to abreakdown in this regulatory system, which may be reflect-ed in the increased tolerance exhibited by SOAs. It is pos-sible that SOAs drink more alcohol partly because they do

not experience the usual negative feedback of intoxicatedfeelings or psychomotor impairment (i.e., increased bodysway). Subsequently, they are at greater risk for developingalcohol-related health, occupational, or legal problems orother complications attributable to their high alcohol intake.

Alcohols Rewarding Effects

A handful of studies suggest that some SOAs show en-hanced responses to alcohol on measures of hormonal(Gianoulakis et al. 1996), EEG (Cohen et al. 1993), andcardiac activity (for a review, see Finn in press) that are

theoretically linked to pharmacological reward mechanisms(i.e., positive reinforcement). For example, Gianoulakis andcolleagues (1996) found that SOAs experience greaterincreases in blood levels of a naturally occurring opiatelikechemical (i.e., beta-endorphin) than non-SOAs do afterconsuming moderate doses of alcohol (defined in this studyas approximately three drinks), but not low doses (i.e., onedrink). Although beta-endorphin activity in the brain hasbeen associated with the basic reward mechanisms of avariety of drugs (Finn in press; Gianoulakis et al. 1996), it isunclear whether blood levels of beta-endorphin levels areassociated with brain reward mechanisms.

Research also suggests that some SOAs exhibit greater

increases in heart rate over baseline after consuming alcoholwhen compared with non-SOAs (Finn in press; Finn et al.1990). Alcohol-induced increases in heart rate are thought toreflect the initial stimulatory effect associated with rising bloodlevels of alcohol (Finn in press) and have been associated withincreases in plasma beta-endorphin levels (cf. Finn in press).

Similarly, Cohen and colleagues (1993) reported thatafter two to three drinks, SOAs show greater enhancementsof low-frequency EEG activity compared with non-SOAs.This effect occurs only immediately after consuming analcoholic beverage, however, while blood alcohol levels riseFurthermore, Cohen and colleagues (1993) reported that theenhancement of low-frequency EEG activity disappears

relatively quickly in SOAs compared with non-SOAs,providing further evidence of SOAs greater tolerance toalcohol. Previous studies have associated drug-inducedincreases in low-frequency EEG activity with euphoria (cf.Finn in press). The 1993 study by Cohen and colleaguesindicates that this heightened effect is short-lived, persistingonly as the SOAs blood alcohol levels rise, and then isreplaced by significantly lower levels of low-frequency EEGactivity as blood alcohol levels decline, which might pro-duce unpleasant feelings (i.e., dysphoria). These resultssuggest that SOAs who experience this effect would bemotivated to continue drinking in order to maintain the

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2.5

0.0

5.0

-2.5

-5.0

-7.50 30 60 90 120 150 180

ChangeinLevelofPlasmaCortisol

(microgramspermilliliter)

Time After Alcohol Administration(minutes)

SOAs

nSOAs

Figure 3 Plasma cortisol levels of sons of alcoholics(SOAs) and sons of nonalcoholics (nSOAs) at

30-minute intervals after consuming 2.5 drinks

of alcohol. Although alcohol consumption

typically increases cortisol production, SOAs

produce less cortisol after drinking compared

with nSOAs, providing further evidence of

SOAs greater tolerance to some alcohol

effects.

SOURCE: Schuckit et al. 1996.


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euphoric experience of enhanced low-frequency EEG activity

and avoid the dysphoric experience of a major reduction in

low-frequency EEG activity while sobering up.Taken together, studies of alcohols effects on SOAs

suggest that SOAs may be more sensitive to alcohols

rewarding effects when their blood alcohol levels are

rising, but less sensitive to impairment and intoxication atpeak and descending blood alcohol levels. The relation-ship among euphoria, plasma beta-endorphin, and low-

frequency EEG activity is purely speculative, however.Alcohol-induced increases in plasma beta-endorphin,low-frequency EEG activity, or heart rate responses havenot been associated with increased alcohol-induced eupho-ria in SOAs.

SUMMARY AND CONCLUSIONS

The general pattern emerging from the studies cited in thisarticle implies that SOAs tend to exhibit levels of physio-

logical activity that indicate increased tension and stress

reactivity. In addition, the studies clearly demonstrate that

SOAs respond differently to alcohol than do non-SOAs

on several dimensions. For example, drinking alcohol

reduces stress reactivity in SOAs to a much greater extent

than in non-SOAs. SOAs also seem less sensitive to

alcohols intoxicating effects, as evidenced by reduced

body sway, cortisol secretion, and subjective reports of

intoxication. Such reduced impairment after drinking has

been found to predict future alcohol problems and appears

to reflect a significant vulnerability to alcoholism. Some

studies also suggest that SOAs may experience more of

alcohols rewarding effects for a brief period after drinking

compared with non-SOAs. In addition, research suggests

that some SOAs may exhibit enhanced beta-endorphin

and EEG responses to alcohol that are hypothetically relat-

ed to positive reinforcement mechanisms.

Finally, it is emphasized that SOAs are not all alike and, in

fact, represent a rather heterogeneous group. Finn and col-

leagues (1997) found three distinct patterns, or subtypes, of

vulnerability to alcoholism in the families of SOAs: (1) low

levels of psychopathology and moderate levels of alcoholism;(2) high levels of antisocial personality, violence, and alco-

holism; and (3) high levels of depression, mania, anxiety disor-

ders, and alcoholism. Finn and colleagues (1997) also report

that SOAs from each family type vary in terms of personality

and adjustment characteristics. It is possible that different

aspects of physiological activity and sensitivity to alcohol may

be associated with distinct vulnerability patterns transmitted

within the various types of alcoholic families. Future research is

needed to further understand the associations among measures

of physiological activity that distinguish SOAs from non-

SOAs, specific types of vulnerabilities transmitted in alcoholic

families, and the development of alcohol problems. s

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