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November 1990, Vol 144, No. 11 >
Article | November 1990

Pediatricians' Knowledge and Practices Regarding Parental Use of Alcohol FREE

Steven W. Greer, MD; Howard Bauchner, MD; Barry Zuckerman, MD
[+] Author Affiliations

Accepted for publication April 25, 1990.

Presented in part at the "Mental Health Services for Children and Adolescents in Primary Care Settings: A Research Conference," New Haven, Conn, June 12, 1989.

Reprint requests to the Department of Pediatrics, Boston City Hospital, 818 Harrison Ave, Boston, MA 02118 (Dr Greer).


Am J Dis Child. 1990;144(11):1234-1237. doi:10.1001/archpedi.1990.02150350066027.
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• Problems with alcohol are common in the United States but are too frequently ignored by physicians, particularly those working with children. We explored pediatricians' knowledge and practices regarding parental use of alcohol and compared these attributes with those of family practitioners. Child health care providers attending three continuing medical education courses in general pediatrics were surveyed using a closed-item questionnaire. One hundred ninety (69%) of the participants responded, including 90 pediatricians and 39 family practitioners. Forty-six percent of responding pediatricians, compared with 90% of family practitioners, stated that they ask about problems with alcohol in taking a routine family history. Thirty-eight percent of pediatricians who knew the frequency of alcoholism, compared with 47% of those who did not, indicated that they include it in taking a routine family history. Forty-six percent of pediatricians who have experienced a problem with alcohol in their own family, compared with 20% of pediatricians without such personal experience, routinely address the issue of alcohol use with parents and children. Similar analyses among the family practitioners revealed no significant differences. We conclude that fewer than half of pediatricians ask about problems with alcohol in taking a family history. The likelihood of asking about such problems was not influenced by the health care provider's knowledge of alcoholism, but it was influenced by the provider's personal family history of problems with alcohol. Because of the important morbidity associated with alcohol use in families, and because intervention can improve functioning and adaptation of the child, training and Continuing Medical Education courses should address this issue.

(AJDC. 1990;144:1234-1237)

REFERENCES

1 +
Geller A. Review Course Syllabus . New York, NY: American Medical Society on Alcoholism and Other Drug Dependencies; 1987;.
2 +
Helzer J, Pryzbeck T.  The co-occurrence of alcoholism with other psychiatric disorders in the general population and its impact on treatment . J Stud Alcohol . 1988;;49:219-224.
3 +
Deutsch C. Broken Bottles, Broken Dreams: Understanding and Helping the Children of Alcoholics . New York, NY: Teachers College Press, Columbia University; 1982;.
4 +
Clarren S, Smith D.  The fetal alcohol syndrome . N Engl J Med . 1978;;298:1063-1067.
5 +
Rosett H, Weiner L, Lee A, Zuckerman B, Dooling E, Oppenheimer E.  Patterns of alcohol consumption and fetal development . Obstet Gynecol . 1983;;61:539-546.
6 +
Russell M, Henderson C, Blume S. Children of Alcoholics: A Review of the Literature . New York, NY: Children of Alcoholics Foundation; 1985;.
7 +
Steinglass P, Bennett L, Wolin S, Reiss D. The Alcoholic Family . New York, NY: Basic Books Inc Publishers; 1987;.
8 +
Wilson C, Orford J.  Children of alcoholics: report of a preliminary study and comments on the literature . J Stud Alcohol . 1978;;39:121-142.
9 +
El-Guebaly N, Offord D.  The offspring of alcoholics: a critical review . Am J Psychiatry . 1977;; 134:357-365.
10 +
Nylander I.  Children of alcoholic fathers . Acta Paediatr Scand . 1960;;49:1-134.
11 +
Fine E, Yudin L, Holmes J, Heinemann S.  Behavioral disorders in children with parental alcoholism . Ann N Y Acad Sci . 1976;;273:507-517.
12 +
Steinhausen H, Gobel D, Nestler V.  Psychopathology in the offspring of alcoholic parents . J Am Acad Child Psychiatry . 1984;;23:465-471.
13 +
Morrison J, Stewart M.  A family study of the hyperactive child syndrome . Biol Psychiatry . 1971;;3:189-195.
14 +
Cantwell D.  Psychiatric illness in the families of hyperactive children . Arch Gen Psychiatry . 1972;;27:414-417.
15 +
Herjanic B, Herjanic M, Penick E, Tomelleri C.  Children of alcoholics . In: Seixas F, ed. Currents in Alcoholism . New York, NY: Grune & Stratton; 1977;;2:445-455.
16 +
Parker D, Harford T.  Alcohol-related problems, marital disruption and depressive symptoms among adult children of alcohol abusers in the United States . J Stud Alcohol . 1988;;49:306-313.
17 +
Rydelius P.  Children of alcoholic fathers: their social adjustment and their health status over 20 years . Acta Paediatr Scand . 1981;;70( (suppl 286) ): 1-89.
18 +
Weir W.  Counselling youths whose parents are alcoholic . J Alcohol Educ . 1969;;15:13-19.
19 +
DiCicco L.  Evaluating the impact of alcohol education . Alcohol H Res World . 1978;;3:1-7.
20 +
Hughes J.  Adolescent children of alcoholic parents and the relationship of Alateen to these children . J Consult Clin Psychol . 1977;;45:946-947.
21 +
Black C. My Dad Loves Me, My Dad Has a Disease . Denver, Colo: MAC Publishing; 1979;.
22 +
Kamerow D, Pincus H, Macdonald DI.  Alcohol abuse, other drug abuse, and mental disorders in medical practice: prevalence, costs, recognition, and treatment . JAMA . 1986;;255:2054-2057.
23 +
Cleary P, Miller M, Bush B, Warburg MM, DelBanco TL, Aronson MD.  Prevalence and recognition of alcohol abuse in a primary care population . Am J Med . 1988;;85:466-471.
24 +
Warburg M, Cleary P, Rohman M, Barnes HN, Aronson MD, DelBanco TL.  Residents' attitudes, knowledge, and behavior regarding diagnosis and treatment of alcoholism . J Med Educ . 1987;;62:497-503.
25 +
Barnes H, O'Neill S, Aronson M, et al.  Early detection and outpatient management of alcoholism: a curriculum for medical residents . J Med Educ . 1984;;59:904-906.
26 +
Adger H, McDonald E, DeAngelis C. Pediatric Minimal Knowledge and Skills: The First Step in Developing a Curriculum in Alcohol and Other Drugs for Pediatricians . Rockville, Md: US Dept of Health and Human Services; 1985;.
27 +
Adger H. Substance abuse: individual and family effects: what the pediatrician should know and can do. Presented as a workshop at the Ambulatory Pediatric Association meeting; April 1989; Washington, DC.

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References

1 +
Geller A. Review Course Syllabus . New York, NY: American Medical Society on Alcoholism and Other Drug Dependencies; 1987;.
2 +
Helzer J, Pryzbeck T.  The co-occurrence of alcoholism with other psychiatric disorders in the general population and its impact on treatment . J Stud Alcohol . 1988;;49:219-224.
3 +
Deutsch C. Broken Bottles, Broken Dreams: Understanding and Helping the Children of Alcoholics . New York, NY: Teachers College Press, Columbia University; 1982;.
4 +
Clarren S, Smith D.  The fetal alcohol syndrome . N Engl J Med . 1978;;298:1063-1067.
5 +
Rosett H, Weiner L, Lee A, Zuckerman B, Dooling E, Oppenheimer E.  Patterns of alcohol consumption and fetal development . Obstet Gynecol . 1983;;61:539-546.
6 +
Russell M, Henderson C, Blume S. Children of Alcoholics: A Review of the Literature . New York, NY: Children of Alcoholics Foundation; 1985;.
7 +
Steinglass P, Bennett L, Wolin S, Reiss D. The Alcoholic Family . New York, NY: Basic Books Inc Publishers; 1987;.
8 +
Wilson C, Orford J.  Children of alcoholics: report of a preliminary study and comments on the literature . J Stud Alcohol . 1978;;39:121-142.
9 +
El-Guebaly N, Offord D.  The offspring of alcoholics: a critical review . Am J Psychiatry . 1977;; 134:357-365.
10 +
Nylander I.  Children of alcoholic fathers . Acta Paediatr Scand . 1960;;49:1-134.
11 +
Fine E, Yudin L, Holmes J, Heinemann S.  Behavioral disorders in children with parental alcoholism . Ann N Y Acad Sci . 1976;;273:507-517.
12 +
Steinhausen H, Gobel D, Nestler V.  Psychopathology in the offspring of alcoholic parents . J Am Acad Child Psychiatry . 1984;;23:465-471.
13 +
Morrison J, Stewart M.  A family study of the hyperactive child syndrome . Biol Psychiatry . 1971;;3:189-195.
14 +
Cantwell D.  Psychiatric illness in the families of hyperactive children . Arch Gen Psychiatry . 1972;;27:414-417.
15 +
Herjanic B, Herjanic M, Penick E, Tomelleri C.  Children of alcoholics . In: Seixas F, ed. Currents in Alcoholism . New York, NY: Grune & Stratton; 1977;;2:445-455.
16 +
Parker D, Harford T.  Alcohol-related problems, marital disruption and depressive symptoms among adult children of alcohol abusers in the United States . J Stud Alcohol . 1988;;49:306-313.
17 +
Rydelius P.  Children of alcoholic fathers: their social adjustment and their health status over 20 years . Acta Paediatr Scand . 1981;;70( (suppl 286) ): 1-89.
18 +
Weir W.  Counselling youths whose parents are alcoholic . J Alcohol Educ . 1969;;15:13-19.
19 +
DiCicco L.  Evaluating the impact of alcohol education . Alcohol H Res World . 1978;;3:1-7.
20 +
Hughes J.  Adolescent children of alcoholic parents and the relationship of Alateen to these children . J Consult Clin Psychol . 1977;;45:946-947.
21 +
Black C. My Dad Loves Me, My Dad Has a Disease . Denver, Colo: MAC Publishing; 1979;.
22 +
Kamerow D, Pincus H, Macdonald DI.  Alcohol abuse, other drug abuse, and mental disorders in medical practice: prevalence, costs, recognition, and treatment . JAMA . 1986;;255:2054-2057.
23 +
Cleary P, Miller M, Bush B, Warburg MM, DelBanco TL, Aronson MD.  Prevalence and recognition of alcohol abuse in a primary care population . Am J Med . 1988;;85:466-471.
24 +
Warburg M, Cleary P, Rohman M, Barnes HN, Aronson MD, DelBanco TL.  Residents' attitudes, knowledge, and behavior regarding diagnosis and treatment of alcoholism . J Med Educ . 1987;;62:497-503.
25 +
Barnes H, O'Neill S, Aronson M, et al.  Early detection and outpatient management of alcoholism: a curriculum for medical residents . J Med Educ . 1984;;59:904-906.
26 +
Adger H, McDonald E, DeAngelis C. Pediatric Minimal Knowledge and Skills: The First Step in Developing a Curriculum in Alcohol and Other Drugs for Pediatricians . Rockville, Md: US Dept of Health and Human Services; 1985;.
27 +
Adger H. Substance abuse: individual and family effects: what the pediatrician should know and can do. Presented as a workshop at the Ambulatory Pediatric Association meeting; April 1989; Washington, DC.

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