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Book Forum: Substance Abuse   |    
Recent Developments in Alcoholism, vol. 13: Alcohol and Violence—Epidemiology, Neurobiology, Psychology, Family Issues
PHILIP E. VEENHUIS, M.D., M.P.H.
Am J Psychiatry 1998;155:1453a-1454.
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edited by Marc Galanter. New York, Plenum, 1997, 421 pp., $89.50

Book Forum

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At a recent National Institute on Drug Abuse (NIDA) conference, Alan Leshner, Ph.D., Director of NIDA, set the stage with the remark, "We must replace ideology with science." This latest volume of the Recent Developments in Alcoholism series continues a tradition of providing reviews of research on key topics of interest to policy makers, clinicians, and researchers. The current volume (number 13 in the series, which began in 1983) focuses on alcoholism and violence. Like previous volumes, the book is divided into four sections, and each section begins with an editorial overview and summary of the papers that follow. This volume has sections on epidemiology, neuroscience, psychology, and family systems that review the relationship of alcoholism and violence from those disciplinary points of view. I found all of the papers to be of high quality. Most are comprehensive literature reviews, making it possible for a clinician to get a grip on where the literature has been and is going. There are probably no two more important public health problems than alcoholism and violence. Are alcohol and violence often associated? Well, yes. Does alcohol cause violence? Well, maybe and maybe not. There is robust evidence of the correlation of alcohol and violence. The issue of alcohol’s causing violence, however, remains unanswerable on the basis of current research. "If alcohol has any causal effects on violence, they almost certainly occur only for some persons and/or some circumstances. The most important research question regarding the alcohol-violence relationship, therefore, is not one of global causal influence. Rather, it is the more focused question of what individual differences, moderator, and situational variables characterize circumstances in which alcohol might potentiate violent behavior" (p. 278).

All of the chapters are of interest, but, perhaps because of my clinical background, I found chapter 8, "Serotonin in Early-Onset Alcoholism," and chapter 10, "Effects of Alcohol on Human Aggression: Validity of Proposed Explanations," particularly useful. Chapter 8 focuses on the approximately 25% of males with alcoholism with early onset, high inheritability, and antisocial personality traits who may have a reduced turnover rate of central serotonin. Both molecular genetic and brain imaging studies on this group of alcoholics, who are particularly problematic for society, appear very promising. Chapter 10 is a succinct summary of research designed to move studies of the relationship of alcohol and violence from correlational studies to experimental studies. It concludes by reporting on a study suggesting that a 10% decrease of alcohol consumption would lead to a 1% decrease in murders, a 6% decrease in forcible rapes, a 6% decrease in aggravated assaults, and a 9% decrease in robberies. "Thus, one way to obtain a kinder and gentler society would be to decrease alcohol consumption." Amen.

This volume continues the high standard of the previous volumes and will be of interest to all in the field of addiction.

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