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This article reviewed the literature covering the last 30 years on the psychopathology, variable risk factors and protective factors associated with children of alcoholics (COAs). COAs can present with externalizing problems, such as attention deficit hyperactivity (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD), and internalizing problems, such as depression and anxiety. COAs also can show with difficulties in intelligence, learning, language, and temperament. All COAs, however, are not associated with psychopathology and cognitive problems and future alcohol and substance related disorder. Although investigators agree that COAs are at higher risk for developing psychiatric illness and alcohol use disorders than children of non-alcoholics, problems with alcohol and psychopathology are not an inevitable consequence of COAs status. Recent research has identified numerous biological, psychological, and social factors associated with a family history of alcoholism that may play a role in determining COAs’ outcome. The risk factors and protective factors associated with COAs have been used as a foundation for preventive and treatment intervention. Researcher and clinician should understand how COAs cope to parental alcoholism. Program for COAs should include the basic components of information, problem- and emotion-focused coping skills, and social and emotional support. School setting are most common intervention sites, but family and broad-based community programs also have shown promise in COAs prevention. More rigorous studies are needed to understand better the complex ways children with parental alcoholism.
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