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June 1965

Social Competence and Essential-Reactive Distinction in Alcoholism

Arch Gen Psychiatry. 1965;12(6):552-556. doi:10.1001/archpsyc.1965.01720360024004

THE ETIOLOGY of alcohol addiction remains obscure. A frequent formulation is that the disorder is a symptom manifestation of an underlying mental or personality disturbance, usually of a nonspecific nature;1-4 however, some consider that even this view is due to a bias in experience, and that alcoholism may be found in people with quite normal5 or even "magnificent"6 personalities.

As in so many other areas in psychiatry causative factors have been sought in family background,7-9 the pressures of culture and the adult role,7 and in biochemical and nutritional abnormalities.6 Although these various approaches may reflect the different emphases of different investigators, often dealing with differing social and cultural groups, it may be more useful from the point of view of research to consider alcohol addiction as a group of disorders, analogous to Bleuler's "group of schizophrenias." Within this group