Running head: ADULT CHILDREN OF ALCOHOLICS 1

Profiling and Labeling Adult Children of Alcoholics:

Acceptance of the ACOA Profile and the Barnum Effect

Jessica L. Mason

University of Virginia

ADULT CHILDREN OF ALCOHOLICS 2

Profiling and Labeling Adult Children of Alcoholics:

Acceptance of the ACOA Profile and the Barnum Effect

Substance abuse affects not only the individual using, but also those around him or her.

In general, parents’ behavior affects their children. What happens when one or both parents have

a history of substance abuse? Do adult children of alcoholics (ACOAs) exhibit a particular array

of symptoms that allows them to be classified into a specific group? Common descriptors

grouped together and listed as a symptom profile of ACOAs include:

Low self-esteem, shame and guilt, tendency to assume too much responsibility for others

at certain times and too little at other times, need for approval from others, difficulties

with intimacy, excessive loyalty to others, feelings of powerlessness, [and] problems with

impulse control. (Lilienfeld, Lynn, Ruscio & Beyerstein, 2010, p. 192)

At first glance, this picture of symptoms may seem to immediately fit those who may have

grown up with one or both parents as alcoholics. However, this is due not to the validity of the

symptom profile, but to the fact that the symptom profile is vague enough to describe a large

portion of the population, and a portion who happen to be adult children of alcoholics. This

phenomenon, where something seems to fit one group of people when it really fits many, is

called the Barnum effect, and can be observed when personality descriptions are tailored to fit

the patient vie their triviality. These statements carry high confidence because of the high base

rates of the characteristic in the population, even if the statement itself is inherently invalid

(Meehl, 1956). This effect can be observed in situations such as monthly horoscopes,

fortunetellers, or tarot card readers. According to Fichten and Sunerton (1983), acceptance of

Barnum statements can be affected by factors including the generality of the statements, high

base rates already existing in the population, the supposed individualization of the descriptions,

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and the descriptions’ favorability. As long as the statement made is vague, but the person

reading it believes it has been tailored specifically to him or her, the statement should (and will

be) accepted by the reader.

Therefore, the distinctive profile of symptoms that seems to fit all adult children of

alcoholics does actually fit them, but only because it fits everyone else as well. The profiles that

have been created that claim to diagnose ACOAs as such are ineffective, as individuals exist who

are ACOAs but show none of the symptoms listed on the profile, and similarly, individuals who

are not ACOAs can exhibit one or many of the listed symptoms. In addition, research shows that

individuals with parents who had other psychological disorders exhibit traits similar to those of

ACOAs. Current literature comparing ACOAs to control groups as well as ACOAs to children

of individuals with other psychological disorders supports the notion that the ACOA label is

incorrect, and should not be used.

Acceptance of the Profile

If the ACOA profile fits more than just adult children of alcoholics, why are people so

inclined to believe that the list of symptoms designates adult children of alcoholics as a distinct

subset of the population? Individuals who are not ACOAs have no reason to look at the symptom

outline for those who are, so they remain unaware that the list of symptoms fit them just as well.

Those readers who are adult children of alcoholics acknowledge the symptoms as fitting their

personalities, because they recognize the symptoms listed as things they have experienced

before, and the acceptance of ideas that are congruent with one’s beliefs is favored by both

analytic and intuitive processing, as long as there are no contradictory elements within the

message that may challenge current knowledge, and the message is easily processed

(Lewandowsky, Ecker, Seifert, Schwarz & Cook, 2012). Access to media sources could also be

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a cause of the widespread acceptance of the ACOA symptom profile. For anyone looking for

information on the subject, a quick Google search for “adult children of alcoholics” returns over

1,850,000 results, most of which contain the erroneous “symptom profile” already mentioned, or

some variant thereof. With so much misinformation readily available, someone who grew up

with one or more alcoholic parents may search online for a solution or explanation for their

struggle with self-esteem, approval, or intimacy may come across a list of symptoms that

includes everything they’ve been dealing with, and the website states that all of these problems

stem from the alcoholic parent. These catchall diagnoses are easily accepted perhaps because

it’s easier to blame someone else for one’s problems than to take the time find fault with oneself.

As previously mentioned, however, someone with these same symptoms who did not grow up

with one or more alcoholic may search online and encounter the exact same webpage, but

dismiss it because everything fits their particular situation, except the presence of an alcoholic

parent. These characteristics should not be listed as symptoms, but as descriptors of a large

portion of people, including those who grew up with one or more parents who abused alcohol.

The list of symptoms describes adult children of alcoholics, but does not define them.

Literature Review

Many studies have attempted to determine whether this specific set of symptoms defining

“adult children of alcoholics” truly exists. Some of the research was conducted comparing

ACOAs to non-ACOAs, some compared ACOAs to children of individuals with other diagnosed

psychological disorders, and some looked only at ACOAs. However, the overarching consensus

between all of the research is that ACOA as a label is useful only for describing adult children of

alcoholics, and has no real diagnostic significance.

ACOAs and Individuals with Adverse Childhood Events

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Fineran, Laux, Seymour, and Thomas (2010) compared four groups of college students;

those who had one alcohol dependent parent, those who experienced an adverse childhood event,

those with an alcohol dependent parent who had also experienced an adverse childhood event,

and those who denied any adverse childhood events. The researchers evaluated the using

parameters supposedly unique to ACOAs in an attempt to ascertain which of three theories –

ACOA, Barnum effect, or Chaos (adverse childhood events create traits similar to ACOA traits)

– offered the best explanations for the findings present in ACOA literature. Of the three ACOA

traits that were selected and evaluated in the study, (social desirability, resistance to change, and

impulsiveness) no differences surfaced between the four groups. In addition, the study

contradicted the findings of Christofferson and Soothill (2003) and did not find any evidence to

support the claim that ACOAs show a greater propensity for alcohol abuse. Between the four

groups, no statistically significant difference in level of alcohol consumption emerged. These

findings support the idea that the ACOA profile is simply a manifestation of the Barnum effect,

and the symptoms listed in the profile are not specific to only adult children of alcoholics, since

students with both only an adverse childhood event and students with no adverse childhood

events and no alcoholic parent displayed any psychological or physiological differences when

compared to the ACOAs also in the study.

The Condition of ACOAs and the Effect of Family History

While Fineran et al. (2010) failed to uncover any links between parental alcohol abuse

and later child alcohol abuse, Jacob, Windle, Seilhamer, and Bost (1999), focusing solely on

adult children of alcoholics, did find a pattern. The study aimed to investigate the drinking,

psychiatric, and psychosocial condition of ACOAs, as well as find any moderators regarding

family history that describe the effect of parental alcoholism on ACOAs. The results of the

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study indicated, according to the researchers, that ACOAs were differentiable from control

groups as far as alcohol and other drug abuse were concerned. In addition, they found that

“personality characteristics associated with externalizing, undercontrolled behavior, and that

family-of-origin social class moderated nondrinking outcomes among COAs” (Jacob et al., 1999,

p. 14). Their results claimed that ACOAs did have higher levels of alcohol and other drug

abuse, and that their personalities were easily identifiable when compared to non-ACOAs; two

claims that are refuted by Fineran et al. (2010). The two studies are completely at odds.

However, since Fineral et al. (2010) compared ACOAs to non-ACOAs, their results are more

representative of the population as a whole. Jacob et al. (1999) focused solely on ACOAs, and

so it is highly likely that the apparent ease of identifying ACOAs from non-ACOAs is due to the

Barnum effect – the profile was tailored specifically to describe ACOAs, so they confirm that it

describes them.

Parental Alcoholism as a Risk Factor

Hall and Webster (2007) claim, “Growing up in an alcoholic home does not necessarily

mean an individual will develop problems, but it does serve as a very real and significant risk

factor” (p. 494). The difference here lays in these two similar but distinct ideas: first, that

parental alcoholism causes alcoholism in the child, and second, that parental alcoholism may

lead the child to engage in activities that may lead to alcoholism later in life. Claiming direct

causation is inadvisable when it comes to alcoholism, since:

The factors intertwined with alcoholism are highly complex and interact in a

multiplicative fashion. It goes well beyond a simple stimulus-response framework or

antecedent-behavior-consequence paradigm. The stimuli are complex and often unclear,

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the antecedents have multiple cues and there is no consistent and clear rules that can be

incorporated.” (Hall & Webster, 2007, p. 507)

It would be simple to say that parental alcoholism causes child alcoholism, however it is not

correct to claim that parental alcoholism is a sure sign of alcoholism developing in the children

later in life.

A study conducted on college-aged adult children of alcoholics investigated the

relationship between coping style and depressive mood symptoms in both ACOAs and non-

ACOAs (Klostermann et al., 2011). The results of the study suggested that ACOAs reported

more avoidant coping behaviors than non-ACOAs (avoidant coping behaviors included those

such as smoking and drinking). However, the researchers stated that their study was limited,

mainly because it relied exclusively on the participants’ self-reports, from parental alcohol abuse

to personal depressive mood state and coping behavior. In this instance, the children’s views of

their alcoholic parents, coupled with the unreliability of memory (especially memories of

childhood) may have skewed the reports of just how alcohol-abusive the parent was. In addition,

the researchers mentioned, “participants who experience depressive symptoms may be less

accurate in their assessment of coping strategies,” since those depressive symptoms may affect

their general assessment of themselves as well as those strategies (Klostermann et al., 2011, p.

1166). The researchers stated that no causal relationships could be established between

categorization as an ACOA or non-ACOA, depressive symptoms, and coping strategies. This

study’s findings support the idea that although ACOAs may exhibit a certain set of symptoms,

not all ACOAs exhibit said symptoms, and therefore the idea of a specific list of symptoms being

used to define ACOAs as a subgroup in the population is faulty. This study could be more

ADULT CHILDREN OF ALCOHOLICS 8

successful with the use of more objective ways to determine coping strategies, depressive mood,

and especially history of parental alcohol abuse.

ACOA as a Label

Logue, Sher, and Frensch (1992) conducted a meta-analysis of the clinical literature

regarding ACOAs, followed by a study of their own, and made several pertinent discoveries.

They first claimed that the ACOA label is problematic, since it implies maladaptive and

pathological characteristics (Burk & Sher, 1998). The practice of labeling ACOAs as such

therefore could cause ACOAs to believe that they show these specific maladaptive or

pathological characteristics. However, misdiagnosis as an ACOA could be harmful and possibly

lead to further problems down the line; diagnosed “ACOAs” may exhibit the previously listed

symptoms because they feel they are supposed to exhibit them as a result of their parents’

alcohol abuse, not because they are actually experiencing them. In addition, the reported effects

of drinking in parents of ACOAs are so widely varied that it suggests that there is no single

symptom picture that applies to ACOAs as a group (Russell, Henderson, & Blume, 1985). There

is no one set of symptoms that applies to, and only to, ACOAs. Finally, the ACOA label does

not differentiate between ACOAs and those coming from a family with one or more members

suffering from disorders such as depression (Jacob & Leonard, 1986). The similarity between

ACOAs and adult children of individuals with other psychological disorders is of paramount

importance – substance abuse in general in parents may lead to the aforementioned ACOA

profile just as much as abuse of specifically alcohol does.

The Barnum Effect in Personality Assessments of ACOAs

Logue et al. (1992) also attributes the acceptance of ACOA profiles, once more, to the

Barnum effect. As previously stated, Barnum profiles are accurate for large numbers of the

ADULT CHILDREN OF ALCOHOLICS 9

population, but are not relevant because they are not specific enough to provide any differential

information for specific groups of people. The study compares descriptions of ACOAs to

Barnum profiles: they are vague, they describe two extremes (for example, being either too

worried or not worried enough about others), they describe traits generally seen as favored or

desirable, and they list traits that already have high base rates in the population. Therefore,

labeling of ACOAs as such should be avoided, since the act of labeling has no proven positive

effect on those labeled, and the method of labeling is inherently flawed.

In addition to a meta-analysis, Logue et al. (1992) conducted a study in which four

groups of college students – female ACOAs, female non-ACOAs, male ACOAs, and male non-

ACOAs – were first given lengthy personality assessment, using questionnaires containing the

Marlowe-Crowne Social Desirability Scale (Crowne & Marlowe, 1960) and Rotter’s (1996)

Internal-External Locus of Control Scale. After the initial personality assessment, the subjects

were given one of four possible personality profiles that there were told was generated based on

their answers to the initial assessment. The second assessment was randomly assigned; the

researchers did not actually base the assignment off of the initial assessment. Each profile

contained six statements, aggregated from either Barnum or ACOA profiles. The results showed

a high rate of acceptance of the ACOA profiles for both the ACOA subjects and the non-ACOA

subjects. 71% of ACOAs and 63% of non-ACOAs rated the ACOA profiles as describing

themselves “very well” or better. In addition, 71% of subjects rated the profiles they were given

as describing themselves “very well” or better, even though the profiles they were given were in

no way correlated to the results on the previous personality assessment, nor were they correlated

to the subjects’ family history. The researchers concluded, “statements that are found to be

highly acceptable as descriptors of ACOAs, but which are also vague, double-headed, or of high

ADULT CHILDREN OF ALCOHOLICS 10

base rate in the general population, may not be valid personality descriptions of ACOAs”

(Logue, et al., 1992, p. 231).

Discussion

Based on the studies reviewed, the idea that “adult children of alcoholics display a

distinct profile of symptoms” is completely false. The list of symptoms has descriptors that are

either far too vague – a tendency to assume too much responsibility for others at times and too

little at other times describes all points in time, except those rare moments in which one assumes

exactly the right amount of responsibility for others – or with exceedingly high base rates in the

general population – one could argue that a “need for approval from others” is part of the human

condition. An adult who is also the child of an alcoholic may look at the profile and agree that it

describes them, but an adult who is not the child of an alcoholic may also agree that the profile

describes them as well. There needs to be a clear distinction between what describes adult

children of alcoholics (which many of the symptom profiles so) and what defines adult children

of alcoholics, since many of them come from complex situations and may exhibit different

physiological or psychological symptoms stemming from parental alcohol abuse. Lumping

everyone whose parents abused alcohol into one group and putting a label on them may also be

dangerous. Sher (1997) states that generalizations should not be made without careful

forethought; although the research shows that children of alcoholics (COAs) are at a higher risk

(compared to non-COAs) for psychological disorders, a small proportion of COAs are actually

affected by those disorders, excluding substance abuse disorders. Therefore, labeling ACOAs

with a particular symptom picture and diagnosis is counterproductive, and overgeneralizations

when labeling this population may do more harm than good.

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The overgeneralizations of ACOAs may have the potential to be harmful, but the idea of

labeling a specific group of people due to their family history can be a viable option in some

instances. If a label is helpful, or if it “identifies a pathological state in need of professional

attention, acceptance of it may serve as the entree into treatment. In clinical populations, labels

may suggest treatment approaches and prognosis” (Logue et al., 1992, p. 226). As an example,

the diagnosis of depression can help individuals affected by the disorder to find a treatment plan

that works for them, whether it be medication, therapy, or a combination of both; this treatment

should then lead to a better long-term prognosis as far as the patient’s physical and mental health

are concerned.

Taking all of the aforementioned into consideration, the conclusion is clear: labeling

adult children of alcoholics with the “ACOA” label and assigning a specific list of symptoms to

that label as defining characteristics of the group is incorrect. Although some studies have

shown that ACOAs are more susceptible to alcoholism or other drug use later in life, the list of

psychological problems first presented has not been proven to be applicable to all ACOAs, and

in fact those traits also applicable to members of the general population. This widespread

acceptance of the list of symptoms as accurate is due to the Barnum effect; either the general

vagueness of the statements on the profile or the high base rate of occurrence in the population

makes them seem valid when in reality, they are not.

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