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3 The Relationship of Problem Drinking to Individual Offending Sequences James I. Collins INTRODUCTION This paper examines the empirical as- sociation ant! etiological relevance of problem drinking to the onset, continua- tion, ant! pattern of criminal careers. The main purpose is to determine, based on previous research, what inferences can be macle about the relation of problem drinking to serious and repetitious in- volvement in crimes that victimize per- sons or property. Hence, the paper is not concerned with crimes that are related to the use or distribution of alcohol. Uncler- age clrinking, public clrunkenness, the il- legal sale of alcoholic beverages, ant] driving while intoxicated are alcohol- clefined offenses and are considered! here only if they are relevant to incliviclual offending sequences (criminal careers). Nor is the paper concerned with the in- fluence of alcohol use in particular crim Jarnes I. Collins is a staff member at the Cer~ter for Social Research and Policy Analysis, Research Triangle Institute, Research Triangle Park, North Carolina. The author acknowledges the assistance of Patricia L. Kristiansen and Elizabeth R. Cavanaugh, both of the Research Triangle Institute. 89 inal events. A substantial literature ad- dresses whether drinking precipitates criminal events or changes their charac- ter especially violent events. Some of that literature will be partially relevant here, but the criminal career focus of the paper requires an emphasis on offenders' life cycles and not on particular events. fReviews of the alcohol-criminal events literature can be found in Roizen and Schneberk (1977) ancl Collins (19811.] It is clear that identifiecl offenders are much more likely than the general popu- lation to engage in problem drinking. It has not been established, however, that the problem drinking explains serious in- volvement in crime. Indeecl, the funcla- mental difficulty of this paper will be distinguishing the pervasive use of alco- hol among offenders from the explanatory relevance of alcohol use to inclividual offending sequences. A basic assumption of the paper is that alcohol use is never the sole cause of a criminal career. Alcohol's behavioral effects are filtere through a variety of physiological, psy- chological, social, an(1 cultural factors. Thus (lrawing etiological or causal infer

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go ences will be clifficult because of the complexity of the aTcohol-behavior rela- tionship and because most of the relevant research has not addressed causal-infer- ence problems. The ideal research design for making inferences about the effect of alcohol use on individual offending sequences is a longitudinal one that begins to collect data on drinking and criminal behavior before the onset of either behavior. No such research has been clone, nor is any planned, so far as this writer is aware. A number of completecl or ongoing longitu- ctinal studies have the ciata with which to analyze the effects of alcohol use on crim- inal careers, but completed Tongituclinal analyses have not focused on the role of alcohol. Some researchers have examined the importance of drug use Johnston, O'Malley, and EvelancI, 1976; Elliott, Huizinga, and Ageton, 1982) but they either ignore alcohol use or combine al- cohol use with drug use in their analyses. Most of the promise of completed and ongoing longitudinal research to cleter- mine whether and how alcohol use affects individual offending sequences remains to be realizecl. METHODOLOGICAL ISSUES Definition and Measurement of Problem Drinking Problem drinking is the main inclepen- dent variable in this analysis. The term can have many definitions and is not consistently clefinect in the literature. Oc- casional ant! light or moderate use of alcohol that does not have adverse out- comes is not of interest here. Neither is the focus only on the conclition of aTcohol- ism. Problem drinking is interpreted here to include: (1) excessive use of alcohol based on quantity or frequency of intake; (2) adverse consequences of drinking, such as family, job, or health problems; CRIMINAL CAREERS AND CAREER CRIMINALS and (3) perceptions of the drinker or oth- ers that he or she has a drinking problem. The literature includes work that is not explicit about the definition of drinking problems or alcoholism. In the discus- sions of inclividual works that follow, the basis for cleaning drinking as a problem is macle explicit. Usually, the definition re- lies on some measure of excessive intake or of adverse outcomes of drinking. Sometimes drinking is defined as a prob- lem on the basis of criminal outcomes, such as arrest or violence after drinking. For the purposes of this paper the latter definition confounds independent and clepenclent variables ant] inhibits a cleter- mination of whether drinking is a causal factor in criminal careers. Problem drinking is usually measured by records of aTcohol-relatec3 arrests or alcohol treatment or by self-reports of aTcohol-use patterns or problems. Bloo alcohol content (BAC) measures, physio- logical indicators, and use of instruments with known reliabilities are rarely found in the literature. The incompleteness an inaccuracy of public records are well- known problems, and the reliability and validity of self-report data are infre- quently cliscusse(1 in the literature. The discussion below specifies the source of data on problem drinking anct discusses those measures when that seems appro- priate for methodological or substantive reasons. If an inclivi(lual clevelops a drinking problem, it is very often not permanent. Typical prevalences and types of clrink- ing problems vary by segment of the life cycle, and drinking problems ten(1 to be highest during the young a(lult years (Cahalan and Room, 1974; Cahalan and Cisin, 1976; Mandell and Ginzburg, 1976; Noble, 19781. There is evidence that problem (lrinkers often stop having problems through abstinence or con- trollec! drinking (Robins, Bates, and O'Neal, 1962; Fillmore, 1975; Cahalan

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PROBLEM DRINKING AND INDIVIDUAL OFFENDING SEQUENCES and Cisin, 1976; Roizen, Cahalan, and Shanks, 1978~. The type of drinking prob- lem experienced by an incTiviclual also varies by age. For example, Cahalan and Room (1974) show that "police" prob- lems clue to drinking are highest between the ages of 21 and 24, but that health problems due to drinking, comparatively Tow between the ages of 25 and 44, in- crease after age 44. An implication of the age-variation and spontaneous-remission evidence is that the lifetime and current prevaTences of drinking problems cliffer. Much of the ciata in the literature on problem drinking ant! criminal careers, however, do not distinguish "ever" having drinking prob- lems from "current" problems, nor do they place the drinking problems within a life-cycle segment. This lack of speci- ficity limits the career inferences that can be drawn from the findings. Long-term drinking patterns and the cumulative ef- fects of drinking alcohol over a long pe- rioc! are more relevant to the career focus of this paper than the acute effects of alcohol use in single drinking episodes. This is also consistent with the focus on indiviclual offending sequences rather than particular criminal events. Some Tong-term effects of drinking are well known. Misuse of alcohol is associ- ated with liver disease, nutritional defi- cits, brain dysfunction, cardiovascular problems, and an increased risk of cancer (Eckarcit et al., 19811. Much less is known about the Tong-term behavioral effects of problem drinking. There are empirically unsupported suggestions in the literature that alcohol's chronic effects may cause "irritability," and although the inference must be tentative, chronic alcohol effects may increase inclividual tendencies toward violence. A more reasonable basis for the pharmacological and physiological effects of alcohol on behavior is through its impact on cognitive capacity. Alcohol use impairs a (lrinker's ability to perceive, 91 process, assess, and integrate cues from the environment (Pernanen, 1976, 19811. A distinction is relevant for purposes of this paper, although it is a distinction not usually made in the literature and thus is not sustainable in the analyses that fol- Tow. Problematic alcohol use over a Tong period creates "neuropsychological clefi- cits" in the drinker (Tarter and Alterman, 19841. Presumably, some ofthose cleficits will affect behavior and may explain some criminal behavior. A priori it seems reasonable to expect such criminogenic deficits to impel one to "irrational" (vio- lent) crime rather than to "rational" (ac- quisitive) crime. A second type of chronic criminogenic effect of problem (lrinking may be a recurrent effect in indivicluals who are not necessarily chronic problem drinkers. Examples would be an infre- quent drinker who totals to have prob- lems when he or she does ([rink ant] a regular drinker who occasionally com- mits offenses when drinking. Even though these distinctions cannot be macle from the existing literature, it is useful to recognize them because of their potential relevance for etiological understanding. The "eye of the behoIcler" issue is also an important one for interpreting alcohol use as problematic. Alcohol occupies unique psychological, cultural, moral, en cl scientific territories in American life. The phenomenological dimension causes definitional and inferential problems, some of which are discussed below. The phenomenological complexities cannot be resolved here, but they are partially arldressec! through explicit (definitions of what is meant by problem drinking. Definition and Measurement of Criminal Careers Criminal careers involving "street" crime are of interest here. In general, these are Uniform Crime Reports Part I and Part II offenses that involve actual or

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92 attempter] violence or property loss. This focus exclucles two major categories of crime: (1) victimless crime, especially al- cohol- and drug-clefined crime includ- ing public-order crimes that result from substance abuse (vagrancy, disorderly conduct, et cetera) ant] (2) white collar crime. The first category is not used to define a criminal career because, as noted, it confounds independent and cle- pendent variables and because interest is in criminal behavior that involves victim- ization of someone's person or property. It will not always be possible to distin- guish the victimless or public-order of- fenses from other offenses because some studies do not make the distinction. White collar crime is not considered because almost no information is avaiT- able on the relationship of alcohol use to such offenses. It is reasonable to infer that white collar criminal careers would be influenced by problem drinking. Alcohol is the principal drug of choice for white collar, psychoactive substance users, and it is known that significant percentages of people of high occupational status are heavy drinkers or have problems with alcohol (Cahalan, Cisin, and Crossley, 1969; Trice and Roman, 1972~. The rela- tionship between alcohol problems and white collar crime, however, has not been studied. Official records and self-report data are used to estimate involvement in crime. Each type of ciata has its strengths ant] weaknesses. The most serious problem with using official records to estimate criminal behavior is their incomplete- ness. Most crimes are not reported to the police (Bureau of Justice Statistics, 1983b). There is also some evidence that alcohol abusers are more By than nonabusers to be arrested. Petersilia, Greenwood, and Lavin (1978), for exam- ple, found that alcohol abusers were ar- rested for 12.1 percent of the offenses they committed compared with 2 to 3 CRIMINAL CAREERS AND CAREER CRIMINALS percent for drug abusers ant! offenders who were neither drug nor alcohol abus- ers. If the problem (drinker is more likely to be arrested given commission of an offense, it may be a result of the cognitive impairment that results from alcohol use. A drinking offender may be an incompe- tent offender. If the probability of arrest is higher for problem (lrinkers than others, official records may overstate the impor- tance of problem drinking to criminal careers. Self-reports of illegal activity have adcled an important dimension to the study of criminal careers. The reliability anct validity of such data have been exam- ined, and the best general conclusion seems to be that offender reports of illegal involvement represent reasonable ap- proximations of the behaviors in question (Marquis, 1981; Hubbard et al., 19821. The data are likely to contain some sys- tematic error, however. Hubbard et al. (1982) found that the frequency of in- volvement and length of recall affected the concordance of self-reports of arrest and official records of arrest. Peterson and Braiker (1980) found rapists less willing than other offender types to report the crimes for which they were convicted. Weis (in this volume) discusses other is- sues relating to self-reports of criminal behavior. Because of the potential for the type of crime data to affect findings in systematic ways, the discussion below specifies the sources of data used in the analyses. Study Populations Studies of problem drinking and crim- inal careers have been carried out on samples of the general population, ar- restees or convicted offenders, alcohol abuse and mental-hearth treatment popu- lations, and prison populations. Studies of the general population are least frequent; studies of prison populations most fre

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PROBLEM DRINKING AND INDIVIDUAL OFFENDING SEQUENCES quent. Clearly, general-population stud- ies are most generaTizable, although such studies are relatively expensive to con- duct. Neither a criminal career nor prob- lem drinking is common among the gen- eral population, so large samples are requires! to produce sufficient data for detailecl analysis. On the other hand, prison populations have a high preva- lence of involvement in criminal activity and problem drinking and are relatively accessible to researchers. The tracle-offin using prison samples is limited generaTiz- ability. Prisoners are not representative of the general population or of all offenders. Because of the representativeness and generalizability issues, discussions that follow are organized in part by the type of sample studied, i.e., general, alcohol treatment, ant] criminal justice system samples. Polydrug Use It is common for individuals to use mul- tiple psychoactive substances (O'Donnell et al., 1976; Fishburne, Abelson, ant] Cisin, 1980; Johnston, Bachman, and O'Malley, 1981; Bray, Guess, et al., 1983~. This may involve the use of alcohol and other drugs at the same time or within a short time (hours), or different psychoac- tive substances on different occasions. Polydrug use Including such combina- tions as alcohol and marijuana, alcohol and barbiturates, heroin ant] cocaine) has become very common in recent years, and there is evidence that it Including alcohol) is the modal pattern among of- fenders and treatment populations (Bray, Schlenger, et al., 1982; Chaiken and Chaiken, 1982; Johnson and Goldstein, 19841. Polydrug use creates a complex analytic problem when the behavioral ef- fects of a particular substance are of inter- est. The behavioral effects of single drugs are not well understoocl, and, when two or more c3 rugs are used in combination, 93 specific behavioral effects are all but im- possible to predict. Despite the proliferation of polyclrug use, most users have a "drug of choice," and inclividuals who have alcohol or drug problems are usually able to identify the substance that is the primary source of their cli~culties. Among 3,325 individu- als entering federally funded drug abuse treatment programs in 1979, for example, 87 percent specified a particular sub- stance as being their "primary" problem (Bray, SchIenger, et al., 19821. The sepa- ration of inclivicluals into categories basest on alcohol or specific-clrug problems, however, does oversimplify the reality of substance-use patterns, and indivicluals may be cIassifiecl in different categories during different phases of their lives. It is the heuristic assumption ofthis paper that individuals can be classified accurately as having or not having a drinking problem (lifetime or current). This classification permits examination of the relationship between problem (lrinking and indivicl- ual offending sequences. Because use of hard drugs is usually . ~ . . . . viewed as a more serious cr1m1nogen1c factor than alcohol use, there is a ten- dency among researchers to create hier- archical indices of psychoactive sub- stance use in which the independent effect of alcohol use by drug users is not consiclered. For example, Johnson, Wish, and Huizinga (1983) analyze the sub- stance use-clelinquency relationship for two groups: those who use alcohol only and those who use ([rugs or drugs and alcohol. This approach assumes, without testing, that drug use is the primary criminogenic effect. The fact that alcohol is a legal (drug encourages such a view. It is important, however, to consider sepa- rately whether alcohol use, which is often quite heavy among (lrug users, makes an inclepen~lent contribution to the occur- rence of criminal behavior as part of a polyclrug-use pattern.

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94 Gender and Race The variables of gender and race re- ceive little attention in this paper, mainly because the literature on problem cirink- ing and criminal careers rarely considers gentler and race effects. When these vari- ables are included in analyses, the finc3- ings are not markedly different for gentler or racial groups. There is evidence that suggests that white-black racial differences in drinking patterns exist and that they have implica- tions for the problem drinking-criminal career relationship. For example, a na- tional survey of state correctional inmates showed a substantial difference by racial group in the percentage of inmates cIas- sifiect as heavy drinkers 50 percent for whites versus 21 percent for blacks (Bu- reau of Justice Statistics, 1983c). The lit- erature that is relevant to the relation between problem drinking and individ- ual offending sequences, however, does not permit assessment of white-black clif- ferences. The same holds for gentler; the literature does not address the question of gender effects in the problem c3rinking- criminal career relationship. Moreover, there seems no reason to believe that problem drinking explains much varia- tion in serious crimes by women. Be- cause women probably commit less than one-fifth of the serious crimes and be- cause the gender variable does not ap- pear to bear on the problem drinking- criminal career relationship, gentler is not considered here in any detail. Making Inferences About Alcohol Effects Despite years of study, a great (leal remains to be understood about the be- havioral effects of alcohol use both acute (short-term) ant! chronic (Iong-term) effects. Woods and Mansfielcl (1983) ar- gue that pharmacological changes in neu CRIMINAL CAREERS AND CAREER CRIMINALS rat functioning brought about by ethanol are "nonspecific." tones and Vega (1972, 1973) found that a rapid increase in BAC causes behavioral effects. Several re- searchers report that racial-ethnic groups differ in their reactions to drinking (Wolff, 1972; Fenna et al., 1976; Marco and Ran- (lels, 19831; others report that individual psychology influences the effects of aTco- hol (McCord and McCord, 1962; Zucker, 1968; McClelland et al., 1972~. Pernanen (1976, 1981) suggests that the effects of alcohol use on cognition probably inter- act with environmental cues in complex ways. In sum, the "state of the art" in understanding the behavioral effects of drinking from pharmacologic and psycho- logical perspectives is not far advanced. Evidence of the complexity of the sub- ject is pointed out by Cordelia (19851. Her analysis suggests that for some types of criminal activity, notably organized crime or planned property crime committed in collaboration with two or more people, problem drinking may act as a bar to criminal activity. Offenders with drinking problems may be viewed as undepend- able and not recruited into criminal en terprises. This scenario suggests an in- verse relationship between problem drinking and organized, rational criminal activity. In recent years the importance of social and cultural factors in mediating alcohol's behavioral effects, as well as the interpre- tation of those effects, has been recog- nized. MacAndrew and Edgerton (1969) generated important insights about the influence of social and cultural factors. They showed how "drunken comport- ment" was affected by cultural factors and, conversely, how some cultures make provision for untoward behavior after drinking during specified "time out" pe- riods. Room (1983) argues that the causal link between alcohol use and behavior is a sociocultural rather than a pharmacolog- ical one.

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PROBLEM DRINKING AND INDIVIDUAL OFFENDING SEQUENCES Three points about sociocultural influ- ences on the alcohol use-behavior inter- action are relevant for this paper. These points have to do with expectancy, dis- avowal, and attribution. The behavior of indivicluals after drink- ing is influenced by effects they expect alcohol to have, quite asicle from actual effects attributable to drinking. Lang et al. (1975) fount! that indivicluals who had been told they c3 rank alcohol, even though they had not, became more ag- gressive in controlled laboratory experi- ments. Tamerin, Weiner, and Mendelson (1970) measured mate alcoholics' expec- tations about how they would fee! after drinking and macle observations about actual behavior after drinking. Their sam- ple of 13 accurately predicted they wouIcl become more aggressive after drinking. However, the subjects inaccurately pre- dicted other effects of drinking (euphoria, sexuality) and their subsequent (after drinking) assessment of their behavior was more concordant with their predrink- ing predictions than with their actual be- havior. Brown et al. (1980) assesses] ex- pectancies associated with moderate alcohol consumption among two samples (N = 125 and N = 440~. Factor analysis of 216 yes-no items produced six behavior- al-expectancy dimensions-one of which was "aggressiveness." Expectancies var- ied by demographic factors (age, sex) and by drinking experience. Drinking is sometimes used as an ac- count (Scott and Lyman, 1968) or devi- ance-clisavowal technique. McCaghy (1968) showed how some men convicted of sexual offenses against children used drinking to excuse their behavior. Mosher (1983) points out how recent ABSCAM-convictecT offenders have at- tempted to excuse or justify their behav- ior by reference to the effects of alcohol. Coleman and Straus (1979) argue that some men drink to give themselves an excuse to beat their wives. 9S The attribution of blame to alcohol in the absence of clear justification is also observable at the macro level. Gusfield (1963) analyzed the nineteenth century temperance movement and argues that the abolition of alcohol became the sub- ject of a moral crusade as the vehicle for playing out the conflict between compet- ing societal interests. In a review of the famiTy-violence literature Hamilton ant! Collins (1981) argue that a "malevolence assumption" underlies much of the pub- lic debate about alcohol. When alcohol is found to be associated with undesirable events and circumstances, it is assumed to be at fault. The major points to be ma(le about previous work on the expectancy, dis- avowal, and attributive aspects of alco- hol's effects on behavior are that percep- tions and interpretations complicate the causal-inference task and make it difficult to assess the validity of self-perceptions of alcohol's effects. Alcohol occupies unique phenomenological territory, an(1 caution is warrantee! when attributing effects to its use. There is no doubt that drinking affects behavior. Explaining how that happens is (lifficult. Moreover, there is a tendency to ascribe blame to drinking without justification. ASSESSMENT OF THE LITERATURE This section of the paper reviews the literature on the relation of problem drinking to in(liviclual offending se- quences. The juvenile, young adult, and later adult life-cycle segments are treated separately. The period that has received most attention by researchers is the young adult period. As will be seen, there are good reasons for this attention. The separation of the analysis into ju- venile, young adult, and later acLult peri- o(ls also reflects society's drinking norms. Most drinking during the juvenile years is illegal and disapproved by adult society.

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96 Nevertheless, drinking is quite common among juveniles. In young adulthood drinking is legally permissible. In fact, heavy drinking accompanied by deviant or disruptive behavior is the norm for young adults in some contexts (for exam- ple, in the military or at fraternity parties). Drinking norms shift again for oicler adults. Family and career responsibilities are expected to mitigate or preclude the heavy use of alcohol, ant] behavior after drinking is expected to meet a higher level of decorum than is expected in the young adult years. There is consiclerable variation around age-gracled drinking norms. For example, young adults might be held to higher behavioral standards regarding alcohol use in some contexts, such as at a family reunion. OIcler adults may be permitted to act like young adults in some situa- tions, such as at a football game. Nonethe- less, drinking and its behavioral conse- quences display age regularities. For this reason, and because the literature itself is roughly organized in this way, the follow- ing review is organized around the three life-cycle segments. As mentioned ear- lier, the reviews will also be roughly organized by sample type (general popu- lation, alcohol treatment, ancI criminal justice) when the literature permits such a separation. The Juvenile Period During the juvenile years any con- sumption of alcohol is a potential prob- lem because drinking is illegal for those uncler statutory drinking age, which ranges from age 18 to 21. Illegal purchase or consumption of alcoholic beverages, however, is not of interest here unless it is associated with other criminal behavior during the juvenile years or later in the life cycle. Specifically, this review fo- cuses on the following questions: Does the age at which drinking begins have CRIMINAL CAREERS AND CAREER CRIMINALS any power to predict involvement in serious crime? Do drinking problems clur- ing the juvenile years predict later crimi- nal careers or aspects of individual of- fending sequences, such as career length or offense specialization? Little previous work has focused on these questions so the answers are necessarily incomplete. Considerable previous work has fo- cusecT on drug use during the juvenile years. Most of that work will not be exam- ined here because another paper in this volume (Wish and Johnson) focuses on drug abuse and indiviclual offending se- quences. Some work has included aTco- ho] use as an aspect of drug use. More commonly, the literature treats alcohol use, drug use, and other clelinquencies (such as truancy, running away from home, ant! precocious sexual behavior) as aspects of a configuration of problem be- haviors (lessor an(l lessor, 1977~. This view of juvenile clelinquency is a func- tion of the acljuclication process for juve- niles and of the typical pattern of conduct of delinquents who come to the attention of the juvenile justice system. Juveniles are more likely to be "adjudicated clelin- quent" than to be convicted of a particu- lar offense, and typically juvenile offend- ers (like adult offenders) exhibit a mixture of problems and illegal involvements. In comparison with the prevalence of prob- lem behavior and delinquency, involve- ment in serious crime is Tow during the juvenile years. It is also low in compari- son with the young adult years. Elliott and Huizinga (1983), for example, show how rates of participation in serious crime by youths in a national sample are Tow in comparison with participation rates for minor crimes and status offenses. In- volvement in felony assault, robbery, fel- ony theft, and hard-drug use tends to be Tower than involvement in minor assault, minor theft, vandalism, and school delin- quency for males and females and across social classes.

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PROBLEM DRINKlI!IG AND INDIVIDUAL OFFENDING SEQUENCES General-Population Stuclies Alcohol use is very common among high-school-age youths. National surveys conclucted in 1974 and 1978 shower! that 87 to 89 percent of the tenth through tweed graders hacl some experience with alcohol (Rachel et al., 19801. Sub- stantial proportions cirank frequently. Twenty-seven to 29 percent in the two surveys drank once a week or more. Heavy drinkers, defined as those cirink- ing at least weekly and taking five or more drinks per drinking occasion, constituted 15 percent of the samples. Basecl on cri- teria of frequency of drunkenness and perceived alcohol-related negative conse- quences, approximately 3 in 10 were cIas- sified as misusers of alcohol. Alcohol misusers were significantly more likely than alcohol users to report having trou- ble with the police; 4.1 percent of male alcohol users and 25.4 percent of mate alcohol misusers had trouble with the police because of drinking. The corre- sponding percentages for female alcohol users and misusers were 2.4 and 11.5, respectively. The finclings from studies of general- population samples of juveniles are that delinquency, as noted above, typically constitutes a varier! configuration of prob- lem behaviors. lessor and lessor (1977) and lessor, Chase, and Donovan (1980), analyzing data from the national surveys of high school students referred to above, found that problem drinking was associ- ated with marijuana use and general de- viance. lessor and associates argue fur- ther that the different forms of problem behavior develop from common etiologi- cal configurations. lessor et al. (1968), in a study of a tri-ethnic community, found that different measures of deviance correlate and that theoretical findings were fairly similar across ctifferent sex, age, and ethnic groups. White, Johnson, and Garrison 97 (1983), in samples (N = 1,381) of 12-, 15-, and 18-year-olds from New Jersey house- holds, found a "synchronous" clevelop- ment of both substance use (alcohol anct drugs) and criminal behavior. The sub- stance-use variable was a stronger predic- tor ofthe intensity of delinquent behavior than the reverse. Rathus, Fox, and Ortins (1980) used a shortened version of the MacAndrew Al- coholism Scale and a self-reported clelin- quency scale in a study of 786 mate and 886 female high school students in a micl- dIe-cIass suburban community. The sam- ple was 97 percent white. The MacAn- c3rew scale was found to predict alcohol abuse successfully, but it also was found to have "global predictive power." The scale preclictec3 some drug use and other delinquency, such as property ant] per- sonal crimes. The authors interpret this to indicate that problem drinking is part of a general pattern of deviance. Ryclelius (1983a,b) interviewed and collectecl blood samples in 1980-1981 from 2,300 young men who came to a military recruiting office in Swollen as a result of the compulsory military-service law. Data for 1,004 of the subjects were analyzed. Approximately 99 percent were between 17 ancI 19 years of age; 93 per- cent were 18 years old. The amount of pure alcohol consumed within the month prior to the interviews was estimated from self-reports of beer, wine, ant! spirits consumption. During the interviews, 21 percent aclmitted minor criminal of- fenses; 6 percent reported committing theft and burglary; 2 percent reported committing assault and malicious dam- age; 9 percent had been convicted of crimes; and 5 percent were known for public drunkenness. Ryclelius cIassifiect the subjects accord- ing to their consumption of pure alcohol and compared high consumers with nonconsumers on a number of climen- sions. The high consumers were more

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98 likely than the nonconsumers to be drug users and to be involved in other crimes. The percentage of high consumers versus nonconsumers who engaged in various offenses are shown below (from Ryclelius, 1983a:Table 71: High Consumers versus Noncon sumers (percent) Pilfering, illegal driving 45 versus 9 Stealing and burglary 38 versus 1 Conviction, any crime 35 versus 3 Known for public drunkenness 35 versus 1 Assault, malicious mischief 14 versus 1 All differences are statistically significant below the .001 level according to the chi-square statistic. In subsequent psychological testing of 50 high consumers and 50 nonconsumers, the high consumers were found to have psychopathic personality traits and the nonconsumers were found to have nor- mal personalities (Ryclelius, 1983b). Dif- ferences were found between the two groups on 13 of 15 scales included in the test. In summary, the evidence from gener- al-population studies of juveniles is that problem drinking covaries with other forms of deviance and with serious crim- inal behavior. The relationship of prob- lem drinking to deviance and crime is best conceived as one involving a com- mon etiology in the juvenile years. Delinquent-Population Studies Studies of delinquent populations also confirm the strong covariation of alcohol use and delinquency. Blane and Hewitt (1977) reviewed a number of studies and concluded that CRIMINAL CAREERS AND CAREER CRIMINALS 1. Age at first drink is earlier for delin- quents than nondelinquents, 2. Prevalence of drinking is higher among (lelinquents than among nonde- linquents, 3. Drunkenness is more prevalent among delinquents than among nonde- linquents, 4. Pathological drinking symptoms are more common among OCR for page 89
PROBLEM DRINKING AND INDIVIDUAL OFFENDING SEQUENCES fore entering training school. The authors focused on whether the correlation be- tween drinking frequency and illegal be- havior differed for whites, blacks, and Hispanics. Multiple regression analyses revealed that drinking had strong net ef- fects on minor delinquency in each racial group. Drinking frequency was found to explain statistically significant variation in serious and nonserious delinquency for whites and blacks. Drinking fre- quency did not explain involvement in serious delinquency for Hispanics but was associated with nonserious delin- quency for this ethnic group. The authors did not clear with the temporal-order is- sue, that is, whether frequent drinking prececlec3, followecI, or was coterminous with involvement in illegal behavior. The analyses do show that the empirical asso- ciation of drinking frequency and crimi- nal behavior was robust among white ant] black training-school residents. Vingilis (1981) is not convinced by the evidence on drinking and clelinquency because of methodological problems, es- pecially the failure of much research to use control groups. Vingilis appears pre- parecl to acknowledge that delinquents drink more than nondelinquents but thinks that delinquents charged with al- cohol-relatec3 crimes are similar to clelin- quents involved in nonaTcohol-related crimes. However, use of"alcohol-relatec! trouble with the law" as an indicator of public drinking may not distinguish de- linquents in a meaningful way. Etiology of Drinking and Crime in Juveniles Evidence on the common etiology of problem drinking and other deviance in the juvenile period an(1 on the covariation of problem drinking and delinquency cloes not address directly the major issue of this paper: that is, to what extent is problem drinking an important factor in 99 the onset, continuation, and pattern of criminal careers. Two studies give more specific insights about the relationship of problem drinking to individual offending sequences for juveniles. VirkLunen (1977) studied recidivism among 741 juvenile offenders convicted in 1965 in Finland. He divided the of- fenders into those with juvenile arrests for drunkenness anc! those with no such arrests; using the records of FinTand's Criminal Register, he examined recicli- vism for the years 1970-1975 (5 to 10 years after the initial contact). Virkkunen found that those who hac! juvenile drunk- enness arrests were more likely to recidivate and were more likely to have arrests for violent (22 versus 12 percent) and property crimes (47 versus 36 per- cent), as well as for traffic offenses. Johnson, Wish, and Huizinga (1983) analyzed National Youth Survey data (El- liott, Huizinga, and Ageton, 1982) with a focus on serious drug use anti high-rate, serious delinquency. They created a hier- archical typology of drug users: users of heroin or cocaine (5 percent), users of pills or psychedelics (7 percent), mari- juana users (19 percent), alcohol users (29 percent), and non-(lrug users (41 percent). Users of alcohol in acIdition to drugs are included in the first three categories. Heavy drug users (heroin, cocaine, pills, psychedelics) were also found to be heavy users of alcohol. Data on criminal activity were collected from self-reports (luring interviews. Johnson and colleagues show that among the hierarchical groups those cIas- sified as heavy drug users were responsi- ble for a clisproportionately large number of index crimes. Those who used only alcohol were comparatively unlikely to commit in(lex offenses or multiple index offenses although they were more likely than nonusers of any drug to commit minor delinquencies. The authors con- clude that alcohol use by itself is not

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110 findings cited above that showed prob- lem drinkers to be offenders of late onset. The inconsistency is perhaps an example of disparate fin(lings (lepencling on whether aTcohol-treatment or criminal- offender samples are studied. In a study of 187 men identified as "chronic police case inebriates," Pittman ancI Gordon (1958) constructed criminal career histories from arrest records. Men incarcerates! for public intoxication were selectecI at random from those serving sentences of 30 days or longer in a county prison in Rochester, New York. They av- eragec] 47.7 years of age. The men had to have served at least one previous sen- tence for public intoxication. The sample is a narrowly defined one, so that gener- alizability is limitecI, but the criminal ca- reer histories provide some interesting information. The men in the sample averaged 16.5 recorclec3 arrests for all offenses; the mean number of arrests increases with age from 6.8 for those uncler 35 to 22.9 for those aged 55 and older. Mean number of ar- rests for public intoxication was 12.8 for all ages, ranging from 4.1 for those under age 35 to 18.6 for those 55 and oIcler. A total of 22.5 percent of all arrests were for charges other than public intoxication. The mean number of arrests on charges other than public intoxication does not increase significantly with age after 35. The authors (Pittman and Gordon, 1958:261) infer: The explanation for the failure of other of- fenses to increase with age lies in the fact that at the end of the first utilized age period, 35, there is a trend for the inebriates who have been involved in more serious crimes, such as automobile theft or burglary, to cease this type of criminal activity, and for the intoxication pattern of behavior to emerge as an adaptation to the life situation. Thirty-seven percent of the sample had been arrested on serious charges, but Pitt CRIMINAL CAREERS AND CAREER CRIMINALS man an(1 Gordon note that those serious offenses tended to occur earlier in the career and reiterate that the "new" pat- tern of arrest for public drunkenness is a reaction to failed criminal careers. While the "biphasic" criminal career pattern is not inconsistent with this interpretation, the notion of an alcoholic adaption to a failed criminal career by Pittman and Gordon is speculative. If problem drinkers are late-onset of- fenders but also have short criminal ca- reers, the above findings may not be in- consistent with each other. In other words, the Edwards, Kyle, and Nicholls (1977) sample may start late and stop quickly. The best tentative conclusion about the effect of problem drinking on serious criminal behavior by those over age 3S is that there is no relationship. The issue needs further study, however, be- cause so little attention has been paid to the question. SUMMARY, RECOMMENDATIONS, AND IMPLICATIONS In this section, fin(lings from the three career-segment reviews are summarized, the magnitude ofthe association between problem drinking and criminal careers is cliscussecl, important methoclological is- sues are notecl, and implications for fu- ture research are drawn. Summary of Findings The best inference regarding the im- portance of problem (lrinking to the onset of criminal careers is that of no relation- ship. Some caution about this conclusion is necessary because age at first drink an the beginning of problem drinking are not adequately clistinguished in past work. Drinking at an early age is often viewed as a problem of itself. Most of the available evidence, however, indicates that involvement in crime precedes prob

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PROBLEM DRINKING AND INDIVIDUAL OFFENDING SEQUENCES lem drinking or that the two start at ap- proximately the same time. A second major inference that is war- ranted by past research is that there is strong covariation between problem drinking and incliviclual offending se- quences. It is not possible to infer confi- dently that the covariation indicates prob- lem drinking is a causal factor. Common etiologies may be involved. It floes ap- pear justified to conclucle that inclivicluals who have drinking problems tend, more than individuals without drinking prob- lems, to continue serious criminal activity during young adulthood. Some research- ers have seen this as the tendency of problem drinking to extend or intensify the criminal career. A robust finding justified by the works reviewed and other evidence is that prob- lem drinkers who have criminal careers or offenders with drinking problems are disproportionately likely to have official records for, and to self-report involve- ment in, violent crime. No fewer than 10 of the studies reviewed shower] this pat- tem, although the finding is most clear among i(lentified criminal justice popula- tions. The connection between problem drinking and violent behavior is consicI- ered robust, also, because the fincling is replicated in the literature that examines assaultive criminal events. In that litera- ture, alcohol has been found present in the offender, victim, or both offender and victim in very substantial percentages of homicides, forcible rapes, aggravated as- saults, ancl other violent crimes. Recent aggregate-level analyses also find a direct relationship between levels of alcohol consumption and levels of violence (Bielewicz ant] Mokalewicz, 1982; Lenke, 1982; Olsson and Wikstrom, 1982) There is little doubt that drinking is etio- Togically important to the occurrence of some violent behavior. It is not possible to identify what spe- cific factors combine with alcohol to pro duce violent behavior. It is clear that some men are at high risk of aTcohol- relatec3 violence, but the identification of indiviclual risk factors has not progressecI beyond the specification of general char- acteristics, such as aggressiveness or psy- chopathic personality traits. Correlates of these global descriptions have been noted, but the etiological tie among drinking, violence, and other characteris- tics has not been made. It may be possi- ble to make some such connections from a meta-analysis of past work, but this has not as yet been accomplished. Finally, although several researchers have noted a relationship between drink- ing problems and the late onset of crimi- nal careers, the assessment in this paper cloes not show that. If late onset of crimi- nal careers is measured by involvement in serious crime, problem drinking has not been shown to be etiologically impor- tant. The ambiguity may be related to sample selection or to the failure of past research to separate serious from aTcohol- relatecl offenses. How Much Crime Does Problem Drinking Explain? At the outset of this paper it was states! that alcohol use is never a sufficient cause of a criminal career. However, the evi- dence reviewed here, as well as other evidence, demonstrates aclequately that problem drinking is associated with crim- inal behavior, especially violent criminal behavior in the young adult years. The question remains of how much crime is explained by problem drinking. A quan- titative answer cannot be provi(led on the basis of previous work. Individual offencl- ing frequencies have not been compared for offenders with and without drinking problems. It is not even possible to com- pare the explanatory power of problem drinking with that of other inclepenclent variables because the alcohol-use vari

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112 able has rarely been incluclec3 in relevant multivariate analyses. Methoclological difficulties aside, there are several reasons why the kinds of anal- yses that would permit a quantitative as- sessment of problem ctrinking's contribu- tion to criminal careers have not been undertaken: 1. Alcohol use and problem drinking are common phenomena in the noncrimi- nal population and thus do not stanc! out as criminogenic factors. 2. Alcohol is an inexpensive drug so that, unlike expensive drugs (such as her- oin and cocaine), there is no economic compulsion associated with its heavy use. 3. A theoretical framework for under- standing how problem drinking causes criminal behavior does not exist. This lack oftheoretical direction, coupled with the fact that drinking is pervasive in of- fender populations, causes concern that the observed relationship between prob- lem drinking and criminal careers is a spurious one. The third point is the most important, but it need not be a serious impediment to the development of quantitative esti- mates of problem drinking's contribution to criminal behavior. Appropriate data and techniques exist to begin clevelop- ment of comparative As and regression coefficients for problem drinking. These would provide estimates of the magni- tude of problem drinking's power to ex- plain criminal careers. The development of theory has been inhibited by the tendency of criminolo- gists to view explanatory factors in a sim- plistic way. Thornberry and Christenson (1984) point out that causal conceptions have tended to be unidirectional and that such conceptions do not mode] criminal behavior very well. They show how un- employment and crime are related to each other in a reciprocal way. Problem drinking is likely to have a similar rela CRIMINAL CAREERS AND CAREER CRIMINALS tionship to criminal behavior. A recipro- cal conception may resolve some of the ambiguities in earlier work and lay the foundation for real understanding of the role of alcohol in the etiology of criminal behavior. Methodological Issues The single most important method- ological aspect of determining whether a causal relationship exists between prob- lem drinking and criminal careers is the nature of the stu(ly populations. General- population ant] captured-sample (i.e., in- stitutional, treatment) study findings are not seriously inconsistent with each other, but differences in findings do exist. Mentioner] above was the fact that the problem drinking-violence relationship is strongest among identified criminal jus- tice samples. One possible reason for this finding is relatecI to the probability of arrest. If the findings that suggest that problem drinkers are more likely to be arreste(1 than offenders who do not have a drinking problem are accurate, problem drinkers who are violent offenders may be overrepresented in criminal justice populations. Measurement of problem drinking neects to be clone more carefully in future research. Measures should be quantity- frequency indicators or indicators of spe- cific drinking-relatecl consequences. Ar- rests for aTcohol-relatecl offenses shouIcl not be use(1 as an indicator of problem drinking in research to examine the rela- tionship between drinking and crime. Alcohol use should also be measured and analyzed separately, not as part of an overall ([rug-use inclicator. The latter ap- proach confounds the effects of alcohol and drug use and may mask the effects of alcohol because drug use overrides aTco- ho] use in hierarchically constructed in- dices. "Current" and "ever" drinking problems also need to be clistinguished.

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PROBLEM DRINKING AND INDIVIDUAL OFFENDING SEQUENCES There is a considerable spontaneous re- mission of problem drinking over the life cycle, and failure to distinguish past and current drinking problems limits infer- ences that can be ctrawn about the effects of problem drinking over the life cycle. Two substantive foci may be helpful to unclerstancling the causal relationship between problem drinking and criminal careers: (1) conceptual and empirical clis- entanglement of the problem rlrinker-an- tisocial personality-criminal career asso- ciation anal (2) development of a problem cTrinker-offencler typology. The first point involves attempting to clarify conceptu- ally and empirically how much overlap exists among the three categories. The ASP disorder designation is a clinical one partially baser! on criteria that also clefine criminal behavior. Examples of ASP ctis- orcler diagnostic criteria that are also crime categories are assault, theft, vanclal- ism, and driving while intoxicated. Other ASP diagnostic criteria include referral to . ~ . ~. ~r ~ ~3 same persons, as cliscussed above and as noted in the APA diagnostic manual. The close association and shared conceptual elements of problem drinking, criminal careers, ant] ASP disorder suggest the need for careful definition and elabora tion of the constructs. With conceptual refinement and subsequent empirical analysis, the causal structure of the asso ciation between problem drinking and criminal careers wouIc3 likely be cIarifiecI. Development of a problem drinker offencler typology is recommenclec] to bring into sharper focus the contribution of inclivi(1ual characteristics (genetic, de velopmental, psychological, and so on) to the problem ctrinking-criminal career as sociation. It is clear that problem drinking is not a criminogenic factor for all individ uals. It would be helpful if individual risk factors, which could serve as typology dimensions, could be identified. Identifi cation of risk factors serves multiple pur poses. Risk factors can provide theoretical Juvenile court, multiple arrests, and a get-direction and, if they are strong predic ony conviction (American Psychiatric As-tors, can inform clinical and policy deci sociation, 19801. The ASP disorder alsosigns as well. includes symptom categories, such as dis turbed interpersonal relations and inabil ity to sustain employment categories that do not necessarily involve antisocial or illegal behavior. However, there is considerable overlap in the factors that define ASP disorder and criminal careers. The ASP disorder and criminal career concepts also share conceptual and em pirical elements in a temporal sense. The criminal career concept implies repeti tious involvement in crime over some number of years. The ASP disorder diag nosis requires onset of three or more diagnostic criteria before age 15 and man ifestation of at least four specified symp toms subsequent to age 18. Thus, both concepts are consistent with over-time continuity in illegal or deviant behavior. The ASP disorder and problem-drink ing categories tend often to coexist in the Recommendations and Implications The problem drinker-criminal career relationship is worthy of further study. A two-step process is recommended. Some work could start immediately with the use of existing data. Examples of longitu- dinal data that provide opportunities for relevant analysis are the National Youth Survey (NYS), the Rutgers Health and Human Development data, the 1945 Philadelphia birth cohort data, and the data from three Racine birth cohorts. The data sets provide information about onset, prevalence, and incidence of criminal be- havior and include over-time measures. Information about alcohol use is limited in the Philadelphia and Racine cohorts, but both the NYS and the Rutgers survey include detailed information about alco

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114 hot use over time. Thus, moclels could be developed to trace the covariation and correlates of drinking and crime in the same individuals over time.) The 1979 survey of state correctional inmates (Bureau of Justice Statistics, 1983a) also can address problem cirinker- criminal career issues. The inmate survey includes information from more than 10,000 individuals about incarceration, criminal careers, and alcohol use and amount consumed during the year before anct at the time of the incarceration of- fense. Information is also included about drug use. There is considerable potential in the inmate data for modeling the rela- tionship of substance use ant] crime. The Treatment Outcomes Prospective Study, which includes data for more than 11,000 individuals who entered publicly funcled drug abuse treatment programs in 197~1981, is also a potentially valuable resource.2 The ciata include a retrospec- tive longitudinal dimension and prospec- tive follow-up of a substantial percentage of the 11,000 subjects. Detailed data were collected about alcohol and drug use and self-reported involvement in serious crime. Data on age at first drink and age at first offensets) provide an opportunity to begin analyses at onset times and to fol- low subjects over many years. After the problem drinking-criminal ca- reer relationship is further clarified by iFor information on the data bases mentioned, contact the principal investigator, as follows: Na- tional Youth Survey, Delbert Elliott, The Behav- ioral Research Institute, University of Colorado; Rutgers Health and Human Development data, Robert Pandina, Center of Alcohol Studies, Rutgers University; Racine, Wisconsin, birth cohorts, Lyle Shannon, Iowa Urban Community Research Cen- ter, University of Iowa; Philadelphia birth cohorts, Marvin E. Wolfgang, Center for Studies in Crimi- nology and Criminal Law, University of Pennsylva- nia. 2For information on this data base, contact the author. CRIMINAL CAREERS AND CAREER CRIMINALS analyses of existing data, it is likely that new longitudinal research will be actvis- able. New research could be carefully designed based on what is known and learned in secondary analyses. A focused, well-informed longitudinal design would have a good chance to clarify how prob- lem drinking, by itself or in combination win other factors, contributes to criminal careers. Few implications for private or public decision making are apparent from the findings of this review. One recommen- clation echoes Robins and Wish (19771. That recommendation is to attempt to delay the onset of drinking. While the early onset of drinking does not appear to be a sufficient cause of problem drinking or criminal behavior, it does appear to be an important factor. Delaying the start of drinking could have a payoff in terms of preventing crime; this approach, were it to work, would also have the advantage of reducing aTcohol-relatect costs connected with health care, decreased productivity, and motor vehicle accidents. It is virtually certain that alcohol use is a factor in some violent crime. This re- view and other evidence support that inference. Violent crime has very high dollar costs and is also responsible for costs not so easily measured, such as altered life-styTes due to the fear of crime. Better understanding of the problem drinking-criminal career relationship could set the stage for informed attempts to reduce those costs. REFERENCES American Psychiatric Association 1980 Diagnostic and Statistical Manual of Mental Disorders. 3d edition. Washington, D.C.: American Psychiatric Association. Barnard, G., Holzer, C., and Vera, H. 1979 A comparison of alcoholics and non-alcohol- ics charged with rape. Bulletin of the Amer- ican Academy of Psychiatry and the Law 7:432~440.

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PROBLEM DRINKING AND INDIVIDUAL OFFENDING SEQUENCES ~ 75 Bell, D., and Champion, R. 1979 Deviancy, cleli~>quency and drug use. Brit- ish Journal of Psychiatry 134:269-276. Bielewicz, A., and Moskalewicz, J. 1982 Temporary prohibition: the Gdansk experi- ence, August, 1980. Contemporary Drug Problems Fall:367-381. Blane, H., and Chafetz, M., eds. 1979 Youth, Alcohol, and Social Policy. New York: Plenum Press. Blane, H., and Hewitt, L. 1971 Alcohol and Youth An Analysis of the Lit- erature, 196~1975. Final report prepared for the National Institute on Alcohol Abuse and Alcoholism. University of Pittsburgh, Pittsburgh, Pa. Bohman, M., Cloninger, C., Sigvardsson, S., and von Knorring, A. 1982 Predisposition to petty criminality in Swed- ish adoptees. I. Genetic and environmental heterogeneity. Archives of General Psychia- try 39: 123~1241. Bray, R., Schlenger, W., Craddock, S., Hubbard, R., and Rachal, J. 1982 Approaches to the Assessment of Drug Use in the Treatment Outcomes Prospective Study. Research Triangle Institute, Research Triangle Park, N.C. Bray, R., Guess, L., Mason, R., Hubbard, R., Smith, D., Marsden, M., and Rachal, J. 1983 1982 Worldwide Survey of Alcohol and Nonmedical Drug Use Among Military Per- sonnel. Report prepared for the Department of Defense. Research Triangle Institute, Re- search Triangle Park, N.C. Brown, S. Goldman, M., Inn, A., and Anderson, L. 1980 Expectations of reinforcement from alcohol: their domain and relation to drinking pat- terns. Journal of Consulting and Clinical Psychology 48(8~:419-426. Bureau of Justice Statistics 1983a Career patterns and crime. Bureau ofJustice Statistics Special Report. Washington, D.C.: U.S. Department of Justice. 1983b Criminal Victimization in the United States, 1981. Washington, D.C.: U.S. De- partment of Justice. 1983c Prisoners and alcohol. Bureau ofJustice Sta- tistics Bulletin. Washington, D.C.: U.S. De- partment of Justice. Cahalan, D., and Cisin, I. 1976 Drinking behavior and drinking problems in the United States. In B. Kissin and H. Begleiter, eds., The Biology of Alcoholism. Vol. 4: Social Aspects of Alcoholism. New York: Plenum Press. Cahalan, D., and Room, R. 1974 Problem Drinking Among American Men. New Brunswick, N.J.: Rutgers Center of A1- cohol Studies. Cahalan, D., Cisin, S., and Crossley, H. 1969 American Drinking Practices: A National Study of Drinking Behavior and Attitudes. New Haven, Conn.: College & University Press. Chaiken, J., and Chaiken, M. 1982 Varieties of Criminal Behavior. Santa Mon- ica, Calif.: Rand Corporation. Cold, J. 1982 Alcoholism and violence. Drug and Alcohol Dependence 9:1-13. Coleman, D., and Straus, M. 1979 Alcohol Abuse and Family Violence. Paper presented at the annual meeting of the American Sociological Association, Boston, Massachusetts. Collins, J., ed. 1981 Drinking and Crime: Perspectives on the Relationship Between Alcohol Consumption and Criminal Behavior. New York: Guilford Press. Collins, J., and Schlenger, W. 1983 The Prevalence of Psychiatric Disorder Among Admissions to Prison. Paper presented at the American Society of Criminology 35th Annual Meeting, Denver, Colorado. Cordelia, A. 1985 Alcohol and property crime: explaining the causal nexus. Journal of Studies on Alcohol 46(2): 161-171. Crawford, A., Hinton, J., Dochertv, C., Dishman, D., an(] Mulligan, P. 1982 Alcohol and crime. I. Self-reported alcohol consumption of Scottish prisoners. Journal of Studies on Alcohol 43(5) :610 613. Dawkins, R., and Dawkins, M. 1983 Alcohol use and delinquency among black, white, and Hispanic adolescent offenders. Adolescence 58(72~:799~09. Eckardt, M., Harford, T., Kaelber, C., Parker, E., Rosenthal, L., Ryback, R., Salmoiragthi, G., Vanderveen, E., and Warren, K. 1981 Health hazards associated with alcohol con- sumption. Journal of the American Medical Association 246(6):64~666. Edwards, G., lIensman, C., and Peto, J. 1971 Drinking problems among recidivist prison- ers. Psychological Medicine 1:388~399. Edwards, G., Kyle, E., and Nicholls, P. 1977 Alcoholics admitted to four hospitals in En- gland. III. Criminal records.Journal of Stud- ies on alcohol 38(9):1648-1664.

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