The Classification of Alcoholics: Typology Theories From the 19th Century to the Present

Abstract

Alcoholics differ in many of their personal and drinking-related characteristics, and for the past 150 years, clinicians and researchers have tried to categorize alcoholics based on these differences. Such typologies can advance our understanding of alcoholism as well as improve treatment of the disease. The history of alcoholism typology can be divided into three periods: the prescientific period, the Jellinek era, and the post-Jellinek era. During the prescientific period, physicians-especially those specializing in treating mental illnesses and addictions-developed numerous typologies, building primarily on clinical observation, anecdotal evidence, and armchair intuition. E.M. Jellinek has been credited with creating the first scientific typology that was developed into a comprehensive theory of alcoholism as a disease. The typologies that have evolved since Jellinek's landmark work have been derived mainly from empirical research data. Despite the wide variety of methodological approaches used, it appears that subtypes from all typologies developed since the 19th century can be classified into two major categories, the Apollonian and Dionysian subtypes.

Keywords: AOD associated consequences; AOD dependence; AOD use pattern; AODR (alcohol and other drug related) disorder; Jellinek typology; comorbidity; disorder classification; etiology; historical review; personality trait; treatment research.

The unitary disease concept, as illustrated in “The Drunkard’s Progress,” by Nathaniel Currier. Typology theorists believe this is an inadequate representation of the heterogeneity of etiologies and drinking patterns. Reproduced with permission from the Journal of Studies on Alcohol. © Alcohol Research Documentation, Inc., Rutgers University Center of Alcohol Studies.