Nature vs. Nurture?
In this video from NJTV, Dr. Tischfield of Rutgers University speaks about genetic markers as well as inheritance being important factors influencing the development of Alcoholism. He states that these markers “seem to increase the chances of one becoming an alcoholic.” Analyze the validity of Dr. Tischfield’s statements, and discuss possible ramifications these elementary findings could have on the general public, given his anecdote presented in the interview. What is the intended audience? Could the inheritable factors be epigenetic? Although he is not using absolute affirmation, how can we be sure that this study is viable? Could any potential biases compel him to prove his research is clinically relevant?
Click the link to access the PBS video “Is Alcoholism Nature or Nurture?”: http://watch.njtvonline.org/video/2180930008/
Dr. Tischfield's findings seem to be valid and they make sense when it comes to alcoholism. Like any human characteristic it stems from the combination of both nature and nurture. Having an addictive personality when it comes to abuse of certain substances seems to definitely be correlated to some genetic markers due to the differences observed within people in the same environment. There is also the nurture perspective where people whom have the genetic markers have differing results due to their environments. His findings seem like very general knowledge that is already considered in the studies of alcoholism. The study that he was referring to that they are going to pursue seems to be one that will give some more conclusive evidence on the amount of impact that nature has over nurture and how much a persons genes will really impact them. These genetic markers could be a result of epigenetic variations and should be investigated further to indicate how these markers result in the genes of individuals. His findings seem to be a basic knowledge that genes definitely affect the complex issue of alcoholism. He wants the audience to be aware that ones family affects these behavioral choices both in a genetic sense and an environmental sense. But our choices can be controlled so that our genetic predisposition is never observed. There are only a few genetic markers that have currently been found so there is definitely extensive research to be done in order to better understand the genetic component of alcoholism. By investigating the trends in alcoholism in the US there can be more conclusive evidence to distinguish between the genetic markers that indicate a persons behavior from the social pressures.
ReplyDeleteI agree with Georgina that Dr. Tischfield's findings seem valid. It is true that it seems to be common knowledge that alcoholism in one's family predisposes that person to alcoholism. One possible ramification of Dr. Tischfield's findings is that people will misinterpret his findings as saying that because someone has these markers that increase the chances of becoming an alcoholic, that person will become an alcoholic and there is very little "nurture" wise that can be done to prevent this. He gave the example of the 60 year old woman who knows that alcoholism runs in her family and actively chose to never take a drink of alcohol. It is important that people understand that just because someone might have a genetic predisposition to alcoholism does not mean that person is destined to be an alcoholic. It is possible after the general public reads Dr. Tischfield's findings, they will not interpret his results in this way.
ReplyDeleteThis comment has been removed by the author.
DeleteIn this interview Dr. Tischfield is clearly downplaying the role that the environment has on alcoholism, so as Alyssa suggests, there is room for people to interpret this to mean that those who have a genetic predisposition to alcohol are destined to be an alcoholic. In thinking about this, I think it is important to consider the bias presented here as well. Dr. Tischfield is a genetics expert (Director of the Human Genetics Institute at Rutgers University), so certainly his field of professional expertise is going to impact what he chooses to emphasize. Perhaps if a social and behavioral health expert were to read the findings of this study they would choose to emphasize some of the personal decision making and social factors that Dr. Tischfield brushes over. This is not to say that Dr. Tischfield is misrepresenting results, but rather that as a geneticist, he will tend to focus on and emphasize the genetic implications of his research rather than other factors that may be involved.
DeleteIn addition to Dr. Tischfield's possible bias as a geneticist, I think this research and the way it is presented serves as a public health message to encourage people to drink less and make responsible social choices - particularly for those who have experienced alcoholism in their families. The example of the woman who chose not to drink due to the prevalence of alcoholism among her family members is a testament to this public health message. The example highlights the genetic implications of the research, while also convincing viewers that drinking less or abstaining from alcohol use can be beneficial to health and even save lives. Although he doesn't come right out and say it, that certainly sounds like a quintessential public health message.
Unlike Georgina and Alyssa, I do not think from this video alone one can determine whether or not Dr. Tischield's findings are valid or in valid. To find this out, one must take a look at his study and see how large the study sample was, who the participants where, etc. I do think there may be some inheritable factors that are linked to epigenetic. But since his attended audience are for lay people, this does not come out in the video. Dr. Tischield's could have a bias to prove that alcoholism is a genetic disease but he is downplaying the role the environment plays on alcoholism. The social factors that come into play when we consider why people turn to alcohol. Would we say that college students are all alcoholics because and have this genetic factor because the are more likely to binge drink?
ReplyDeleteI agree with Tamika on this issue - it is very difficult to assess the validity of Dr. Tischfield's findings without actually looking at the study, examining the study sample, the methods, and the statistical significance of the findings. However, that being said, I do think there is a commonly accepted link between genetics and alcoholism that we can acknowledge. But as Dr. Tischfield even acknowledges, there is still a lot we don't know about this link. Furthermore, as Tamkia points out, the social factors that influence alcohol use and abuse are often very significant, so I would be interested to know how Dr. Tischfield's study considered or took into account these factors. How was the social environment evaluated among the study participants that were classified as "alcoholics"?
DeleteAfter listening to Dr. Tischfield, I went to PubMed to see if I could learn a little more on the subject of alcoholism inheritance. Here's an abstract that seems to sum up the current research pretty well (it also mentions epigenomics and proteomics!): http://www.ncbi.nlm.nih.gov/pubmed/22021628.
ReplyDeleteI disagree, however, with the idea that he intentionally downplayed the effects of the environment on alcoholism development. Yes, he had an agenda of presenting his research findings but he wasn't forcing it on an audience. It's a given that one's environment, including friends and family, influences alcoholism. Dr. Tischfield wasn't invited onto the program to reinforce this.
I agree with Tamika as well. I believe that we need to analyze his study in order to determine validity. How many subjects were involved? Did they use many genetic samples or just one or two? It also depends greatly on who participated in the study and how accuractely the results were recorded. Dr. Tischield's findings definitely seem plausible and follow the inheritable pattern of many other diseases/disorders, but one must really take a closer look to be sure the findings are valid. Just like others have stated, the possible down side of these findings is that people may take them too seriously. Just because you're at a genetic disposition to have a certain disease or disorder does not mean you are destined to get it. Nature is only one part of the puzzle and how you choose to act in your daily life is what will ultimately determine whether or not you overdose on substances like alcohol. The 60 year old women story that he shares is a good example of how one can easily assume that they will become an alcoholic based on genetic history and may take drastic steps to avoid it. I'm not saying that obstaining from drinking is bad by any means, I just think that this assumption could lead to other possibly more harmful assumptions like believing that since skin cancer runs in your family then you can never go outside, or to the beach, or even out to lunch with a friend. Sometimes people can intrepret genetic findings in a much too radical way.
ReplyDeleteI think the intended audience is really anyone who is interested. Of course people who have relatives with alcholism are going to be more intriguided by these findings, however physicians, researchers, and even the general public may find it fascinating and applicable as well. The inheritable factors could be epigentic because he talks about how certain markers (6 at this point) were found that can cause alcoholism (of course his findings would need to be validated first before one can really say that epigentics plays a role). Any researcher wants his findings to matter and be known across the world, so of course this doctor could have a bias towards wishing to prove his theory as correct. He does seem to really overplay the nature/genetic part of alcoholism and doesn't seem to give much credit to the environmental factors that should certainly be included in the development of this disease. I think his next study should focus more on the social and environmental factors of the study participants to compare that to their genetic make-up and see how the results interact.
- Caroline Booth
I agree with Tamika and Michelle that there are many important factors that influence alcoholism, beyond genetic factors. Considering that genetics influences much of human development, it is likely that there is some genetic association with alcohol use. Also, the fact that alcoholism has many risk factors, both genetic and environmental means that there may be some epigenetic factors, perhaps hypomethylation of some genes that would normally be inactive.
ReplyDeleteHowever, he talked about how they focused on people with family history of alcoholism and then compared their genomes. As he mentions, a family history of alcoholism influences both environmental and genetic factors for alcohol use. Unfortunately, the nature of his sample population opens up the risk for confounding factors and therefore the validity of his current information. This is a very brief summary of the several risk factors for alcoholism: http://www.mayoclinic.com/health/alcoholism/DS00340/DSECTION=risk-factors. Since a risk factor for alcohol use is family history and social and cultural factors, it is possible that these families all share other genetic markers besides ones that may increase the risk of alcoholism. Of course, his role as a geneticist means that he will look for a genetic association with alcoholism not social, cultural or environmental factors (as Tamika pointed out about college students).
That being said, the new study he described could be very useful. A study that includes a large and diverse sample is much more likely to find markers that are actually linked to alcoholism rather than some other confounding factor. I found it very interesting that he described the possibility of feasibly studying the entire genome in the foreseeable future, an advancement that would also increase the accuracy of the results. Either way, the information he is spreading emphasizes that alcoholism is a serious problem and that a great deal of "nurture" may be required to overcome "nature." The woman he mentioned completely avoided alcohol to avoid suffering the problems that her family faced.
I too agree with the above responses that alcoholism is more than just a genetic disease. There is no doubt that it has to do with genetic conditions and family history, but what about the social aspects of family history? For instance, if a family has a "history" of living in poor economic conditions, with little education, money, and support then that individual will be more likely to become an alcoholic in the future. But does that mean that alcoholism is brought on by an individuals genes? Or does that mean the alcoholism was brought on by the social conditions an individual lives in? I think with any debate, and as the title of this blog post depicts, alcoholism is a nature vs nurture debate.
DeleteDr. Tischfield's findings also seem a little obvious to me. I know that may seem ignorant, but I feel like it is common knowledge that alcoholism runs in families. I understand that to validate this "rule of thumb" he has to conduct the research, but is there a better way to better understand the human genome? I'm also interested how this will help anyone with alcoholism or prevent alcoholism from occurring, which in my mind should be the main concern of the project. I'm interested to see the results and what the research brings to further help the public.
Julie Goldberg
Julie and Sami bring up interesting points. Yes, Dr. Tischfield's findings are re-enforcing previous beliefs that one is prone to alcoholism if it occurred in the family line beforehand, but I think he also brings up important suggestions. We are finally in an age where we can experimentally assess the genetic-environmental interaction; this is one of the main points that the video is making! It is incredible that investigators can combine genetics with epidemiology to study genes/family history as a risk factor for alcoholism. Although somewhat redundant, Dr. Tischfield's findings confirmed previous beliefs and now his team can move forward and continue further experimentation and analysis.
DeleteBut like Sami said, there is room for confounding or bias in the previous experiment, especially since the sample was not taken from the general population but rather from a smaller cohort. In the next study, Dr. Tischfield must find a clear way to differentiate between the effect of social influence and genetic predisposition. What if the entire family had genes that made them predisposed to alcoholism, but it wasn't the gene but the actual social exposure that caused the inclination to become alcoholic? What if both genetics and the environment affected the participant's vulnerability to alcoholism-- how will Dr. Tischfield distinguish between and measure the two risk factors' level of influence?
In the end, the knowledge gained from studies like these may help advise health programs to incorporate more education of genetic effects on social decisions into their curricula. Health classes can teach students to be aware of family history and take more seriously the social decisions that must be made throughout their lives.
As a number of individuals have mentioned here, this video is down-playing the role of an individual's environment on an outcome such as alcoholism. In my opinion, the influence of family, a neighborhood, a life crisis, or certain social group can have a huge impact on decisions that could lead to alcoholism. However, if his study does determine a definitive genetic sequence that could increase an individual's predisposition to be affected by alcoholism, there could be positive results for those people. For example, for recovering alcoholics, it could aid with some of the emotional stress or any self blame that they might be feeling. If the view of alcoholism were to change, the stigma and societal damage could be diminished; and, hopefully as a result more people avoid being ostracized, receive support, and recover. Additionally, it will be interesting to see if this study or similar ones can reveal information about genetic protective factors from alcoholism.
ReplyDeleteI agree with what Amanda says. I think alcoholism has more to do with the environment than anything else. If they are doing research with alcoholism, I wonder if that could lead to other drugs such as marijuana or even the more serious ones like methamphetamines. Doctors describe alcoholism as a disease and something to overcome but maybe not exactly recover. What about other addictions? Alcohol is considered a drug so is there a gene for other addictive behaviors? There could be a gene that makes certain people suseptable to alcoholism but I would believe more easily the studies done about psychological weaknesses. Maybe they are related, I'm not sure. I feel like I don't know enough about this to make any assumptions but I feel there may be a missing link.
Delete--Carissa Forte
I think Carissa's thoughts about the potential for understanding human genetic predispositions for other drugs/addictions in the future is really provocative. What would happen if we could determine if certain people are predisposed to developing certain drug addictions to more illicit drugs beyond alcohol ? Perhaps this would help us to encourage preventative behavior, abstinence from drug use, or even rehab, but the ability to obtain such sensitive information would have enormous implications for individuals - even more so than alcohol - especially when considering illegal drug use. GINA would certainly protect individuals to a certain extent from having this information publicly disseminated, but how would this change when part of the information being collected may include information about personal illegal drug use? It seems that there could be an increased possibility for discrimination in this area given the illegal nature of the activity that one could be predisposed to and given some of the loopholes in GINA protection.
DeleteThis knowledge could certainly be a powerful public health tool to assist in intervening in areas where there is a high prevalence of drug abuse, but at what cost to personal privacy? I imagine it would also be difficult to develop the research in order to understand genetic factors associated with illegal drug-use, given that potential research subjects may be unwilling to participate due to the illegal nature of drug-use and fears that personal information about drug habits could be exposed. But it is still a really interesting question to ponder in thinking about the future of genetic research. What else might we be able to predict in the future? And what challenges do these future developments pose for us as a society to continue protecting ourselves and our genetic information?
I think that Dr. Tischfield’s epidemiological study will provide the public with a lot of valuable information. The large, diverse study will allow them to distinguish between behavioral and environmental factors and genetic markers. Perhaps this study will be able to identify a similarity in genes in those who are addicted to cigarettes and/or alcohol. I am curious whether the survey focuses only on alcohol, or other addictive behaviors such as smoking, drugs and gambling. This study could not only find the genetic marker for alcoholism but also for addictive personalities in general. Although this study has potential, I think that Dr. Tischfield seems to be very one-sided in his thinking, being a genetic expert. He does not necessarily consider or mention outside factors other than genetic markers for alcoholism.
ReplyDeleteThis must have been directed to a general public audience, because he does not mention any other studies that have been done in the past that have already proven that 50-60% of the risk alcoholism is related to genetic factors, as Suzann found on PubMed. I agree with Julie that he is stating information that is already known by most people. But I think that if his study can look into other addictions, then it would be more valuable than only looking at alcoholism.
I agree with Dr. Tischfield's findings that there is both a genetic and environmental component to Alcoholism but I think there is a serious ramification to these findings and the fact that he suggests that genes have more of an influence that environment. It seems unethical to imply to people that their genetic predisposition seriously increases their chances of having a disease which has no cure. You can change your environment and behavior, but you can't change your genetic makeup and this will inevitably cause people to worry that they will develop Alcoholism. Knowing that I had a higher change of becoming an alcoholic than most and that there was potentially nothing I could do about it, would definitely cause me to worry and have psychological issues.
ReplyDeleteWhile it is great that the 60 year old woman was able to actively ensure that she did not drink her entire life, it is unreasonable to expect most people with a family history of Alcoholism to do that. Drinking in moderation is an accepted social norm in many societies so if people thought that completely abstaining from drinking was the only way to be 100% sure they would not become alcoholics, I think it would inevitably lead to other health problems. While it would be beneficial for the scientific community to have the knowledge about Alcoholism and its links to genetics, I think it could hurt a lot of the individuals who are actually affected.
This is not to say that the information Dr.Tischfield presents should not be further explored, I just think that influential statements like his should not be made without solutions to back them up. As Alyssa mentioned, it needs to be made more clear that the genetic factor is not a guarantee that you will become an alcoholic. Additionally, if there were suggestions made about more reasonable lifestyle changes people could make, then it would be more ethical to release this information.
Laura Alfisher
I completely agree with what Laura has stated above. While it is scientifically proven that their are genetic markers for alcoholism, I feel that environment definitely plays a larger role into developing alcoholism. In my experience, growing up with an alcoholic in my immediate family and having other alcoholics in my extended family, I feel that it all depends on the environment you are raised in and the experiences you encounter.
DeleteI agree with Laura's statement about the psychological damage that could be caused from worrying about one's predisposition. Knowing and worrying may cause the individual to either turn to drinking to deal with issues or cause them to turn to other drugs. Causing more harm then good.
The information that Dr. Tischfield presented is valuable information, but must be taken, I feel, more lightly since the genetic markers are not a guarantee that one will develop alcoholism.
When I was watching this I thought about my own family situation. My grandfather and great grandfather on my mothers side were extreme alcoholics. Thinking about my grandmother, mother and I we are not alcoholics. I bring this up because possibly alcoholism is sex linked since the 60 year old women Dr. Tischfield was speaking about went to the funeral of her nephews. I do agree that you can't pick one side ( nature ) or the other ( nurture) every thing is interconnected. Dr. Tischfield's work looks like that it is viable but he doesn't talk much about his work. He says that there are half a dozen markers but what does that mean if you are addressing a large audience then how could they understand what "markers" mean. I think more work is needed to find out if there is a very strong connection of alcoholism and genes. Hopefully the new study that he has underway will uncover more trends, or not. I think that this is directed to the general public and also people who have alcoholism that runs in the family.
ReplyDeleteI agree with alot of these comments, and I think Amanda makes a great point that alcoholism is profoundly impacted (or brought out) by environmental factors. I also think that while the study Dr. Tischfield mentioned is currently underway (with over 40,000 people to be surveyed) will absolutely provide a great deal of valuable information for his research, I also feel that understanding and identifying life and environmental risk factors that may have led many people to drink heavily may be very difficult to identify in a simple survey. More in-depth information into what experiences people have had and what they perceive to be the main causes of their alcohol struggles will be missed in this kind of study. However, I do think that this research is very important and could potentially have very positive outcomes. If certain genetic factors could be identified, people could be forewarned about the possible consequences of drinking (even socially) and could have access to more social supports. (On the flipside people who find out they do not have the genetic markers could potentially be less cautious with their drinking habits.) Also, in the future, perhaps there will be more discoveries on potential therapies that could actually target these markers instead of focusing solely on behavioral changes.
ReplyDeleteI would like to add on to what Kaitlin had to say about Dr. Tischfield's work in finding the genetic links to alcoholism. He stated that there are several markers for alcoholism, that seem to increase the likelihood of becoming an alcoholic. Though I find this remarkable in terms of the development of science and genome research, I can't help but think about the other factors that Dr. Tischfield did not mention in this interview. For instance, he said his data sample was comprised of people with alcoholism being a serious problem in their families. Instantly, I thought of a key social determinant to alcoholism in a family: socioeconomic status. Taking this a step further, I automatically assumed that his sample was most likely of a certain racial or cultural background. This profile leads back to his results. Could the overwhelming overlaps he found between genetic markers have anything to do with race/ethnicity, rather than simply just alcoholism traits?
DeleteDr. Tischfield's current study of 46,000 individuals does seem interesting and promising. However, I right away thought about the other factors that a simple DNA test may not be able to examine. Just as Kaitlin mentioned, we need much more in-depth information in order to gain any knowledge about the full picture of one's alcoholism. I think this study should be broadened in a way to include public health perspectives as well as genome science.
Branching off from Kaitlin's last statement, I think that these studies are indeed valuable. However, as a believer in social epidemiology and behavioral sciences, I think that Dr. Tischfield's work should serve as a supplement to knowledge we have regarding behavioral factors of alcoholism. What we definitely do not want to happen (as Kaitlin and a few others have said) is that a simple genetic test could lead a person to be careless in their alcohol consumption.
Although Dr. Tischfield shared an anecdote about genetic disposition not certainly equating to actual demeanors, I cannot help but wonder if society is ready to take on this information which could lead to a whole new generation of prejudice. Prejudice from social clubs who may be less welcoming to individuals with unfavorable genetic dispositions such as those for addictive tendencies. Prejudice from within families who may favor one child over the other because they have a more desirable genome- perhaps a genetic disposition for being successful. Prejudice from educators who may enroll students based upon their genetic disposition to achieve. The possibilities for prejudice resulting from an individual’s genetic information seems nearly as endless as the base pairs that make us who we are. GINA does not protect against all of these prejudices either, just genetic prejudices dealing with healthcare and employment. As this information becomes more available I believe it has the possibility to reshape much of our social lives in both positive and negative ways.
ReplyDeleteDr. Tischfield's ancedote was the most note-worthy part of this clip. It was used to prove a point and presented an opinion amongst facts to reinforce his belief. Although certain facts cannot be disputed, the uncertainty of the influence of genetics and environment may lead to dangerous social consequences. Like Katelin, I see the dangers in favoring one side of the genetics-versus-environment debate. Like many other students who have taken Medical Ethics and discussed the benefits and possible harms of eugenics programs, this is another example of a case in which the risks lie in unfinished research and misinterpreted conclusion.
DeleteDr. Tischfield statements appeared valid in my opinion because I think he was very wise in his wording. He said that both genetics and environment had roles in alcoholism and provided support for his findings by describing his research and the genes/markers he has discovered. However although his statements appear valid I can not be sure because like Tamika said we must assess the validity of Dr. Tischfield's findings by looking at the study, examining the study sample, the methods, and the statistical significance of the findings. Although he is not using absolute affirmation, we can be sure that this study is viable because there have been several studies done about alcoholism. But like I said before it is important to review the study for yourself and to make your own decisions about how viable the study is. However depending on how the audience’s interpretation of the information there could be some ramifications of misinterpretation. The intended audiences are people with a family history of alcoholism and for anyone who drinks or has friends who drink. The audience is anyone that could benefit from the information whether it be directly or indirectly.
ReplyDeleteAlyssa Biller brought up a good point that people could possibly misinterpret Dr. Tischfield’s findings. I think a lot of times when doctors or researchers come out with a new finding people focus on the most negative aspect of that information or hold on to one part of it and exaggerate it a little bit without really reading further into the situation. Like Alyssa said because someone might have one or several of the markers that suggest a chance of alcoholism doesn’t meant the person will definitely become an alcoholic. As Dr. Tischfield in the beginning of the video nature and nurture contribute to alcoholism. In the case of the 60 year old who chose not to drink at all because of her family history of alcoholism she chose to manipulate her “nature”. Nevertheless this doesn’t mean that she would have definitely become an alcoholic had she chosen to drink. Again as Alyssa mention a genetic predisposition to alcoholism does not mean that person is destined to be an alcoholic. But people interpret and process information differently and might have gone away from the video with a completely different message from what Dr. Tischfield intended.
In addition, because of the story about the 60 year old woman who chose not to drink people with similar family history might believe that they should stop drinking immediately and completely and just because that process worked for the 60 year old woman it does not mean that that would apply to everyone else. People might not be able to see that there are different paths to battling alcoholism or even preventing alcoholism in general.
I disagree with Michelle that Dr. Tischfield is “downplaying the role that the environment has on alcoholism”. He is a genetics expert as Michelle also mentioned and his focus is on genetics so he is obviously going to spend more time discussing what he knows. But I do agree that there could be some potential bias as he is a genetics expert and he would possibly be more inclined to believe or suggest that genetics has a greater relevance to alcoholism but in my opinion I think Dr. Tischfield stated what he knew in an objective manner.
The inheritable factors could be epigenetic since alcoholism appears to run through generations as seen in the example of the 60 year old woman and several others not mentioned. As Veronika mentioned it could be sex linked but I do believe that with all the research and findings we will find out soon enough!
This article also gives further information on inherited SNPS (like we learned about in class) and examples of alcoholism.
“Disease-driven detection of differential inherited SNP modules from SNP network.”
http://apps.webofknowledge.com.ezproxy.bu.edu/full_record.do?product=MEDLINE&search_mode=Refine&qid=6&SID=1Fip6gck8IJcfAHECdk&page=1&doc=1
I agree with many of the comments above about the invalidity of this study. First of all, Dr. Tischfield is discussing the study but I would like to take a look at the actual study and see how he could actually distinguish between those with markers and those without markers that became alcoholics as well as those who had markers and did not become alcoholics. He comments that they are going to look at certain races, genders, etc. to see which are more likely to have these markers as well as who are more likely to become alcoholics. Although he is a genetic specialist and is focused on this aspect of the research, he needs to understand how large of a role our environment plays in situations like this. People who have mental instability such as depression, PTSD or bipolar disorder are much more likely to drink heavily than those that are mentally stable. I believe, not from this research but from other classes I have taken on biology and human physiology, that a person may have a propensity to be an alcoholic and a certain change internally or externally can turn this propensity into a reality. From this class, we have learned that genes can be turned on or off by internal factors but external factors altering genes is less clear. I would very much like to understand how this works; however, this research is still in the process of being understood by scientists.
ReplyDeleteI think that testing alcoholics and their genes according to gender, race, etc. could have serious negative implications for our society. Here is the grant for the National Epidemologic Survey on Alcohol and Related Conditions (NESARC) study that Dr. Tischfield was referring to in the video: http://aspe.hhs.gov/hsp/06/catalog-ai-an-na/nesarc.htm. If we were to find out, through this study, that a single race had a higher chance of become alcoholics, there could be a lot of stigma associated with that race and more discrimination. Same idea with gender. If men were found to be at a higher risk genetically for alcoholism, men who drank alcohol could be looked poorly upon. I think our society has enough discrimination and prejudice as is without a new finding such as this. However, I am torn in this argument. Sometimes I feel that if a person has a higher risk of getting a disease, they should know, especially if they can prevent themselves from having it (which in this case, alcoholism can be prevented by staying away from drinking).
I think it is interesting that alcoholism is finally being seen as a "disease," rather than just a lifestyle abnormality. This could mean positive things for treatment as it pertains to health insurance. People may start being covered under insurance for alcoholism treatment, such as therapy and perhaps a drug that could curb the addiction. At this point, we are not there yet. But who knows, maybe in our lifetime we will see this change.
-Dana Hindman
As many of my peers have said, it is quite difficult to tell whether Dr. Tischfield's statements are valid or not due to the fact that we do not know the details of his study. However, his statements are very plausible and do provide good insight into this topic. But, there are ramifications to his statements and anecdotes. Viewers may automatically assume that just because one has a history family members who suffered from alcoholism that they may be more prone to being an alcoholic; when in fact, environmental factors play a vital role in the outcome of a disease. For example, just because my grandparents and a couple of my aunts and uncles have diabetes, it would be silly for me to automatically assume that I will suffer from this as well. One must be sure to look at social factors and behavioral factors when dealing with any type of disease or health problem. Although Dr. Tischfield briefly mentions the importance of decision-making, this interview does provide the public with good information and may cause people to look deeper into this topic.
ReplyDeleteThe inheritable factors definitely could be epigenetic because of the simple fact that the genetic markers are passed down from generation to generation. In addition, it could also be epigenetic because one's environment could affect the inheritance of a specific gene, and as result be passed to one's offspring.
I think there are potential biases that would compel him to prove that his research is clinically relevant. One being that he is obviously a geneticist, so much of what he is saying solely focuses on just that (rather than other issues like environment, behavior and decision-making).
-Danielle Colon
I think it is very difficult to determine the validity of a subject, such as alcoholism linked to genetic predisposition, that is still so "new" in the genomic world. With that said, I do agree with many of the people who have said that even if a person is predisposed to a condition, the environment in which as person lives impacts his/her life completely - the environment could be deciding factor on whether or not a person ever has his/her first drink; the environment in which a person lives could also determine whether he/she is able to quit drinking ( I'm sure the 60 year-old-woman who decided to stop drinking doesn't surround herself with alcohol on a daily basis).
ReplyDeleteIn terms of determining Mr. Tischfield's bias - I looked up his information of Rutger's directory and it seems that he earns in excess of $25M/ year for genetic studies (http://www.hginj.org/administration.html). This could allow for some bias, even if he is not consciously bias. To his defense, I also have to say that I looked at a study he did with twins and alcoholism dependence (twins have same/similar DN) and the study shows that one twin who is alcohol dependent, increases the chance that the other is alcohol dependent (http://www.ncbi.nlm.nih.gov/pubmed/20468071).
The problem that I find frightening is geared for those individuals who find that they are "NOT predisposed" to alcoholism; the problem I have is the misconception. People may believe that since they do not have a genetic marker for alcoholism, they can drink profusely without any adverse effects - which is simply not true since a person can never totally be "NOT predisposed" to alcoholism.
This interview with Dr. Tischfield seems very vague. He doesn't seem to answer the questions of the interviewer clearly. I agree with him that alcoholism is very complex. Alcoholism is presented through a combination of genetic and environmental factors. Only being exposed to the environmental factors or only having the genetic factors will not directly lead to becoming an alcoholic.
ReplyDeleteThe anecdote that Dr. Tischfield told didn't quite answer the question of the interviewer. The interviewer asked whether having all the genetic markers for alcoholism would definitely lead down the road to alcoholism. Dr. Tischfield could only answer by referring to a woman who chose to abstain from drinking alcohol to "save" herself from the disease. I am more interested to hear whether social drinking is capable for a person genetically predisposed to alcoholism.
Janaki's research on Tischfield's previous experience is interesting to show that he does have bias. However, it is difficult not to show bias when arguing a point.
I am interested to see the results of future studies. Like Dr. Tischfield stated, when these techniques become more affordable, and when more data is able to be extracted, I feel that there will be clear patterns for the alcoholism gene.
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ReplyDeleteI've heard about the biological links of alcoholism inheritance before, so I'm inclined to be persuaded by Dr. Tischfield's commentary. I agree with many of my classmates that alcoholism is indeed a disease, and like many diseases that are not "infectious," deserves our attention to possible "routes of transmission." Often, in studies, it is hard to identify if something that seems to have a relationship with an outcome is really a cause. Environmental causes are just as likely to produce alcohol abuse as a genetic cause. Something I think is interesting that would support Dr. Tischfield's view is the relationship between adopted children with alcoholism and their biological parents. This type of situation creates an interesting opportunity to evaluate a potential biological influence. Of course, there are possible events in an adopted child's life that could be environmental causes of alcoholism. Some might argue that in fact, adopted children are even more prone to alcohol abuse. An interesting study that looks at this relationship is the Stockholm Adoption Study. http://ukpmc.ac.uk/abstract/MED/3975456/reload=0;jsessionid=fjR8Yx6VeoZ30V5L7Xtd.19
ReplyDeleteThe conclusions drawn in this study support the link between genetics and alcoholism. I think it's an interesting relationship, and I'm curious what other experts have to say about this study!
Abigail Williams
I've heard about the biological links of alcoholism inheritance before, so I'm inclined to be persuaded by Dr. Tischfield's commentary. I agree with many of my classmates that alcoholism is indeed a disease, and like many diseases that are not "infectious," deserves our attention to possible "routes of transmission." Often, in studies, it is hard to identify if something that seems to have a relationship with an outcome is really a cause. Environmental causes are just as likely to produce alcohol abuse as a genetic cause. Something I think is interesting that would support Dr. Tischfield's view is the relationship between adopted children with alcoholism and their biological parents. This type of situation creates an interesting opportunity to evaluate a potential biological influence. Of course, there are possible events in an adopted child's life that could be environmental causes of alcoholism. Some might argue that in fact, adopted children are even more prone to alcohol abuse. An interesting study that looks at this relationship is the Stockholm Adoption Study. http://ukpmc.ac.uk/abstract/MED/3975456/reload=0;jsessionid=fjR8Yx6VeoZ30V5L7Xtd.19
ReplyDeleteThe conclusions drawn in this study support the link between genetics and alcoholism. I think it's an interesting relationship, and I'm curious what other experts have to say about this study!
Abigail Williams
I agree with what many people have stated before that we can not truly judge the validity of Dr. Tischfield's study without knowing more about the study itself. However, I do believe that he down played the importance of environment and focused primarily on the role of genetics. But, what about families who do not have a history of alcoholism but have a family member who developed alcoholism? Surely that can be the result of environmental factors more so than genetics.
ReplyDeleteI do believe that both nature and nurture play a significant role in determining alcoholism, but I also believe that the nurture aspect has a far larger role than Dr. Tischfield expressed. Nonetheless, I think that this is an extremely interesting subject and study and I look forward to learning in more detail the different risk factors associated with alcoholism based on genetics, environment, race, and gender.
-Kristen Marotta
I agree that many if not most characteristics are a combination of nature and nurture, and that it is important that people understand it is not destiny they are dealing with when they see their DNA sequence. However, I think that people may see a genetic predisposition for something as a way to become less accountable for their actions. In many people, this could be justified if the genetic predisposition has flourished into a condition. These people should usually receive treatment for these conditions. However, do you treat the people with the genetic predisposition who show no signs of developing the condition? If not, where do you draw the line between treating those who may develop the condition and those who have the full-blown condition? With the knowledge of genetic markers, we would have to restructure the way we think about where medical resources should go.
ReplyDeleteAs far as alcoholism being caused by epigenetic factors, I suppose it could be possible that the brain could see alcohol abuse as the most efficient means of stress relief and pass on this predisposition. This would mean that while there isn't a marker in your genes for alcoholism, if you abuse alcohol, you could still potentially pass on an epigenetic predisposition to your children.
Dr. Tischfield opens his interview by saying, “We have come to a realization that alcoholism is very complex… a matter of the environment and inheritance.” This seems to be a well-known, valid fact of alcoholism as many of my classmates have already stated as well. Through the observation of people, Dr. Tischfield states that there are at least “a half dozen markers (many left to be discovered), which seem to increase the chance of one becoming an alcoholic.”
ReplyDeleteAs one can see, there is much more to be done in studying this, as he then goes on to talk about a new study. In this study, researchers will look at 46,000 people’s entire DNA sequence (money permitting) and try to correlate specific genome DNA sequences to their behaviors. This of course is yet to be done but seems as though it will really validate and give more conclusive evidence on the impact and origins of alcoholism. Some of the validated information being used right now consists of this research finding: “We’ve collected thousands of individuals from families with dense alcoholism. Looked to see if certain variants of genes are more represented in these families than in the general population, and the answer is yes.” Going on to figure out and discover more on this issue is extremely necessary.
As other people have stated before, Dr. Tischfield does focus more on the genetic factors that could potentially be associated with alcoholism, he does not discount the environmental factors. The environmental factors are extremely important, but the new information and research that could link DNA sequences to a predisposition to alcoholism is very important. Once it is more affordable, it could help people who have family members who are alcoholics decide whether or not the best option is to completely avoid alcohol.
ReplyDeleteI have a question, would it be possible that these DNA sequences are for a predisposition for addiction in general, or is it clear that they are specifically for a predisposition to alcoholism?
To continue with points previously stated by my classmates, although Dr. Tischfield and his studies have focused primarily on the genetic factors that may be linked to one developing alcoholism, I appreciate the fact that he does not reject the possibility of environmental influences also causing such an addiction. This is because many studies have shown that regardless of genetic make-up, one's environment does prove to have a significant impact on one's health for it has been seen that even if one is or is not predisposed to some illness or disease, living and working within certain geographical locations have caused people to develop health issues that they otherwise would not have if they lived in a different environment. Furthermore, I do think research into genetic factors linked to alcoholism and other addictions aside from environmental factors is important because it can help those with a family history of an addiction like alcoholism have a better understanding of themselves from a genetic perspective and therefore be able to make a better, more informed decision about how to approach maintaining their own health.
ReplyDeleteBianca Farro
My views on Dr. Tischfield's study are similar to Andrew's. I am skeptical about the social ramifications of probing for genetic answers to a problem like alcoholism and what that means in relation to an individual's accountability for the choices they make in life vs. their "natural" heightened disposition towards a potentially harmful thing. Alcoholism is something that has historically gone from being thought of as a form of medicine, to normal behavior for men, to a mental illness, to a diagnosable physical illness for men and women alike. I believe the significance of alcoholism is largely cultural and to eliminate this as a major factor, the study has to look beyond American culture and compare the rates of alcoholism among other groups as well.
ReplyDeleteAnd like Tamika said, since the intended audience is the general public, it's hard for us to determine the validity of his argument from an academic perspective. We would need much more information about the study than the video provides.
Shakeela Najjar
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ReplyDeleteLike Michelle (Padreza) says, there really is much more to be done to further illuminate the correlation between genetic markers and behaviors like alcoholism. Although there is not much evidence as of now to affirm Dr. Tischfield's points in the video, his new research that will include 46,000 people has the potential to really show the extent to which the DNA affects alcoholism. However, I strongly agree with Shakeela when she says that alcoholism is also heavily cultural and that the study or at least another research should involve people from different background as well.
ReplyDeleteThis interview was intended for everyone-whether they're in the health field or not. Even if one is not affected by alcoholism it is important to be aware of how genetic information can be utilized to predict one's predisposition and likelihood of developing a behavior. I think it also sends an optimistic message even for those who are genetically predisposed to alcoholism because as seen in Dr. Tischfield's example of the woman who chose not to be an alcoholic, one can still make his or her own decision to fight the tendency (although it may be relatively more difficult) to engage in this type of behavior.
The inheritable factors of alcoholism may be epigenetic. And with the rate of the development of gene sequencing, I would not be surprised if a few years from now, the health care field is able to develop a technology that activates or deactivates these genetic factors. What we can take away from this interview is that there are a lot of research to be done, and by acquiring more knowledge and understanding of how the human genome works, we can make significant discoveries on the link between genetic factors and other behaviors.
-Sophia Pascual
I found this video to be very interesting because the “nature vs. nurture” argument is a challenging barrier that confounds research and results. Although the information presented in the video was limited, the diction Dr. Tischfield used seemed to be an accurate and fair presentation of the current research and beliefs about alcoholism. He fairly expressed that alcoholism is a complex disease that is affected by a variety of factors, and that although a person may have more genetic markers for alcoholism, that does not necessarily mean that he or she will be an alcoholic. He seemed to be accurately reporting the current research and even cited a women whose genetic history had a large amount of alcoholics, and because of her personal decision she was not an alcoholic, proving that it is a combination of factors, and not merely the genetic markers solely. Like Tamika stated however, I do believe that when evaluating a study or opinion it is important to have specific information such as the sample size, location of the study, information specific to the participants, follow up/attrition rate, etc.
ReplyDeleteI think that many of the genetic questions that are being answered have the ability to affect the public. This information did not seem to be presented in a totalitarian/negative way (i.e. “if you have this genetic marker, you WILL be an alcoholic”), allowing me to believe that the information may be taken seriously or may be disregarded completely by the public. This may be influenced on the people’s experience with alcoholism and their particular genetic history, however, I do not think the information was presented in a controversial way that would create a public uproar, especially because it is widely known that many diseases are genetically inherited and are determined by a person’s genetic make up and history. This is widely known even to lay people who are not necessarily familiar with genetics. I think the intended audience is the general public because although this information may not affect everyone directly, it may affect people indirectly (i.e. a friend of a friend, etc.) I also think that people who may be affected by alcoholism may be more interested and more likely to follow this research.
I believe the inheritable factors are likely to be epigenetic because the human genetic make up is so similar, at 99.9% that epigenetics is largely responsible for these varying factors and diversifying factors in who may or may not be more likely to have a certain disease.
By watching merely a 4 minute video clip it is not possible to tell if the information being presented is entirely accurate, however, as mentioned above, many of the ideas he presents are already widely acknowledged and understood by the academic community and the general public. He may be partially biased as a geneticist and may choose to focus specifically on the genetics, however he does state firmly that it is a complex issue that involves the environment. He does not brush this aside and focus solely on the genetics, so I think his short video did not seem to be extremely biased. Despite my belief after seeing the video, because he is a geneticist it would make sense for him to focus more on his agenda and his clinically relevant results, however, I did not feel that he did during the video.
Allison Manfreda
As mentioned previously in other comments, Dr. Tischfield was using this interview to target a lay audience, and thus did not go into some of the more technical information his study collected - including his opinions on the potential for an epigenetic factor in hereditary alcoholism. However, I found a recent study in the Journal of Neuroscience that did address the way that alcohol can affect gene expression without permanently altering the genome.
ReplyDeleteAn enzyme called a histone deacetylase tightens the histones and prohibits some gene expression because the DNA is wrapped more tightly and fewer genes are visible. In this study, alcohol exposure decreased the activity of histone deacetylases (resulting in greater gene expression). These genes cause the production of a neurotransmitter called NPY that has been found to be lower in animals with a "preference" for alcohol. Though NPY increases with alcohol consumption, it decreases once a person stops drinking and hits the "withdrawal" phase. Therefore it is likely that a person who's NPY levels are exceptionally low after experiencing withdrawal may be more likely to seek out alcohol again in the future. This could, over time, lead to alcoholism.
Because this study was performed on rats rather than humans, its applicability to the inheritance of a genetic predisposition to alcohol wasn't part of the researchers' hypothesis. However, it is interesting (and a little scary) that a long night of binge drinking can have an effect on our genes and not just end in a headache!
The article:
Pandey, et al. 2008, Brain Chromatin Remodeling: A Novel Mechanism of Alcoholism. The Journal of Neuroscience 28(14): 3729-3737.
Dr. Tischfield mentioned that the NESARC study will survey 46,000 people, collect extensive data, and a do a simply genetic analysis. It will be interesting to see what kind of information these initial results will produce. Especially once technology becomes more affordable and one can look at their entire DNA sequence. The data that might arise from this study could have profound effects on how alcoholism is treated!
ReplyDeleteI think it is important to note that the environment plays a very significant role on an individual’s development. Humans may be genetically prone to thousands of different behaviors, however often an environmental trigger is required to actually initiate it. If people, such as the woman mentioned by Dr. Tischfield, make the conscious decision to not engage in the behavior, then they will not adopt the dangerous behavior. Therefore, knowing one’s entire genome and being aware of various inheritable behaviors allows individuals to decide how they want to proceed with the information. Some people, such as the woman, will utilize this information and stay away from any triggers. However, other people might feel that it is inevitable, and therefore they partake in the behavior without caution.
I think that Dr. Tischfield’s position—that alcoholism is a complex disorder influenced by both genetic and environmental factors—is valid. I recently read an article in National Geographic (January 2012) that supports what he is saying. The article discusses how twin studies have helped us to understand the roles of nature and nurture in human development, including their influences in disorders such as alcoholism. Studies have shown that when one identical twin is diagnosed with alcoholism, there is about a 60% chance that the other twin will be, too. However, when one fraternal twin is diagnosed with alcoholism, the chance of the other twin being an alcoholic is only about 30%. That identical twins share alcoholism about twice as often as fraternal twins suggests the influence of heredity. Furthermore, that one identical twin may become an alcoholic while the other does not suggests the influence of environment. The article also talks about how epigenetic factors may be responsible for the differences that we see in identical twins: Epigenetic tags (such as methyl groups) can affect the extent to which genes are expressed; some of these tags can be inherited. Environmental factors, such as stress and nutrition, can cause tagging, in turn altering the expression of genes. As gene expression occurs over time, differing tags make twins different. Given this, I do believe that epigenetics may play an important role in alcoholism.
ReplyDeleteThe intended audience is the general public, and I think that Dr. Tischfield sends an important message to the audience. His anecdote emphasizes that although a person may have a genetic predisposition to becoming alcoholic, personal decisions and behaviors can and do affect whether one does become an alcoholic. However, one issue with this anecdote is that it may make people feel that if they have a family history of alcoholism, complete abstinence from alcohol is the only way to avoid becoming alcoholics themselves. What Dr. Tischfield does not address (as April pointed out) is the interviewer's question: Can a person with genetic markers for alcoholism be a social drinker and not become alcoholic? Also, I think it is important to note that Dr. Tischfield is coming from the perspective of a geneticist, so he makes the point that people with genetic predispositions for alcoholism can make choices to reduce their likelihoods of becoming alcoholics. However, what he does not address explicitly, and what is important to realize, is that people may not have the genetic markers for alcoholism, but that environmental factors and personal choices and behavior can affect their likelihoods of becoming alcoholics.
Dr. Tischfield’s study sounds very ambitious. One would hope that with the large sample size and the extensive amounts of information they plan to collect, they can contribute significant (and valid) evidence for the roles of nature and nurture in alcoholism. It would be helpful to know more about the study design. For example, do they plan to have a prospective aspect to it? Such a study that tests the DNA of people who are not alcoholics and then follows them into the future to see who becomes alcoholics would provide valuable information about the role of genetics in alcoholism.
I feel that Dr. Tischfield is valid in his statements considering he acknowledged that both genetics and the environment play significant roles in the development of alcoholism. His area of focus though is centered around looking at what genetic markers, if any, make some more predisposed to alcoholism than others. With the general public as his audience, he must be careful in how he chooses to present this information. It can be easily taken by some people to mean that anyone with a history of alcoholism in their family will most certainly become an alcoholic. Also the fact that Dr. Tischfield takes the notion that one’s genetic makeup has more of an impact would be worrisome to many since that is something you cannot control. I do however think his study would prove to have positive effects. With this information those who are genetically predisposed to alcoholism can be more careful with their alcohol use knowing that they have an increased chance of abusing it. Although completely abstaining from alcohol it is not always necessary like the 60 year old woman Dr. Tischfield spoke of, at least learning to consume it in moderation will be very helpful. Although his theory sounds promising, the only way that we can be assured that his study is viable would be to look at it ourselves since the short video does not provide enough to go on. This would require us analyzing the components of the study and its participants, looking at the findings and asking if he considered at all aspects of the development of alcoholism. We must also be wary of any bias presented. As a doctor in the field of genetics it is possible that his interests impact his findings.
ReplyDeleteAlcoholism being epigenetic is definitely a plausible idea considering many who turn to alcohol abuse are doing it as a result of environmental factors such as stress. Their surroundings may trigger certain gene markers of alcoholism that can be passed down.
I feel that Dr. Tischfield is targeting an audience who has a background of alcoholism. Although there is both a nature and nurture factor to both this subject, I personally feel that his data or studies may not be as reliable as he makes it seem. When you are exposed to an environment of alcoholism it may make you more susceptible to pick up this practice, but also having a background of it like Dr. Tischfield states may have the same effect. SImply because our past can affect our future. Most diseases have the tendency to cross generations, such as heart diseases, diabetes, etc. But with all those examples it is possible to break the streak, and take the proper precautions needed to avoid these medical conditions. Although alcoholism can be a source of nature or nurture steps can be taken to not be a victim of this condition. I feel that although Dr. Tischfield is on to something, more studies must be made with broader study samples before this data can be taken into consideration. From the video it sounds as if his study was based on people with a history of alcoholism and then he began to consider people without a history, which makes the consideration of his data a bit difficult.
ReplyDeleteDr. Tischfield's comments, to me, seem rather dangerous to be making because it could result in some alcoholics justifying their disease based on their genes and therefore not trying to do anything to reverse it. Certainly, alcoholism involves biological pathways of dependance, and these pathways can certainly be affected by one's genes. However, it is impossible to argue against the fact that people are not born with the innate desire to consume alcohol in copious quantities in an unhealthy and dependent manner. Certainly, the environment in which one grows up can play a role (for example, if a parent or grandparent is an alcoholic), but ultimately it is a choice that every person makes, both to begin drinking alcohol and to abuse it.
ReplyDeleteI agree with others that state that Dr. Tischfield's data is certainly interesting, but it should not be considered the ultimate cause for alcoholism, and his probable start point looking at those with a history of alcoholism first lends itself to this. Ultimately, alcoholism, I believe, is a behavioral choice that may be peripherally associated with some genetic factors, but is not determined by it.
I would be very interested to see the results of Dr. Tischfield's study. It seems as though he relies heavily on the genetic causes of alcoholism. While I do not discount that certain genetic mutations can lead to a higher risk of alcoholism, I feel as though the nurture aspect is far more important. One's upbringing has so much to do with how that person develops. I feel as though an environment conducive to becoming an alcoholic can outweigh a person's genetic makeup. A person without a mutation that grows up in such an environment clearly has a high risk of becoming an alcoholic. Conversely, a person with the mutation that grows up in a healthy environment will not automatically become an alcoholic. Therefore, regarding the issue of alcoholism I believe that nurture takes a much more prominent role than nature.
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