Stressful life events and alcohol misuse in women: a critical review.

The literature on stressful life events and alcohol misuse in women is critically reviewed. Many researchers have suggested that women begin to misuse alcohol in response to stress linked to precipitating circumstances or life events. Middle-aged women are felt to be especially at risk because of the nature of the events that they are likely to experience, e.g., divorce, bereavement and departure of children from the home. Evidence for these views has been collected by asking patients to recall particular events in their past that they considered may have caused their heavy drinking. This approach has several methodological problems, most notably the failure to deal with the possibility that heavy drinking produced an increased frequency of stressful life events rather than vice versa. It has been speculated that women are more likely to attribute their heavy drinking to causes that are more likely to elicit sympathy than condemnation. None of the studies discussed has considered the possibility that the link between life events and heavy drinking reflects the activities of a sizable subgroup of women described as "sociopathic" alcoholics, the disturbance producing an excess of both events and excessive alcohol consumption. Considerable criticism has been leveled at the use of poorly validated concepts such as "mid-life crisis" and the tendency to use terms such as "menopausal syndrome" as an explanation for almost any difficulty experienced by women in middle age. It is concluded that the hypothesis that stressful life events cause excessive drinking remains to be empirically demonstrated.