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Impact of the Number of Parents With Alcoholuse Use disorder on Alcohol Use Disorder in Offspring: A Population – Based Study
Abstract
Objective: Although parental alcohol use disorder (AUD) increases risk for alcohol phoblems in offspring, no studies have evaluated the odds of alcohol use disorder in offspring based on the number of biological parents with alcohol use disorder in a population – based national sample. The purpose of this study was to investigate the relationship between the number of alcohol use disorder parents and prevalence of alcohol use disorder in offspring.
Method: This study utilized data from the 2001 -2002 National Epidemiologic Survey on Alcohol and related Conditions, which assessed alcohol use disorder using the Alcohol Use Disorder and Associated Disabilities Interview Schedule – DSM – IV Version (main outcome variable). We analyzed the sample to investigate the effect of the number of alcohol use disorder parents on lifetime alcohol use disorder in offspring. In a subgroup analysis, gender differences were examined.
Results: 22% of adults in the United States had at least 1 biological parent with alcohol use disorder. Compared with offspring of non- alcohol use disorder parents, offspring of 1 alcohol use disorder parent had a 2.5-fold increase and offspring of 2 alcohol use disorder parents had a 4.4-fold increase in the odds of lifetime alcohol use disorder. Each addition alcohol use disorder parent increased the odds of alcohol use disorder in offspring in an additive pattern. Female offspring were more vulnerable to the impact of parental alcohol use disorder than male offspring .
Conclusions: offspring of alcohol use disorder parents had heightened odds of lifetime alcohol use disorder, with an additive parental effect. Awareness of this risk can be useful for clinicians to educate individuals with alcohol use disorder parents about prevention and intervention.
Alcohol use disorder (AUD) is a serious public health problem in the United States and worldwide. Previous studies have indicated that parental alcohol use disorder increases risk for alcohol use disorder in offspring Both genetic and environmental risk factors are associated with higher odds of alcohol use disorder in offspring. Twin studies have demonstrated that the heritability of alcohol dependence is 50%-60%.
Patients and their family members often ask clinicians about the odds and probability of developing Alcohol use disorder when their father ,mother, or both parents have alcohol problems. Studies on the number of Alcohol use disorder parents can help us further understand the relationship between parental and offspring Alcohol use disorder. This information would be valuable in providing preventive and clinical interventions. A recent Danish cohort study answered this question and reported that paternal Alcohol use disorder and maternal Alcohol use disorder increased the odds of Alcohol use disorder in offspring. Howevr, this study did not examine odds of Alcohol use disorder among offspring of 2 Alcohol use disorder parents. In a community study of adolescents and young adults in Munich, Germany, the odds of alcohol dependence were 2.14 time higher in offspring of 1 Alcohol use disorder parent and 2.75 time higher in offspring of 2 Alcohol use disorder parents compared to offspring of non- Alcohol use disorder parent. The difference was not significant between offspring of 1 Alcohol use disorder parent and those of 2 Alcohol use disorder parents on the 95% CI. This study, however, may not represent all population groups because many individuals develop alcohol dependence long after adolescence and young adulthood. In addition to these 2 important studies, clinical studies have shown that patients with 2 alcoholic parents manifested more alcohol-related symptoms and problems than patients with no alcoholic parents. However, clinical samples tend to represent patients with severe or treatment refractory Alcohol use disorder and therefore may not be generalizable to the population at large. Currently, no studies have examined the association between the number of Alcohol use disorder parents and odds of Alcohol use disorder ih offspring in a population-based national sample.
The primary goal of this study was to investigate the relationship between the number of Alcohol use disorder parents and Alcohol use disorder in offspring in nationally representative data. Our hypothesis was that prevalence of Alcohol use disorder in offspring would be higher in offspring of 2 Alcohol use disorder parents as compared to offspring of non- Alcohol use disorder parents. We also examined gender differences among offspring and their Alcohol use disorder parents in this association.
METHOD
A survey sample consisted of participants in the 2001 – 2002 National Epidemiologic survey on Alcohol and Related Conditions, which was designed, sponsored, and conducted by the National Institute on Alcohol Abuse and Alcoholism. The NESARC is a nationally representative household survey of the US civilian noninstitutionalized population. Nationwide face-to-face personal interviews were conducted with 43,093 participants aged 18 years by the US Census Bureau in 2001-2002. The overall response rate was 81%. The NESARC procedures were reviewed and approved by the US census bureau and the US office of Management and budget. All NESARC participants provided informed consent. The survey provides data on alcohol and drug use, psychiatric classification of substance use disorders and other psychiatric disorders, alcohol theatment utilization, sociodemographic information, and family history of Alcohol use disorder.
Of 43,093 individuals in the NESARC, 40,374 participants provided data on parental history of Alcohol use disorder for both parents. The current study was based on the subsample of these 40,374 participants. The mean age of the study sample was 46.4 years. The majority of this study sample was female, white, and married/ cohabiting.
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