DOI: 10.1111/acer.70365 ISSN: 2993-7175
Patterns, Predictors, and Correlates of Problematic Alcohol Use and Remission From Adolescence to Early Midlife
Megan E. Cooke, Erin Lumpe, Mallory Stephenson, Sally I‐Chun Kuo, Peter B. Barr, Sarah J. Brislin, Holly Poore, Fazil Aliev, Maarit Piirtola, Antti Latvala, Jill A. Rabinowitz, Richard J. Rose, Jaakko Kaprio, Danielle M. Dick, Jessica E. Salvatore ABSTRACT
Background
The goal of this paper is to identify environmental, behavioral, and genetic predictors and early midlife correlates of problematic alcohol Use (
PAU
) patterns from adolescence to early midlife.
Methods
The data are from 1463 twin individuals (60.5% female) in the population‐based
FinnTwin12
cohort born 1983–1987.
PAU
was assessed at ages 14, 22 and 37 using symptoms of alcohol use disorder (
AUD
) obtained from psychiatric interviews,
mmMAST
scores, and the
AUDIT
. Self‐reported health and well‐being were assessed at age 37. A behavioral and environmental risk index (
BERI
) was created by summing six risk factors: low socioeconomic status in childhood, family history of
AUD
, childhood externalizing and internalizing behaviors, adolescent substance use, peer substance use, and stressful life events in adolescence. The twins' genetic predispositions were indexed using polygenic scores for externalizing behavior (
PGS
EXT
),
PAU
(
PGS
PAU
), and depression (
PGS
MDD
).
Results
Twins were classified into four
PAU
groups:
Never
(
n
= 599, reference),
Remitted
(
n
= 480),
Persistent
(
n
= 271), and
Late‐onset
(
n
= 113). When included in the same model, both
BERI
and
PGS
EXT
were significantly associated with
Remitted
PAU
, while
BERI
scores and
PGS
PAU
were significantly associated with
Persistent
PAU
. Compared to the
Never
PAU
group, individuals in the
Persistent
and
Late‐onset
PAU
groups reported lower educational attainment, poorer physical health, lower relationship satisfaction, lower life satisfaction, a worse financial situation, more depressive symptoms, recurrent pain, and sleep problems, and were less likely to be partnered or have children.
Conclusions
Persistent
PAU
was associated with the most negative outcomes in early midlife, and childhood and adolescent risk factors and genetic risk as indexed by
PGS
PAU
were strong predictors of group membership.
Late‐onset
PAU
may be the result of novel stressors in adulthood, given the lack of association with childhood and adolescent environmental risk or genetic risk.