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Alcohol and illicit drug dependence among parents: associations with offspring externalizing disorders

  • N. R. Marmorstein (a1), W. G. Iacono (a2) and M. McGue (a2)

Previous research indicates that alcohol and drug dependence constitute aspects of a general vulnerability to externalizing disorders that accounts for much of the parent-offspring resemblance for these and related disorders. This study examined how adolescent offspring risk for externalizing psychopathology varies with respect to parental alcoholism and illicit drug dependence.


Data from the Minnesota Twin Family Study, a community-based investigation of adolescents (age 17 years, n=1252) and their parents, were used. Lifetime diagnoses of alcohol and drug dependence (among both parents and offspring) and offspring attention deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder, adult antisocial behavior, and nicotine dependence were assessed via structured interviews.


Parental alcohol dependence and parental drug dependence were similarly associated with increased risk for nearly all offspring disorders, with offspring of alcohol and drug-dependent parents having approximately 2–3 times the odds for developing a disorder by late adolescence compared to low-risk offspring. Compared to parental dependence on other illicit drugs, parental cannabis dependence was associated with weaker increased risk for offspring externalizing disorders.


Both parental alcohol and drug dependence are independently associated with an increased risk for a broad range of externalizing psychopathology among late-adolescent offspring.

Corresponding author
*Address for correspondence: N. R. Marmorstein, Ph.D., Department of Psychology, Rutgers University, Camden, 311 North 5th Street, Camden, NJ 08102, USA. (Email:
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Barnow S, Schuckit M, Smith TL, Preuss U, Danko G (2002). The relationship between the family density of alcoholism and externalizing symptoms among 146 children. Alcohol and Alcoholism 37, 383387.
Burt SA, Krueger RF, McGue M, Iacono WG (2001). Sources of covariation among attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder: the importance of shared environment. Journal of Abnormal Psychology 110, 516525.
Chassin L, Pitts SC, DeLucia C, Todd M (1999). A longitudinal study of children of alcoholics: predicting young adult substance use disorders, anxiety, and depression. Journal of Abnormal Psychology 108, 106119.
Clark DB, Cornelius J, Wood DS, Vanyukov M (2004). Psychopathology risk transmission in children of parents with substance use disorders. American Journal of Psychiatry 161, 685691.
Curran GM, Stoltenberg SF, Hill EM, Mudd SA, Blow FC, Zucker RA (1999). Gender differences in the relationships among SES, family history of alcohol disorders and alcohol dependence. Journal of Studies on Alcohol 60, 825832.
Dick D (2007). Identification of genes influencing a spectrum of externalizing psychopathology. Current Directions in Psychological Science 16, 331335.
Dick DM, Aliev F, Wang JC, Grucza RA, Schuckit M, Kuperman S, Kramer J, Hinrichs A, Bertelsen S, Budde J.P, Hesselbrock V, Porjesz B, Edenberg HJ, Bierut LJ, Goate A (2008). Using dimensional models of externalizing psychopathology to aid in gene identification. Archives of General Psychiatry 65, 310318.
Gabel S, Shindledecker R (1993). Parental substance abuse and its relationship to severe aggression and antisocial behavior in youth. American Journal on Addictions 2, 4858.
Hicks BM, Krueger RF, Iacono WG, McGue M, Patrick CJ (2004). Family transmission and heritability of externalizing disorder: a twin-family study. Archives of General Psychiatry 61, 922928.
Hill SY, Muka D (1996). Childhood psychopathology in children from families of alcoholic female probands. Journal of the American Academy of Child and Adolescent Psychiatry 35, 725733.
Holdcraft LC, Iacono WG (2004). Cross-generational effects on gender differences in psychoactive drug abuse and dependence. Drug and Alcohol Dependence 74, 147158.
Hollingshead AB (1975). Four Factor Index of Social Status. New Haven, CT: Yale University Department of Sociology.
Iacono WG, Carlson SR, Taylor J, Elkins IJ, McGue M (1999). Behavioral disinhibition and the development of substance-use disorders: findings form the Minnesota Twin Family Study. Development and Psychopathology 11, 869900.
Iacono WG, Malone SM, McGue M (2008). Behavioral disinhibition and the development of early-onset addiction: common and specific influences. Annual Review of Clinical Psychology 4, 12.112.24.
Iacono WG, McGue M (2002). Minnesota Twin Family Study. Twin Research 5, 482487.
Iacono WG, McGue M, Krueger RF (2006). Minnesota Center for Twin and Family Research. Twin Research and Human Genetics 9, 978984.
Jacob T, Windle M, Seilhamer RA, Bost J (1999). Adult children of alcoholics: drinking, psychiatric, and psychosocial status. Psychology of Addictive Behaviors 13, 221.
Kandel DB (2002). Stages and Pathways of Drug Involvement: Examining the Gateway Hypothesis. Cambridge University Press: New York.
Kuperman S, Schlosser SS, Lindral J, Reich W (1999). Relationship of child psychopathology to parental alcoholism and antisocial personality disorder. Journal of the American Academy of Child and Adolescent Psychiatry 38, 686692.
Lieb R, Merikangas KR, Hofler M, Pfister H, Isensee B, Wittchen H-U (2002). Parental alcohol use disorders and alcohol use and disorders in offspring: a community study. Psychological Medicine 32, 6378.
Loukas A, Zucker RA, Fitzgerald HE, Krull JL (2003). Developmental trajectories of disruptive behavior problems among sons of alcoholics: effects of parent psychopathology, family conflict, and child undercontrol. Journal of Abnormal Psychology 112, 119131.
Marmorstein NR, Iacono WG (2005). Longitudinal follow-up of adolescents with late-onset antisocial behavior: a pathological yet overlooked group. Journal of the American Academy of Child and Adolescent Psychiatry 44, 12841291.
Merikangas KR, Dierker LC, Szatmari P (1998). Psychopathology among offspring of parents with substance abuse and/or anxiety disorders: a high-risk study. Journal of Child Psychology and Psychiatry 39, 711720.
Milberger S, Faraone SV, Biederman J, Chu MP, Feighner JA (1999). Substance use disorders in high-risk adolescent offspring. American Journal on Addictions 8, 211219.
Ohannessian CM, Hesselbrock VM, Kramer J, Kuperman S, Bucholz KK, Schuckit MA, Nurnberger JI (2005). The relationship between paretnal psychopathology and adolescent psychopathology: an examination of gender patterns. Journal of Emotional and Behavioral Disorders 13, 6776.
Reich W, Welner Z (1988). Diagnostic Interview for Children and Adolescents – Revised: DSM-III-R Version (DICA-R). Washington University: St. Louis.
Robins LN, Baber T, Cottler LB (1987). Composite International Diagnostic Interview: Expanded Substance Abuse Module.
Robins LN, Wing J, Wittchen HU, Helzer JE, Babor TF, Burke J, Farmer A, Jablenski A, Pickens R, Regier DA, Sartorius N, Towle LH (1988). The Composite International Diagnostic Interview. Archives of General Psychiatry 45, 10691077.
Schuckit MA, Smith TL, Radziminski S, Heyneman EK (2000). Behavioral symptoms and psychiatric diagnoses among 162 children in nonalcoholic or alcoholic families. American Journal of Psychiatry 157, 18811883.
Spitzer RL, Williams JBW, Gibbons M, First MB (1987), Structured Clinical Interview for DSM-III-R Personality Disorders (SCID II). Biometrics Research Division, New York State Psychiatric Institute: New York.
Stanger C, Higgins ST, Bickel WK, Elk R, Grabowski J, Schmitz J, Amass L, Kriby KC, Seracini AM (1999). Behavioral and emotional problems among children of cocaine- and opiate-dependent parents. Journal of the American Academy of Child and Adolescent Psychiatry 38, 421428.
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Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
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