Association for Medical Education and Research in Substance Abuse Bethesda, MD November 7-9, 2013

1. Social Network Drinking Outweighs Family History in the Development of Alcohol Dependence in AdultsVivia V. McCutcheon, PhD, Christina Lessov-Schlaggar, PhD, Douglas Steinley, PhD., Kathleen K. Bucholz, PhD. Association for Medical Education and Research in Substance Abuse Bethesda, MD November 7-9, 2013

2. Background • Genetic influences on risk for alcohol use disorder account for 40-60% of variance • Alcohol use and peers • Homophily • Influence Heath et al., 1997; Prescott et al., 1999; Knopik et al., 1999

3. Peer Influence on Alcohol Use • Additional heavy drinkers/abstainers in close network increases likelihood heavy drinking/abstention in principal (Rosenquist et al., 2010) • Affiliation with substance use promoting peers predicted increase in AUD symptoms at subsequent ages from age 17 to 40 (Chassin et al., 2012) • Peer network substance use predicted changes in drinking from adolescence into young adulthood after controlling for genetic and shared environmental influences on peer selection (Cruz et al., 2012)

4. Objective • Characterize group of adults with high familial risk for AD • Parental alcohol problems • Drinking behavior in network • Examine associations of network drinking and familial risk with first-onset AD

5. Sample • 11-year follow-up of subset of ECA sample selected for high risk of developing alcohol dependence (N=753) • Previous reports heavy drinking in self or 1st-degree relatives • Risk score including conduct disorder, illicit drug use, depression • Age 18-49 at baseline ECA interview • 29-62 at 11-year follow-up Regier et al., 1984; Bucholz et al., 1996

6. Assessments • DSM-III AD • Current (6.8%) • Remitted (7.7%) • Family history alcohol problems in one or both parents • “I’d like to ask you some questions about the drinking of some of your relatives. Have any of the following relatives drunk heavily or had ANY drinking problems, like problems with health, family, job, or police?”

7. Assessments • Network drinking • “Now I’d like to know about the current drinking habits of the people you may be close to. Which of the patterns on the card best describes the drinking pattern of (closest friend outside family, closest sibling, current spouse/partner)?” • Lifelong abstainer/Non-drinker/Light drinker • Moderate/Heavy/Problem drinker or Alcoholic • Recovering problem drinker or alcoholic who doesn’t drink now

8. Demographic Characteristics

9. Drinking Characteristics

10. AD Incidence by Parental Alcohol Problems * 65% 30% 5%

11. AD Incidence by Spousal Drinking * 57% 38% 5%

12. AD Incidence by Friend, Sib Drinking Closest Friend Closest Sibling * * * * 41% 57% 2% 52% 44% 4%

13. Multinomial Regression Predicting Remitted and Current Incident AD Adjusted for gender, age, marital status

14. Logistic Regression Predicting Incident AD Adjusted for gender, age, marital status

15. Conclusions • Network heavy drinking and recovery had effects equal to that of alcohol problems in both parents in predicting first-onset AD, and outweighed the influence of AD in one parent. • Future: Does association of recovery in network with remitted AD reflect network selection or network influence? • Does recovery spread within network?

16. Acknowledgements • K01 AA018146 (McCutcheon, PI) • K01 DA027046 (Lessov-Schlaggar, PI) • K25 AA017456, R21 AA022074 (Steinley, PI) • R01 AA008752, P50 AA 011998, R01 AA012640, R01 DA 014363 (Bucholz, PI)

17. Thank You!Questions? Contact info: Vivia V. McCutcheon, Ph.D. Research Assistant Professor of Psychiatry Washington University School of Medicine, St. Louis, MO vmccutcheon@wustl.edu 314-286-2297