Individual Differences in the Associations Between Risk Factors for Alcohol Use Disorder and Alcohol Use-Related Outcomes

Background: Family history of alcohol use disorder; AUD (FH+) and impulsivity-related traits are known risk factors for problem drinking that have been investigated in predominately White samples. This cross-sectional study examined whether these risk factors vary by sex in the overall, majority White sample and in a Black subsample. Method: A model building regression procedure was used to investigate the combined effect of FH+ and impulsivity-related traits on alcohol quantity, frequency, and problems by sex (overall sample: N = 757, 50% female, 73% White, agemean = 33.74, SD = 11.60; Black subsample: n = 138, 47% female, agemean = 33.60, SD = 9.87). Results: Overall Sample. No sex differences were found in the compounding effects of FH+ and impulsivity-related traits on alcohol outcomes. Males reported more physical, social, and overall alcohol-related problems than females. FH+ was positively associated with all alcohol-related consequences. Poor self-regulation was the only trait associated with all alcohol outcomes. Black Subsample: A three-way interaction suggested a negative association between inhibition and frequency of alcohol use among FH+ males only. A two-way interaction also suggested impulse control was associated with more interpersonal alcohol-related problems among males only. Main effects were also found in the expected direction such that higher impulsivity and FH+ were associated with poorer alcohol outcomes. Conclusion: These findings suggest no sex differences in the overall sample in the interactive effects of established risk factors for AUD on alcohol outcomes, and that poor self-regulation may be key for personality-targeted alcohol prevention and intervention programs. Preliminary findings of sex differences in the Black subsample should be replicated. Public Health Significance Statement This study suggests the combination of risk factors (family history and impulsivity-related traits) for alcohol use and problems differs across sex in a Black subsample but not in a predominately White sample. Although these findings should be considered preliminary and replicated in future research, they highlight the importance of attending to race and sex when seeking to understand risk pathways for alcohol use disorder.