Externalizing symptoms among children of alcoholic parents: Entry points for an antisocial pathway to alcoholism.

We examined heterogeneity in risk for externalizing symptoms in children of alcoholic parents as it may inform the search for entry points into an antisocial pathway to alcoholism. Specifically, we tested whether the number of alcoholic parents in a family, the comorbid subtype of parent alcoholism, and the gender of the child predicted trajectories of externalizing symptoms over the early life course as assessed in high-risk samples of children of alcoholic parents and matched controls. Through integrative analyses of two independent, longitudinal studies, we showed that children with either antisocial alcoholic parents or two alcoholic parents were at greatest risk for externalizing symptoms. Moreover, children with a depressed alcoholic parent did not differ from those with an antisocial alcoholic parent in reported symptoms. These findings were generally consistent across mother-, father- and adolescent-reports of symptoms, child gender and child age (ages 2 through 17), and the two independent studies examined. Multi-alcoholic and comorbid-alcoholic families may thus convey a genetic susceptibility to dysregulation along with environments that both exacerbate this susceptibility and provide few supports to offset it