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Multiple types of genetic influence affect the severity and presentation of alcohol use disorder (AUD), according to what may be the first study examining the joint effects of three types of genetic liability on alcohol outcomes. About half the risk for AUD is known to be genetically inherited. Some genetic influences manifest as struggles with self-regulation, such as childhood conduct problems and risk-taking ("externalizing" behaviors). Other genetic vulnerabilities show up as tendencies toward depression and negative affect ("internalizing" behaviors), while a third group of genetic influences is alcohol-specific (e.g., affecting how alcohol is metabolized).

Large studies mapping relevant genetic variants are enabling polygenic scoring (PGS) that captures individuals' overall genetic susceptibility to AUD. The study in Alcohol: Clinical & Experimental Research explored how genetic factors underlying externalizing, internalizing and alcohol-specific effects jointly shape AUD and co-occurring behavioral issues and personality traits.

The authors worked with data from 6,883 adults of European-like ancestry. The participants were assessed for AUD, childhood conduct problems and adult antisocial behavior, major depressive disorder, and additional traits and tendencies. The participants were grouped according to whether they were high or low on each of the three genetic liabilities, with 2,006 people falling into groups with different patterns of genetic risk that were compared.

Nearly 6 in 10 participants in the high-risk sample met criteria for AUD, with varying severity. Broadly, those with high PGS across multiple genetic risk dimensions met more AUD diagnostic criteria than people with high PGS in fewer categories or with lower PGS.

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