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Psychol Med. 2015 Oct;45(14):3047-58. doi: 10.1017/S0033291715001014. Epub 2015 Jun 29.

Gender differences in the structure of risk for alcohol use disorder in adolescence and young adulthood.

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Department of Psychology,University of Michigan,Ann Arbor,MI,USA.
Department of Psychiatry,University of Michigan,Ann Arbor,MI,USA.
Department of Psychology,University of Minnesota,Minneapolis,MN,USA.



Gender differences in the prevalence of alcohol use disorder (AUD) have motivated the separate study of its risk factors and consequences in men and women. However, leveraging gender as a third variable to help account for the association between risk factors and consequences for AUD could elucidate etiological mechanisms and clinical outcomes.


Using data from a large, community sample followed longitudinally from 17 to 29 years of age, we tested for gender differences in psychosocial risk factors and consequences in adolescence and adulthood after controlling for gender differences in the base rates of AUD and psychosocial factors. Psychosocial factors included alcohol use, other drug use, externalizing and internalizing symptoms, deviant peer affiliation, family adversity, academic problems, attitudes and use of substances by a romantic partner, and adult socio-economic status.


At both ages of 17 and 29 years, mean levels of psychosocial risks and consequences were higher in men and those with AUD. However, the amount of risk exposure in adolescence was more predictive of AUD in women than men. By adulthood, AUD consequences were larger in women than men and internalizing risk had a stronger relationship with AUD in women at both ages.


Despite higher mean levels of risk exposure in men overall, AUD appears to be a more severe disorder in women characterized by higher levels of adolescent risk factors and a greater magnitude of the AUD consequences among women than men. Furthermore, internalizing symptoms appear to be a gender-specific risk factor for AUD in women.


Adolescent risk factors; adult consequences; alcohol use disorder; gender differences.

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