Heterogeneity of risk aggregation for alcohol problems between early and middle childhood: Nesting structure variations

We examined how family and child risk factors jointly affected stability an d change in externalizing behavior over time in a prospective study of even tual alcohol use disorder. Study participants were community-recruited alco holic and control families, and their initially preschool-aged male and fem ale children (N = 335). Family risk varied as a function of both parental a lcoholism (ALC) and antisocial personality disorder (ASPD) and was evaluate d for both parents. Child risk was characterized by a set of risky temperam ent attributes pertaining to high activity, high reactivity, and low attent ion span. Externalizing behavior was used as the proxy indicator for later alcohol problems. For children in the high family risk group (involving cur rent ALC in both parents or current ALC + ASPD comorbidity or both), child risk when children were 3-5 years old (Wave 1) directly predicted externali zing behavior when children were 6-8 years old (Wave 2), even when Wave 1 c hild risk was controlled for. In addition, parents' negative interaction wi th children at Wave 1 mediated the effect of child risky temperament on Wav e 2 externalizing behavior. No such pattern was observed in the low family risk group, where only autostability effects were predictive of outcomes at Wave 2. The importance of nesting structure as an ingredient in the epigen esis of risk was discussed. Its particular relevance in understanding the p rocess of risk transmission among offspring from antisocial alcoholic famil ies was emphasized.