Alcohol Use Disorder, Psychiatric Comorbidities, Marriage and Divorce in a High-Risk Sample

• Published in: Psychology of addictive behaviors 2022-06, Vol.36 (4), p.364-374
• Main Authors: Thomas, Nathaniel S., Kuo, Sally I-Chun, Aliev, Fazil, McCutcheon, Vivia V., Meyers, Jacquelyn M., Chan, Grace, Hesselbrock, Victor, Kamarajan, Chella, Kinreich, Sivan, Kramer, John R., Kuperman, Samuel, Lai, Dongbing, Plawecki, Martin H., Porjesz, Bernice, Schuckit, Marc A., Dick, Danielle M., Bucholz, Kathleen K., Salvatore, Jessica E.
• Format: Article
• Language: English
• Subjects: Adult; Alcohol related disorders; Alcohol use; Alcohol Use Disorder; Alcohol-Related Disorders - psychology; Alcoholism; Alcoholism - epidemiology; Alcoholism - genetics; Alcoholism - psychology; Antisocial personality disorder; At Risk Populations; Comorbidity; Depressive Disorder, Major - epidemiology; Depressive personality disorders; Divorce; Divorce - psychology; Environmental aspects; Female; High risk; Human; Humans; Life Span; Major Depression; Male; Marijuana; Marijuana Abuse; Marriage; Mental depression; Mental Disorders; Random effects; Tobacco
• ISSN: 0893-164X; 1939-1501; 1939-1501
• DOI: 10.1037/adb0000840

Objective: To examine associations between alcohol use disorder (AUD), its psychiatric comorbidities, and their interactions, with marital outcomes in a diverse high-risk, genetically informative sample. Method: Participants included European ancestry (EA; n = 4,045) and African ancestry (AA; n = 1,550) individuals from the multigenerational Collaborative Study on the Genetics of Alcoholism (COGA) sample (56% female, Mage ∼ 41 years). Outcomes were lifetime marriage and divorce. Predictors included lifetime AUD, an alcohol problems polygenic score (PRS), and AUD comorbidities, including conduct or antisocial personality disorder (ASP), cannabis dependence/abuse (CAN), frequent tobacco use (TOB), and major depressive disorder (MDD). Mixed effect Cox models and generalized linear mixed effects models were fit. Results: Among EA participants, those with AUD and CAN were less likely to marry (hazard ratios [HRs] 0.70-0.83, ps < 0.01). Among AA participants, those with AUD and TOB were less likely to marry (HRs 0.66-0.82, ps < 0.05) and those with MDD were more likely to marry (HR = 1.34, ps < 0.01). Among EA participants, AUD, CAN, TOB, and MDD were associated with higher odds of divorce (odds ratios [ORs] 1.59-2.21, ps < 0.01). Among AA participants, no predictors were significantly associated with divorce. Significant random effects indicated genetic and environmental influences on marriage, but only environmental factors on divorce. Conclusions: In a high-risk sample, AUD was associated with reduced likelihood of marriage in EA and AA individuals and increased risk of divorce in EA individuals. These associations were largely independent of comorbidities. Genetic and environmental background factors contributed to marriage, while only environmental background factors contributed to divorce. Public Health Significance Statement The social correlates/consequences of alcohol use disorder in high-risk populations are not well established. The results from this study indicate that, in a sample enriched for risk, those with alcohol use disorder and related conditions were less likely to marry, and more likely to divorce, with some evidence for differences in European and African ancestry groups.