VCU news

By Tom Gresham

Children of parents who have alcohol use disorder are more likely to get married under the age of 25, less likely to get married later in life, and more likely to marry a person who has alcohol use disorder themselves, according to a new study by researchers at Virginia Commonwealth University and Lund University in Sweden.

“There are many pathways through which a parent’s alcohol problems can influence our own risk for alcohol problems. One important pathway, of course, has to do with the genes that parents pass to their children,” said the study’s lead author, Jessica E. Salvatore, Ph.D., an assistant professor in the Department of Psychology in the College of Humanities and Sciences at VCU. “But another important pathway, which we demonstrate here, is through the social environment.”

The study, “Parental Alcohol Use Disorder and Offspring Marital Outcomes,” was published in the most recent issue of the journal Addiction. It is based on data from legal, medical and pharmacy registries with detailed information on 1.17 million people in Sweden who were born between 1965 and 1975.

“Although there have been many studies along these lines in the past, there were some key methodological limitations to these prior studies, including the reliance on small samples,” Salvatore said. “We were able to leverage the Swedish national registries to look at these questions in a large sample of over 1 million people.”

The researchers set out to discover if alcohol use disorder (AUD) — which affects an estimated 16 million people in the United States — among parents would predict their adult offspring’s likelihood of marriage and marriage to a spouse with alcohol use disorder.

“We know from previous research that who you marry plays a big part in whether you develop an alcohol problem,” Salvatore said. “What we found in this study is that who you marry is not random — and, in fact, the people who are at greatest risk for developing an alcohol problem (because they have an affected parent) are most likely to end up with a spouse who is going to exacerbate this risk.”

Researchers found that parental alcohol use disorder is associated with a higher probability of marriage at younger ages, a lower probability of marriage at older ages and a higher likelihood of marriage to an affected spouse compared with no parental alcohol use disorder.

“In this case, we found that you do marry someone who is like your parents,” Salvatore said.

The researchers also found that most of these effects become stronger when the number of parents with alcohol use disorder increases from one to two. Most effects also held after statistically controlling for parents’ socioeconomic status, marital history, other externalizing disorders, and the offspring’s own alcohol use disorder status.

Additionally, daughters of affected mothers are more likely to have an affected spouse, the researchers found.

The researchers were interested in their findings because previous research has shown that forming and maintaining romantic relationships with “prosocial” spouses reduces one’s risk of developing alcohol use disorder.

“And what we find here is that people who are at risk of developing AUD (by virtue of growing up with an AUD-affected parent) are less likely to find themselves in these types of protective marital environments,” Salvatore said.

From a practical standpoint, she said, the study’s findings could be useful for clinicians and others who work with the offspring of parents with alcohol use disorder to raise awareness of how parental AUD can influence the types of social environments that can increase one’s risk for alcohol use disorder.

“There are large international organizations, like Al-Anon and Alateen, that are geared towards helping and supporting the family members, and in particular children of people affected by alcohol use disorders,” Salvatore said. “I think that there is a role for findings like ours as part of these types of family education programs. Specifically, becoming aware of how a parent’s alcohol problem might shape one’s own likelihood of ending up in the kind of marriage that will increase risk for alcohol problems may help people choose differently.”

In addition to Salvatore, the study was conducted by Kenneth S. Kendler, M.D., professor of psychiatry and human and molecular genetics in the Department of Psychiatry at VCU’s School of Medicine; Elizabeth Long, Ph.D., in the Institute for Drug and Alcohol Studies at VCU; and Alexis Edwards, Ph.D., at VCU’s Virginia Institute for Psychiatric and Behavioral Genetics; along with Swedish colleagues Sara Larsson Lönn, Ph.D.; Jan Sundquist, M.D., Ph.D.; and Kristina Sundquist, M.D., Ph.D., of the Center for Primary Health Care Research at Lund University.