Vulnerability for Alcohol Use Disorder and Rate of Alcohol Consumption

Am J Psychiatry. 2017 Nov 1;174(11):1094-1101. doi: 10.1176/appi.ajp.2017.16101180. Epub 2017 Aug 4.


Objective: Although several risk factors have been identified for alcohol use disorder, many individuals with these factors do not go on to develop the disorder. Identifying early phenotypic differences between vulnerable individuals and healthy control subjects could help identify those at higher risk. Binge drinking, defined as reaching a blood alcohol level of 80 mg%, carries a risk of negative legal and health outcomes and may be an early marker of vulnerability. Using a carefully controlled experimental paradigm, the authors tested the hypothesis that risk factors for alcohol use disorder, including family history of alcoholism, male sex, impulsivity, and low level of response to alcohol, would predict rate of binging during an individual alcohol consumption session.

Method: This cross-sectional study included 159 young social drinkers who completed a laboratory session in which they self-administered alcohol intravenously. Cox proportional hazards models were used to determine whether risk factors for alcohol use disorder were associated with the rate of achieving a binge-level exposure.

Results: A greater percentage of relatives with alcoholism (hazard ratio: 1.04, 95% CI=1.02-1.07), male sex (hazard ratio: 1.74, 95% CI=1.03-2.93), and higher impulsivity (hazard ratio: 1.17, 95% CI=1.00 to 1.37) were associated with a higher rate of binging throughout the session. Participants with all three risk factors had the highest rate of binging throughout the session compared with the lowest risk group (hazard ratio: 5.27, 95% CI=1.81-15.30).

Conclusions: Binge drinking may be an early indicator of vulnerability to alcohol use disorder and should be carefully assessed as part of a thorough clinical evaluation.

Trial registration: NCT00713492.

Keywords: Alcohol Abuse; Binge Drinking; Family History of Alcoholism; Impulsivity; Sex Differences.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Administration, Intravenous
  • Adult
  • Alcohol Drinking / epidemiology*
  • Alcohol-Related Disorders / epidemiology*
  • Alcoholism
  • Binge Drinking / epidemiology*
  • Blood Alcohol Content
  • Central Nervous System Depressants / administration & dosage
  • Cross-Sectional Studies
  • Ethanol / administration & dosage
  • Female
  • Humans
  • Impulsive Behavior*
  • Male
  • Medical History Taking
  • Middle Aged
  • Proportional Hazards Models
  • Risk
  • Risk Factors
  • Self Administration
  • Sex Factors
  • Young Adult


  • Blood Alcohol Content
  • Central Nervous System Depressants
  • Ethanol

Associated data