Mothers' maximum drinks ever consumed in 24 hours predicts mental health problems in adolescent offspring

Abstract

Background: The maximum number of alcoholic drinks consumed in a single 24-hr period is an alcoholism-related phenotype with both face and empirical validity. It has been associated with severity of withdrawal symptoms and sensitivity to alcohol, genes implicated in alcohol metabolism, and amplitude of a measure of brain activity associated with externalizing disorders in general. In a previous study we found that the maximum number of drinks fathers had ever consumed in 24 hrs was associated with externalizing behaviors and disorders in preadolescent and adolescent children. The purpose of the present study was to determine whether maternal maximum consumption has similar correlates.

Method: We examined associations between maternal maximum consumption and alcohol dependence, respectively, and disruptive disorders and substance-related problems in two large independent population-based cohorts of 17-year-old adolescents.

Results: Maximum consumption was associated with conduct disorder, disruptive disorders in general, early substance use and misuse, and substance disorders in adolescent children regardless of sex. Associations were consistent across cohorts, providing internal replication. They also paralleled our previous findings regarding paternal status. They could not be explained by maternal alcohol dependence, effects of drinking during pregnancy, or paternal maximum consumption. They were not simple artifacts of the fact that maximum consumption is a continuous measure while alcohol dependence is dichotomous.

Conclusions: Despite deriving from a single question about lifetime behavior, parental maximum consumption appears to reflect vulnerability for mental health problems, especially substance-related ones, more directly than a diagnosis of alcohol dependence.

Figure 1

The distribution of the maximum number of drinks is plotted for women with and without a diagnosis of alcohol dependence. A nonparametric Gaussian kernel was used to smooth the distributions, which are also given in the form of box plots at the top of the figure. Open circles represent observations between the inner and outer “fences,” where the inner fences are given by the median plus or minus 1.5 times the interquartile range and the outer fences are given by the median plus or minus three times the interquartile range. Filled circles represent observations outside the outer fences.

Figure 2

Odds ratios (black circles) and 95% confidence intervals around them (gray lines, one for each cohort) representing the magnitude of association between maternal maximum consumption and alcohol dependence, respectively, and offspring outcomes. ORs whose confidence intervals include 1 (the y-axis) are not significant (p > .05). The upper panels give unadjusted ORs, the bottom panels give ORs adjusted for effects of the other maternal characteristic. The association between maternal maximum consumption and ODD was significant for females, which is plotted, but not for males, where it was essentially nil. ADHD = attention deficit/hyperactivity disorder; ODD = oppositional defiant disorder; Early Use measures indicate use before age 15 (without parental permission in the case of alcohol); Any SUD = any substance disorder.