Alcoholism, antisocial behavior and family history.

Previous investigations in selected and clinical samples have demonstrated a close association between alcoholism and both antisocial behavior and a family history of problem drinking. This study uses the National Institute of Mental Health (NIMH) Epidemiological Catchment Area (ECA) data to assess this relationship in the general population in St. Louis, Missouri (U.S.A.). The results showed that serious antisocial behavior (both conduct disorder and antisocial personality disorder), gender, and a family history of problem drinking were all significantly associated with alcoholism (DSM-III alcohol abuse or dependence). Having either conduct disorder, antisocial personality, or a first-degree relative (parent, sibling, or child) with problem drinking increased the probability of alcoholism; being male also increased its probability. Antisocial behavior and gender interacted in that antisocial behavior was a more potent risk factor for women than for men. However, despite their close association with alcoholism, having either antisocial personality or a positive family history of problem drinking identified only 49% of male alcoholics and 14% of female alcoholics. Thus, these two important predictors of alcoholism would be somewhat inefficient screeners for primary prevention. More investigation is needed to understand the development of alcoholism in those without these major risk factors and the lack of alcoholism in those with them.