TY - JOUR
T1 - The rearing environment and the risk for alcohol use disorder
T2 - A Swedish national high-risk home-reared v. adopted co-sibling control study
AU - Kendler, Kenneth S.
AU - Ohlsson, Henrik
AU - Sundquist, Jan
AU - Sundquist, Kristina
PY - 2021
Y1 - 2021
N2 - Background: Although alcohol use disorder (AUD) runs strongly within families, studies examining the impact of rearing environment, unconfounded by genetic effects, are rare and, to date, contradictory. We here seek to conduct such a study using an adoptive co-sib control design. Methods: Defining high-risk as having 3/41 biological parent with an externalizing syndrome (AUD, drug abuse or crime), we identified 1316 high-risk full-sibships and 4623 high-risk half-sibships containing at least one member who was home-reared and one who was adopted-away. Adoptive families are carefully screened in Sweden to provide high-quality rearing environment for adoptees. AUD was assessed from national medical, criminal and pharmacy registries. Results: Controlling for sex, parental age at birth, and, for half-siblings, affection status of the non-shared parent, hazard ratios (±95% CI) for AUD in the matched adopted v. home-reared full- and half-siblings were, respectively, 0.76 (0.65-0.89) and 0.77 (0.70-0.84). The protective effect of adoption on AUD risk was stronger in the full- and half-sibling pairs with very high familial liability (two high-risk parents) and significantly weaker when the adoptive family was broken by death or divorce or contained a high-risk adoptive parent. Conclusions: In both full- and half-sibling pairs, we found evidence that the rearing environment substantially impacts on the risk for AUD. High-quality rearing environments can meaningfully reduce the risk for AUD, especially in those at high familial risk.
AB - Background: Although alcohol use disorder (AUD) runs strongly within families, studies examining the impact of rearing environment, unconfounded by genetic effects, are rare and, to date, contradictory. We here seek to conduct such a study using an adoptive co-sib control design. Methods: Defining high-risk as having 3/41 biological parent with an externalizing syndrome (AUD, drug abuse or crime), we identified 1316 high-risk full-sibships and 4623 high-risk half-sibships containing at least one member who was home-reared and one who was adopted-away. Adoptive families are carefully screened in Sweden to provide high-quality rearing environment for adoptees. AUD was assessed from national medical, criminal and pharmacy registries. Results: Controlling for sex, parental age at birth, and, for half-siblings, affection status of the non-shared parent, hazard ratios (±95% CI) for AUD in the matched adopted v. home-reared full- and half-siblings were, respectively, 0.76 (0.65-0.89) and 0.77 (0.70-0.84). The protective effect of adoption on AUD risk was stronger in the full- and half-sibling pairs with very high familial liability (two high-risk parents) and significantly weaker when the adoptive family was broken by death or divorce or contained a high-risk adoptive parent. Conclusions: In both full- and half-sibling pairs, we found evidence that the rearing environment substantially impacts on the risk for AUD. High-quality rearing environments can meaningfully reduce the risk for AUD, especially in those at high familial risk.
KW - Adoption
KW - alcohol use disorder
KW - rearing
UR - http://www.scopus.com/inward/record.url?scp=85083701803&partnerID=8YFLogxK
U2 - 10.1017/S0033291720000963
DO - 10.1017/S0033291720000963
M3 - Article
C2 - 32317035
AN - SCOPUS:85083701803
SN - 0033-2917
VL - 51
SP - 2370
EP - 2377
JO - Psychological Medicine
JF - Psychological Medicine
IS - 14
ER -