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Patterns, Predictors, and Correlates of Problematic Alcohol Use and Remission From Adolescence to Early Midlife
Megan E Cooke1,2, Erin Lumpe3, Mallory Stephenson4,5
1Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, New Jersey, USA.
Alcohol, Clinical & Experimental Research
|June 30, 2026
Summary
Childhood and adolescent risk factors, alongside genetic predispositions, predict persistent problematic alcohol use (PAU) into early midlife. Late-onset PAU may stem from adult stressors, not early life risks.
Area of Science:
- Psychiatry
- Behavioral Science
- Genetics
Background:
- Understanding predictors of problematic alcohol use (PAU) is crucial for early intervention.
- PAU patterns develop across adolescence into early midlife.
- Identifying environmental, behavioral, and genetic factors is key.
Purpose of the Study:
- To identify environmental, behavioral, and genetic predictors of PAU patterns.
- To examine early midlife correlates of these PAU patterns.
- To differentiate between persistent and late-onset PAU.
Main Methods:
- Utilized data from 1463 twins in the FinnTwin12 cohort.
- Assessed PAU at ages 14, 22, and 37 using AUD symptoms, mmMAST, and AUDIT.
- Created a behavioral and environmental risk index (BERI) and used polygenic scores (PGS) for genetic risk.
Main Results:
- Classified twins into Never, Remitted, Persistent, and Late-onset PAU groups.
- BERI and PGSEXT predicted Remitted PAU; BERI and PGSPAU predicted Persistent PAU.
- Persistent and Late-onset PAU were linked to poorer educational attainment, health, finances, and well-being in early midlife.
Conclusions:
- Persistent PAU is strongly predicted by childhood/adolescent risks and genetic factors (PGSPAU).
- Negative midlife outcomes are most pronounced in the Persistent PAU group.
- Late-onset PAU may arise from adult stressors, independent of early life risks.
Keywords:
late‐onsetpersistentremittedearly midlifeenvironmental riskpolygenic scoreproblem alcohol useMore Related Videos
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