The Causal Role of Alcohol Use in Adolescent Externalizing and Internalizing Problems: A Mendelian Randomization Study

Chao, Miao; Li, Xinying; McGue, Matt

doi:10.1111/acer.13493

Cited by 56 publications

(18 citation statements)

References 57 publications

(66 reference statements)

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“…A genetic correlation can reflect a causal relationship (Gage, Smith, Ware, Flint, & Munafò, 2016), but for environmentally influenced disorders one would expect also to find an environmental correlation in the same direction. Previous twin studies have failed to find an environmental association (Nelson et al, 2000;Tambs et al, 1997), and the lack of effects from AUD to anxiety is also in line with a previous Mendelian randomization study (Chao et al, 2017). The model that included a small and negative environmental path from AUD to other anxiety disorders had slightly better fit than the model with only the genetic path.…”

Section: Discussionsupporting

confidence: 78%

“…This could be true also for SAD. On the other hand, a Mendelian randomization study found alcohol use not to cause symptoms of anxiety (Chao, Li, & McGue, 2017).…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, from a psychopharmacological perspective, it is likely that alcohol use produces anxiety, at least during withdrawal, and a few studies indicate that AUD causes anxiety (Becker, 2012;Fergusson, Boden, & Horwood, 2011). On the other hand, a Mendelian randomization study found alcohol use not to cause symptoms of anxiety (Chao, Li, & McGue, 2017). On the other hand, a Mendelian randomization study found alcohol use not to cause symptoms of anxiety (Chao, Li, & McGue, 2017).…”

Section: Introductionmentioning

confidence: 99%

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Explaining the association between anxiety disorders and alcohol use disorder: A twin study

et al. 2019

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Background: It is unknown whether social anxiety disorder (SAD) has a unique association with alcohol use disorder (AUD) over and beyond that of other anxiety disorders, how the associations develop over time, and whether the associations are likely to be causal.Methods: Diagnoses of AUD, SAD, generalized anxiety disorder, panic disorder, agoraphobia, and specific phobias were assessed twice using the Composite International Diagnostic Interview among 2,801 adult Norwegian twins. The data were analyzed using logistic regression analyses and multivariate biometric structural equation modeling.Results: SAD had the strongest association with AUD, and SAD predicted AUD over and above the effect of other anxiety disorders. In addition, SAD was prospectively associated with AUD, whereas other anxiety disorders were not. AUD was associated with a slightly elevated risk of later anxiety disorders other than SAD. Biometric modeling favored a model where SAD influenced AUD compared to models where the relationship was reversed or due to correlated risk factors. Positive associations between AUD and other anxiety disorders were fully explained by shared genetic risk factors.Conclusions: Unlike other anxiety disorders, SAD plausibly has a direct effect on AUD. Interventions aimed at prevention or treatment of SAD may have an additional beneficial effect of preventing AUD, whereas interventions aimed at other anxiety disorders are unlikely to have a similar sequential effect on AUD. K E Y W O R D S agoraphobia, alcohol use disorder, anxiety disorders, social anxiety disorder, social phobia, specific phobia, twin studies Depress Anxiety. 2019;36:522-532. wileyonlinelibrary.com/journal/da 522 |

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Section: Discussionsupporting

confidence: 78%

“…This could be true also for SAD. On the other hand, a Mendelian randomization study found alcohol use not to cause symptoms of anxiety (Chao, Li, & McGue, 2017).…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Explaining the association between anxiety disorders and alcohol use disorder: A twin study

et al. 2019

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“…So far, one MR study found evidence for a causal effect of alcohol use on attention problems and aggression in adolescents (but not on delinquency, anxiety, or depression) 30 . Two other studies provided evidence that genetic liability to ADHD, as well as higher extraversion, has a causal effect on smoking initiation 31,32 .…”

Section: Introductionmentioning

confidence: 99%

Investigating causal pathways between liability to ADHD and substance use, and liability to substance use and ADHD risk, using Mendelian randomization

Treur

Demontis

Sallis

et al. 2019

Preprint

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BackgroundAttention-deficit hyperactivity disorder (ADHD) has consistently been associated with substance (ab)use, but the nature of this association is not fully understood. In view of preventive efforts, a vital question is whether there are causal effects, from ADHD to substance use and/or from substance use to ADHD.MethodsWe applied bidirectional Mendelian randomization using summary-level data from the largest available genome-wide association studies (GWASs) on ADHD, smoking (initiation, cigarettes/day, cessation, and a compound measure of lifetime smoking), alcohol use (drinks/week and alcohol use disorder), cannabis use (initiation and cannabis use disorder (CUD)) and coffee consumption (cups/day). Genetic variants robustly associated with the ‘exposure’ were selected as instruments and then identified in the ‘outcome’ GWAS. Effect estimates from individual genetic variants were combined with inverse-variance weighted regression and five sensitivity analyses were applied (weighted median, weighted mode, MR-Egger, generalized summary-data-based MR, and Steiger filtering).ResultsWe found strong evidence that liability to ADHD increases likelihood of smoking initiation and also cigarettes per day among smokers, decreases likelihood of smoking cessation, and increases likelihood of cannabis initiation and CUD. In the other direction, there was evidence that liability to smoking initiation and CUD increase ADHD risk. There was no clear evidence of causal effects between liability to ADHD and alcohol or caffeine consumption.ConclusionsWe find evidence for causal effects of liability to ADHD on smoking and cannabis use, and of liability to smoking and cannabis use on ADHD risk, indicating bidirectional pathways. Further work is needed to explore causal mechanisms.

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“…Early use of alcohol during adolescence is an important risk factor for alcohol‐related problems (ARP) including blackouts (Marino and Fromme, ) as well as several internalizing and externalizing problems (Chao et al., ). Although several studies have explored different facets of impulsivity and its relationship with adolescent drinking, many questions about this relationship remain unanswered (Peeters et al., ).…”

mentioning

confidence: 99%

What Predicts What? Self‐Reported and Behavioral Impulsivity and High‐Risk Patterns of Alcohol Use in Spanish Early Adolescents: A 2‐Year Longitudinal Study

Fernández-Artamendi

Martínez‐Loredo

Grande-Gosende

et al. 2018

Alcoholism Clin & Exp Res

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Within-person levels of self-reported impulsivity and sensation seeking significantly predicted further heavy drinking from as early as 13 years old, whereas behavioral measures were not predictive. In our study, neither IE nor ARP predicted prospective changes in impulsivity. Further studies should address additional specific relationships between facets of impulsivity and specific outcomes of heavy drinking.

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The Causal Role of Alcohol Use in Adolescent Externalizing and Internalizing Problems: A Mendelian Randomization Study

Abstract: The results suggest that alcohol use is a cause of adolescent aggression and attention problems but not adolescent delinquency, anxiety, or depression.

Cited by 56 publications

References 57 publications

Explaining the association between anxiety disorders and alcohol use disorder: A twin study

Explaining the association between anxiety disorders and alcohol use disorder: A twin study

Investigating causal pathways between liability to ADHD and substance use, and liability to substance use and ADHD risk, using Mendelian randomization

What Predicts What? Self‐Reported and Behavioral Impulsivity and High‐Risk Patterns of Alcohol Use in Spanish Early Adolescents: A 2‐Year Longitudinal Study

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