Social Psychiatry and Psychiatric Epidemiology

, Volume 53, Issue 12, pp 1381–1389 | Cite as

The role of parent and offspring sex on risk for externalizing psychopathology in offspring with parental alcohol use disorder: a national Swedish study

  • E. C. Long
  • S. L. Lönn
  • J. Sundquist
  • K. Sundquist
  • K. S. Kendler
Original Paper



The substantial literature showing that offspring of parents with alcohol use disorder (AUD) is at increased risk for externalizing psychopathology rarely examines the differential effects of parental and offspring sex. This literature also has other important limitations, such as modest sample sizes and use of unrepresentative samples. Using a large, nationwide Swedish sample, we aim to investigate the roles of parental and offspring sex in externalizing psychopathology among offspring with parental AUD.


AUD diagnosis and externalizing measures were obtained from national registries. Associations between outcomes and parental AUD were examined using logistic regressions. Parental and offspring sex effects were examined with interaction terms.


Risks for externalizing disorders were increased in sons and daughters with parental AUD, with significant differences between sons and daughters for criminal behavior; maternal AUD had a greater impact than paternal AUD (regardless of offspring sex), but having two parents with AUD increased risk for all outcomes substantially more than having one parent; and maternal AUD increased risk of drug abuse for daughters more than sons, while paternal AUD increased risk of AUD and criminal behavior for sons more than daughters.


Offspring of parents with AUD are at increased risk for externalizing psychopathology. Maternal and paternal AUD differentially affected sons’ vs. daughters’ risks for AUD, drug abuse, and criminal behavior. The transmission of psychopathology within the externalizing spectrum appears to have sex-specific elements.


Parental alcohol use disorder Externalizing disorders Sex differences Children of alcoholics 



This project was supported by grants AA0235341 and K01AA024152 from the US National Institutes of Health, the Swedish Research Council (2014-2517), the Swedish Research Council for Health, Working Life and Welfare (in Swedish: FORTE; Reg. no. 2013-1836), and FORTE (Reg. no. 2014-0804) and the Swedish Research Council (2012-2378 and 2014-10134) as well as ALF funding from Region Skåne.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical standards

The study has been approved by the appropriate ethics committee and has, therefore, been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Supplementary material

127_2018_1563_MOESM1_ESM.docx (137 kb)
Supplementary material 1 (DOCX 137 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • E. C. Long
    • 1
  • S. L. Lönn
    • 2
  • J. Sundquist
    • 2
    • 5
    • 6
  • K. Sundquist
    • 2
    • 5
    • 6
  • K. S. Kendler
    • 1
    • 3
    • 4
  1. 1.Virginia Commonwealth UniversityVirginia Institute for Psychiatric and Behavioral GeneticsRichmondUSA
  2. 2.Center for Primary Health Care ResearchLund UniversityMalmöSweden
  3. 3.Department of PsychiatryVirginia Commonwealth UniversityRichmondUSA
  4. 4.Department of Human and Molecular GeneticsVirginia Commonwealth UniversityRichmondUSA
  5. 5.Department of Family Medicine and Community HealthIcahn School of Medicine at Mount SinaiNew YorkUSA
  6. 6.Department of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew YorkUSA

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