Foster, K. T., Hicks, B. M., Iacono, W. G., & McGue, M. (2015). Gender differences in the structure of risk for alcohol use disorder in adolescence and young adulthood. Psychol Med, 45(14), 3047-3058. doi: 10.1017/S0033291715001014 PMCID: PMC4631679

RESULTS: At both ages of 17 and 29 years, mean levels of psychosocial risks and consequences were higher in men and those with AUD. However, the amount of risk exposure in adolescence was more predictive of AUD in women than men. By adulthood, AUD consequences were larger in women than men and internalizing risk had a stronger relationship with AUD in women at both ages.
CONCLUSIONS: Despite higher mean levels of risk exposure in men overall, AUD appears to be a more severe disorder in women characterized by higher levels of adolescent risk factors and a greater magnitude of the AUD consequences among women than men. Furthermore, internalizing symptoms appear to be a gender-specific risk factor for AUD in women.

Foster, K., Hicks, B., Iacono, W.G., & McGue, M. (2014). Alcohol use disorder in women: Risks and consequences of an adolescent onset and persistent course. Psychology of Addictive Behaviors, 28(2), 322-335. PMCID: PMC4067596

Abstract: Women are more vulnerable to the deleterious effects of both acute and protracted alcohol use than men, but women's lower levels of alcohol consumption and alcohol use disorder (AUD) have resulted in a paucity of investigations on the development of alcohol problems in women. In particular, it is not clear to what extent the cascading effects of key etiological factors that contribute to an especially severe course of AUD in men also underlie the development of AUD in women. To fill this gap, we examined the adolescent risk factors and adult consequences associated with an adolescent onset and persistent course of AUD in a community sample of women (n = 636) from ages 17 to 29. Women with AUD exhibited greater psychopathology and psychosocial impairment than those without, with an adolescent onset and persistent course indicative of the greatest severity. Notably, high levels of impairment across all women with AUD reduced the utility of onset and course to differentiate profiles of risk and impairment. In contrast to previous work in men, even women whose AUD symptoms desisted continued to exhibit impairment, suggesting that an adolescent onset of AUD is associated with enduring consequences for women's health and functioning, even after ostensible "recovery."

Holdcraft, L.C. & Iacono, W.G. (2004). Cross-generational Effects on Gender Differences in Psychoactive Drug Abuse and Dependence. Drug and Alcohol Dependence, 74, 147-158.
Background: Studies of patients with cocaine and heroin use disorders have shown gender differences in prevalence, course, and outcome.
These differences may be decreasing in successive generations. Less is known about gender differences in course and symptomatology for other illicit drug use disorders, especially in community samples.
Method: Participants (1323 men and 1384 women) who were biological or step-parents of twins and born in the 1940–1960s, from the Minnesota Twin-Family Study (MTFS) were divided into two cohorts based on the median birth year. A structured interview was used to assess DSM-III-R cannabis, amphetamine, cocaine and hallucinogen use disorders.
Results: There was a higher prevalence of each of these drug disorders and earlier onset of cannabis and amphetamine use disorders in later-born participants. For most drug use disorder categories, men and women were similar with respect to age of onset and severity of disorder but women had a shorter course of drug use disorders. Women with amphetamine disorders were atypical with respect to having a higher frequency of use but similar number of lifetime uses compared to men, and more emotional effects of amphetamine intoxication than men. In addition, women with amphetamine disorders were more likely to have anorexia nervosa than those without amphetamine disorders.
Conclusions: These results have several implications for prevention, etiology and treatment.

Holdcraft, L.C., & Iacono, W.G. (2002). Cohort effects on Gender Differences in Alcohol Dependence. Addiction, 97, 1025-1036.
Aims: The present study investigated the presence of cohort effects on gender differences in the course, severity and symptomatology of DSM-III-R alcohol dependence in a community-based sample.
Design: A comparison of substance-related variables among men and women divided into two groups based on the median birth year of the sample was conducted.
Participants: Participants were 468 men and 132 women with life-time alcohol dependence, the vast majority of whom were born between 1941 and 1960.
Measurements: Substance use and DSM-III-R substance use disorders were assessed by a structured interview administered in person.
Findings: Individuals born after 1951 had higher rates of alcohol dependence. Among individuals with alcohol dependence, those born after 1951 had an earlier onset and longer duration of alcohol-related problems. Significant interactions indicated that these effects were stronger for women than men.
Conclusions: Risk for alcohol dependence appears to be rising in younger generations, and particularly for younger women, making them an important target group for prevention and treatment programs.

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