Alcohol Use Disorder, Psychiatric Comorbidities, Marriage and Divorce in a High-Risk Sample

Nathaniel S. Thomas, Sally I.Chun Kuo, Fazil Aliev, Vivia V. McCutcheon, Jacquelyn M. Meyers, Grace Chan, Victor Hesselbrock, Chella Kamarajan, Sivan Kinreich, John R. Kramer, Samuel Kuperman, Dongbing Lai, Martin H. Plawecki, Bernice Porjesz, Marc A. Schuckit, Danielle M. Dick, Kathleen K. Bucholz, Jessica E. Salvatore

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Objective: To examine associations between alcohol use disorder (AUD), its psychiatric comorbidities, and their interactions, with marital outcomes in a diverse high-risk, genetically informative sample. Method: Participants included European ancestry (EA; n = 4,045) and African ancestry (AA; n = 1,550) individuals from the multigenerational Collaborative Study on the Genetics of Alcoholism (COGA) sample (56% female, Mage ~ 41 years). Outcomes were lifetime marriage and divorce. Predictors included lifetime AUD, an alcohol problems polygenic score (PRS), and AUD comorbidities, including conduct or antisocial personality disorder (ASP), cannabis dependence/abuse (CAN), frequent tobacco use (TOB), and major depressive disorder (MDD). Mixed effect Cox models and generalized linear mixed effects models were fit. Results: Among EA participants, those with AUD and CAN were less likely to marry (hazard ratios [HRs] 0.70–0.83, ps < 0.01). Among AA participants, those with AUD and TOB were less likely to marry (HRs 0.66–0.82, ps < 0.05) and those with MDD were more likely to marry (HR = 1.34, ps < 0.01). Among EA participants, AUD, CAN, TOB, and MDD were associated with higher odds of divorce (odds ratios [ORs] 1.59–2.21, ps < 0.01). Among AA participants, no predictors were significantly associated with divorce. Significant random effects indicated genetic and environmental influences on marriage, but only environmental factors on divorce. Conclusions: In a high-risk sample, AUD was associated with reduced likelihood of marriage in EA and AA individuals and increased risk of divorce in EA individuals. These associations were largely independent of comorbidities.

Original languageEnglish
Pages (from-to)364-374
Number of pages11
JournalPsychology of Addictive Behaviors
Issue number4
StatePublished - 2022


  • Alcohol use disorder
  • Collaborative study on the genetics of alcoholism (coga)
  • Divorce
  • Marriage
  • Psychiatric comorbidities


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