A genetically informative approach to understanding the impact of spousal psychiatric disorders on alcohol use disorder onset, remission, and relapse

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Project Summary Our objective in this new R01 proposal is to delineate the impact of a spouse’s substance use and psychiatric disorders on their partner’s alcohol use disorder (AUD) onset, remission, and relapse during marriage within a genetically informative framework. To date, efforts to understand spousal influences on alcohol outcomes have largely focused on alcohol-specific contagion models, whereby alcohol use behaviors in one partner are socially transmitted to the other. Yet, this prior focus alcohol-specific contagion is restrictive in view of epidemiological evidence that spouses of AUD-affected individuals also tend to suffer from other common disorders, including major depressive disorder, generalized anxiety disorder, other drug abuse/dependence, ADHD, and antisocial personality disorder. We build on these epidemiological findings to clarify the nature of the associations between these other forms of spousal substance use and psychiatric disorders and key alcohol outcomes including AUD onset, remission, and relapse. We do this within a genetically informative framework that also recognizes the potential contributions of a spouse’s genetic propensity for a disorder even in the absence of a diagnosis (i.e., social genetic effects), as well as how the focal individual’s genotype may differentially sensitize him/her to a spouse’s disorder (i.e., gene-environment interaction effects). Relevant phenotypic and genotypic data for this secondary data analysis project come from spousal dyads (N = 1,688 dyads) collected as part of the NIAAA-funded Collaborative Study on the Genetics of Alcoholism (COGA). Our specific aims are to: (1) Delineate the temporal dynamics underlying associations between spousal substance use and psychiatric disorder diagnoses (inclusive of cannabis use disorder, other psychoactive drug use disorder, antisocial personal disorder, ADHD, nicotine dependence, major depressive disorder, and PTSD) and their partner’s AUD onset, remission, and relapse; (2) Identify whether a spouse’s genetic propensity for psychiatric disorders (above and beyond a diagnosis itself) is associated with their partner’s AUD onset, remission, and relapse; (3) Examine whether the focal individual’s genetic predisposition for alcohol problems predicts variability in their sensitivity to spousal substance use and psychiatric disorders; and (4) Evaluate whether the expected effects differ as a function of sex and parenthood. The results may have theoretical implications for expanding social stress models of AUD to include spousal substance use and psychiatric disorders, and in turn this knowledge is anticipated to have implications for couples and family systems-based preventive interventions for AUD. More broadly, this work will contribute to the collaborative research team’s long-term goal to elucidate how genetic factors and close relationship factors come together to influence the onset, persistence, and discontinuity of AUD.