These distal effects were unique from (i.e., net the effect of) the proximal effects of parents’ alcohol-related consequences on children’s externalizing symptoms. Proximal effects may suggest that children acquire additional risk through concurrent exposure to their parents’ drinking and related consequences that goes beyond the risk that is conveyed through more genetically or biologically mediated mechanisms. Proximal effects were present across reporters, and thus evident early in life and through adolescence. Moreover, proximal effects increased risk for externalizing symptoms regardless of whether parents met diagnostic criteria for an alcohol use disorder or not (i.e., regardless of distal effects), and thus even non-COAs showed greater risk for externalizing symptoms if their parents’ had greater alcohol-related consequences.
