Several factors are associated with an increased risk of initiating heavy drinking during adolescence. Among these, a positive family history of alcohol dependence is perhaps the most robust indicator of risk for an alcohol use disorder (Cloninger et al. 1986; Goodwin 1979; Schuckit 1985). Offspring of alcoholics are 3–5 times more likely to develop AUD than offspring of non-alcoholics (Cotton 1979; Finn et al. 1990; Goodwin 1985; Lieb et al. 2002; Merikangas et al. 1998; Schuckit et al. 1972) with a particularly high level of risk for dense (Dawson and Grant 1998) or multigenerational (Hill et al. 2000; Peterson et al. 1992) family history. Externalizing disorders including conduct disorder, oppositional defiant disorder, and ADHD, and related conditions, such as juvenile delinquency, behavioral undercontrol, aggression, impulsivity, high novelty seeking (Sher et al. 2000; Zuckerman and Kuhlman 2000), and sensation-seeking personalities (Martin et al. 2004) are associated with increased risk for substance use disorders (Bukstein et al. 1989; Chassin et al. 1999; DeMilio 1989; Kaminer and Frances 1991; Rose et al. 2004; Schuckit 1998; Wilens et al. 1997). Conduct disorder that is
