The following important limitations apply to the present investigation. First, impulsivity as defined by the BPD 4 criterion, requires at least two self-harming and recurring behaviors, one of which can be alcohol intoxications and the other an illicit substance use. When studying substance use, it would help to be able to better distinguish specific “impulsive” behaviors both from substance use and from each other [51]. However, the criterion BPD 4 should not be excluded merely based on potential construct overlap with AUD because it predicted future AUD over and above present AUD (Figure 1c; the online supplement provides a full sensitivity analysis without the BPD 4 criterion). Second, although conduct disorder is a single criterion for adulthood ASPD, it is also a diagnostic composite of multiple conduct problems that may have distinct etiologies; for example, “rule breaking”, “overt aggression”, and “covert delinquency” factors have been reported [64]. Thus, future studies could inquire whether this composite can be further broken down to its constituents or whether the use of multiple indicators is the source of its predictive power. Third, the sample
