We have replicated and extended our group’s prior preliminary findings20,21 demonstrating that HD report greater acute subjective positive effects and lesser sedative and cortisol response to an intoxicating dose of alcohol than do LD. Multivariate models in the HD revealed that both the positive (more stimulation, like, and want more) and negative (less sedation) response factors were significant independent predictors of binge drinking during the subsequent 2 years. These findings were observed even after taking into account other risk factors for problem drinking, such as sex, race, FH, educational level, and disinhibited personality.2,31 Thus, young adult HD who experience heightened stimulant and rewarding and diminished sedative effects of alcohol are at risk for escalation of binge drinking over time. They also consume more alcohol overall (typical frequency, quantity, and maximum quantity) and experience clinically relevant outcomes, such as greater alcohol consequences and higher rates of DSM-IV alcohol use disorders (Table 2).
