Most studies of the impact of alcohol dependence on the brain have examined individuals in treatment. Such samples represent a small proportion of alcoholics in the general population, and we have shown that treated adults are not a representative sample of adult alcoholics: they have more severe alcoholism and substantially more psychiatric comorbidity (Di Sclafani et al., 2008; Fein, 2006; Fein et al., 2004; Fein and Landman, 2005; Fein et al., 2006). A reasonable assumption is therefore that adolescents in treatment for alcohol use disorders (AUDs) are also heavier drinkers with more comorbidities than untreated adolescents with AUDs in the general population. For these reasons, it is crucially important to study untreated, community-dwelling adolescents with AUDs to understand the effects of alcohol on the adolescent brain.
