There are several limitations of the current study, namely the use of retrospective reporting of both self-harm and age at first drink, the latter of which may be susceptible to reporting bias (Sartor et al. 2011). Additionally, due to the lack of assessment of the age of onset of NSSI, the hypothesis that EAU exerts a causal influence on subsequent NSSI could not be fully tested (i.e., participants who engaged in NSSI prior to their first drink could be included in the analyses). Future studies would benefit from more detailed assessment of the time of initiation of these self-harm behaviors relative to initiation of alcohol use. Larger sample sizes could also confirm the differential odds of NSSI for MZ and DZ twins endorsing EAU, which would substantiate the lack of a causal pathway between these phenotypes observed in the current study. Additionally, due to lack of power, it was not possible to examine potential differences in the link between EAU and subgroups of individuals engaging in SA. Previous work has established that cannabis use is associated with increased odds for
