This study provided the first nationally representative U.S. estimates of gender differences in the lifetime comorbidity and clinical expression of alcohol dependence as a function of internalizing and externalizing psychopathology. Consistent with clinical and general population data (Epstein et al., 2002; Carpenter and Hasin, 2001; Pombo and Lesch, 2009; Baumeister and Harter, 2007; Kessler et al., 2005), this study found that men were overrepresented among individuals with externalizing psychopathology and that women were overrepresented among individuals with internalizing psychopathology. The male excess prevalence of externalizing psychopathology was reduced among lifetime alcoholics; in fact, male and female alcoholics were equally likely to have combined internalizing and externalizing psychopathology. Consistent with this reduction and in line with Kessler et al. (1997), we confirmed a stronger association between externalizing psychopathology and alcohol dependence among women compared to men. Unlike Kessler et al., we also found a stronger association between internalizing psychopathology and alcohol dependence among women. This disparity likely reflects the larger sample size and greater statistical power of the NESARC sample, as Kessler et al. did find nonsignificantly higher OR for the
