Although we computed both dichotomous and density FH measures using familial data from the same COGA subjects and their family members, the strengths of density measures outweigh those of dichotomous measures for the following reasons: First, density measures are more comprehensive and incorporate contributions of alcohol-affected biologically related relatives, type of relatives (e.g., first- or second-degree), and degree of relatedness. Moreover, affectedness of family members was defined using two criteria (DSM-5 AUD lifetime diagnosis and DSM-5 AUD maximum symptom count at any one assessment). Importantly, using DSM-5 based maximum symptom count as an affectedness criterion, allowed for improving on previous measures in capturing the density of the FH more effectively. That is, given the possibility that some family members may not fulfill the diagnostic criteria for AUD but may nevertheless present at least one alcohol-related symptom, inclusion of relatives based on the maximum symptom count is meaningful and more informative. In doing so, the density of one’s FH is more closely captured and the sensitivity of density measures as risk indices is increased even for individuals without any AUD diagnosed
