Although studies of offspring of AUD individuals typically have emphasized externalizing psychopathology, Kellam et al. (1980) first proposed that the presence of internalizing disorders might predispose children to developing AUD. Internalizing disorders have not been studied as often in association with familial risk for AUD, though a few early studies have suggested an elevation in internalizing symptoms in offspring of alcohol dependent individuals (Earls et al. 1988; Hill and Muka 1996; Reich et al. 1993). More recent reports also find offspring at elevated risk for internalizing disorders (Hill et al. 2008). It should be noted that greater incidence of internalizing psychopathology may be associated with the more severe form of alcohol dependence seen in offspring from multiplex families (Hill et al. 2008) than in offspring selected for the presence of single alcohol dependent parent (Clark et al. 2004). Epidemiological studies confirm that a family history of AUD increases the risk for both major depression and/or AUD, with comorbid AUD and depression most notable in individuals with greater familial loading for alcohol dependence (Dawson and Grant 1998).
