A notable strength of our analysis was our ability to simultaneously assess familial risk, prenatal exposures, and personal alcohol and cigarettes exposure. This demonstration of a differential effect of familial risk and prenatal exposure on brain volumes provides a unique understanding of the separate and potentially interactive effects of these conditions. Another strength of the study was its use of data from third generation offspring from a long-term follow-up family study. The offspring participated in a longitudinal follow-up in which multiple assessments of alcohol and drug use were obtained. These prospectively gathered measures provided a cumulative estimate of personal exposure to substances (alcohol, cigarettes, and drugs) known to have a direct effect on brain morphology.
