In contrast, gender differences in the adjusted associations of psychopathology with the expression and course of alcoholism were primarily restricted to the category of BIE, which was more strongly associated with heavy drinking and early- and rapid-onset dependence among women. The ORs for women with BIE were generally higher (though not always significantly so) than those for women with EO, but this was not the case for men. It is not clear from this study whether this reflects a greater sensitivity among women to the total number of comorbid disorders (by definition at least two among individuals with BIE compared to only one required for IO and EO) or to something specific about the combination of internalizing and externalizing. One gender difference that extended to all externalizing alcoholics, both EO and BIE, was a stronger association with alcohol treatment among women. This may again reflect gender differences in type of externalizing psychopathology, i.e., women’s greater prevalence of drug dependence having led to increased likelihood of combined alcohol and drug treatment.
