Whether cognitive deficits in AUD are the result of harmful consequences of excessive alcohol consumption, premorbid risk factors for addiction, or their combination remains unanswered. Family history studies have informed this area, with social cognitive deficits in high-risk individuals with a family history of alcoholism reported, suggesting that emotional and social impairments could be a risk factor in the development of AUD (Hill et al., 2007). Regarding decision-making deficits, a family history study (Lovallo et al., 2006) supported the premorbid vulnerability hypothesis, with individuals having a positive family history for alcoholism (FH+) demonstrating compromised decision-making abilities as assessed by the Iowa Gambling Task compared with individuals who did not have a family history of alcoholism (FH−). Although this finding suggests that deterioration or poor development of the decision-making processes can occur before the emergence of AUD, it does not negate the hypothesis that decision-making is also negatively affected as a result of chronic heavy drinking. Not all deficits, however, show a relationship with a positive family history of alcohol; for example, ToM impairment was not more prevalent in children of
