In addition to potentially heritable effects on abstinent remission, another explanation for the current findings might rest with a social contagion model, or the spread of behavior within a family due to social proximity. Analysis of large social networks from a population-based study indicated that both heavy drinking and abstinence clustered in networks, and also that the heavy drinking or abstinence of relatives and friends at one time point were associated with changes in the subject’s alcohol consumption, to heavier drinking or abstinence, at a subsequent time point (53). The same may be true within families affected by severe AUDs, where abstinence in one person may influence another family member with an AUD to try to quit drinking. This possibility is consistent with evidence that abstinence is the most stable form of remission among individuals with severe AUDs (11, 54–56). If older family members with lifetime AUD are abstinent as younger family members are developing alcohol problems, it is possible that younger members, if they recognize severe problems in themselves, may look to older members for direction or example, or
