Theoretical and empirical literature describing the risk and protective factors for AUDs can also be explicated through a biopsychosocial approach. This approach, originally described by Engel (1977, 1980), argued that in order to fully understand and treat any type of disease, health professionals should consider cultural, social, and psychological factors in addition to biological indices that tended to be the primary markers of diagnosis and treatment. It has since been argued that problematic alcohol use has to be approached from this perspective as a means of fully understanding this complex set of problems (Zucker, 2006). We have used this approach to guide our understanding of developmental processes and gender differences discussed in this review. Although the majority of studies reviewed here examine specific factors based in a biological, psychological, or social/environmental perspective, the culmination of research suggests that a complete picture of the “heritability” of risk for AUDs must incorporate multiple internal and external components.
