Another important aspect of parental EB exposure concerns its duration or chronicity. Accumulated risk refers to the build-up over time of repeated/sustained exposure to AUD risk factors. Compounding of risks engendered in early developmental stages impacts later health and development (24). This concept is similar to the cumulative risk hypothesis (25), although here we are examining chronic exposure to a constellation of related risk factors grouped as exposure to parental EB rather than exposure to diverse risk factors. In the study of sequelae of child abuse, chronic exposure was associated with significantly increased risk of heavy drinking and AUD, and this risk was greater than that seen for time-limited child abuse (19). This line of questioning also can be applied to the impact of chronicity of parental EB exposure on AUD risk. Children of parents with EB likely experience more sustained exposure to a variety of environmental stressors than do their peers (26). As noted above, evidence that adoptive parental EB confers risk for AUD (11, 27, 28) confirms that environmental exposure is a risk factor. Because parental EB can
