Familial and area-level factors were associated with high-risk drinking and alcohol dependence in this national sample of adults, with findings similar to prior research on social control of heavy alcohol use and associated risk behaviors (Dick and Kendler, 2012, Kendler et al., 2011). We saw some key differences between predictors of high-risk drinking and alcohol dependence, however; full-sample models suggested context-dependent FH effects (evidenced by the interaction of FH and alcohol availability) for high-risk drinking and stronger FH main effects for dependence. The FH and alcohol dependence relationship may be less susceptible to changes in access to alcohol, once consumption becomes compulsive and motivated by negative reinforcement (Koob & Volkow, 2016), although this explanation does not fit with findings from our stratified analyses. A fuller examination of the different mechanisms through which FH and increased alcohol availability may affect high-risk drinking and alcohol dependence in different population subgroups is warranted. Considering the large proportion of the population with affected relatives, studies describing how FH of alcohol problems interacts with social control mechanisms has potential clinical and policy implications. However, few previous studies have examined sex- and racial/ethnic-specific influences of FH and area-level social controls on high-risk drinking and alcohol dependence.
