This study found that early AFD was as strongly associated with abuse as with dependence. This finding, coupled with the specific AUD criteria for which significant associations were noted, suggests that the increased risk of adult-onset AUD among individuals with early AFD derives in large part from a greater likelihood of their engaging in heavy and/or hazardous patterns of drinking in adulthood. This interpretation, consistent with studies that have examined the direct association of AFD and consumption in adolescence or adulthood (Pedersen and Skrondal, 1998; Pitkänen et al., 2005; York et al., 2005), is further supported by total attenuation of AFD and AUD associations that resulted from adjusting for volume of consumption. Additional support is provided by the lack of association between AFD and abuse in a low-risk population that excluded individuals with characteristics reflecting impulsivity or impaired ability to make choices based on perceived consequences of their drinking behavior — characteristics that would predispose to adverse drinking patterns. There was no indication that early AFD was associated with impaired control, the hallmark of addiction. Indeed, at comparable levels of
