This is one of a few studies that have prospectively assessed the onset of internalizing and externalizing disorders as well as Substance Use Disorders from childhood/adolescence into young adulthood. This follow up is unique in having followed offspring from multiplex AD families identified through a pair of female alcohol dependent individuals. As such, this is the first report documenting the temporal order of psychopathology in offspring from families with a high density of maternal AD. The present findings indicate that offspring from high-risk families with maternal AD (mother and/or multiple maternal relatives are alcoholic) have a significantly earlier age of onset of a variety of psychiatric conditions compared to offspring from control families.