Studies looking at the effect of familial risk on brain morphology and functioning in offspring from alcohol dependent parents often have difficulty separating the effects of familial risk from prenatal exposure because mothers who drink during pregnancy often come from families with AD and substance abuse (Wendell, 2013; O'Brien and Hill, 2015). Complicating the inquiry is the fact that those studies that have assessed prenatal exposure on brain morphology often have minimal or no information about familial risk. Additionally, the history of personal use of alcohol, drugs and cigarettes needs to be taken into account to accurately assess the effects of prenatal exposures and familial risk effects. Uncovering the specific brain structures altered by familial risk, prenatal alcohol exposure, and personal exposure to alcohol and other drugs may provide clues for targeted interventions.