Testing has supported the hypothetical model in Figure 1 regarding how a low LR, which occurs more frequently in individuals with a family history of AUD, increases the risk for heavy drinking and alcohol problems both directly and indirectly through these potential mediators.31,37,42 The findings suggested that as much as half of the impact of low LR on adverse alcohol outcomes occurs indirectly, through associating with heavier-drinking peers, expectations that getting drunk is rewarding and desirable, and using alcohol to cope with stress. These findings raised the possibility that for individuals with low LR, interventions that decrease the impact of these three mediators on heavier drinking might reduce the risk for higher maximum drinks and alcohol problems later.
