Evaluations of the relationships in Figure 1 have been carried out using structural equation models (SEMs), survival analyses, and latent trajectory approaches. Most have focused on U.S. samples, and have included higher functioning adults, lower income subjects from families with a high density of AUDs, as well as several non-clinical samples of adolescents (Schuckit et al., 2004; Kramer et al., 2008; Schuckit et al., 2008c; Trim et al., 2008, 2010; Schuckit et al., 2009a). The focus on U.S. samples raises the question of whether the model generalizes to other cultures or is a unique reflection of a U.S.-based environment.
