Further investigation of factors impacting respondent’s endorsement patterns of sensitive topics such as CPA is crucial to developing effective assessment measures that can accurately capture CPA exposure more efficiently and thus improve our ability not only to conduct epidemiologic research with minimum burden on respondents but to identify individuals at risk in the general population, e.g., through screeners in medical settings. As behaviorally defined CPA may be a proxy for a more general pathological family environment in AA women, the exploration of family-level risk factors (e.g. parental support) with CPA endorsement would be useful to disentangle this relationship. Investigation of other problem drinking behaviors as well as problems with other substances, and inclusion of males in future studies are also key to refining the measurement of the relationship between CPA and substance-related problems. AA women who experience CPA might be at increased risk of non-alcohol-related substance use disorders and the etiological impact of different CPA endorsement patterns on AUD in men remains unknown.
