The two subtypes that appear to be gender related (i.e., internalizing and externalizing) share some characteristics; these attributes suggest that the etiologies among these groups may depend less on inherited characteristics than do the disease origins of the high risk-high severity subtype. The internalizing and externalizing groups are equivalent in terms of family history (i.e., both have moderate levels), degree of alcohol dependence, and alcohol-related consequences. The predominantly male, externalizing subtype, however, shows more early signs of problem behavior, including conduct problems, and earlier age of onset for problem drinking. In contrast, the internalizing subtype exhibits higher levels of depression, anxiety, and relief drinking. The characteristics are not entirely gender specific. They do, however, mirror gender differences—such as a higher incidence of depression and anxiety among women—commonly reported for nonalcoholic populations. The subtype differences also bear a clear correspondence to traditional gender roles (see Del Boca 1994), which reflect social norms about what is thought to be the “appropriate” behavior of men and women. Traditionally, the social “shoulds” for men within our culture emphasize assertive, task-oriented behavior, whereas those for
