Alcohol use disorders (AUD) are associated with deficits in social cognition, the mental processes involved in perceiving, attending to, remembering, thinking about, and making sense of the people in our social world. Consistent findings of impaired theory of mind and affective face processing in AUD raise questions as to whether these deficits are the consequence of neural damage associated with AUD or potentially reflect premorbid risk for alcohol-related problems. Offspring with a family history of AUD are at increased risk for substance use disorders (SUD) by young adulthood, and some research suggests that alcohol-naïve, high-risk offspring also have deficits in social-cognitive functioning. However, evidence linking premorbid social-cognitive functioning to SUD outcome has not yet been established. Accordingly, this dissertation sought to examine specific measures of social functioning, thought to reflect underlying social-cognitive abilities, and their relationship to both familial risk status and SUD outcome. The sample included high-risk offspring (n = 137) from multiplex, alcohol-dependent families and low-risk controls (n = 122) from an ongoing longitudinal study comprising 2,387 separate evaluations. Risk-group differences were examined on parent-report measures of social competence and social problems collected during childhood, self-report measures of social support from parents and friends during adolescence, and self-report measures of personality administered in young adulthood. Structural equation modeling (SEM) was used to examine relationships between familial risk status, social functioning, adolescent alcohol use, and SUD outcome. Compared to low-risk controls, high-risk offspring had poorer performance on measures of social functioning administered during childhood, adolescence, and young adulthood, higher rates of alcohol use during adolescence, and increased likelihood of developing SUD by young adulthood. SEM analyses indicated that the relationship between familial risk status and SUD outcome was partially mediated by social competence in childhood, by alcohol use in adolescence, and in association with social connectedness and alienation in young adulthood. This dissertation provides preliminary evidence that social functioning is impaired among high-risk offspring before the onset of regular alcohol use and that these deficits confer additional risk for SUD above and beyond the influence of familial risk. Interventions targeting early social functioning may improve outcomes among youth at high familial risk for AUD.
|Advisor:||Hill, Shirley Y.|
|Commitee:||Eack, Shaun M., Pogue-Geile, Michael F., Sayette, Michael A., Shaw, Daniel S.|
|School:||University of Pittsburgh|
|Department:||Dietrich School Arts and Sciences|
|School Location:||United States -- Pennsylvania|
|Source:||DAI-A 82/3(E), Dissertation Abstracts International|
|Subjects:||Clinical psychology, Psychology, Individual & family studies|
|Keywords:||Adolescent alcohol, Alcohol use disorder, Alienation, Familial risk, Social competence, Substance use disorder|
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