Reactivity to uncertain threat as a familial vulnerability factor for alcohol use disorder

S. M. Gorka*, D. Hee, L. Lieberman, Vijay Anand Mittal, K. L. Phan, Stewart A Shankman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Background When sober, problematic drinkers display exaggerated reactivity to threats that are uncertain (U-threat). Since this aversive affective state can be alleviated via acute alcohol intoxication, it has been posited that individuals who exhibit heightened reactivity to U-threat at baseline are motivated to use alcohol as a means of avoidance-based coping, setting the stage for excessive drinking. To date, however, no study has attempted to characterize the dispositional nature of exaggerated reactivity to U-threat and test whether it is a vulnerability factor or exclusively a disease marker of problematic alcohol use. Method The current investigation utilized a family study design to address these gaps by examining whether (1) reactivity to U-threat is associated with risk for problematic alcohol use, defined by family history of alcohol use disorder (AUD) and (2) reactivity to U-threat is correlated amongst adult biological siblings. A total of 157 families, and 458 individuals, participated in the study and two biological siblings completed a threat-of-shock task designed to probe reactivity to U-threat and predictable threat (P-threat). Startle potentiation was collected as an index of aversive responding. Results Within biological siblings, startle potentiation to U-threat [intraclass correlation (ICC) = 0.35] and P-threat (ICC = 0.63) was significantly correlated. In addition, independent of an individuals' own AUD status, startle potentiation to U-threat, but not P-threat, was positively associated with risk for AUD (i.e. AUD family history). Conclusion This suggests that heightened reactivity to U-threat may be a familial vulnerability factor for problematic drinking and a novel prevention target for AUD.

Original languageEnglish (US)
Pages (from-to)3349-3358
Number of pages10
JournalPsychological Medicine
Issue number16
StatePublished - Dec 1 2016


  • Alcohol use disorder
  • startle potentiation
  • uncertain threat
  • vulnerability factor

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health


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