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

  • S. M. Gorka (a1), D. Hee (a2), L. Lieberman (a2), V. A. Mittal (a3), K. L. Phan (a1) (a2) (a4) (a5) and S. A. Shankman (a1) (a2)...



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.


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.


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).


This suggests that heightened reactivity to U-threat may be a familial vulnerability factor for problematic drinking and a novel prevention target for AUD.


Corresponding author

*Address for correspondence: Dr S. M. Gorka, University of Illinois at Chicago, 1747 Roosevelt Road, Chicago, IL 60608, USA. (Email:


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

  • S. M. Gorka (a1), D. Hee (a2), L. Lieberman (a2), V. A. Mittal (a3), K. L. Phan (a1) (a2) (a4) (a5) and S. A. Shankman (a1) (a2)...


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