Family history reflect many factors and an individual may of inherited just some of them. A validated endotype in an individual better reflects the vulnerability of that individual. Reduced body sway following a standard dose of alcohol has been found to predict the development of alcohol dependence.

Family History Predicts Alcohol Dependence, but Level of Reaction to Alcohol May Be a Better Mediator of Future Alcohol Dependence than Is Family History

Of 450 white men followed up for 8 years after testing (mean age at follow-up: 31), 10.8 of the family history (FH) negative and 26.8% of the FH positive developed alcohol dependence. Level of reaction to alcohol (LR)(.75 ml/kg) was derived from measures of subjective high, body sway and cortisol response. Individuals with low level of reaction to alcohol had higher rates of alcohol dependence and in a sub sample of 72 subjects this relationship remained significant even when controlled for FH, while FH when controlled for LR was not significant. Data plotted is from the 72 subjects who comprised the top 15% and bottom 15% distribution of LR from 244 subjects. (Constructed from data in Shuckit, M.A. and Smith, T.L. et al. Arch Gen Psychiatry, 53: 202, 1996) ©2008NBEP