Gender Differences in the Psychosocial Determinants Underlying the Onset and Maintenance of Alcohol Use Disorder

Andrea M. Maxwell, Katherine Harrison, Eric Rawls, Anna Zilverstand

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


A large number of different mechanisms have been linked to Alcohol Use Disorder (AUD), including psychosocial, neurocognitive, affective, and neurobiological factors. Gender has been shown to impact the presentation and progression of AUD; yet, little work has been done to parse the different mechanisms underlying AUD within the lens of gender differences. A review of the literature on adolescence revealed that psychosocial factors, in particular lack of family social support and interactions with peers, drive the onset of alcohol use more strongly in girls relative to boys. However, research done on gender differences in disease progression in adults remains limited. Our gender-specific analysis of the mechanisms underlying AUD in adults revealed that lack of social support was causally linked to negative affect, mental health symptoms, and AUD symptom severity in women, but not men. These novel results suggest that psychosocial factors may play a gender-specific role not only in the onset of use in adolescence, but also in the maintenance of addiction in adults. If confirmed, this suggests the need for investigating gender-specific recovery trajectories. In this perspective piece, we review the literature regarding gender differences in the onset and maintenance of AUD and present original data that support unique risk factors in women.

Original languageEnglish (US)
Article number808776
JournalFrontiers in Neuroscience
StatePublished - Mar 14 2022

Bibliographical note

Funding Information:
We acknowledge the Minnesota Supercomputing Institute (MSI) at the University of Minnesota for providing resources that contributed to the research results reported within this manuscript ( ). Data were provided (in part) by the Human Connectome Project, WU-Minn Consortium (Principal Investigators: David Van Essen and Kamil Ugurbil; 1U54MH091657) funded by the 16 NIH Institutes and Centers that support the NIH Blueprint for Neuroscience Research; and by the McDonnell Center for Systems Neuroscience at Washington University.

Funding Information:
AM was funded by predoctoral training from the National Institute of Neurological Disorders and Stroke (T32-NS105604). ER was supported by a postdoctoral training grant from the National Institutes of Mental Health (NIMH; T32 MH115866).

Publisher Copyright:
Copyright © 2022 Maxwell, Harrison, Rawls and Zilverstand.


  • addiction
  • alcohol use disorder (AUD)
  • causal modeling
  • gender differences
  • social support


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