Correlational and causal modeling of alcohol‐related symptoms and internalizing disorder status: Further elucidation of a harm paradox

Those with INTD are at greater risk for a wide range of alcohol symptoms than others who drink at the same level, even at relatively low levels of alcohol use. We consider that INTD could exert a direct causal influence specifically on withdrawal and dependence symptoms due to overlapping experiential and/or neurobiological aspects of these alcohol use symptoms and INTD. We conclude that the harm paradox likely contributes to the elevated risk of developing alcohol use disorder comorbidity among those with INTD.