OBJECTIVES:The retrospective self-report of the effects of alcohol (SRE) questionnaire generates three scores reflecting drinking quantities required for effects: SRE-5 (first five times of drinking), SRE-3 (recent 3 months of drinking), and SRE-H (heaviest drinking). Data to date indicate that SRE-5 scores, potentially reflecting genetic effects, have high reliabilities across 9 months. Data presented here evaluated the consistencies of all three SRE scores obtained five times over a decade. METHOD:Participants were 331 young adults (45% male) from the Collaborative Study on the Genetics of Alcoholism (COGA) Prospective Study of youth who completed the SRE and were evaluated at least five times using the Semi-Structured Assessment for the Genetics of Alcoholism interview. Analyses documented changes in SRE scores, changes in drinking quantities, and the relationship between these measures over time using repeated measures ANOVA and regression analyses. RESULTS:SRE-5 scores did not change significantly across evaluations despite significant changes in drinking quantities. SRE-3 and SRE-H demonstrated significant changes over time that related to changes in drinking quantities during each period. Participants with low levels of response (low LRs) to alcohol, based on a median split of SRE-5 at Time 1, were likely to remain low LR throughout the decade. CONCLUSIONS:This is the first report on the longer-term consistency of all three SRE scores during a decade of life in which a person's heaviest drinking and AUD development are likely to occur. Results indicate that retrospective SRE-5 scores, potentially reflecting genetic predispositions to AUD, do not change over a decade despite changes in drinking patterns.

BACKGROUND:Romantic relationships are important contexts for substance use and emotional well-being. We tested the hypotheses that (i) genetic predispositions for alcohol consumption would be positively associated with partner substance use, (ii) partner substance use would moderate genetic influences on one's own alcohol outcomes, and (iii) partner discordance in substance use would be associated with lower emotional well-being and relationship quality. METHODS:Analyses included 2,357 participants (Mage = 51.4, 58.2% female) from the Collaborative Studies on the Genetics of Alcoholism. Focal measures included participants' reports of their own and their current partner's past-year substance use (frequencies of alcohol use, heavy drinking, drunkenness, cannabis use, and nicotine use), emotional well-being, and relationship quality. Participants' genetic predispositions were indexed with genome-wide polygenic scores for alcohol consumption (PGSAlc). Participant-partner substance use discordance was calculated as the difference between the participant's and their partner's use for each substance use measure, separately. RESULTS:Participant PGSAlc was not significantly associated with partners' perceived substance use. Frequent perceived partner alcohol use and heavy drinking significantly amplified the association between PGSAlc and alcohol use or drunkenness. Frequent perceived partner drunkenness and cannabis use significantly attenuated the association between PGSAlc and heavy drinking or frequency of alcohol use. Participant-partner discordance for several substance use measures was significantly associated with lower emotional well-being and relationship quality, controlling for participant and partner substance use main effects. CONCLUSIONS:The results highlight the importance of partner substance use in etiological models of alcohol use, emotional health outcomes, and relationship quality.

Background Social-Emotional Health (SEH)—the quality of social relationships and emotional well-being—is crucial for maintaining health and cognitive functioning. Given elevated cognitive impairment risk in aging and Alcohol Use Disorder (AUD) populations, we investigated associations between specific SEH factors and cognitive and physical functioning in individuals from families enriched for AUD. Methods Data from the Collaborative Study on the Genetics of Alcoholism (COGA, analytic N = 1,476, 61% lifetime AUD) were analyzed, grouping participants into younger (22–49 years) and later-life (50 + years) adults. Six SEH factors, fluid cognition (e.g., logical reasoning), and crystallized cognition (e.g., vocabulary) were measured via the NIH Toolbox Cognition and Emotion batteries. Physical functioning (SF-36), a self-reported measure of general health, was included as a non-cognitive comparison, with age and gender tested as moderators. Results SEH associations with fluid cognition and physical functioning were robust and conditional on age and gender. In later-life adults, all three positive SEH factors (Emotional Support, Instrumental Support, Friendship) were associated with higher fluid cognition, while all three negative factors (Loneliness, Negative Affect, Perceived Stress) were associated with lower fluid cognition. These associations were predominantly observed in later-life women and were independent of lifetime AUD history. While physical functioning showed widespread SEH associations across groups, SEH was not associated with fluid cognition in younger adults. Conclusion SEH shows robust, age- and gender-specific associations with fluid cognition and physical health. The SEH-fluid cognition link appears to be a late-life phenomenon particularly salient for women and independent of an individual’s lifetime AUD history.

Ethiopia's climate exhibits significant regional variability, with varying rainfall patterns and consistently rising temperatures across the country. Climatic changes have direct and indirect effects on human health by increasing natural disasters such as flooding and droughts, increase food insecurity through reduced crop yields, and increase infectious disease transmission. Significant gaps exist in climate-health research, compounded by insufficient funding and a dependence on international evidence for local policy development. We explored community perspectives on the impact of climate variations on the environment, health and livelihood of people in Ethiopia to prioritize and inform mitigation strategies. We conducted a qualitative study in Ethiopia to discuss effects of climate change on human health, livelihoods, and the environment, as well as potential mitigation strategies for the country. Health workers, public health experts, and representatives from various organizations were interviewed. We systematically coded the data to identify prominent and emerging themes. We identified three overarching themes: (I) drivers of climate disruption and environmental degradation, (II) socioeconomic impacts of climate change on communities, (III) strategies for mitigating climate change and its impact. Key findings reveal weather pattern shifts, reduced crop yields, and environmental degradation caused by urbanization and improper waste disposal. Participants shared concerns including weather impacts on crop production and rising health risks, and proposed solutions including afforestation and reducing carbon emissions. Further research is needed to address climate disruptions, especially in low-resource, industrializing areas. Our findings underscore the imperative for collaborative efforts among policymakers, researchers, and local communities to address the multifaceted challenges posed by climate change. Future research should prioritize developing evidence-based policies and interventions tailored to local contexts, aiming to enhance resilience and minimize the adverse impacts on Ethiopia's population and ecosystems. By leveraging these insights, we can work towards a sustainable future that mitigates climate risks while fostering socio-economic and environmental stability. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The research conducted herein was not funded by any external sources. All aspects of this study, including data collection, analysis, and interpretation, were undertaken without financial support from grants, institutions, or organizations. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Verbal informed consent was obtained from all participants involved in the study. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The datasets used and analyzed during the current study are available at the HaSET (info@haset.org) on a reasonable request.

OBJECTIVE:We investigated offspring alcohol use outcomes as a function of unremitted and remitted parental alcohol use disorder (AUD). METHOD:Self-report data of participants in the Collaborative Study on the Genetics of Alcoholism (COGA) were used. Offspring (n = 2,244, mean age 16.3 years at baseline, 26.9 years at follow-up, 50.8% female) were linked to parental data. Time-varying associations of parental AUD and remission with offspring age at first drink, years from first drink to AUD onset, and years from AUD onset to first remission were tested in Cox models adjusted for polygenic risk for problematic alcohol use (PGSPAU). Analyses were stratified by genetically inferred continental groups of European Americans (EA; 65.9%) and African Americans (AA; 34.1%) because of sociocultural factors that can contribute to differences in alcohol use and problems. RESULTS:In EA, maternal remission was associated with increased risk for offspring AUD; neither maternal nor paternal remission was associated with other outcomes. In AA, maternal and paternal remission were associated with an increased likelihood of early drinking; the association with maternal drinking varied as a function of whom offspring lived with during adolescence. Paternal, but not maternal, remission was associated with a heightened risk for AUD onset. Parental status had no association with offspring remission in EA or AA. CONCLUSIONS:Evidence that parental remission can help mitigate the risk associated with parental AUD and increase the likelihood of remission in affected offspring was limited and mixed based on continental group and sex. These nuanced outcomes highlight the complex interplay of parental AUD status and offspring's alcohol-related behaviors.

Background:Child mortality remains a concern in Ethiopia despite the significant achievements in the past three decades. Proper implementation of the existing low-cost interventions can prevent two-thirds of the deaths. Understanding illness recognition, care-seeking behaviours, and barriers that caregivers encounter during a child's illness along care pathways is imperative. We aimed to describe illness recognition and reactions of caregivers of children <2 years, and factors associated with severe illness or death related to the care pathways, including the child, caretaker, household, and health system. Methods:We conducted a prospective cohort study using an open birth cohort of Birhan field site, from December 2018 to November 2022. The analysis included newborns followed up to two years old who had an illness episode and for whom data were available for the mother-child dyad. We extracted and linked data on community follow-up and morbidity visits, clinical signs and symptoms of illness at health facility visits, verbal autopsy of deceased children, and maternal health and healthcare. We used descriptive and logistic regression analyses. Results:Of 3969 eligible children enrolled in the Birhan Cohort, 1397 (37.8%) had at least one episode of illness during the first two years of life. Of those, 108 (8%) experienced a severe illness or died, of which the majority (n = 76; 70.4%) were newborns. Most sick children (n/N = 714/1187) did not get treatment from a formal source; 53.1% (n/N = 684/1289) of those with mild or moderate illness and 27.8% (n/N = 30/108) of the severely ill or deceased. The mean delay in care-seeking was 5.9 (standard deviation (SD) = 10.6) days for those with mild or moderate illness, and 1.7 (SD = 0.58) for the severely ill or deceased. Only 4.8% (n/N = 27/559) of children sought care from a health post (HP), and 68.1% (n/N = 94/138) of children were referred for further care. Only 68.4% (n/N = 13/19) of the severely ill or deceased children were referred, of which 3 (4.9%) accepted the referral. Compared to a newborn, being a young infant (adjusted odds ratio (aOR) = 0.05; 95% confidence interval (CI) = 0.008-0.27) and a child (aOR = 0.03; 95% CI = 0.005-0.17) were associated with a reduction in the odds of severe illness or death. Children who sought care from an HP had a higher risk of severe illness or death than those who consulted a government hospital (aOR = 19.6; 95% CI = 2.71-142.40). Belonging to a rich family resulted in a reduction in the odds of the outcome compared to a poor household (aOR = 0.15; 95% CI = 0.02-0.94). Conclusions:Illness recognition and care-seeking were low in the Birhan field site, and when care was sought, it was delayed. Care was sought from an HP in rare cases. Health workers did not refer about a third of severely ill or deceased children for further care. Being a newborn, consulting a HP rather than a hospital, and belonging to a poor family had a significantly higher risk of severe illness or death. Strategies should be devised targeting the modifiable factors identified at individual, family, or community and health facility levels to improve child survival.

Introduction:Research has identified multiple risk factors associated with suicide attempt (SA) among individuals with psychiatric illness. However, there is limited research among those with an alcohol use disorder (AUD), despite their disproportionately higher rates of SA. Methods:We examined lifetime SA in 4,068 individuals with an AUD from the Collaborative Study on the Genetics of Alcoholism (23% lifetime SA; 53% female; mean age: 38). We explored risk for lifetime SA across other clinical conditions ascertained from a clinical interview, polygenic scores for comorbid psychiatric problems, and neurocognitive functioning. Results:Participants with an AUD who attempted suicide had greater rates of trauma exposure, major depressive disorder, post-traumatic stress disorder, other substance use disorders (SUDs), and suicidal ideation. Polygenic scores for SA, depression, and PTSD were associated with increased odds of reporting an SA (ORs = 1.22-1.44). Participants who reported an SA also had decreased right hemispheric frontal-parietal theta and decreased interhemispheric temporal-parietal alpha electroencephalogram resting-state coherences relative to those who did not, but differences were small. Conclusions:Overall, individuals with an AUD who report lifetime SA experience greater levels of trauma, have more severe comorbidities, and carry increased polygenic risk for other psychiatric problems. Our results demonstrate the need to further investigate SAs in the presence of SUDs.

OBJECTIVE:Marriage is associated with improved health and alcohol outcomes, yet prior research has often combined diverse non-marital relationships, obscuring whether benefits are unique to marriage or a result of strong interpersonal relationships. This study examines whether marriage, compared to cohabitation, exclusive dating, or being single, is associated with alcohol use disorder (AUD) remission and whether this varies by sex and partner drinking. METHOD:Participants were adults from the Collaborative Study on the Genetics of Alcoholism Lifespan Study (n = 1494; 54.4% female) who met criteria for lifetime DSM-5 AUD. Multivariate logistic regression models examined the association between marital status and remission. Subsequent models tested interactions among marital status, partner drinking, and sex. Predicted remission prevalence was estimated using marginal standardization and compared across groups on an additive scale using prevalence differences (PD). RESULTS:Married individuals had greater predicted prevalence of remission, particularly compared to those who were exclusively dating (PD = 9.2, P = .020). Married females whose partners were average alcohol consumers (PD = 12.20, q = .049) or abstinent (PD = 17.98, q = .017), and married males whose partners had above average alcohol consumption (PD = 25.30, q = .049) had greater predicted prevalence of remission compared to their counterparts who were in non-marital committed relationships. CONCLUSION:The findings suggest differences in marital status and relationship factors may indicate increased risk and challenges in sustaining remission and highlight potential caveats of marital status as a protective factor. This emphasizes the need to consider these factors in designing treatment strategies.

OBJECTIVE:To examine the prevalence of large-for-gestational age (LGA) and macrosomia in 23 countries between 2000 and 2021. DESIGN:Descriptive multi-country secondary data analysis. SETTING:Subnational, population-based cohort studies (k = 45 for LGA, k = 25 for macrosomia) in 23 low- and middle-income countries (LMICs). POPULATION:Liveborn infants. METHODS:We conducted a secondary analysis of individual-level data from the Vulnerable Newborn Measurement Collaboration, using INTERGROWTH-21st standards to define LGA (> 90th centile for gestational age and sex) and macrosomia (≥ 4000 g, regardless of gestational age). We included LMIC population-based datasets with reliable gestational age and birthweight data, excluding studies with small sample sizes, high missing data, or implausible measurements. Prevalence estimates were stratified by region, study period and gestational age, and results were summarised as medians and interquartile ranges (IQR). MAIN OUTCOME MEASURES:Prevalence of LGA and macrosomia. RESULTS:Among 476 939 live births, the median prevalence of LGA was 5.1% (IQR: 2.9%-9.6%) and was highest in Latin America and the Caribbean at 9.6% (4 studies, IQR: 2.7%-16.1%) and lowest in South Asia at 2.7% (13 studies, IQR: 2.3%-3.7%). Over time, the median LGA prevalence increased from 4.9% (12 studies; IQR: 4.1%-7.9%) during the period from 2000 to 2010 to 5.9% (33 studies, IQR: 2.7%-11.2%) from 2011 to 2021. Term LGA was more common at 3.2% (0.9-5.1) than preterm or post-term LGA. Among 313 064 live births, the median prevalence of macrosomia was 1.3% (n = 313 064, IQR: 0.2%-2.4%), which was highest in Latin America and the Caribbean (4 studies, 3.1%, IQR: 0.7%-6.8%) and lowest in South Asia (8 studies, 0.1%, IQR: 0.0%-0.7%). The median prevalence remained stable over time: 1.1% (8 studies, IQR: 0.2%-3.1%) in older studies (2000-2010) and 1.3% (17 studies, IQR: 0.5%-2.4%) in more recent studies (2011-2021). Term macrosomia was more common at 1.2% (0.2-2.0) than preterm and post-term macrosomia. CONCLUSIONS:The overall prevalence of LGA and macrosomia was lower in these LMIC studies than is reported in high-income countries. The prevalence of large babies was highest in Latin America and the Caribbean.

BACKGROUND:Trauma exposure during adolescence can lead to impaired executive function and altered neural development in related cognitive control networks. Studies have shown that adolescents with a family history of alcohol use disorders have a disproportionately high rate of trauma exposure, as well as impaired response inhibition, making them particularly vulnerable to cognitive impairment and poor mental health outcomes in adulthood. While studies have suggested that this may be due partly to genetic influences, no study to our knowledge has investigated the influences of trauma exposure and polygenic scores (PGS) for cognitive function on later cognitive function. METHODS:This study used data from trauma-exposed individuals in the Collaborative Study on the Genetics of Alcoholism prospective cohort (N = 912), comprising offspring from alcohol-dependent high-risk and comparison families, to investigate main and interaction effects of PGS for cognitive function (fluid intelligence score, UK Biobank study) and trauma exposure (nonsexual assaultive, nonassaultive, sexual assaultive) on performance measures and frontal theta event-related oscillations (EROs) during a continuous performance test (CPT). RESULTS:A significant interaction between fluid intelligence PGS and nonsexual assaultive trauma was observed for CPT ERO power (B = 0.094, p < 0.01), such that individuals with a lower PGS who experienced a nonsexual assaultive traumatic exposure had lower frontal theta ERO power during the cued no-go condition of the CPT. CONCLUSION:These findings suggest that a polygenic predisposition for higher fluid intelligence may be associated with differences in neural response inhibition depending on trauma type.

[This corrects the article DOI: 10.1016/j.cdnut.2024.102964.].

Student anxiety impairs school functioning. Anxiety reduction interventions are effective, but most youth do not receive these services. Task shifting intervention delivery to teachers can improve access to these interventions. This exploratory analysis used data from a randomized clinical trial and examined the impact of a teacher-delivered school-home intervention (TAPES) compared to a didactic teacher training on student anxiety (Teacher Anxiety Training (TAT)) on school related outcomes. It was hypothesized that students in TAPES, compared to TAT, would show greater improvements. Teachers (N = 54) identified potentially eligible students in their classrooms who were assessed by study staff using a diagnostic interview to confirm impairing levels of anxiety at school and at home. Fifty-four students (mean age 8.0 years; 46% females; 78% white; 81% with an anxiety disorder) participated. Outcomes were assessed, by multiple informants, at approximately eight weeks (postintervention) and six months after a student was enrolled. Results indicated no statistically significant between group differences, but within group changes showed that students receiving TAPES demonstrated significant improvements in math and English grades and in parent-reports of school-related impairment. Students in both groups showed significant improvements in teacher-rated classroom behavior. Implications of these exploratory findings for providing, improving, and evaluating teacher interventions for anxiety are discussed.Trial registration ClinicalTrials.gov, NCT03899948

Objective Parental separation and relationship discord are linked to alcohol use behaviors, but their influence on the longitudinal course of alcohol misuse and interactions with genetic predisposition remain unclear. This study examined how the longitudinal course of heavy episodic drinking (HED) from adolescence to young adulthood varies with polygenic risk, parental separation, and relationship discord. Method Participants were from the Collaborative Study on the Genetics of Alcoholism (COGA) Prospective Sample, and included individuals from 2 genetically inferred continental groups: European-like (EA; n = 1761) and African-like (AA; n = 894) who were reassessed biennially (mean age = 16.39 at first assessment; mean assessments = 4.65). Alcohol misuse was indexed by past-year HED frequency. Predictors included parental separation, parental relationship discord, and problematic alcohol use polygenic scores (PGSPAU). Data were analyzed using linear mixed-effects growth models. Results HED increased through young adulthood before declining. In European Americans (EA), parental separation was associated with HED intercepts, but not with linear slope or quadratic curvature. Higher PGSPAU was associated with a faster initial growth and slower decline. In African American (AA), parental relationship discord was not associated with HED intercepts but was associated with a faster initial growth and slower decline. PGSPAU were not associated the intercept or the course of HED. No interaction was found between PGSPAU and parental separation or discord to predict the longitudinal course of HED in either EA or AA samples. Conclusion Genetic risk and exposure to parental separation and discord are associated with the course of HED, with some differences across continental groups. Plain language summary This study utilized data from the Collaborative Study on the Genetics of Alcoholism (COGA) to examine how the course of heavy episodic drinking (HED) from adolescence to young adulthood varies with genetic risk, parental separation, and relationship discord. Parental separation and relationship discord were associated with initial levels of heavy episodic drinking and their course into young adulthood. In the European American sample, these family stressors were associated with higher initial levels of heavy episodic drinking, which were sustained over time with genetic factors amplifying this pattern. In the African American sample, parental relationship discord was associated with a rapid increase in heavy episodic drinking that declined slowly. These findings highlight the contributions of genetics and family adversity in shaping risk for harmful patterns of alcohol use across development.

Background:Despite progress in reducing maternal and child mortality worldwide, adverse birth outcomes such as preterm birth, low birth weight (LBW), small for gestational age (SGA), and stillbirth continue to be a major global health challenge. Developing a prediction model for adverse birth outcomes allows for early risk detection and prevention strategies. In this systematic review, we aimed to assess the performance of existing prediction models for adverse birth outcomes and provide a comprehensive summary of their findings. Methods:We used the Population, Index prediction model, Comparator, Outcome, Timing, and Setting (PICOTS) approach to retrieve published studies from PubMed/MEDLINE, Scopus, CINAHL, Web of Science, African Journals Online, EMBASE, and Cochrane Library. We used WorldCat, Google, and Google Scholar to find the grey literature. We retrieved data before 1 March 2022. Data were extracted using CHecklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies. We assessed the risk of bias with the Prediction Model Risk of Bias Assessment tool. We descriptively reported the results in tables and graphs. Results:We included 115 prediction models with the following outcomes: composite adverse birth outcomes (n = 6), LBW (n = 17), SGA (n = 23), preterm birth (n = 71), and stillbirth (n = 9). The sample sizes ranged from composite adverse birth outcomes (n = 32-549), LBW (n = 97-27 233), SGA (n = 41-116 070), preterm birth (n = 31-15 883 784), and stillbirth (n = 180-76 629). Only nine studies were conducted on low- and middle-income countries. 10 studies were externally validated. Risk of bias varied across studies, in which high risk of bias was reported on prediction models for SGA (26.1%), stillbirth (77.8%), preterm birth (31%), LBW (23.5%), and composite adverse birth outcome (33.3%). The area under the receiver operating characteristics curve (AUROC) was the most used metric to describe model performance. The AUROC ranged from 0.51 to 0.83 in studies that reported predictive performance for preterm birth. The AUROC for predicting SGA, LBW, and stillbirth varied from 0.54 to 0.81, 0.60 to 0.84, and 0.65 to 0.72, respectively. Maternal clinical features were the most utilised prognostic markers for preterm and LBW prediction, while uterine artery pulsatility index was used for stillbirth and SGA prediction. Conclusions:A varied prognostic factors and heterogeneity between studies were found to predict adverse birth outcomes. Prediction models using consistent prognostic factors, external validation, and adaptation of future risk prediction models for adverse birth outcomes was recommended at different settings. Registration:PROSPERO CRD42021281725.

ObjectivesInfections are one of the most common causes of neonatal mortality, and maternal colonization has been associated with neonatal infection. In this study, we sought to quantify carriage prevalence of extended-spectrum-beta-lactamase (ESBL) -producing and carbapenem-resistant Enterobacterales (CRE) among pregnant women and their neonates and to characterize risk factors for carriage in a rural Amhara, Ethiopia.MethodsWe conducted a prospective cohort study nested in the Birhan field site. We collected rectal and vaginal samples from 211 pregnant women in their third trimester and/or during labor/delivery and perirectal or stool samples from 159 of their neonates in the first week of life.ResultsWe found that carriage of ESBL-producing organisms was fairly common (women: 22.3%, 95% CI: 16.8-28.5; neonates: 24.5%, 95% CI: 18.1-32.0), while carriage of CRE (women: 0.9%, 95% CI: 0.1-3.4; neonates: 2.5%, 95% CI: 0.7-6.3) was rare. Neonates whose mothers tested positive for ESBL-producing organisms were nearly twice as likely to also test positive for ESBL-producing organisms (38.7% vs. 21.1%, p-value: 0.06). Carriage of ESBL-producing organisms was also associated with woreda (district) of sample collection and recent antibiotic use.ConclusionsUnderstanding carriage patterns of potential pathogens and antibiotic susceptibility among pregnant women and newborns will inform local, data-driven recommendations to prevent and treat neonatal infections.

Research has identified clinical, genomic, and neurophysiological markers associated with suicide attempts (SA) among individuals with psychiatric illness. However, there is limited research among those with an alcohol use disorder (AUD), despite their disproportionately higher rates of SA. We examined lifetime SA in 4,068 individuals with DSM-IV alcohol dependence from the Collaborative Study on the Genetics of Alcoholism (23% lifetime suicide attempt; 53% female; 17% Admixed African American ancestries; mean age: 38). We 1) conducted a genome-wide association study (GWAS) of SA and performed downstream analyses to determine whether we could identify specific biological pathways of risk, and 2) explored risk in aggregate across other clinical conditions, polygenic scores (PGS) for comorbid psychiatric problems, and neurocognitive functioning between those with AD who have and have not reported a lifetime suicide attempt. The GWAS and downstream analyses did not produce any significant associations. Participants with an AUD who had attempted suicide had greater rates of trauma exposure, major depressive disorder, post-traumatic stress disorder, and other substance use disorders compared to those who had not attempted suicide. Polygenic scores for suicide attempt, depression, and PTSD were associated with reporting a suicide attempt (ORs = 1.22-1.44). Participants who reported a SA also had decreased right hemispheric frontal-parietal theta and decreased interhemispheric temporal-parietal alpha electroencephalogram resting-state coherences relative to those who did not, but differences were small. Overall, individuals with alcohol dependence who report SA appear to experience a variety of severe comorbidities and elevated polygenic risk for SA. Our results demonstrate the need to further investigate suicide attempts in the presence of substance use disorders.