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Although new or persistent alcohol misuse is common during this period, early midlife is understudied in alcohol use literature. We examined the heritability of alcohol misuse; the associations between alcohol misuse and sociodemographic factors, physical health, and well\u2010being; and whether these associations were robust in cotwin comparisons.<\/jats:p><\/jats:sec>Methods<\/jats:title>Participants were 1446 Finnish twin pairs and 748 nonpaired Finnish twins with mean age 34\u2009years. The alcohol misuse index was a composite measure of frequency of use, intoxication, heavy episodic drinking, and alcohol problems assessed with the Malm\u00f6\u2010modified Michigan Alcoholism Screening Test and the Rutgers Alcohol Problem Index. Early midlife correlates included relationship status and length, family formation, unemployment status, education level, self\u2010rated health, pain, sleeping difficulties, life satisfaction, psychological health, and other substance use. We employed a sex\u2010limitation model to estimate early midlife heritability. Linear and fixed effects regression models were used for individual and cotwin comparison analyses, respectively.<\/jats:p><\/jats:sec>Results<\/jats:title>Additive genetic (A) and unique environmental (E) components of alcohol misuse variance differed across sex (Females: A\u2009=\u200962%, E\u2009=\u200938%; Males: A\u2009=\u200949%, E\u2009=\u200951%). In individual\u2010based analyses, higher scores on the alcohol misuse index were associated with lower relationship stability, financial situation, education level, self\u2010rated health, physical fitness, life satisfaction and psychological health, and higher self\u2010reported pain, sleep difficulties, unemployment rates and other substance use (R<\/jats:italic>2<\/jats:sup>\u2009=\u20090.008\u20130.12). Associations remained significant in cotwin comparison analyses (R<\/jats:italic>2<\/jats:sup>\u2009=<\/jats:italic>\u20090.004\u20130.10) except for financial situation and education level.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>There is evidence of sex differences in the etiological factors that influence early midlife drinking. After controlling for confounding familial factors, associations between alcohol misuse and poorer early midlife functioning largely remained, suggesting that alcohol misuse may play a role in poorer functioning across several outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.15513","type":"journal-article","created":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T11:23:51Z","timestamp":1734693831000},"page":"301-314","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Etiology and correlates of alcohol misuse in early midlife"],"prefix":"10.1111","volume":"49","author":[{"given":"Erin","family":"Lumpe","sequence":"first","affiliation":[{"name":"Department of Psychology Rutgers University New Brunswick New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6258-9477","authenticated-orcid":false,"given":"Angela","family":"Pascale","sequence":"additional","affiliation":[{"name":"Department of Psychology Virginia Commonwealth University Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1498-4333","authenticated-orcid":false,"given":"Mallory","family":"Stephenson","sequence":"additional","affiliation":[{"name":"Department of Psychology Virginia Commonwealth University Richmond Virginia USA"},{"name":"Virginia Institute for Psychiatric and Behavioral Genetics Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Barr","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences SUNY Downstate Health Sciences University Brooklyn New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan E.","family":"Cooke","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Rutgers Robert Wood Johnson School of Medicine Piscataway New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antti","family":"Latvala","sequence":"additional","affiliation":[{"name":"Institute of Criminology and Legal Policy University of Helsinki Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hermine H. 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