A frailty model of segregation analysis: understanding the familial transmission of alcoholism.

Coupled with environmental factors, genes contribute to numerous human diseases and traits. While there are many epidemiological methods to assess the familial clustering of traits, few are flexible enough to accommodate interactions between covariates and familial factors. In this paper, we propose and develop a frailty model that establishes an integrated framework to evaluate familial transmission of a disease by controlling for covariate effects and conveniently testing the interactions between covariates and familial factors. We also present a peeling algorithm that dramatically reduces the computational burden. This frailty model is employed to examine the familial transmission of major subtypes of alcoholism, namely, alcohol abuse and dependence. We conclude that alcohol dependence is strongly familial whereas alcohol abuse expresses a marginally significant pattern of familial transmission. Moreover, females manifest alcoholism at a lower threshold, and there is no sex-specific familial transmission of alcoholism after adjustment for the threshold effect.