Precursors and consequences of heavy alcohol use in adolescence

© 2006 Dr. Katherine E. WatersThere is evidence of high and escalating rates of alcohol use in adolescents today and concern that high use is related to concurrent and later difficulties. Despite overlap with other substances, alcohol is by far the most commonly used substance during adolescence and is considered normative in some countries. Thus, it is important for research to focus on alcohol use in adolescence and early adulthood, to determine its patterns, developmental paths and outcomes. This study used extensive longitudinal data from a large community sample, followed from infancy to young adulthood (the Australian Temperament Project), and sought to examine the precursors and consequences of adolescent alcohol use. Firstly, it sought to identify clusters of adolescents with different alcohol usage patterns. Next, predictors of adolescent alcohol use were investigated to determine whether developmental paths differed for moderate and heavy adolescent alcohol users. Sex differences in the patterns and precursors of alcohol use were explored. In addition, a small sub-sample of participants was followed into young adulthood to examine the psychosocial outcomes of different patterns of adolescent alcohol use. Results confirmed high levels of alcohol use among Australian adolescents, and striking increases over time. Five alcohol-use clusters emerged representing trajectories from 13 to 18 years, with somewhat different developmental pathways. As hypothesised, individual risk factors, identifiable in childhood, were predictive of heavy alcohol use, although effects were small, while social risk factors were predictive of both heavy and moderate alcohol use. This finding has implications for intervention, supporting both early intervention for behaviour problems and social skill deficits, as well as multi-modal prevention efforts during adolescence incorporating a range of social domains. Importantly, there were no sex differences in patterns of adolescent alcohol use. Regarding predictors, some minor sex differences emerged in the link between childhood behaviour problems and heavy alcohol use, but not in the manner expected, suggesting that more research is required to determine the presence or absence of sex-specific pathways. Finally, alcohol-use patterns changed between late adolescence and young adulthood, revealing significant increases for most groups. While most adolescent abstainers were drinking in early adulthood, their earlier abstinence appeared to protect them against harmful levels of use. Moderate users experienced the most marked increases, reaching levels similar to heavy users in young adulthood. Unexpectedly however, adolescent alcohol-use patterns did not predict young-adult psychosocial adjustment, suggesting that alcohol use is more closely related to concurrent than future adjustluent, and indicating a need for further longitudinal research in this area