Sequence of alcohol involvement from early onset to young adult alcohol abuse: differential predictors and moderation by family-focused preventive intervention.

AIMS: This study tests risk factors for four dimensions of alcohol use in the sequence from (i) early onset prior to age 13 to (ii) adolescent alcohol use and (iii) alcohol problems to (iv) young adult alcohol abuse. It also examines whether family-focused preventive interventions buffer predictive relationships.

DESIGN

Data were from a randomized prevention trial extending from ages 11 to 21 years.

SETTING

Families of sixth graders enrolled in 33 rural schools in the Midwestern United States were invited to participate.

PARTICIPANTS

Families (n = 667) were pretested and assigned randomly to a control group (n = 208) or to family interventions (n = 459). The average age of participating youth was 11.3 years when the study began (52% female).

MEASUREMENTS: Questionnaire data were collected on alcohol dimensions during adolescence (early onset, alcohol use, alcohol problems) and young adulthood (alcohol abuse), and on risk factors in early adolescence (male gender, impulsive behaviors, aggression-hostility, peer deviance and parent problem drinking).

FINDINGS: Impulsive behaviors predicted early onset, peer deviance predicted alcohol use and parent problem drinking predicted alcohol problems (P < 0.05). Aggression-hostility and alcohol problems predicted alcohol abuse in the control group (P < 0.05), but not in the family interventions group (P > 0.05).

CONCLUSIONS

Different dimensions of alcohol use and problems from before age 13 to young adulthood are predicted by different risk factors. Family-focused preventive interventions can reduce the influence of some of these risk factors, including early adolescent aggression-hostility and late adolescent alcohol problems.