Developmental shifts in the anxiety and hazardous alcohol use relationship: Moderating factors from adolescence to young adulthood.

Findings on the relationship between anxiety symptoms and hazardous alcohol use across adolescence and young adulthood has been mixed. Evidence suggests that anxiety may function as either a risk or protective factor, depending on the age examined. Moderating biological and psychological factors may help explain these age-related differences. To clarify the developmental nature of the anxiety-alcohol relationship, this study examined both cross-sectional and longitudinal associations across seven timepoints, spanning mean ages 13.4 to 20.5 years. Potential biological (sex) and psychological (depressive symptoms, externalising symptoms, and drinking motives) moderators of the anxiety-alcohol relationship were also explored. Data were drawn from the Australian Climate and Preventure study (n = 418). Cross-sectional analyses revealed a consistent positive association between anxiety and hazardous drinking across the first five waves (ages 13.4 to 16.4), which did not persist into young adulthood. Evidence to support longitudinal associations from one timepoint to the next was weak, although middle adolescence (ages 14.5-15.4) emerged as a potentially critical developmental window. The cross-sectional effect of anxiety on hazardous alcohol use during early adolescence was weaker for girls than boys. Symptoms of depression, impulsivity, and sensation seeking, as well as drinking motives (coping-anxiety, conformity, enhancement, and social motives) significantly moderated the cross-sectional anxiety-alcohol relationship up to middle adolescence. These findings highlight early to middle adolescence as a key period for interventions aimed at preventing the escalation and persistence of alcohol-related harms. Tailored approaches may be particularly important for youth experiencing elevated negative affect and externalising symptoms.