title: Relations Among Internalizing and Externalizing Symptoms and Drinking Frequency During Adolescence.
abstract: BACKGROUND
  In adolescence, internalizing (e.g., anxious, depressive, and withdrawn) and externalizing (e.g., aggressive, oppositional, delinquent, and hyperactive) symptoms are related with alcohol use. However, the directionality among internalizing symptoms, externalizing symptoms, and alcohol use during adolescence is equivocal. Moreover, gender differences and similarities among these behaviors are not definitive in existing literature.
  
  
  OBJECTIVE
  This study examined longitudinal relationships between internalizing and externalizing symptoms and past-month alcohol use among adolescent boys and girls.
  
  
  METHODS
  Using longitudinal survey data from a study of community-dwelling adolescents (n = 724), we estimated cross-lagged structural equation models to test relations between internalizing and externalizing symptoms (as measured by the Youth Self Report, YSR [Achenbach, 1991]) and self-report alcohol use in the past month among adolescents. Gender differences were tested in a multiple group structural equation model.
  
  
  RESULTS
  Alcohol use at age 12 was a predictor of internalizing and externalizing symptoms at age 15 for both boys and girls. With regard to gender differences, girls demonstrated an association between internalizing symptoms and drinking at age 12, whereas boys showed a stronger association between externalizing symptoms and drinking at age 18.
  
  
  CONCLUSIONS
  Early alcohol use is problematic for youth, and results of this study lend support to prevention programs for youth. Preventing or curbing early drinking may offset later externalizing and internalizing symptoms, as well as ongoing alcohol use, regardless of gender.
authors.affiliation: a School of Social Work , University of Maryland , Baltimore, Baltimore , Maryland , USA.
authors.forename: Hyun-Jin
authors.initials: HJ
authors.lastname: Jun
authors.affiliation: a School of Social Work , University of Maryland , Baltimore, Baltimore , Maryland , USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Sacco
authors.affiliation: a School of Social Work , University of Maryland , Baltimore, Baltimore , Maryland , USA.
authors.forename: Charlotte Lyn
authors.initials: CL
authors.lastname: Bright
authors.affiliation: a School of Social Work , University of Maryland , Baltimore, Baltimore , Maryland , USA.
authors.forename: Elizabeth A S
authors.initials: EA
authors.lastname: Camlin
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000374:Aggression; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology; D001007:Anxiety / Q000523:psychology; D002641:Chicago / Q000453:epidemiology; D002648:Child; D003863:Depression; D004644:Emotions; D005260:Female; D006801:Humans; D007604:Juvenile Delinquency; D008137:Longitudinal Studies; D008297:Male; D011581:Psychological Tests; D012044:Regression Analysis; D017678:Sex Distribution; D000066608:Underage Drinking / Q000523:psychology* / Q000706:statistics & numerical data*
keywords: adolescence; alcohol; drinking; externalizing symptoms; gender; internalizing symptoms