title: A prospective longitudinal model predicting early adult alcohol problems: evidence for a robust externalizing pathway.
abstract: BACKGROUND
  Risk factors for alcohol problems (AP) include biological and environmental factors that are relevant across development. The pathways through which these factors are related, and how they lead to AP, are optimally considered in the context of a comprehensive developmental model.
  
  
  METHODS
  Using data from a prospectively assessed, population-based UK cohort, we constructed a structural equation model that integrated risk factors reflecting individual, family and peer/community-level constructs across childhood, adolescence and young adulthood. These variables were used to predict AP at the age of 20 years.
  
  
  RESULTS
  The final model explained over 30% of the variance in liability to age 20 years AP. Most prominent in the model was an externalizing pathway to AP, with conduct problems, sensation seeking, AP at age 17.5 years and illicit substance use acting as robust predictors. In conjunction with these individual-level risk factors, familial AP, peer relationships and low parental monitoring also predicted AP. Internalizing problems were less consistently associated with AP. Some risk factors previously identified were not associated with AP in the context of this comprehensive model.
  
  
  CONCLUSIONS
  The etiology of young adult AP is complex, influenced by risk factors that manifest across development. The most prominent pathway to AP is via externalizing and related behaviors. These findings underscore the importance of jointly assessing both biologically influenced and environmental risk factors for AP in a developmental context.
authors.affiliation: Department of Psychiatry,Virginia Institute for Psychiatric and Behavioral Genetics,Virginia Commonwealth University,Richmond, VA,USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Edwards
authors.affiliation: Department of Psychiatry,Virginia Institute for Psychiatric and Behavioral Genetics,Virginia Commonwealth University,Richmond, VA,USA.
authors.forename: C O
authors.initials: CO
authors.lastname: Gardner
authors.affiliation: Department of Psychiatry,Virginia Institute for Psychiatric and Behavioral Genetics,Virginia Commonwealth University,Richmond, VA,USA.
authors.forename: M
authors.initials: M
authors.lastname: Hickman
authors.affiliation: Department of Psychiatry,Virginia Institute for Psychiatric and Behavioral Genetics,Virginia Commonwealth University,Richmond, VA,USA.
authors.forename: K S
authors.initials: KS
authors.lastname: Kendler
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000235:genetics; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008960:Models, Psychological; D015999:Multivariate Analysis; D010379:Peer Group; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Alcohol problems; Avon Longitudinal Study of Parents and Children; development; externalizing pathways