Childhood and adolescent predictors of heavy episodic drinking and alcohol use disorder at ages 21 and 33: a domain-specific cumulative risk model.

OBJECTIVE Guided by a domain-specific cumulative risk model and an emerging notion of general and alcohol-specific influences, this study examined whether general and alcohol-specific influences from family, peer, and school contexts in childhood and adolescence differentially predict heavy episodic drinking and alcohol use disorder at two developmental periods: the transition to adulthood (age 21) and later in adulthood (age 33). METHOD Data are from a longitudinal panel study (n = 808) examining the etiology of substance use problems and associated behavior problems from age 10 to age 33 in a Northwest United States urban community sample. The sample is ethnically diverse and evenly distributed by gender (51% male). RESULTS At age 21, alcohol problems were most consistently predicted by adolescent family alcohol and peer alcohol environments and by peer general environment, but not by general family functioning. Conversely, by age 33, alcohol problems were more consistently predicted by general poor family functioning in adolescence and not by family alcohol or any of the peer environment measures. CONCLUSIONS Adolescent family and peer alcohol environment influenced alcohol problems at the transition to adulthood. However, alcohol problems later in adulthood were more strongly associated with general poor family functioning in adolescence. These results suggest that alcohol prevention efforts should involve both components designed to reduce alcohol-specific risk and components to improve general family and peer environments during childhood and adolescence.