Age at first drink and the first incidence of adult-onset DSM-IV alcohol use disorders
Open accessAbstract
Background: Existing studies of the association between age at first drink (AFD) and the risk of alcohol use disorders (AUD) suffer from inconsistent levels of control and designs that may inflate associations by failure to control for duration of exposure to risk. Methods: This study examined associations between AFD (ages <15 and 15–17 vs. 18+ years) and first incidence of DSM‐IV alcohol dependence, abuse, and specific AUD criteria over a 3‐year follow‐up in a longitudinal study of U.S. drinkers 18 years of age and older at baseline ( n = 22,316), controlling for duration of exposure, family history, and a wide range of baseline and childhood risk factors. Results: After adjusting for all risk factors, the incidence of dependence was increased for AFD < 15 years (OR = 1.38) and for women only with AFD at ages 15 to 17 (OR = 1.54). The incidence of abuse was increased at AFD <15 and 15 to 17 years (OR = 1.52 and 1.30, respectively). Most dependence criteria showed significant associations with AFD, but hazardous drinking and continued drinking despite interpersonal problems were the only abuse criteria to do so. All associations were nonsignificant after controlling for volume of consumption, except that AFD at all ages <18 combined was associated with a reduced likelihood of impaired control, and AFD at ages 15 to 17 was associated with lower odds of drinking more/longer than intended among heavy‐volume drinkers. In a population of low‐risk drinkers that excluded those with positive family histories, personality disorders, and childhood risk factors, there were strong associations between early AFD (<18) and the incidence of dependence (OR = 3.79) and continued drinking despite physical/psychological problems (OR = 2.71), but no association with incidence of abuse. Conclusions: There is a robust association between AFD and the risk of AUD that appears to reflect willful rather than uncontrolled heavy drinking, consistent with misuse governed by poor decision‐making and/or reward‐processing skills associated with impaired executive cognitive function (ECF). Additional research is needed to determine causality in the role of impaired ECF, including longitudinal studies with samples of low‐risk adolescents.
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Early substance use initiation is positively associated with later substance use problems.
“research has provided evidence for the positive relationship between early substance use initiation and smoking, drinking, and drug using and later substance use problems (Dawson et al., 2008; DeWit et al., 2000; Hingson et al., 2006; Merline et al., 2004).”
From Reading for pleasure in childhood and adolescent healthy behaviours: Longitudinal associations using the Millennium Cohort Study (2020) · cites this paper as Dawson et al., 2008
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- Authors
- Dawson, D. A., Goldstein, R. B., Patricia Chou, S., June Ruan, W., & Grant, B. F.
- Affiliations
- National Institutes of Health (US)
- Venue
- Alcoholism: Clinical and Experimental Research
- Publisher
- Wiley
- Published
- 2008-12
- Volume
- 32
- Issue
- 12
- Pages
- 2149-2160
- ISSN
- 0145-6008 (ISSN-L)
- 1530-0277
- PMC
- PMC2760820
- OpenAlex
- W2037989969
- Cited by
- 548
- References
- 1
- Citations by year
- 2026: 23 · 2025: 22 · 2024: 31 · 2023: 34 · 2022: 22 · 2021: 30 · 2020: 47 · 2019: 50 · 2018: 43 · 2017: 35 · 2016: 37 · 2015: 31 · 2014: 40 · 2013: 35 · 2012: 23
- FWCI
- 11.17
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Alcoholism Clinical and Experimental Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Health and Human Services
- National Institutes of Health (Z99‐AA999999)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
- Keywords
- age at first drink, alcoholism, alcohol abuse, adolescent alcohol use, DSM-IV diagnostic criteria, duration of exposure, heavy drinking, women, family history (medicine), childhood risk factors
- MeSH terms
- Adolescent, Age Factors, Alcohol Drinking, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Risk Factors, Incidence, Alcohol-Related Disorders, Diagnostic and Statistical Manual of Mental Disorders, Young Adult
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