Externalising pathways to alcohol‐related problems in emerging adulthood

BACKGROUND: Both ‘early‐onset persistent’ and ‘adolescent‐onset’ conduct problems (CPs) are associated with alcohol‐related problems in emerging adulthood. The escalation of early CPs into criminal behaviour and heavy alcohol consumption prior to emerging adulthood are both likely to be important pathways. METHODS: Data were analysed from 3,038 young people in a UK birth cohort, the Avon Longitudinal Study of Parents and Children. The exposure was developmental trajectories of CPs (‘low’, ‘childhood‐limited’, ‘adolescent‐onset’ and ‘early‐onset persistent’) between ages 4 and 13 years. The mediator was latent classes representing heavy alcohol consumption and/ or criminal behaviour at age 15 years. For the outcome, a quadratic latent growth curve was estimated to capture nonlinear change in alcohol‐related problems between ages 18 and 23 years. RESULTS: Those with ‘early‐onset persistent’ [b(95% CI) = 1.16 (0.17, 2.14)] and ‘adolescent‐onset’ CPs [b(95% CI) = 1.31 (0.17, 2.45)] had higher levels of alcohol‐related problems at age 18 years compared to those with ‘low’ CPs’, but there was little evidence of an association with alcohol‐related problems after age 19 years. There was evidence for an indirect effect of ‘early‐onset persistent’ CPs [b(95% CI) = 1.12 (0.52, 1.72)] on alcohol‐related problems at age 18 years via the latent classes of alcohol and criminal behaviour in adolescence. This was not found for ‘adolescent‐onset’ CPs [b(95% CI) = 0.35 (−0.36, 1.07)]. CONCLUSIONS: Strong associations exist between early CPs, adolescent alcohol consumption and criminal behaviour and alcohol‐related problems at age 18 years. Associations between early CPs and alcohol‐related problems weakened considerably across emerging adulthood.