Developmental prediction model for early alcohol initiation in Dutch adolescents.

OBJECTIVE Multiple factors predict early alcohol initiation in teenagers. Among these are genetic risk factors, childhood behavioral problems, life events, lifestyle, and family environment. We constructed a developmental prediction model for alcohol initiation below the Dutch legal drinking age (16 years), elaborating on the pathways identified by earlier studies. METHOD A set of 22 prospectively measured variables, previously associated with alcohol initiation, was examined by path analytic techniques in a sample of 1,804 Dutch adolescents (ages 13-15 years, 56% girls). The predictors included genetic risk for alcohol initiation and behavioral/emotional problems; prenatal and childhood stressors and childhood behavioral/emotional problems; and adolescent behavioral/emotional problems, lifestyle, family functioning, and peer-related factors. RESULTS The model explained 66% of variance in early alcohol initiation. Subjects at higher genetic risk of alcohol initiation who had friends who drank alcohol and who had started smoking at an early age were at increased risk of initiating alcohol use before age 16. Behavioral (externalizing) problems were moderately and indirectly associated with early alcohol initiation, and emotional (internalizing) problems were marginally and indirectly associated with alcohol initiation. CONCLUSIONS The Netherlands has relatively lenient alcohol laws.In this permissive environment, early alcohol initiation is explained by alcohol-specific genetic risk, smoking initiation, and peer-related factors, whereas behavioral and emotional problems are only indirectly related to early alcohol initiation.