Physiological alcohol dependence symptoms in early adulthood: a longitudinal perspective

The developmental course of physiological dependence on alcohol was investigated by estimating the prevalance, stability, and prognostic significance of individual tolerance and withdrawal symptoms, prospectively over 7 years, in 450 young adults. Different prevalence rates and patterns of stability were observed with alternate tolerance items. Consistently low base rates were observed for all withdrawal items. Person-level stability of tolerance and withdrawal indicators was moderate at test-retest intervals of 1 year and increasingly modest at longer intervals. Reporting tolerance and withdrawal in early adulthood was associated with a substantial risk for later alcohol use disorder. Results suggest that the likelihood of experiencing tolerance or withdrawal symptoms may vary as a function of an individual's stage of development and drinking history. Implications for future assessment and classification of alcohol dependence are discussed.