Directional associations between antisocial behavior and alcohol use disorder symptoms from adolescence through...

A well-established link between antisocial behavior (ASB) and problematic alcohol use in adolescence has been demonstrated, yet the direction of this association across the lifespan remains unclear. Although antisocial conduct may increase exposure to known social and environmental risk factors for developing alcohol use disorder (AUD), alcohol use may also impair social functioning and self-regulation that subsequently increases ASB risk. Using a sibling comparison design in a high-risk sample, this study tested bidirectional associations between symptom counts of ASB and AUD from adolescence through adulthood.

Participants were a sample of 783 probands with adolescent-onset ASB and AUD symptoms at baseline and 556 of their siblings assessed during adolescence (18 years and younger), emerging adulthood (19-26 years), and later adulthood (27 years and older). We applied multilevel cross-lagged panel models to assess lagged associations between ASB and AUD symptoms across three waves. Clustering was specified at the family level, with outcomes centered within families.

Greater within-family ASB in adolescence predicted moderate increases in AUD in emerging adulthood (ß = 0.25, p < 0.001); whereas adolescent AUD did not predict subsequent ASB. Within-family associations between AUD and ASB were not found in the emerging-to-later adult periods.

Accounting for family-level confounding, ASB symptoms in adolescence may be a precursor to AUD in emerging adulthood; whereas AUD and ASB symptoms may follow independent trajectories through adulthood. Findings highlight the importance of considering developmental specificity in the prevention and treatment of copresenting AUD and ASB risk.