Reciprocal relationships between adolescent mental health difficulties and alcohol consumption
Reciprocal relationships between adolescent mental health difficulties and alcohol consumption
The directionality of the relationship between adolescent alcohol consumption and mental health difficulties remains poorly understood. This study investigates the longitudinal relationship between alcohol use frequency, internalizing and externalizing symptoms from the ages of 11 to 17. We conducted a random-intercept cross-lagged panel model across three timepoints (ages: 11yrs, 14yrs, 17yrs; 50.4% female) in the Millennium Cohort Study (N = 10,647). Survey weights were used to account for attrition. At each timepoint, past month alcohol use frequency was self-reported, parents and cohort members reported internalizing/externalizing symptoms using the Strengths and Difficulties Questionnaire. We controlled for alcohol expectancies, sex, and four cumulative risk indices (perinatal risk, early childhood adverse parenting, longitudinal parent-level risk occurrence, and persistent household socioeconomic deprivation). More frequent past month alcohol use at age 11 predicted increased internalizing symptoms at age 14 (β = 0.06; p =.01). More frequent past month alcohol use at age 14 predicted increased externalizing symptoms at age 17 (β = 0.11; p <.001). Increased internalizing symptoms consistently predicted reduced alcohol use at the next timepoint throughout the study period (11 years: β= -0.04; p =.03; 14 years: β= -0.09; p <.001). Increased externalizing symptoms at age 11 predicted increased alcohol consumption at age 14 (β = 0.06; p =.004). Frequent adolescent alcohol consumption represents a significant risk for subsequent mental health difficulties. Externalizing symptoms and alcohol use frequency appear to exacerbate one another. Internalizing symptoms may reduce the risk of frequent alcohol consumption. Incorporating routine alcohol screening into adolescent mental health treatment settings could reduce the risk of comorbid externalizing and alcohol use disorders.
Alcohol consumption, Developmental psychopathology, Mental health difficulties, Random-intercept cross lagged panel model
Kiri, Janet
c72113ab-1cca-4a3d-a908-eca007516a72
Hall, James
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Cortese, Samuele
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Brandt, Valerie
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Kiri, Janet
c72113ab-1cca-4a3d-a908-eca007516a72
Hall, James
29e17a2b-dca0-4b91-be02-2ace4abaa6c4
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
Brandt, Valerie
e41f5832-70e4-407d-8a15-85b861761656
Kiri, Janet, Hall, James, Cortese, Samuele and Brandt, Valerie
(2025)
Reciprocal relationships between adolescent mental health difficulties and alcohol consumption.
European Child & Adolescent Psychiatry.
(doi:10.1007/s00787-025-02644-6).
Abstract
The directionality of the relationship between adolescent alcohol consumption and mental health difficulties remains poorly understood. This study investigates the longitudinal relationship between alcohol use frequency, internalizing and externalizing symptoms from the ages of 11 to 17. We conducted a random-intercept cross-lagged panel model across three timepoints (ages: 11yrs, 14yrs, 17yrs; 50.4% female) in the Millennium Cohort Study (N = 10,647). Survey weights were used to account for attrition. At each timepoint, past month alcohol use frequency was self-reported, parents and cohort members reported internalizing/externalizing symptoms using the Strengths and Difficulties Questionnaire. We controlled for alcohol expectancies, sex, and four cumulative risk indices (perinatal risk, early childhood adverse parenting, longitudinal parent-level risk occurrence, and persistent household socioeconomic deprivation). More frequent past month alcohol use at age 11 predicted increased internalizing symptoms at age 14 (β = 0.06; p =.01). More frequent past month alcohol use at age 14 predicted increased externalizing symptoms at age 17 (β = 0.11; p <.001). Increased internalizing symptoms consistently predicted reduced alcohol use at the next timepoint throughout the study period (11 years: β= -0.04; p =.03; 14 years: β= -0.09; p <.001). Increased externalizing symptoms at age 11 predicted increased alcohol consumption at age 14 (β = 0.06; p =.004). Frequent adolescent alcohol consumption represents a significant risk for subsequent mental health difficulties. Externalizing symptoms and alcohol use frequency appear to exacerbate one another. Internalizing symptoms may reduce the risk of frequent alcohol consumption. Incorporating routine alcohol screening into adolescent mental health treatment settings could reduce the risk of comorbid externalizing and alcohol use disorders.
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s00787-025-02644-6
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Accepted/In Press date: 9 January 2025
e-pub ahead of print date: 18 January 2025
Keywords:
Alcohol consumption, Developmental psychopathology, Mental health difficulties, Random-intercept cross lagged panel model
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Local EPrints ID: 499273
URI: http://eprints.soton.ac.uk/id/eprint/499273
ISSN: 1018-8827
PURE UUID: 840c15fb-e247-400e-b430-bff3b0bfb2ee
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Date deposited: 13 Mar 2025 17:38
Last modified: 29 Aug 2025 01:55
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Author:
Janet Kiri
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