Interactions Between Internalizing Symptoms and Urgency in the Prediction of Alcohol Use and Expectancies Among Low-Income, Minority Early Adolescents

Alcohol use in late adolescence and early adulthood: The role of generalized anxiety disorder and drinking to cope motives

BACKGROUND

The relationship between anxiety and alcohol use is unclear, and moderating factors, such as drinking to cope (DTC) motives, may explain mixed findings.

METHODS

Using the Avon Longitudinal Study of Parents and Children (ALSPAC), we examined associations between generalized anxiety disorder (GAD) at age 18 and frequent drinking, frequent bingeing, hazardous drinking, and harmful drinking at ages 18 (unadjusted n = 3462) and 21 (unadjusted n = 2076), in a sample of late adolescent drinkers. Analyses were adjusted for sociodemographic, parental, and adolescent confounders. We also examined whether DTC motives influenced the strength and direction of associations between GAD and alcohol use.

RESULTS

GAD was positively associated with all alcohol outcomes at baseline (unadjusted OR (95% CI): frequent drinking 1.40 (1.02-1.91); frequent bingeing 1.40 (0.96-2.04); hazardous drinking 1.44 (1.08-1.92); harmful drinking 1.98 (1.22-3.23)). GAD increased the odds of harmful drinking at age 21 (unadjusted OR 1.72, 95% CI 1.09-2.73), but there was no clear evidence of a longitudinal relationship between GAD and the other alcohol use outcomes. There was no clear evidence of a GAD x DTC interaction on alcohol use at ages 18 or 21. Findings were consistent across various multiply imputed datasets.

CONCLUSIONS

In adolescence, GAD symptoms are associated with frequent drinking, frequent bingeing, hazardous drinking, and harmful drinking. In early adulthood, associations remain for harmful drinking only. DTC motives do not appear to moderate the relationship at either age.

Associations of child and adolescent anxiety with later alcohol use and disorders: a systematic review and meta-analysis of prospective cohort studies

BACKGROUND AND AIMS

Despite a wealth of literature, the relationship between anxiety and alcohol use remains unclear. We examined whether (a) child and adolescent anxiety is positively or negatively associated with later alcohol use and disorders and (b) study characteristics explain inconsistencies in findings.

DESIGN AND SETTING

We conducted a systematic review of 51 prospective cohort studies from 11 countries. Three studies contributed to a meta-analysis. We searched PubMed, Scopus, Web of Science and PsycINFO databases, and studies were included if they met the following criteria: English language publication, human participants, anxiety exposure (predictor variable) in childhood or adolescence and alcohol outcome at least 6 months later.

PARTICIPANTS

Study sample sizes ranged from 110 to 11 157 participants. Anxiety exposure ages ranged from 3 to 24 years, and alcohol outcome ages ranged from 11 to 42 years.

MEASUREMENTS

Ninety-seven associations across 51 studies were categorized by anxiety exposure (generalized anxiety disorder, internalizing disorders, miscellaneous anxiety, obsessive compulsive disorder, panic disorder, separation anxiety disorder, social anxiety disorder and specific phobias) and alcohol use outcome (drinking frequency/quantity, binge drinking and alcohol use disorders).

FINDINGS

The narrative synthesis revealed some evidence for a positive association between anxiety and later alcohol use disorders. Associations of anxiety with later drinking frequency/quantity and binge drinking were inconsistent. Type and developmental period of anxiety, follow-up duration, sample size and confounders considered did not appear to explain the discrepant findings. The meta-analysis also showed no clear evidence of a relationship between generalized anxiety disorder and later alcohol use disorder (odds ratio = 0.94, 95% confidence interval = 0.47-1.87).

CONCLUSIONS

Evidence to date is suggestive, but far from conclusive of a positive association between anxiety during childhood and adolescence and subsequent alcohol use disorder.