Familial density of alcoholism and onset of adolescent drinking.

OBJECTIVE Utilizing a longitudinal prospective design, the purpose of this study was to: (1) assess the age of onset to begin drinking in relation to family history of alcoholism using survival analysis, and (2) examine the importance of selected risk factors in predicting outcome, using a Cox proportional hazards model analysis. METHOD Fifty-two children and adolescents at low risk for developing alcoholism and 73 children and adolescents from high-risk families were studied. Subjects, spanning the ages of 7 to 18, were evaluated annually (268 total evaluations), providing 2.1 waves of longitudinal data concerning age of onset along with a number of predictors (positive familial loading of alcoholism, extraversion, and manifest anxiety scores). RESULTS High-risk children showed a significantly earlier age of onset to begin drinking. The Cox proportional hazards analysis revealed that the onset could be predicted by a positive familial loading of alcoholism and extraversion. Further analyses revealed that extraversion was a mediator of the familial density effect. CONCLUSIONS Age of onset to begin drinking has been shown in general population studies to predict the likelihood of developing alcohol/abuse/dependence problems. Further follow-up will determine if these high-risk children develop alcohol abuse/dependence at higher rates than control children. Further follow-up would also establish links between early childhood predictors, such as having an extraverted temperament and development of alcohol problems.