Multi-dimensional predictors of first drinking initiation and regular drinking onset in adolescence: A prospective longitudinal study.

Early adolescent drinking onset is linked to myriad negative consequences. Using the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA) baseline to year 8 data, this study (1) leveraged best subsets selection and Cox Proportional Hazards regressions to identify the most robust predictors of adolescent first and regular drinking onset, and (2) examined the clinical utility of drinking onset in forecasting later binge drinking and withdrawal effects. Baseline predictors included youth psychodevelopmental characteristics, cognition, brain structure, family, peer, and neighborhood domains. Participants (N=538) were alcohol-naïve at baseline. The strongest predictors of first and regular drinking onset were positive alcohol expectancies (Hazard Ratios [HRs]=1.67–1.87), easy home alcohol access (HRs=1.62–1.67), more parental solicitation (e.g., inquiring about activities; HRs=1.72–1.76), and less parental control and knowledge (HRs=.72–.73). Robust linear regressions showed earlier first and regular drinking onset predicted earlier transition into binge and regular binge drinking (βs=0.57–0.95). Zero-inflated Poisson regressions revealed that delayed first and regular drinking increased the likelihood (Incidence Rate Ratios [IRR]=1.62 and IRR=1.29, respectively) of never experiencing withdrawal. Findings identified behavioral and environmental factors predicting temporal paths to youthful drinking, dissociated first from regular drinking initiation, and revealed adverse sequelae of younger drinking initiation, supporting efforts to delay drinking onset. • Pre-drinking youth, family, peer, and neighborhood characteristics all predict alcohol onset. • Youth personality/disposition and parental involvement are most predictive of alcohol use onset. • Age at first drink is a stronger predictor of withdrawal symptoms than weekly drinking onset age. • Delaying first and weekly drinking onset may mitigate potential downstream deleterious effects. [ABSTRACT FROM AUTHOR]