Childhood Conduct Problems Predict Age of First Drink

Behavior problems are better predictors of when children will have their first drink than a family history of alcohol dependence, according to researchers here.

For each of 13 conduct problems a child had - issues such as fighting, lying, stealing, or skipping school - the age of the first drink decreased by about three months, said psychiatrist Samuel Kuperman, M.D., of the University of Iowa in a study published in the October issue of Alcoholism: Clinical and Experimental Research.

However, having a parent or several second-degree relatives with alcohol dependence did not influence the age of first drink, Dr. Kuperman and colleagues reported.

Many psychiatrists believe that the age of a first drink is an important predictor of negative alcohol-related outcomes later in life, such as marital, legal, and job problems, the investigators noted.

“This study helps put things in perspective,” they wrote. “It is not just the age at first drink that relates to negative outcomes. There are often bad things happening to these children, and the age of first drink represents just one of them and is not the most important one.”

The researchers analyzed data from 339 children, ages seven to 17, and their families who are part of the Collaborative Study on the Genetics of Alcoholism, an ongoing project supported by the National Institute on Alcohol Abuse and Alcoholism. Data from this group were compared with a control group of 101 families.

To identify what factors might predict an early age of first drink, the team analyzed several behaviors and conditions, including attention-deficit hyperactivity symptoms, conduct disorder symptoms (such as fighting, lying, stealing, skipping school), anxiety and depression, and family history of alcoholism or antisocial personality disorder.

Of these factors, only conduct disorder symptoms were strongly associated with age at first drink (P=.0001). There was a weak association with the number of adult siblings with alcohol dependence, but this only verged on statistical significance (P=.0413) and probably represents an environment conducive to early drinking rather than a genetic cause, the researchers said.

Dr. Kuperman and colleagues are engaged in further studies of this cohort to determine the extent to which conduct problems may contribute to alcohol dependence and related negative outcomes later in life.

Source: Alcoholism: Clinical and Experimental Research

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Revision date: June 11, 2011
Last revised: by Dave R. Roger, M.D.