The experience of physiological and psychosocial alcohol-related harms across adolescence and its association with alcohol use disorder in early adulthood: A prospective cohort study

Background Different forms of alcohol-related harm (e.g., hangovers, fighting) may confer differential risk of clinically relevant alcohol problems. We examine: (i) patterns of transition in experiencing alcohol-related harms across adolescence; (ii) whether factors in early adolescence predict transition patterns; and (iii) whether transition patterns predict later alcohol use disorder (AUD) symptoms. Methods We used a longitudinal Australian cohort (n = 1828) to model latent class transition patterns of alcohol-related harms across three timepoints (M-age = 13.9, 16.8, 18.8 years). Regression models assessed whether child, peer, and parent factors in early adolescence (M-age = 12.9) predicted harms transition patterns and whether these patterns predicted AUD symptoms in early adulthood (M-age = 19.8). Results Five transition patterns characterized most of the cohort (n approximate to 1609, 88.0%): (i) minimal harms (n approximate to 381, 20.8%); (ii) late physiological harms (n approximate to 702, 38.4%); (iii) early physiological harms (n approximate to 226, 12.4%); (iv) late all harms (n approximate to 131, 7.2%); and (v) gradual all harms (n approximate to 169, 9.2%). With late physiological harms as the reference, females had increased risk of experiencing early physiological harms (relative risk [RR]: 2.15; 99.5% CI: 1.19, 3.90). Late all harms (RR: 1.71; CI: 1.19, 2.47) and gradual all harms (RR: 1.84; CI: 1.37, 2.47) were each associated with increased odds of meeting criteria for AUD, even when patterns of alcohol consumption are considered. Conclusions Adolescents display heterogeneous transition patterns across physiological and psychosocial alcohol-related harms. Females are at greater risk of experiencing early physiological harms. Experience of both physiological and psychosocial harms in late adolescence is an important and potentially modifiable precursor to clinically relevant alcohol problems in early adulthood.