Early onset problem behaviors and alcohol, tobacco, and other substance use disorders in young adulthood.

OBJECTIVE: Ten early onset problem behaviors were used to prospectively predict alcohol, tobacco, cannabis, and cocaine disorders in young adulthood (mean age=28.6 yrs) for a U.S. community sample of 671 participants.
METHOD: Data from a longitudinal study of participants who were recruited from high schools during adolescence and followed into young adulthood were used to evaluate prospective associations. The relationship between early onset problem behaviors, reported when participants were age 16 years, and psychiatric diagnoses assessed in young adulthood was tested. Structural equation models were used to evaluate both generality and specificity hypotheses regarding relationships between early onset problem behaviors and young adult disorders.
RESULTS: Findings supported the specificity hypothesis in that "like" early onset problem behaviors significantly predicted "like" young adult outcomes (e.g., early cocaine use predicted cocaine disorders). Furthermore, eliminating such "like" predictors in regression equations resulted in a 36% reduction in the amount of variance accounted for by the equation. The generality hypothesis was also supported in that a larger number of early onset problem behaviors strengthened the prediction of young adult disorders beyond the "like" attribute, and a dose-response pattern indicated that additional early onset problem behaviors increased the probable occurrence of a young adult disorder.
CONCLUSIONS: A comprehensive framework relating early onset problem behaviors to young adult substance disorders will require the integration of both generality and specificity hypotheses, and a developmental orientation focused on the unfolding of mediating and moderating processes. Early screening of multiple, rather than single, early onset problems is also discussed.