Desistance and Severity of Alcohol Use Disorder: A Lifespan-Developmental Investigation.

Key to an understanding of alcohol use disorder (AUD) are the drinking-related reductions that begin in young adulthood and continue throughout the adult lifespan. Research is needed to precisely characterize the form of these reductions, including possible developmental differences across the lifespan. Using U.S.-representative data, we estimated multiple-group Markov models characterizing longitudinal transitions among five drinking statuses and differences in transition patterns across six adult age periods. While past research indicates relative developmental stability in overall AUD-desistance rates, we found far higher rates of Severe-AUD desistance in young adulthood relative to later ages. Especially considering the dramatic change reflected by Severe-AUD desistance (from 6+ symptoms to 0-1 symptoms), this result indicates a substantial developmental shift, with Severe-AUD-desistance rates peaking at 43-50% across ages 25-34 and then dropping to 22-24% across ages 35-55. We discuss implications regarding practical significance of young-adult "maturing out" and predictions regarding lifespan variability in desistance mechanisms.