Alcohol Use During the Transition to Adulthood

by National Institute of Health

People's alcohol use and abuse tend to increase, peak, and then decrease as they go through the transition to adulthood, a period that spans the late teenage years through the mid- to late twenties. However, more specific pathways, or trajectories, of alcohol use are embedded within the normative alcohol use pathway. Studying these trajectories of alcohol use can elucidate the origins and consequences of alcohol problems as well as guide prevention and treatment programs. Models of the average trend (i.e., normative trajectory approaches) are simpler than models that posit multiple trajectories and may replicate more consistently across samples and age spans. However, multiple-trajectory approaches allow for a more specific understanding of the origins, developmental course, and outcomes of alcohol use and abuse among adolescents and young adults.

This article considers the average, or normative, developmental course of alcohol use and abuse, as well as some common developmental pathways, or trajectories, embedded within the normative course. The article also reviews key research on the events and circumstances during adolescence that predict different paths of alcohol use, as well as outcomes during young adulthood that are associated with different trajectories.

In the years after people graduate from high school, they undergo major transitions in every domain of their lives. Young people may embark on diverse life paths and the age and order in which they reach developmental milestones tend to vary widely. Flexibility and self-direction in day-to-day life increase for many, and their geographic mobility may be greater than at any other time of life. In the past few decades, this transition period has lengthened considerably, and people tend to begin to settle into adult roles, such as work and marriage, later than their counterparts in past generations. These changes have led Arnett to argue that this period should be viewed as unique and important in its own right rather than as simply a staging ground for adulthood.

On average, people start drinking during their adolescence, increase the amounts they drink into their early twenties, and decrease the amounts when they take on adult roles. Some personal and role changes (such as becoming a college student) coincide with these increases, and others (such as becoming a spouse, parent, or worker) coincide with the decreases.

Many young people establish lifelong patterns of alcohol use (and nonuse) during this period of emerging adulthood. Others take a different trajectory, engaging in a particular pattern of use only in their late teen or young adult years and not thereafter. Variations in the timing and intensity of changes in alcohol consumption can be predicted partly on the basis of demographic, psychological, social, and behavioral factors. Hidden within the normative pattern are subgroups of people whose drinking patterns take different developmental trajectories over time. By identifying common trajectories of alcohol use and abuse across adolescence and young adulthood, researchers can better understand the origins of alcohol use disorders, predict different outcomes, and plan prevention and intervention programs. At a clinical level, knowledge of the drinking patterns that define the different subgroups can expedite the early identification of alcohol problems, facilitate diagnosis, and inform treatment.

Alcohol Use Patterns From Late Adolescence to Young Adulthood

Studies that aim to identify the causes and likely outcomes of young adults' alcohol use typically consider the age at which young people begin drinking and the frequency and intensity of alcohol use. One common approach to examining associations between drinking and age is to compare different age groups at once (cross-sectional studies). However, this method provides limited information about how a person's alcohol use may change over time. Although cross-sectional studies can identify average developmental trends in alcohol use, they are less effective at predicting one person's future drinking patterns based on his or her past and present alcohol use.

In contrast to cross-sectional studies, studies that track the same people over time (long-term longitudinal studies) allow investigators to examine why some people do not follow trajectories that seemed likely based on their earlier behavior. Trajectory approaches using longitudinal data focus on a person's course of alcohol use over several years.1 (1 A major distinction between trajectory models and other longitudinal analyses is that nontrajectory longitudinal analyses compare only two time points. Even if data are collected on multiple occasions, the analyses predict Time 2 from Time 1, and Time 3 from Time 2, and so on. In contrast, trajectory approaches map the cumulative progression of behavior over time.) Some emphasize the trajectory that is most commonly observed within a population (normative trajectory approaches). A second kind of trajectory approach, known as a multiple-trajectory (or taxonomy) approach, focuses on distinct subgroups of people who follow similar trajectories. For example, a study using a multiple-trajectory approach might compare a group of people who are chronic heavy drinkers and a group of people who are decreasing their alcohol use. These approaches are discussed in the following sections.

Normative Trajectory Approaches: Describing the Average Course

Many pivotal research questions pertain to the normative course of alcohol use and abuse as well as to how important factors associated with alcohol use, such as having friends who drink, are correlated and predict changes in drinking. Although not all people follow the same pathway, understanding the average or normative developmental trend is of significant value for science and for prevention.

One benefit of normative trajectory approaches is their parsimony: Statistical analyses that describe the average trend (and note individual differences around it) are simpler to understand than multiple-trajectory analyses because they focus on the total sample and tend to be less mathematically complex. Furthermore, because they focus on the total sample (rather than sample-specific subgroups, which might show greater variability across different studies), these models seem to replicate more consistently across samples and age spans. Finally, because they are less complex, normative trajectory approaches can more readily incorporate measures of stable factors (e.g., gender) and time-varying factors (e.g., having substance-using peers) that are associated with alcohol use patterns.

Two analytic methods used in normative trajectory approaches are latent growth curve (LGC) models and multilevel models (MLM). These statistical techniques mathematically summarize the behavior of a group of people across multiple occasions, yielding a trajectory, or curve. LGCs are well suited to examining whether trajectories of multiple variables are correlated. For example, Duncan and colleagues demonstrated that some adolescents' substance use (first variable) trajectories were predicted by their older siblings' substance use (second variable) trajectories across a 3-year period.

In addition to modeling cumulative developmental trajectories, MLMs also can be used to examine whether, over time, levels of a variable (e.g., alcohol use) rise and fall in tandem with other fluctuating variables (e.g., mood, time spent hanging out in unsupervised settings). For example, Maggs and Schulenberg showed that adolescents reported greater alcohol use on occasions when they gave more reasons in favor of drinking and fewer reasons against it, independent of the developmental trend toward more alcohol use.

About the Author

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