As expected, EXT was robustly associated with all subsequent alcohol transitions, and earlier alcohol involvement was prospectively associated with increased hazards for EXT onset. Conduct disorder symptoms exhibited the most consistent associations with all alcohol transitions, and alcohol initiation increased hazards for conduct disorder symptoms. ADHD hyperactive—but not inattentive—symptoms were associated with all transitions except progression from initiation to intoxication and from intoxication to first AUD symptom. Oppositional defiant disorder symptoms were linked with increased hazards for future alcohol initiation, but not vice versa. These findings align with prior work showing that ‘disruptive behavior disorders” are associated with shorter time to alcohol problems and AUD onset (Edwards, Gardner, Hickman, & Kendler, 2016; Farmer et al., 2016), and that childhood/adolescent conduct symptoms and hyperactive—but not inattentive—ADHD symptoms are prospectively associated with later substance involvement (Elkins et al., 2018; Fergusson et al., 2007). Studies in young adults have documented associations between inattentive symptoms, which tend to be stable over time, and alcohol use and AUD (Glass & Flory, 2012; Grazioli et al., 2019; Roberts, Peters, Adams, Lynam, & Milich, 2014). Hyperactivity typically
