Finally, a possible mechanism underlying the telescoping effect is depressive affect. Depression is associated with escalation to heavy drinking [41] and rapid progression from first drink to alcohol dependence [27], perhaps due to negative affect regulation or changes in the underlying neurobiology of the addictive process [21]. Given higher rates of emotional distress among girls [42] and greater rates of depression in the present study, depressive affect may account for telescoping among girls. Given that early onsetters had slower progression but were more likely to be depressed, this mechanism may not explain age of onset differences.
