Disinhibited behavioral problems at age 11 years, including oppositionality, hyperactivity, impulsivity, and inattention, predict an earlier onset of drinking (McGue et al. 2001a, b). Greater externalizing problems indicative of behavioral under-control have been reported to be related to earlier age at first drink (Kuperman et al. 2005). There is also abundant evidence that behavioral under-control is an important determinant of later development of substance use disorders (SUD) (reviewed by Stice et al. 1998; Zucker 2008). Behavioral under-control observed as early as 3 years is predictive of alcohol-related problems at 21 years (Caspi et al. 1996), and in adolescents mediates the relationship between family history of alcoholism and young adult SUD (King and Chassin 2004). Risk for AUD appears to be associated with under-controlled behaviors that may derive from certain personality traits including impulsivity, novelty and sensation-seeking, and extraversion (Sher et al. 1991; Sher and Trull 1994). Interestingly, extraversion in adolescence completely mediates the relationship between family history of alcoholism in multiplex families and earlier onset to begin drinking seen in these offspring when compared to controls (Hill et al. 2000a).
