Many studies have explored the relationship between internalizing symptoms and alcohol use during adolescence and into adulthood, with most reporting a positive association (Goodwin et al., 2004; Marmorstein, 2009; Marmorstein, 2010; McCarty et al., 2012; Needham, 2007). However, there are relatively fewer reports on the association between childhood internalizing symptoms and adolescent alcohol outcomes. Some evidence from prospective studies suggests that individuals who experience internalizing symptoms during childhood and/or early adolescence are at an increased risk of early alcohol use (Crum et al., 2008a; Kaplow et al., 2001; King et al., 2004; Marmorstein et al., 2010b). However, others have reported a negative association between childhood internalizing symptoms and alcohol use (Maggs et al., 2008), or no association (Englund et al., 2008). Relationships could differ across the sexes, and across alcohol outcomes (Crum et al., 2008b). Thus, the predictive value of childhood internalizing symptoms with respect to alcohol use in early adolescence is not well established. The relative paucity of studies on the relation between these phenotypes, particularly in large representative samples, impedes our understanding of factors contributing to early alcohol use.
