Alcohol misuse and internalizing problems are common, contribute substantially to the global mental health burden, and frequently co-occur. Alcohol experimentation typically begins during adolescence, with over 20% of US students reporting having had a drink by age 13 (Centers for Disease Control and Prevention, 2012); “early-onset drinking” is defined differently across studies, ranging from age 12 and earlier to age 15 and earlier (Donovan and Molina, 2011). Internalizing problems can begin in early childhood, with 10–15% of children or early adolescents experiencing some symptoms of depression (Smucker et al., 1986), though the prevalence of clinical depression in children is low (<5%, Birmaher et al., 1996; Fleming et al., 1989). Anxiety disorders are relatively common, with a prevalence approaching 10–20% in very young children, older children, and adolescents (Costello, 1989; Pine, 1997). Despite abundant research on both childhood internalizing symptoms and adolescent alcohol use, questions remain about their relationship. Does the unfolding of internalizing symptoms during childhood have an impact on adolescent alcohol use, or are the two unrelated?
