That said, we also posit that a subgroup of youth engage in SUDs consistent with the internalizing pathway without evidencing processes associated with the externalizing pathway. In fact, the extent to which youth experience internalizing and externalizing related processes for their SUDs likely exists on a continuum, with each set of processes dominant for different youth and perhaps at different points in their individual development. This raises the possibility that externalizing symptoms themselves may serve to moderate risk for substance involvement associated with the internalizing pathway. Negative Affect SUDs specifically may be more evident in youth with ‘pure’ forms of internalizing symptoms because their use is more centrally motivated by coping efforts. Although several studies of adolescents fail to support a moderating hypothesis (Capaldi, 1991; Capaldi & Stoolmiller, 1999; Miller-Johnson, Lochman, Coie, Terry, & Hyman, 1998), others find that internalizing is only predictive of substance use in the absence of externalizing symptoms (Dierker, Vesel, Sledjeski, Costello, & Perrine, 2007). For example, using an experience sampling method assessing daily negative affect and drinking in rising 9th graders over a 21 day
