Although associations during youth and adolescence between alcohol problems and internalizing symptoms generally appear weaker than those with externalizing symptoms (King et al., 2004), a recent review of adolescent studies (Saraceno et al., 2009) identified numerous studies in which alcohol problems preceded the development of internalizing symptomatology and vice versa (e.g., Hahesy et al., 2002; Kuo et al., 2006; Trim et al., 2007; White et al., 2001). As is the case with externalizing symptomatology, the co-occurrence of alcohol problems and interlizing symptomatology shows evidence of both shared genetic and nongenetic factors (Kendler et al., 2003; Middlethorp et al., 2005; Windle and Davies, 1999; see also review in Hopfer et al., 2003).
