A third clear implication is that internalizing symptoms may be a useful target for early prevention efforts. Evidence suggests that the relation between parent alcoholism and child internalizing symptoms is weaker than that between parent alcoholism and child externalizing symptoms (Chassin, Rogosch, & Barrera, 1991; Edwards, Leonard, & Das Eiden, 2001). Nonetheless, previous studies consistently support COAs’ greater risk for internalizing symptoms compared to children of non-alcoholic parents, with COAs as young as 18 months showing elevated parent-reports on internalizing symptoms (Colder et al., 1997). Similar results come from studies focusing on early and middle childhood (Puttler, Zucker, Fitzgerald, & Bingham, 1998; Tubman, 1993). Studies by Chassin and colleagues (Chassin et al., 1991; Chassin et al., 1999) show that adolescent COAs have higher maternal reports of internalizing symptoms than their peers, and that this risk continues into young adulthood when COAs show higher rates of affective and anxiety disorders.
