In sum, prominent theories of AUD development endeavor to explain its associations with impulsivity, negative affect, and EF. Existing longitudinal studies provide some evidence of bidirectional associations, with some specificity (e.g. internalizing more strongly linked to later milestones). Longitudinal studies that not only measure these traits both before and after relevant alcohol milestones but also incorporate indicators of genetic liability can be further used to parse the directionality and potential shared etiology of these relationships, especially when considering potentially censored observations (e.g. later expression of internalizing symptoms, limited phenotypic expression of high genetic risk).
