In a sample of up to 3681 individuals aged 12–36, we found that externalizing psychopathology accelerates and is accelerated by alcohol transitions. Externalizing features (i.e. conduct disorder and hyperactive ADHD symptoms) were associated with all subsequent alcohol transitions, but only alcohol initiation increased hazards for externalizing. Internalizing features (i.e. suicidal ideation and social anxiety disorder symptoms) were only associated with increased hazards for severe AUD, with evidence that early (initiation) and later stages (AUD) may accelerate subsequent depression and suicidal ideation. We found no evidence that the EF measures used may modify the pace of alcohol transitions or vice versa.
