This study was not designed to identify the specific mechanisms through which childhood internalizing problems and adolescent alcohol use are associated. However, previous studies suggest that early childhood internalizing might be related to behaviorally inhibited temperament (Hussong et al., 2011), which could lead to difficulty interacting with peers later in childhood. This could represent a non-causal negative association, where internalizing symptoms merely index temperament, which itself predicts less alcohol use. As alcohol use in early adolescence occurs largely within the context of peer interactions (Hussong, 2000; Hussong, 2002), individuals whose childhood internalizing problems inhibit their ability to establish strong social contacts might be less likely to find themselves among peers who are experimenting with alcohol later. This represents a potential causal relationship.
