2007). Studies in young adults have documented associations between inattentive symptoms, which tend to be stable over time, and alcohol use and AUD (Glass & Flory, 2012; Grazioli et al., 2019; Roberts, Peters, Adams, Lynam, & Milich, 2014). Hyperactivity typically decreases with age (Biederman, Mick, & Faraone, 2000). In childhood, hyperactivity may show stronger associations with alcohol milestones/transitions, but in late adolescence or adulthood, inattention may appear more relevant. These findings suggest that externalizing is a more robust risk factor for alcohol initiation and escalation than the reverse, and that associations between alcohol milestones and subsequent EXT are restricted to early alcohol involvement. Of course, this pattern might be influenced by the typical development of EXT at earlier ages than problematic alcohol use (Kessler et al., 2005), or these associations might be due to shared underlying disposition that has variable expression across time (Hicks, Foster, Iacono, & McGue, 2013; Karlsson Linnér et al., 2021).
