Our study estimated longitudinal relationships between alcohol milestones/transitions (i.e. first drink, intoxication, AUD symptom, AUD diagnosis) and internalizing (INT), externalizing (EXT), and executive function (EF) phenotypes. By examining reciprocal time-varying associations, these findings critically extend the literature by clarifying the directionality and specificity of alcohol-psychopathology associations from early adolescence through young adulthood and the extent to which genetic liability maps onto phenotypic associations. Four broad findings emerged. First, EXT (i.e. ADHD hyperactive, oppositional defiant, and/or conduct disorder symptoms) was prospectively associated with increased hazards for all alcohol transitions. In contrast, only alcohol initiation prospectively predicted later EXT. Second, some INT phenotypes (i.e. social anxiety, suicidal ideation) were prospectively associated only with subsequent transitions to severe AUD. Alcohol milestones were prospectively associated with an accelerated risk for depression and suicidal ideation, but not panic or social anxiety symptoms. Third, EF (i.e. Tower of London Test, Visual Span Test) was not associated with hazards for any alcohol transition, nor were alcohol milestones associated with EF trajectories. Fourth, greater problematic alcohol use PGS was associated with increased hazards for suicidal ideation and the
