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Psychosocial Processes

and Mechanisms of

Risk and Protection

Psychosocial research on adolescent drinking includes studies of personality and the impact
of particular personality traits on drinking risk, expectancies (that is, the effects someone
expects after drinking alcohol), and cognitive development. Although studies involving
adolescents have not identified specific sets of personality traits that uniquely predict alcohol
use, some traits have been shown to be associated with heavy alcohol use and alcohol use
disorders. These traits include disinhibition or poor self-regulation, impulsiveness and
aggression, novelty-seeking, and negative affectivity. Externalizing behaviors in childhood
and early adolescence have been found to predict alcohol use disorders in early adulthood, as
have certain internalizing behaviors. This article examines the theories and psychosocial
processes thought to underlie underage drinking. KEY WORDS: underage drinking; adolescent;
cause of AODU (alcohol and other drug use); risk factors; protective factors; AOD expectancies;
predictive factor; AOD use behavior; personality theory of AODU; psychosocial environment;
personality trait; negative emotionality; positive emotionality

regulation, impulsiveness and aggression, to how adolescents think and make


Overview and novelty-seeking. Longitudinal decisions about the world around them.
studies have found that externalizing Despite much literature suggesting that

T
he interactions among alcohol-
behaviors in childhood and early ado- adolescents have not yet reached full
related genes, biological develop- lescence predict alcohol use disorders in maturity in their cognitive processing,
ment, and environment play out early adulthood. when called upon to make reasoned
in the psychological processes underlying Negative emotionality—depression decisions using abstract processes, they
adolescent decisions to drink or to abstain and anxiety—also have been found to generally do as well as adults. Differences
from drinking. Psychosocial research predict alcohol problems. Adolescents in decisionmaking appear between adults
on adolescent drinking encompasses in this case may use drinking as a cop- and adolescents in situations that may
studies of personality and the impact of ing strategy. have social or emotional overtones.
particular personality traits on drinking Expectancies about the effects of Like adults, adolescents may vary their
risk, expectancies (the effects someone alcohol are measurable in children before judgments based on social context,
expects from drinking alcohol), and they ever begin to drink. Alcohol-related but the contexts that encourage such
cognitive development. expectancies influence how early a child decisionmaking differ for adults and
As is true for adults, studies involving will begin to drink and how much she adolescents.
adolescents have repeatedly failed to find or he will drink at that point. Research With this in mind, adolescent think-
specific sets of personality traits that suggests that people who have expectan- ing and decisionmaking may be best
uniquely predict alcohol use. In addi- cies of more positive experiences from understood as fully developed for the
tion, adolescence is a period of change, drinking tend to drink more than others purpose for which they evolved: to deal
and personality is not as stable as it will and are at highest risk for excessive with the tremendous transitions that
be in adulthood. Nonetheless, some drinking. Research is looking into the humans face at this stage of life. The
personality traits have been shown to neural processes underlying expectancies goal for research is how to integrate
be associated with heavy alcohol use and and exactly how they drive behavior. this emerging understanding of adoles­
alcohol use disorders in adolescents. These An almost universal theme whenever cence with the need to reduce adverse
traits include disinhibition or poor self- adolescent drinking is addressed relates outcomes.

Vol. 28, No. 3, 2004/2005 143


Many factors play a part in the adolescent drinking within a developmen­ with respect to personality and alcohol
development of adolescent drinking. tal framework. involvement earlier in adolescence.
Comprehensive theories on (or models Indeed, personality in adolescence in
of ) the development of adolescent general is much less developed as a
drinking create a framework for under­ Personality and Alcohol research area than it is in adults. This
standing and testing ideas about how
Problems in Youth is probably due in part to the tendency
among researchers interested in indi­
multiple factors interact to lead to prob­ Although the relationship between per­ vidual differences in infancy and child­
lems with alcohol. One of the goals of sonality and alcohol use disorders (AUDs) hood to focus on temperamental traits
NIAAA’s underage drinking initiative is has been extensively studied in older that are thought to represent very basic
to stimulate the synthesis and testing of adolescents and adults (Sher et al. 1999), tendencies in a person’s response to the
new and comprehensive models for far less research has been conducted environment. These temperamental traits

Cognitive Development and Adolescent


Decisionmaking
doing. A more recent version of this theme is based on

A
n almost universal theme whenever adolescent
drinking is addressed relates to how adolescents neurological development: the neural substrate for emo­
think and make decisions about the world around tional behavior develops in advance of the more frontal,
them. As perhaps a reflection of this emphasis, the recent rational decisionmaking portion of the brain (Luna and
National Research Council and Institute of Medicine Sweeney 2004). Other versions of this theme are more
report on underage drinking includes two separate specific to the alcohol field. For example, a recurrent view
background papers on this topic (Halpern-Felsher and is that young people systematically overestimate the fre­
Biehl 2004; Jacobs 2004), which provide a foundation quency and quantity of drinking being undertaken by
for this overview. The classic conclusion in this their peers (DeJong 2002; Aas and Klepp 1992; Beck
domain is that adolescents have not yet achieved full and Treiman 1996).
maturity of their cognitive processing and that they are Although there may be aspects of the above views that
more likely than adults to make risky decisions. A large warrant further consideration, our understanding of the
body of literature exists containing many variations on general domain of cognitive development and risk taking
the theoretical underpinnings for this conclusion. We also is evolving in a way that offers an entirely different
will not attempt to review this material in any depth perspective on these issues. First of all, adolescent deci­
for this article, but a few ideas that have been central sionmaking generally has not been found to be inferior
to this conclusion are worth noting. One is that the to that of adults. When called upon to make reasoned
transition to the Piagetian concept of “formal opera­ decisions using abstract processes, adolescents generally
tions” in thinking style has not yet taken place. do as well as adults. In many instances, however, both
Another view is that adolescents are very egocentric and adolescents and adults perform poorly; unless reasoned
feel invulnerable to harm because of their perceived thinking is somehow explicitly required in a particular
uniqueness (Elkind 1967, 1978). Still another view is circumstance, both adolescents and adults will use the
that adolescents use rational (reason-based) thinking in more intuitive style of problem solving, leading to a gen­
fewer situations than adults and depend more on intu­ erally equal rate of errors. It is evident, therefore, that we
itive processing that involves cognitive heuristics and cannot entirely attribute the apparent riskiness of adoles­
judgment biases (Agnoli 1991; Barrouillet et al. 2002; cence to fundamental differences in problem solving
Davidson 1995; Jacobs and Potenza 1991). between adolescents and adults. Where differences do
Social considerations are a potentially important factor; appear, however, is in real-world situations that may have
that is, adolescents are understood to be very interested in social and/or emotional overtones. In these situations,
their social standing among their peers and therefore are adolescents often do not make the same choices as adults.
more vulnerable to decisionmaking that relies heavily on When adolescent decisionmaking is analyzed closely for
what other adolescents are doing. Related to this notion underlying processes, the results suggest that adolescents
is that personal identity is less well established in adoles­ do not use appropriate base rate information about peers
cence, with the result that young people are more influ­ but instead use social heuristics or “rules of thumb”
enced by what they perceive others around them to be rather than actual counts of behavioral frequencies to

144 Alcohol Research & Health


Psychosocial Processes and Mechanisms
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of xxx
Riskxxx
andxxx
Protection
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are highly heritable and are usually Numerous personality traits have been as representing: (1) negative emotionality
assessed by parents or other adults. In described in the literature, but research or neuroticism, (2) positive emotionality
contrast, researchers focusing on adults suggests that most of these can be sub­ or sociability or extraversion, and (3)
tend to look at more complex traits sumed by a handful of higher order traits. impulsivity or behavioral undercontrol
obtained through self-reports. Thus, Researchers disagree on the number of or (lack of ) constraint. Both negative
the period of adolescence (especially these higher order traits, but current emotionality/neuroticism and positive
early adolescence) sits at the junction of influential models are usually defined emotionality/sociability/extraversion have
research traditions on childhood tem­ as either “Big Three” (Eysenck 1990; their counterparts in Big Five approaches,
perament and adult personality, which Tellegen 1985) or “Big Five” (e.g., Costa but impulsivity or behavioral under-
may be why this age has not received and McCrae 1992; Digman 1989, 1990; control or (lack of ) constraint appears
a greater amount of attention and Goldberg 1990, 1992). Big Three primarily to be reflected in the Big Five
development. approaches typically describe their factors trait of (or lack of ) conscientiousness as

vary their judgments based on particular contexts (e.g., BARROUILLET, P.; MARKOVITS, H.; AND QUINN, S. Developmental and
to use different judgment rules when they are with social content effects in reasoning with causal conditionals. Journal of
Experimental Child Psychology 81:235–248, 2002.
peers with high standing in the peer group, etc.) (Gardner
and Steinberg 2005; Steinberg 2004). BECK, K.H., AND TREIMAN, K.A. The relationship of social context of
It is important to appreciate that adults also make drinking, perceived social norms, and parental influence to various drink­
ing patterns of adolescents. Addictive Behaviors 21:633–644, 1996.
decisions and judgments based on these biases. It is just
that the particular content areas that accentuate biased DAVIDSON, D. The representativeness heuristic and conjunction fallacy
decisionmaking may be different (e.g., appearance vs. effect in children’s decision-making. Merrill-Palmer Quarterly
role performance), as may the contexts in which these 41:328–346, 1995.
biases most often occur. And in some domains, decision- DEJONG, W. The role of mass media campaigns in reducing high-risk
making actually may become more biased (i.e., based on drinking among college students. Journal of Studies on Alcohol (Suppl.
social heuristics) as children mature into adolescence. It 14):182–192, 2002.
is clearly not the case, therefore, that humans become ELKIND, D. Egocentrism in adolescence. Child Development 38:1025–
more “rational” with age in a linear fashion. 1034, 1967.
Hence, although it is clearly appropriate to apply ELKIND, D. Understanding the young adolescent. Adolescence 13:127–134, 1978.
cognitive development and decisionmaking models to
the understanding of adolescent drinking, these models GARDNER, M., AND STEINBERG, L. Peer influence on risk taking, risk pref­
should be informed by the emerging picture of adoles­ erence, and risky decision making in adolescence and adulthood: An
experimental study. Developmental Psychology 41:625–635, 2005.
cent development. For example, it might be best to
broaden our conceptualization of adolescent thinking HALPERN-FELSHER, B.L., AND BIEHL, M. Developmental and environmental
and not assume that adolescent thinking is deficient in influences on underage drinking: A general overview. In: National Research
Council and Institute of Medicine. Reducing Underage Drinking: A Collective
some sense relative to adult decisionmaking, only to Responsibility. Bonnie, R.J., and O’Connell, M.E., eds. Washington, DC:
arrive at “full” levels of cognition with adulthood. Instead, National Academies Press, 2004. pp. 402–416. Available online at:
adolescent thinking and decisionmaking may be better http://www.nap.edu/books/030908 9352/html.
understood as fully developed for the purpose for which
JACOBS, J.E. Perceptions of risk and social judgments: Biases and motiva­
they evolved; that is, to deal with the tremendous transi­ tional factors. In: National Research Council and Institute of Medicine.
tions that humans face at this stage of life. How to inte­ Reducing Underage Drinking: A Collective Responsibility. Bonnie, R.J., and
grate this emerging understanding of adolescence with O’Connell, M.E., eds. Washington, DC: National Academies Press, 2004.
the need to reduce adverse outcomes from drinking is a pp. 417–436. Available online at: http://www.nap.edu/books/0309089352/html.
critical question. ■ JACOBS, J.E., AND POTENZA, M.T. The use of judgment heuristics to make
social and object decisions: A developmental perspective. Child Development
References 62:166–178, 1991.

AAS, H., AND KLEPP, K.I. Adolescents’ alcohol use related to perceived LUNA, B., AND SWEENEY, J.A. The emergence of collaborative brain func­
norms. Scandinavian Journal of Psychology 33:315–325, 1992. tion: fMRI studies of the development of response inhibition. Annals of
the New York Academy of Sciences 1021:269–309, 2004.
AGNOLI, F. Development of judgmental heuristics and logical reasoning:
Training counteracts the representativeness heuristic. Cognitive STEINBERG, L. Risk taking in adolescence: What changes, and why? Annals
Development 6:195–217, 1991. of the New York Academy of Sciences 1021:51–58, 2004.

Vol. 28, No. 3 2004/2005 145


well as in the Big Five traits of (low) It also should be noted that the conduct disorder, oppositional defiant
agreeableness and neuroticism. In addi­ structure and correlates of alcohol dis­ disorder, and borderline personality
tion, a higher order trait referring to either orders tend to change across the life disorder are highly comorbid with alcohol
“openness to experience” or “intellect” span. For example, a growing body of and other drug pathology in adolescents,
(depending upon the personality system) research suggests that different AUD suggesting the possibility of shared eti­
also emerges. Research in older adoles­ symptoms have different meanings at ological pathways (Clark et al. 1997;
cents and adults strongly suggests that different developmental levels (Chung Gabel et al. 1999; Serman et al. 2002;
traits related to behavioral undercontrol et al. 2005; O’Neil and Sher 2000). Chassin et al. 2002). Indeed, research
are the most strongly associated with Moreover, there are significant age-related by Slutske and colleagues (2002) indicates
both alcohol use and alcohol use disor­ changes in the prevalence and course that much of the high genetic correlation
ders, whereas traits associated with neg­ of AUDs (Grant et al. 1994; Hasin and between conduct disorder and adult
ative emotionality are somewhat less Grant 2004). It will be important for alcohol use disorders is associated with
important (Sher et al. 1999). Existing future research to examine adolescent personality traits related to behavioral
research suggests that these basic findings alcohol and other drug use from a disinhibition.
generalize to younger adolescents, but developmental perspective with a focus Additionally, adolescents at high risk
the evidence base at present is somewhat on how changes in the structures of for the development of alcohol use dis­
underdeveloped (Caspi et al. 2005). both personality and AUDs interact orders because of a family history of
across the life span. alcoholism have been shown to be
The relationship between personality characterized by high levels of disinhi­
Stability of Adolescent Personality and adolescent alcohol use is complex. bition. Specifically, several researchers
Because adolescence is a period of dra­ As is true for adults, studies involving have found high levels of impulsive and
matic physical, social, and interpersonal adolescents have repeatedly failed to externalizing behaviors among adoles­
change, it is reasonable to believe that find specific constellations of personal­ cent children of alcoholics (COAs). For
the structure and stability of adolescent ity traits that uniquely predict alcohol example, Clark and colleagues (1999)
personality differs in important ways use (e.g., an “alcoholic personality”). In found elevated rates of antisocial disorders
from the structure and stability of adult addition, a dearth of research has exam­ among early adolescent COAs compared
personality. Much of the current research ined the stability and structure of ado­ with their non-COA peers. Similarly,
on adolescent personality focuses on the lescent personality traits. At the same Sher and colleagues (1991) found high
time, however, certain personality traits levels of behavioral undercontrol among
rank order stability of various personality
have been consistently associated with late adolescent college students with fam­
traits from adolescence through adult­
adolescent drinking patterns. ily histories of alcoholism. It is impor­
hood. Surprisingly, amidst a prepon­ tant to note, however, that a number of
derance of significant life changes, the Disinhibition. Traits related to disinhi­ studies have failed to find associations
rank order stability of adolescent per­ bition or poor self-regulation have been between COA status and externalizing
sonality remains remarkably high. shown to predict both heavy alcohol use behavior (Alterman et al. 1986; Pihl et
Specifically, correlations across time and alcohol use disorders in adolescent al. 1990). Moreover, COA–disinhibition
among Big Five personality traits range samples. For example, Soloff and col­ relationships tend to be small and may
from .47 to .51 throughout adolescence leagues (2000) found higher levels of be the result of shared third variables
(Roberts and DelVecchio 2000; Shiner impulsiveness and aggression among a such as parental antisociality or chaotic
2005). Importantly, however, these rel­ sample of young adults with AUDs family environments (Sher 1997). Despite
atively high correlations are far from than among age-matched control subjects. these methodological concerns, how­
unity. Moreover, personality stability Similarly, Gabel and colleagues (1999) ever, the majority of high-risk studies
appears to increase throughout adulthood found that novelty-seeking predicted support COA/non-COA behavioral
(with peak correlations after age 50), alcohol and other drug dependence differences across a variety of method­
suggesting that personality during adoles­ symptoms both in a sample of treatment- ologies and samples (Pihl et al. 1990).
cence is relatively kinetic and unsettled. referred male adolescents and in age- Perhaps the most informative data
Other studies of adolescent personality matched control subjects. Other studies on disinhibition and adolescent alcohol
focus on differing levels of various traits have found relationships between alcohol use come from longitudinal studies.
in adult and adolescent populations problems and behavioral undercontrol These studies often find that externaliz­
(Caspi et al. 2005). These studies typically (King and Chassin 2004), rebelliousness ing behaviors assessed in childhood/early
find that traits related to agreeableness, (Brook et al. 1995), low constraint adolescence predict AUDs in early adult­
conscientiousness, dominance, and (Chassin et al. 2004), low harm avoid­ hood. For example, Cloninger and col­
openness to experience increase from ance (Jones and Heaven 1998), and a leagues (1988) used teacher ratings of
adolescence to middle adulthood, whereas host of other disinhibited traits (Colder 431 schoolchildren assessed at age 11 to
traits related to neuroticism and socia­ and O’Connor 2002; Moss and Kirisci predict alcohol abuse at age 27. Results
bility decrease during the same period 1995; Colder and Chassin 1997). More­ showed that high novelty-seeking and
(Caspi et al. 2005). over, impulse control disorders such as low harm avoidance measured during

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Protection
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childhood predicted alcohol abuse during predicted alcohol dependence at age 21. considered a marker of externalizing
adulthood. Similarly, Caspi and colleagues Using a somewhat different methodology, disorders) were at risk for alcohol and
(1997) found that aggression, alienation, Iacono and colleagues (2002) found other drug use disorders at age 20. More-
low harm avoidance, low control, and that 17-year-olds with attenuated P3 over, studies using growth mixture models
low social closeness assessed at age 18 event-related potential amplitudes (often suggest that disinhibited traits measured

A Snapshot of Research Findings on Adolescent Alcohol Use Disorders and Personality Traits
Findings Study

Disinhibition/Poor Self-Regulation
Higher rates of impulsiveness and aggression were found in young adults with alcohol Soloff et al. 2000
and other drug use disorders than among an age-matched control group.

Higher rates of novelty-seeking predicted substance dependence symptoms in both a Gabel et al. 1999
sample of treatment-referred male adolescents and age-matched control subjects.

Alcohol problems were found to be associated with: • King and Chassin 2004
• Behavioral undercontrol • Brook et al. 1995
• Rebelliousness • Chassin et al. 2004
• Low constraint • Jones and Heaven 1998
• Low harm avoidance • Colder and O’Connor 2002; Moss and
• Other disinhibited traits. Kirisci 1995; Colder and Chassin 1997

Impulse control disorders such as conduct disorder, oppositional defiant disorder, and border­ Clark et al. 1997; Gabel et al. 1999;
line personality disorder are highly comorbid with substance use disorders in adolescents. Serman et al. 2003; Chassin et al. 2002

Adolescents at high risk for development of alcohol use disorders because of family
history have been found to have high rates of disinhibition:
• Early adolescent children of alcoholics had higher rates of antisocial • Clark et al. 1999
disorders than non-COA peers.
• College students showed higher levels of behavioral undercontrol. • Sher et al. 1991
BUT:
• Some studies have failed to find associations between COA status and • Alterman et al. 1986; Pihl et al. 1990
externalizing behavior.
• Relationships between COA status and disinhibition are small and may be caused • Sher 1997
by third variables such as parental antisociality or chaotic home environments.

High novelty-seeking and low harm avoidance among 11-year-olds predicted alcohol Cloninger et al. 1988
abuse during adulthood.
Aggression, alienation, low harm avoidance, low control, and low social closeness at Caspi et al. 1997
age 18 predicted alcohol dependence at age 21.

Disinhibited traits measured during adolescence are associated with problematic alco­ Chassin et al. 2002, 2004
hol and drug use trajectories.

Negative Affectivity/Neuroticism
• Negative affect was associated with both heavy drinking and frequency of • Colder and Chassin 1993
alcohol use in a sample of early adolescents.
• A later assessment of the same sample found that negative affect predicted • Colder and Chassin 1997
alcohol use and interacted with impulsivity to predict both alcohol use and
alcohol-related impairment.
• High rates of negative emotionality were found among nonalcoholic adoles­ • Elkins et al. 2004
cents with a parental history of alcoholism.
• Baseline anxiety disorders predicted the subsequent onset and course of • Zimmerman et al. 2003
AUDs in an adolescent sample.
BUT:
• Some researchers have found that relationships between negative affectivity • Brook et al. 1986; White et al. 1986
and alcohol use problems were not significant.
• Some research with adults indicates that negative emotionality is a result • Sutherland 1997
rather than a cause of alcohol pathology.
• Recent studies suggest that negative emotionality is only predictive of alcohol • Cooper 1994; Newcomb et al. 1988
problems among adolescents who use drinking as a coping strategy.

SOURCE: www.MonitoringtheFuture.org.

Vol. 28, No. 3 2004/2005 147


during adolescence are associated with involvement and toward specifying the have contained alcohol (see Goldman
problematic alcohol and other drug use ways that personality could affect alcohol et al. 1987). In general, according to
trajectories (Chassin et al. 2002; Chassin involvement through plausible mediating these studies, the behavior displayed
et al. 2004). mechanisms. To date, several mediating after alcohol consumption often was
models have been proposed, including as much a function of the expectation
Neuroticism/Negative Affectivity. Negative those which suggest that certain per­ (instructional set) that alcohol had been
affectivity also has been shown to predict sonality traits are related to specific administered as it was related to what
alcohol problems in adolescent samples. drinking motivations (e.g., anticipated actually was administered (up to partic­
For example, Colder and Chassin (1993) social facilitation or self-medicating ular dosage levels).
found that negative affect was associ­ motives), deviant socialization into heavy- In the early 1980s, reports appeared
ated with both heavy drinking and fre­ drinking peer groups, and pharmaco­ in the literature describing studies in
quency of alcohol use in a sample of logical vulnerability to reinforcement which participants responded to ques­
452 early adolescents. In a later assess­ from alcohol (Sher et al. 1999). In turn, tionnaires that inquired directly about
ment of the same sample, Colder and these mediators are believed to their expectancies—that is, the effects
Chassin (1997) found that negative affect account, in part, for the association they anticipated if they were to consume
(1) predicted alcohol use and (2) inter­ between personality and alcohol alcohol (e.g., alcohol makes it easier to
acted with impulsivity to predict both involvement. Available data suggest talk to people, to pick a fight, to be sexu­
alcohol use and alcohol-related impair­ that these same general mechanisms are ally responsive; see review by Goldman
ment. Other cross-sectional studies have applicable to adolescent drinking, et al. 1999). Since that time, hundreds
yielded similar findings (Labouvie et al. although there is probably some devel­ of studies of this type have been com­
1990; Loukas et al. 2000; Krueger 1999). opmental specificity, with deviant pleted, with the consistent finding that
High-risk and prospective studies also socialization being a more important particular response patterns on these
suggest a relationship between negative mechanism during adolescence. questionnaires correlate substantially
affectivity and AUDs. For example, Elkins with self-reported alcohol use, and that
and colleagues (2004) found high rates these same response patterns can be used
of negative emotionality among nonalco­ Alcohol Expectancies to predict later drinking over a time-
holic adolescents with a parental history and Related Concepts lagged (longitudinal) period. Among
of alcoholism. Similarly, Zimmerman those expectancies these studies most
and colleagues (2003) found that base­ Although the expectancy concept1 has often identified as being related to higher
line anxiety disorders predicted the sub­ been used across a wide variety of levels of drinking are those for enhanced
sequent onset and course of AUDs in domains within behavioral science, it social/sexual functioning and positive
an adolescent community sample. It has received particular attention within emotional outcomes. Summed across
should be noted, however, that several the alcohol field (see Goldman et al. studies, the data suggest that partici­
researchers have found nonsignificant 1987, 1999). And within the alcohol pants who hold more expectancies for
relationships between negative affectivity field, one point of special focus has been positive/arousing outcomes from drink­
and alcohol use problems (Brook et al. expectancy and the development of ing, or more strongly endorse such
1986; White et al. 1986). In addition, drinking patterns from childhood through expectancies on a Likert scale (with which
some research using adult samples indi­ adolescence and into young adulthood respondents rate the extent to which
cates that negative emotionality is a conse­ (Christiansen et al. 1989; Dunn and they agree or disagree with a given state­
quence, rather than a cause, of alcohol Goldman 1996, 2000; Gaines et al. 1988; ment), tend to drink more.
pathology (Sutherland 1997). Interestingly, Lang and Stritzke 1993; Miller et al. Of special relevance to the present
other studies suggest that negative emo­ 1990; Smith et al. 1995; Zucker et al. review is that these expectancies are
tionality is only predictive of alcohol prob­ 1995). The original application of the measurable in children before they ever
lems among adolescents who use drink­ term “expectancy” within the alcohol begin to drink (Christiansen et al. 1989;
ing as a coping strategy (Cooper 1994; field was to experimental conditions Dunn and Goldman 1996, 1998; Gaines
Newcomb et al. 1988). More research in balanced-placebo studies of the psy­ et al. 1988; Lang and Stritzke 1993;
is needed to clarify the mediational role chopharmacological effects of alcohol. Miller et al. 1990; Noll et al. 1990; Smith
of drinking motives in the negative affec- In these conditions, the participants were et al. 1995; Stacy et al. 1991; Zucker et
tivity/alcohol problem relationship. led to believe that they were drinking al. 1995). And expectancies, even at this
alcohol but actually may have received early point in development, are related
either alcohol or a placebo beverage, to how early children will begin to drink
Functional Relations Between or were led to believe that they were and to how much they will drink when
Personality and Drinking drinking a nonalcoholic beverage but they begin drinking. It is important to
Within the adult literature, there has actually received a beverage which may note that some assessment devices for
clearly been a move away from simply obtaining expectancies from children
demonstrating correlations between 1
Expectancies are stored information (memories) that have been accommodated to their
specific personality traits and alcohol anticipate future events. developmental level (in terms of reading

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level or mode of presentation; see Dunn in genetically selected animal lines treat expectancies as the primary content
and Goldman 1996, 1998; Miller et al. (Katner et al. 1996) and the manner in of memory and then to use memory
1990). It is also important to note that the which well-established individual dif­ models and methods as a basis for
rudimentary development of expectancies ferences in the metabolism of alcohol examining expectancy operation. This
has been established even before the influence alcohol consumption effort has made use of empirical models
start of elementary school (Noll et al. (McCarthy et al. 2000). of memory networks and associated
1990). Perhaps most interesting is the Viewed in this way, alcohol expectan­ mathematical techniques (e.g., multi­
finding that children in general shift cies can have significant implications dimensional scaling and clustering)
from a primary emphasis on the negative to depict these networks (Rather et al.
or adverse effects of drinking alcohol 1992). Based on these models, experi­
before about age 9 to a primary empha­ It is the goal of ments have been performed using well-
sis on the positive and arousing effects
of alcohol by about age 13 (Dunn and
NIAAA’s underage
established cognitive paradigms (e.g.,
implicit and explicit stimulus priming,
Goldman 1996, 1998). Those at high­ drinking initiative to
false memory techniques, Stroop task,
est risk for excessive drinking show the free association), resulting in findings
largest emphasis on positive/arousing
stimulate the synthesis
consistent with the empirically derived
effects. Although speculation as to the and testing of new
memory models (e.g., Kramer and
processes that might cause this develop­ Goldman 2003; Stein et al. 2000).
mental shift has been offered, the actual and comprehensive
Particularly noteworthy were studies
causes remain to be determined.
It is, of course, quite possible to simply
models ... within a
showing that cognitive priming influences
actual alcohol consumption (Roehrich
regard alcohol expectancies as a list or developmental
and Goldman 1995; Stein et al. 2000).
inventory of expected effects of alcohol. Such approaches are only just begin­
The history of the use of the expectancy framework.
ning to be applied to the development
concept in several different venues in of behavioral approaches to reduce the
behavioral science suggests, however, for how people make choices to use risk for excessive alcohol use and abuse.
that expectancies can be an active pro­ alcohol and about how much to use.
cess variable, with causal or mediational Six increasingly stringent levels of evi­
influence over behavioral output. For dence support a causal role (see Goldman Influential Theories
example, expectancy explanations have 2002): (1) expectancies correlate with of the Development of
been applied to a wide variety of clinical reports of alcohol use, accounting for Adolescent Problems
phenomena including pain reduction, up to 50 percent of the variance in with Alcohol and Other
placebo effects, psychotherapy, and drinking outcomes (Earlywine 1994; Substances
hypnosis (see Kirsch 1999), and to expla­ Leigh and Stacy 1993); (2) expectancies
nations of other psychological phenom­ are found in children before drinking The theories outlined below are among
ena including comparative judgment begins and predict drinking prospectively the historically most influential in
(Ritov 2000), music appreciation into adolescence and young adulthood research on the origins and progression
(Krumhansl and Toivaine 2000), and (Dunn and Goldman 1996, 1998; of problems in adolescents with alcohol
even operant (Dragoi and Staddon Zucker et al. 1995); (3) expectancies and other drugs. These theories have
1999) and classical conditioning increase with drinking experience (Smith tended to be directed toward antisocial
(Rescorla and Wagner 1972). et al. 1995); (4) at the point in life and deviant involvement with alcohol
Research also has linked underlying at which drinking decreases in many and other drugs; they fail to address the
neural phenomena with expectancy. people, expectancies typically decrease underage drinking behavior of youth
For example, neuronal signaling involv­ (Sher et al. 1996); (5) when tested with thought to be successful and mainstream.
ing the neurotransmitter dopamine in statistical methods for demonstrating It is the goal of NIAAA’s underage drink­
the nucleus accumbens (part of the mediation, expectancies can be shown ing initiative to stimulate the synthesis
brain’s reward/reinforcing circuitry) has to mediate the influence of other known and testing of new and comprehensive
been noted to encode expectations about antecedents of drinking risk (Finn et models that reflect the complex multi-
external rewards (Kupfermann et al. al. 2000); and (6) expectancies can be causality of all underage drinking behav­
2000). Emotional responses, centering manipulated in true experiments, with ior within a developmental framework.
on the operation of the amygdala consequent changes in drinking levels
(another component of the brain’s (Roehrich and Goldman 1995).
reward circuitry), also can be linked to Despite the extensive body of research
The “Gateway,” or Stage Theory
expectancy (Kupfermann et al. 2000). that has related the expectancy concept This theory comes from epidemiological
Within the alcohol and substance abuse to alcohol (and other drug) use and abuse, research that has examined patterns of
fields, expectancy has been understood precise processes have only recently begun alcohol and other drug use progression
to reflect differential dopamine activity to emerge. One approach has been to among adolescents. The original findings

Vol. 28, No. 3 2004/2005 149


suggested that adolescents initially themselves within the same person use and a substance use disorder diag­
experiment either with alcohol and/or (Jessor 1991). For example, adolescents nosis (Costello et al. 1999). The child­
cigarettes (as legal and culturally accepted with alcohol problems may engage in hood psychiatric disorders known as
drugs) and then progress to marijuana. a spectrum of problem behaviors, such the disruptive behavior disorders (i.e.,
Once experience with marijuana as an as illicit drug use, delinquent behaviors attention deficit hyperactivity disorder,
illicit drug is acquired, adolescents may (e.g., truancy, petty theft, vandalism, oppositional defiant disorder, and con­
then try other illicit drugs such as heroin lying, running away), risky and preco­ duct disorder) have the strongest asso­
and cocaine. The experimentation with cious sexual activity, and other high- ciations with problematic involvement
alcohol and tobacco, as legal drugs, is risk behaviors (e.g., drag racing, drunk with alcohol, tobacco, and other drugs
viewed as a necessary intermediate or driving). during adolescence. It is noteworthy
“gateway” to illicit drug use (Kandel A single, possibly genetic, factor is that among these, adolescent conduct
and Faust 1975). hypothesized to underlie a general syn­ disorder increases the risk for alcohol
Opponents of this theory suggest drome of deviance that may predate abuse and dependence (Deykin et al.
that there may be a common risk factor adolescence and persist into adult life. 1987; Disney et al. 1999; Lewinsohn
(or factors) for illicit drug use that could Developmental support for this con­ et al. 1993; Moss and Lynch 2001).
account for the relationship between ceptualization comes from the findings Depression also is associated with
marijuana and other drug use indepen­ of the Dunedin Multidisciplinary problematic involvement with a wide
dent of initial exposures to alcohol and Health and Development Study. In variety of alcohol and other drugs dur­
tobacco. Examples of a theorized “third one group of adolescents in this study, ing adolescence (Kandel et al. 1997).
factor” include a genetic predisposition significant conduct problems were Some anxiety disorders, such as separa­
to problematic involvement with alcohol observed in preadolescence, adolescence, tion anxiety, may be protective against
and other drugs, a predisposition toward and later adulthood (life-course-persistent alcohol and other drug use behavior
adolescent high-risk behavior in general, antisocial behavior). Another adolescent during adolescence, whereas others, such
or shared opportunities to obtain both group was characterized as having behav­ as generalized anxiety disorder, may
marijuana and other drugs (Morral et ioral deviancy that began and ended enhance alcohol drinking and augment
al. 2002). during adolescence (adolescence-limited risk (Kaplow et al. 2001). Adolescents
A less controversial offshoot of this antisocial behavior). Adolescents in this with comorbid psychiatric disorders
theory deals with the age of first experi­ group ultimately had a positive adult present a significant challenge for both
mentation with a broad class of abused outcome (Moffit 1993). prevention and treatment of adolescent
drugs (whether it includes alcohol, alcohol problems.
tobacco, marijuana, or hard drugs),
and the timing of stages of regular use
Comorbidity Theory
and problematic involvement. The lit­
Maladaptive Coping Theory
Epidemiological research has demon­
erature converges around the association strated significantly elevated rates of High-risk behaviors also may be adaptive
of early alcohol and other drug use, alcohol and other drug use problems to the extent that they serve a social or
including underage drinking, and sub­ among adolescents with defined psy­ maturational goal such as separating from
sequent problematic involvement (Choi chiatric disorders. Most, but not all, parents, achieving adult social status, or
et al. 2001; Choi et al. 1997; Kandel clinical and community studies suggest gaining peer acceptance (Spear 2000).
and Logan 1984; Schuckit and Russell that psychiatric disorders precede the Engagement in high-risk behaviors may
1983; Yamaguchi and Kandel 1984; development of adolescent alcohol and help an adolescent cope with failure,
Hawkins et al. 1997; Grant and Dawson other drug use problems in these people boredom, stress, social anxiety or isola­
1998; Warner and White 2003). For (e.g., Ellickson and Hays 1991; Boyle tion, unhappiness, rejection, and low
this reason, substantial attention has et al. 1992; Van Kammen and Loeber self-esteem. One example of maladap­
been focused on prevention interven­ 1994; Kellam and Anthony 1998). tive coping is an adolescent’s reported
tions that delay the initiation of alcohol Some studies have found that psychi­ use of alcohol and other drugs as a means
and other drug use. atric symptoms emerge during or after of gaining social status and acceptance
problematic involvement with alcohol from peers and, at the same time,
and other drugs (e.g., Brook et al. enhancing mood and assuaging feelings
Problem Behavior Theory 1998; Fergusson and Horwood 1996). of low self-worth (DuRant 1995; DuRant
Problem behavior theory is an influential Developmental research has suggested et al. 1995). Thus, problematic involve­
conceptual framework for understand­ that the initial subsyndromal symp­ ment with alcohol and other drugs for
ing not only problematic alcohol and toms of most psychiatric disorders some adolescents may be a maladaptive
other drug use but also a wide variety (except depression) precede the onset means of coping with the stresses and
of high-risk adolescent behaviors (Jessor of adolescent alcohol and other drug social pressures that are characteristic
and Jessor 1977). The theory proposes use in people with both. Over time, these of the adolescent stage of development,
a syndrome of comorbid adolescent people receive full psychiatric diagnoses particularly in the absence of adult sup­
problem behaviors that may manifest and subsequently progress to substance port, guidance, and monitoring.

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