Adolescent Predictors of a Typology of DSM-5 Alcohol Use Disorder Symptoms in Young Adults Derived by Latent Class Analysis Using Data From an Australian Cohort Study.

Abstract

There is little research examining alcohol use disorder (AUD) symptoms (based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5]) in young adulthood. We assessed symptom structure at 24 years using latent class analysis (LCA), examining relationships between class membership and (a) concurrent alcohol use and DSM-5 AUD severity and (b) adolescent risk factors. A stratified, random sample of 1,943 adolescents ages 14-15 years was recruited from 44 secondary schools in Victoria, Australia, and interviewed during adolescence and young adulthood. We report findings on drinkers who completed the AUD module (N = 1,268; 51% male). Data clearly fit a three-class, dimensional model, comprising "mild symptoms" (63.2%), "moderate symptoms" (32.2%), and "severe symptoms" (4.6%) classes. Class membership was validated by concurrent drinking patterns and in reasonable agreement with DSM-5 AUD severity categories. Relative to mild symptoms class membership, moderate symptoms class membership increased odds of adolescent alcohol problems (odds ratio [OR] = 2.0, 95% CI [1.2, 3.5]) and persisting anxiety/depression symptoms (OR = 1.9, 95% CI [1.2, 3.1]). Daily smoking (OR = 2.6, 95% CI [1.1, 5.9]), persisting anxiety/ depression symptoms (OR = 2.5, 95% CI [1.3, 5.0]), and antisocial behavior (OR = 3.2, 95% CI [1.5, 6.8]) increased odds of severe symptoms class membership. Adolescent daily smoking (OR = 0.3, 95% CI [0.11, 0.81]) and antisocial behavior (OR = 0.3, 95% CI [0.14, 0.64]) were less likely among members of the moderate symptoms class, relative to the severe symptoms class. We found support for a dimensional AUD typology like that in DSM-5. Young adults with more severe AUD symptoms had a different adolescent risk profile than those in the low and moderate classes. These findings provide a focus for preventive intervention in adolescence to limit the severity of AUDs in young adulthood.