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. 2017 May 21;78(3):452–457. doi: 10.15288/jsad.2017.78.452

Social and Individual-Level Predictors of Alcohol Use Initiation and Escalation: Replicating and Extending Tests of Differential Effects

Hector I Lopez-Vergara a,*, Jennifer E Merrill a, Tim Janssen a, Kristina M Jackson a
PMCID: PMC5440369  PMID: 28499113

Abstract

Objective:

Although alcohol use is considered a developmental phenomenon, there is a relative dearth of studies disaggregating predictors of alcohol use initiation versus early escalation of drinking. One perspective that has emerged is that social levels of influence may be relevant for the initiation of drinking, whereas individual levels of influence may be relevant for the early escalation in level of drinking among initiators, which we refer to as the specificity hypothesis.

Method:

A sample of alcohol-naive youth (n = 944; mean age = 12.16 years, SD = 0.96) was prospectively assessed for 3 years, spanning six waves of data collection.

Results:

Both social (parental conflict, perceived prevalence of peer drinking) and individual-level (higher sensation seeking) variables uniquely predicted increases in the likelihood of alcohol initiation. Likewise, both social (perceived descriptive norms of peer drinking) and individual-level (lower school grades, higher sensation seeking) variables uniquely predicted escalation in level of drinking among initiators (although only marginally for sensation seeking).

Conclusions:

Overall, there was little support for the specificity hypothesis. Our findings suggest that to assume that social and individual-level processes differentially predict drinking outcomes may be a false dichotomy. Theoretical work may benefit from drawing from developmental models emphasizing the interplay between individual and environmental factors in the prediction of the early development of drinking. The emergence of drinking behaviors is likely to result from a developmental cascade of interacting variables that make the ontogeny of drinking unlikely to emerge from a single class of variables.

Alcohol use is best conceptualized within a developmental framework (Chassin et al., 2013), although there is a dearth of research investigating the early developmental phases of alcohol involvement. Hoffman and Bahr (2010) have argued that most investigations neglect to disaggregate the initiation of drinking from early escalations in volume of drinking (among youth who have initiated drinking) and suggest that this is a crucial limitation of the literature, because different variables may predict alcohol use initiation versus escalation. According to the specificity hypothesis, social processes are expected to predict the initial decision to experiment with alcohol, whereas individual-level processes are hypothesized to predict early escalation of drinking.

Because neglecting to account for who selects to drink may bias results (Cameron & Trivedi, 1998; Cheung, 2002), as well as make it conceptually impossible to test differential predictors of initiation versus escalation, Hoffman and Bahr (2010) tested the specificity hypothesis in a cross-sectional sample of youth ages 12–17. Supportive of the specificity hypothesis, higher levels of parental conflict predicted alcohol use initiation but did not predict escalation of drinking. However, the majority of their findings were contradictory to the specificity hypothesis, because other social (low parental support) as well as individual-level (school grades and religiosity) variables predicted both initiation and escalation of drinking. Although parental conflict (Shortt et al., 2007), parental support (Stice et al., 1998), school grades (Donovan, 2004), and religiosity (Rew & Wong, 2006) have been found to be associated with adolescent drinking, the majority of studies have not tested whether these variables are specifically related to initiation versus escalation of drinking. This illustrates the contribution of Hoffman and Bahr’s (2010) test of the specificity hypothesis.

However, testing the specificity hypothesis with crosssectional data does not allow for the establishment of temporal precedence in the prediction of alcohol use initiation and escalation. Hence, prospective data with alcohol-naive youth are needed to test the specificity hypothesis. The present study seeks to provide a conceptual replication of the specificity hypothesis using a longitudinal sample of alcohol-naive youth.

Present study

In addition to prospective replication, we sought to extend tests of the specificity hypothesis by including two important sources of influence: perceptions of peer substance use and personality. Perceived peer substance use, which has typically been considered a social variable, has been hypothesized to be particularly important for early escalation in level of drinking (Kandel & Andrews, 1987). However, there is evidence to suggest that perceived peer drinking predicts both the initiation and early escalation of drinking (D’Amico & McCarthy, 2006). Similarly, sensation seeking, typically characterized as an individual-level variable, is a robust predictor of drinking (Hittner & Swickert, 2006). Although there is a dearth of research disentangling the effect of sensation seeking on the early development of drinking, there is evidence that higher levels of sensation seeking predict both the onset and escalation of drinking (Janssen et al., 2014).

In sum, there is a relative lack of longitudinal research disaggregating predictors of alcohol use initiation versus early escalation in drinking, and the research that does disaggregate these outcomes investigates only a single domain of influence, such as perceptions of peer drinking (D’Amico & McCarthy, 2006) or personality (Lopez-Vergara et al., 2016). Longitudinal research that simultaneously investigates distinct predictors is needed to elucidate the early development of drinking. A better understanding of who is likely to initiate drinking, as well as which initiators are likely to escalate drinking, has the potential to inform etiologically targeted and stage-specific interventions. If the specificity hypothesis is correct, we would expect social variables (parental support and conflict, perceived prevalence and descriptive norms of peer drinking) to predict initiation but not escalation and individual-level variables (grades, religiousness, and sensation seeking) to predict escalation but not initiation.

Method

Participants

This study draws from an ongoing project of 1,023 middle school students (Jackson et al., 2015). To establish temporal precedence in the prediction of alcohol use initiation, youth who had initiated drinking by Wave 1 were removed from the analyses (7% of youth). Hence, we used a sample (n = 944) of adolescents (Mage at Wave 1 = 12.16 years [SD = 0.96]; Mage at Wave 6 = 15.14 years [SD = 0.95]) who reported no history of drinking at Wave 1. Youth were recruited from middle schools in Rhode Island; 52% were female; and 12% identified as Hispanic, 77% as White, 7% as multiracial, 5% as African American, 3% as Asian, 2% as Native American, and 6% as other.

Procedures

The Brown University Institutional Review Board approved all study procedures. Recruitment took place in a middle school setting. Youth who expressed interest and whose parents had provided written consent were invited to attend an in-person orientation session during which participants completed a survey (Wave 1). Internet surveys were used to prospectively follow youth for four waves of semiannual data collection spanning a total of 2 years (Waves 2–5) and a Wave 6 survey 1 year later. Compensation was $25 at baseline and $20 for each follow-up survey. Attrition was 8% for Wave 2, 12% for Wave 3, 15% for Wave 4, 17% for Wave 5, and 17% for Wave 6. Participants lost to attrition were more likely to be male, qualify for free/reduced-price school lunches, and have parents with lower education and income (Marceau et al., 2015).

Measures

Demographic information was collected at Wave 1. School grades were self-reported by youth on a Likert-response scale (1 = never to 5 = almost always) to the question, “How often do you get good grades (like As or B’s)?”A latent religiousness factor was indicated by three items: participation in religious organizations (e.g., youth group, go to church) on a scale from no participation (0) to participation more than once a day (7); importance of religion in one’s life on a scale from not important (0) to extremely important (3); and attendance of religious activities on a scale from never (0) to once or more a week (3). All standardized factor loadings for the religiousness factor were substantial (>.65) and statistically significant (p < .05).

Parental social support and conflict were assessed with the Network of Relationships Inventory (Furman & Buhrmester, 1985). Participants were asked about the degree to which social support and conflict qualify their relationship with their parents, using a scale ranging from little or none (1) to the most (5). Social support was assessed using six items (e.g., “How much do you play around and have fun with this person?”), and negative interchanges were assessed using nine items (e.g., “How much do you and this person get upset with or mad at each other?”). Internal consistency was α ɑ .89 for support; α ɑ .91 for conflict.

Perceived peer alcohol involvement was assessed with two items, one assessing perceived prevalence of peer drinking (perceptions regarding whether typical peers [same grade and sex] drank alcohol [0 = no; 1 = yes]); and another assessing perceived descriptive norms of peer drinking (perceptions of how many drinks their typical peer consumes per drinking occasion [zero if peers don’t drink]) (Wood et al., 2001, 2004). These items were selected to provide conceptual overlap with our outcomes (initiation and escalation) because specificity of cognitive content is emphasized in information-processing models of behavior (Maccoon & Newman, 2006).

Sensation seeking was assessed by six items from the UPPS-P impulsive behavior scale (Lynam et al., 2006) assessing interest in and tendency to pursue activities that are exciting and novel (Cyders et al., 2007), rated from agree strongly (1) to disagree strongly (4), and reverse-scored such that high scores indicate high sensation seeking. Internal consistency was α ɑ .82.

Alcohol involvement was a measure assessing the average number of drinking days (frequency) and the average number of drinks per drinking occasion (quantity) (Sobell & Sobell, 2004). Quantity by Frequency (Q x F) was calculated at each wave as the product of the average number of drinking days and the average number of drinks per occasion. Q x F estimates of drinking for Waves 2 through 6 were used as indicators for statistical methods to disaggregate initiation and escalation of drinking.

Analytic plan

We recruited participants at a time when alcohol use is characterized by highly nonnormal distributions, with a high concentration of values indicative of no drinking experience being the typical situation. This is to be expected, given that youth have not yet established regular patterns of drinking and that there is variability in the initiation of drinking. The nature of this distribution is not a nuisance that violates assumptions of conventional statistical models (e.g., models that assume normal distributions), but rather it is an important feature of the development of drinking. To differentiate between initiation and escalation of drinking, we used a two-part random-effects model (Olsen & Schafer, 2001), which was developed to investigate phenomena with highly nonnormal distributions (for a review, see Flora, 2011). These models decompose the original distribution of drinking into two parts of the same model: a dichotomous use versus nouse contrast in Part 1 (representing changes in the likelihood of alcohol use initiation) and a continuous distribution in Part 2 (representing the amount of drinking among youth who have initiated drinking). Both linear and quadratic forms of growth were examined. Time was modeled by wave structure; models controlled for age and gender. All analyses were conducted in Mplus Version 7.11 (Muthen & Muthen, 2013) using maximum-likelihood estimation that is robust to nonnormally distributed data.

Results

Because we selected alcohol-naive participants, 0% of the sample reported drinking at Wave 1, and, by Wave 6, 16% of youth had initiated drinking. By Wave 6, the majority of alcohol initiators reported drinking two or fewer standard drinks per drinking occasion (ranging from less than a drink to five drinks per occasion), which indicates that we are assessing developmentally early low levels of drinking escalation. Mean Q x F at Wave 2 was 0.09 (SD = 0.99); 0.29 (SD = 3.68) at Wave 3; 0.30 (SD = 2.37) at Wave 4; 0.47 (SD = 3.96) at Wave 5; and 1.82 (SD = 5.50) at Wave 6. Outcomes were highly nonnormally distributed, as indicated by skew and kurtosis (skew range: 4.06–23.65; kurtosis range: 19.03–622.0). For a more thorough description of these drinking outcomes, see Lopez-Vergara et al. (2016). The two-part model suggested that increases in the probability of alcohol use initiation was linear (M = 0.88, p < .001), as were increases in Q x F among initiators (M = 0.17, p = .001). Increases in alcohol initiation were not significantly associated with increases in Q x F of drinking among initiators (r = -03, p = .92).

Multivariate associations predicting increases in the likelihood of alcohol initiation and escalation are presented in Table 1. Results in Table 1 are standardized coefficients, and, as such, they represent effects in standard deviation units, which makes it possible to compare the size of effects across all predictor variables. The empirical replication model suggested that increases in the likelihood of initiation were predicted by female gender, older age, and more parental conflict. Increases in Q x F among initiators (escalation) were predicted by male gender and older age.

Table 1.

Results predicting alcohol use initiation and escalation

graphic file with name jsad.2017.78.452tbl1.jpg

Likelihood of use vs. no use
 Q x F of use among drinkers
Variable Standardized Β p Standardized Β p
Empirical replication model
 Sex -.17 .001 .34 .023
 Age .33 .000 .34 .044
 Grades -.04 .464 -.23 .080
 Religiousness .07 .388 -.16 .244
 Parental support -.03 .555 -.03 .846
 Parental conflict .16 .002 .05 .647
Conceptual extension model
 Sex -.22 <.001 .27 .15
 Age .27 <.001 .27 .10
 Grades -.04 .39 -.34 .04
 Religiousness .07 .41 -.16 .27
 Parental support -.02 .63 -.06 .70
 Parental conflict .12 .008 .02 .84
 Perceived prevalence of peer drinking .10 .05 -.22 .11
 Perceived descriptive norms of peer drinking .01 .85 .14 .03
 Sensation seeking .21 <.001 .26 .07
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Notes: Sex was coded as 0 = female, 1 = male. Perceived prevalence of peer drinking was coded as 0 = peers don’t drink, 1 = peers drink. Perceived descriptive norms of peer drinking coded as number of drinks peers drink per drinking occasion or zero if peers don’t drink. Q x F = Quantity by Frequency of drinking.

The conceptual extension model indicated that increases in the likelihood of initiation were predicted by female gender, older age, more parental conflict, perceived prevalence of peer drinking, and higher levels of sensation seeking. Increases in Q x F among initiators (escalation) were predicted by lower school grades and greater perceived descriptive norms of peer drinking, as well as marginally by higher levels of sensation seeking.

Discussion

We prospectively tested social and individual-level predictors of alcohol use initiation and early escalation. Importantly, we established temporal precedence in the prediction of alcohol use initiation and statistically disaggregated predictors of who is likely to initiate drinking versus who (among the initiators) is likely to escalate their level of drinking. “Unpacking” predictors of initiation and escalation contributes to the literature, because the correlates of volume of drinking may be biased when who selects to drink is not accounted for (Cheung, 2002).

We found that parental conflict may be important in predicting alcohol use initiation but may not be relevant in predicting which youth are likely to escalate drinking. Also consistent with Hoffman and Bahr (2010), we found evidence (albeit marginal) that lower school grades predict escalation of drinking. However, we did not find any significant effects of religiousness or parental support on either initiation or escalation, suggesting that these variables may not account for any variance above and beyond other predictors in the model.

Results of the conceptual extension including sensation seeking and perceptions of peer drinking were similar. Of note, perceptions of peer substance use were differentially related to alcohol use initiation and escalation, depending on the content of perception being assessed. The perception of peers as more likely to be drinkers (vs. being alcohol-naive) predicted alcohol use initiation but did not predict escalation in the volume of use among initiators. In contrast, perceptions of a higher number of drinks consumed per drinking occasion by their drinking peers predicted escalation of drinking but did not predict initiation of drinking. This is consistent with information-processing models of behavior that view the specific content of cognition as a crucial contributor to behavior (Vergara-Lopez et al., 2016). Last, sensation seeking predicted changes in both the likelihood of initiation and escalation (although only marginally for escalation). This finding is contradictory to the specificity hypothesis, but consistent with previous research (Janssen et al., 2014), as well as with Problem Behavior Theory (PBT; Jessor & Jessor, 1977). According to PBT, the emergence of different drinking milestones may be the result of the same etiology—namely, an underlying tendency for unconventionality.

Although we had no a priori hypotheses regarding gender differences, gender differentially predicted initiation and escalation. Female gender was predictive of initiation, whereas male gender was predictive of escalation of drinking. Females tend to enter puberty earlier than males (Spear, 2010), which could result in increased access to alcohol due to promoting associations with older male peers (Westling et al., 2008). However, social sanctions against drunkenness are greater for females (relative to males; Nolen-Hoeksema, 2004), which may explain why males were more likely to escalate their drinking.

Conclusions, limitations, and future directions

Overall, our study provides weak support for the specificity hypothesis. Hypothesizing environmental and individual-level variables as differential predictors of initiation and escalation of drinking is reminiscent of scientific debates of “nurture versus nature.” Developmental scientists have long considered explaining the origins of behavior as driven by nurture or nature to be a false dichotomy (Gottlieb, 1998; Lehrman, 1953; Lewkowicz, 2011). For example, interpreting our finding that parental conflict predicts alcohol initiation (but not escalation) as supportive of the view that social processes are more important for initiation may obscure the complexity of human development. Although having established temporal precedence ensured that our measure of parental conflict preceded alcohol involvement, there is evidence to suggest that there is a bi-directional association between parenting behaviors and behavior problems in childhood (Burke et al., 2008; Pettit & Arsiwalla, 2008). In other words, although negative interchanges with parents temporally precede alcohol involvement, it is likely that these negative interchanges emerged in a dynamic, transactional process between child and parent characteristics. Hence, models that posit social versus individual-level factors as unique predictors of outcomes may obscure the dynamic and synergistic processes that culminate in the emergence of adolescent drinking (Dodge et al., 2009).

Despite these criticisms of the specificity hypothesis, it is important to note that parental conflict predicted initiation but not escalation—which is noteworthy, because this pattern of findings was found in two independent samples from different laboratories. Altering the specificity hypothesis to be more nuanced in its predictions would suggest that parental conflict may be important in the initiation of drinking but not in early escalation of drinking. In other words, it is possible to provide more nuanced versions of the specificity hypothesis without alluding to broader terms such as “social” or “individual” variables and, hence, to potentially avoid a false dichotomy.

The present study needs to be interpreted according to several limitations. Study findings should not be generalized to heavier forms of drinking that are likely to emerge during later developmental periods, because our results are based on low levels of drinking during the early developmental phases of alcohol use. In addition, all of our measures consisted of self-report, which is susceptible to recall or self-presentation biases. Finally, all of our predictor variables were measured at Wave 1, which provides a static snapshot of development, because these constructs may change across adolescence.

In sum, the present study suggests that there may be some specificity in the predictors of early drinking milestones. Most notably, we replicated the finding that parental conflict predicts who is likely to initiate drinking but does not predict escalation of drinking. However, labeling such effects as being supportive of social versus individual-level processes may create an artificial and potentially invalid dichotomy. Long-term, multi-wave prospective studies are needed to investigate the dynamic set of processes that culminate in drinking, as well as how the predictors of drinking (e.g., parental conflict) emerge.

Footnotes

This sample was drawn from a larger study funded by National Institute on Alcohol Abuse and Alcoholism Grant R01 AA16838 (principal investigator: Kristina M. Jackson). Preparation of this study was supported by National Institutes of Health Grants T32 AA007459, K01 AA022938, and K02 AA021761.

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