A Developmental Perspective on Alcohol Use and Heavy Drinking during Adolescence
and the Transition to Young Adulthood*
JOHN E. SCHULENBERG, Ph.D., and JENNIFER L. MAGGS, Ph.D.† Survey Research Center, Institute for Social Research and Department of Psychology,
University of Michigan, Ann Arbor, Michigan 48106-1248
ABSTRACT. Objective: This article offers a developmental perspective
on college drinking by focusing on broad developmental themes during adolescence
and the transition to young adulthood. Method: A literature review was
conducted. Results: The transition to college involves major individual
and contextual change in every domain of life; at the same time, heavy drinking
and associated problems increase during this transition. A developmental contextual
perspective encourages the examination of alcohol use and heavy drinking in
relation to normative developmental tasks and transitions and in the context
of students' changing lives, focusing on interindividual variation in the course
and consequences of drinking and on a wide range of proximal and distal influences.
Links between developmental transitions and alcohol use and other health risks
are discussed in light of five conceptual models: Overload, Developmental Mismatch,
Increased Heterogeneity, Transition Catalyst and Heightened Vulnerability to
Chance Events. We review normative developmental transitions of adolescence
and young adulthood, focusing on the domains of physical and cognitive development,
identity, affiliation and achievement. Conclusions: As shown in a selective
review of empirical studies, these transitions offer important vantage points
for examining increasing (and decreasing) alcohol and other drug use during
adolescence and young adulthood. We conclude with a consideration of research
and intervention implications. (J. Stud. Alcohol, Supplement No. 14:
54-70, 2002)
"I'm 21 and in my prime drinking years, and I intend to take full advantage
of it!"
College student, after a few drinks at a wedding
AS RESEARCHERS and practitioners, we may some-
times underestimate the clarity of young people's
thinking about their alcohol use. Most view late adolescence
and early adulthood as a time when drinking is common
and accepted. Among those who drink, the large
majority perceive social and coping benefits of alcohol use
and even occasional heavy drinking; they tend to limit their
drinking such that it interferes little with work and school
responsibilities; and they will diminish their heavy drinking
as they move into adult roles. Although many experience
negative consequences, most make it through their
"prime drinking years" with, in balance, more positive experiences
with alcohol than negative ones. At the same time,
alcohol use becomes problematic and tragic for many. Heavy
drinking, alcohol-related problems and associated risky and
illegal behaviors peak during late adolescence and early
adulthood (Baer, 1993; Johnston et al., 2001a,b), as do problems
with substance use in general (Glantz et al., 1999;
Johnston et al., 2001a,b). This period is an important juncture
in the etiology of alcohol misuse and alcoholism, a
time when initiation and escalation of heavy drinking may
set the stage for lifelong difficulties (e.g., Babor et al., 1992;
Zucker, 1987). Even sporadic drinking can lead to a lifealtering
tragedy when combined with a lapse of judgment
or with simple misfortune.
Recognizing how drinking fits into the lives of most
young people is a necessary foundation for effective remedies.
In the United States (and many other countries;
Fillmore et al., 1993), alcohol use and heavy drinking are
culturally embedded in the experience of adolescence and
the transition to young adulthood in general (Blane, 1979;
Donovan et al., 1983) and in the college experience in particular
(Straus and Bacon, 1953; Wechsler et al., 1998).
During high school, college-bound students have lower rates
of alcohol and other drug use than their noncollege-bound
classmates; in the years immediately following high school,
however, college students have higher rates of alcohol use
and frequent heavy drinking (but still lower rates of use of
other substances) (Johnston et al., 2001a,b; Schulenberg et
al., 2001a).
Perhaps most indicative of the embeddedness of heavy
drinking in the transition to young adulthood is the remarkable
historical stability in rates of frequent heavy drinking
(i.e., five or more drinks in a row). During the past two
decades, despite many social, demographic, political and
economic changes-and despite dramatic shifts in cigarette
and illicit drug use-rates of frequent heavy drinking among
those ages 19-22 have shifted little (average 2-week rate of
39%), especially for college students (42%) (Johnston et
al., 2001a,b). This imperviousness to historical change, and
to numerous national and local intervention efforts, suggests
that excessive drinking during the transition to young
adulthood and especially in college is overdetermined (see
Wechsler et al., 1998). This is not to justify excessive drinking
nor to convey pessimism about the effectiveness of ongoing
interventions, but rather to underscore that a multitude
of forces at the cultural and individual levels keep this phenomenon
in place for many young people.
Our purpose is to provide a developmental perspective
on college drinking by examining how the many developmental
transitions of adolescence and young adulthood relate
to the etiology of alcohol use and heavy drinking. By
taking this broader developmental view, we hope to portray
the many ways that drinking can fit into the lives of
young people in general, and college students in particular.
We first consider the meaning and importance of taking a
developmental perspective. We then present a conceptual
and empirical summary of normative developmental transitions
and discuss how they relate to alcohol use. We conclude
with a discussion of research, intervention and policy
implications.
Developmental Perspective on the Etiology of Alcohol
Use and Heavy Drinking
An important question for anyone interested in adolescence
is the extent to which this time in life is inherently
troublesome. G. Stanley Hall (1904), the founder of the
scientific study of adolescence (Muuss, 1996), gave us the
enduring image of adolescence as a time of unavoidable
"storm and stress." According to Hall, we can do little to
ease adolescents' pain because development is largely controlled
by evolution and biology and thus generally unaffected
by culture or context. That is, adolescence is "just a
stage," and when it passes, civility and mental health will
return. This view is consistent with psychoanalytic theories:
Anna Freud (1958), in particular, argued that the lack
of adolescent storm and stress signified psychopathology.
In contrast, Margaret Mead (1950) and Ruth Benedict (1950)
viewed storm and stress primarily as a cultural phenomenon
due to the discontinuity in roles and responsibilities
between childhood and adulthood in modern societies (see
also Schlegel and Barry, 1991). Similarly, Robert Havighurst
(1952) viewed adolescent difficulties in terms of a failure
to accomplish necessary age-graded, culturally defined developmental
tasks.
Although diversity in present-day scientific images of
adolescence remains, reflecting strong roots in biology and
culture, the notion that adolescence is necessarily a turbulent
time has received little empirical support (e.g., Douvan
and Adelson, 1966; Lerner and Galambos, 1998). A common
view consistent with our own perspective is that "adolescence
is characterized by change, and is challenging, but
it need not be tumultuous and problematic unless societal
conditions prompt it" (Petersen and Leffert, 1995, p. 3).
Building on this view, this section provides a brief discussion
of some key developmental themes as they relate to
the etiology of alcohol use and heavy drinking during adolescence
and the transition to young adulthood (see also
Schulenberg and Maggs, 2001; Schulenberg et al., 2001b).
Developmental-contextual perspective
The developmental-contextual perspective emphasizes
multidimensional and multidirectional development across
the life span, characterized by a dynamic and progressive
mutual selection and accommodation of individuals and their
contexts (Baltes, 1987; Elder, 1998; Lerner, 1982; Sameroff,
1987). Humans are viewed as playing a strong role in their
own development (Caspi and Moffitt, 1993; Lerner, 1982;
Scarr and McCartney, 1983). Through a process of niche
selection, individuals elect environments and activities based
on personal characteristics, skills, beliefs and goals. Selected
ecological niches then expose them to various opportunities
and constraints (Nurmi, 1993; Plomin et al.,
1997; Scarr and McCartney, 1983).
To help envision contextual influences and person-context
interactions on development, Bronfenbrenner (1979)
offered an ecology of human development framework that
involves nested, interconnected systems to represent the
structure of the social context. The developing individual's
primary contexts (microsystems) include, for example, his
or her family and school. Interrelations among microsystems
(mesosystems) are extremely important in that harmonious
ties among microsystems (e.g., supporting common goals
for the developing individual) are generally viewed as beneficial.
Additional systems include exosystems (i.e., influential
external contexts, such as the child's parents' work
settings) and macrosystems (i.e., broader cultural and historical
influences) in which all the other systems are
embedded.
Central to our goal of linking developmental transitions
with alcohol use are ecological transitions, which Bronfenbrenner
(1979) defined as occurring "whenever a person's
position in the ecological environment is altered as a result
of a change in role, setting, or both" (p. 26). Ecological
transitions typically involve changes at the individual,
microsystem and mesosystem levels. As a result of a given
transition, mesosystems among new and recurring micro-
systems may become stronger or weaker, which in turn has
implications for the developing individual's health and wellbeing.
Furthermore, links between pretransitional microsystems
(e.g., high school) and new microsystems (e.g.,
college) can be viewed as mesosystems as well, suggesting
the importance of contextual influences on successful adaptation
during transitions.
This emphasis on ecological transitions highlights both
developmentally proximal and distal influences on behavior,
setting the foundation for considerations of turning
points and developmental discontinuity (Elder, 1998; Rutter,
1996). Furthermore, following from the emphasis on person-
context interactions, considerations of interindividual
similarities and differences in intraindividual change are
essential, with less emphasis on normative trends in developmental
change and more emphasis on different trajectories
ofchange over time.
As we illustrate throughout this article, key developmental
themes-including person-context interactions, continuity
and discontinuity, distal and proximal influences and
individual differences and similarities in intraindividual
change-represent important foundations for understanding
how alcohol and other drug use fits into the lives of young
people.
Trajectories of frequent heavy drinking
When considering the etiology of heavy drinking during
adolescence and the transition to young adulthood, it is
essential to examine different trajectories of drinking over
time; otherwise, one may be misled by the normative developmental
trend and fail to appreciate the wide diversity
of patterns of change in heavy drinking over time (e.g.,
Bates and Labouvie, 1997; Guo et al., 2000; Muthén and
Muthén, 2000; NIAAA, 2000). For example, based on the
Monitoring the Future data, Schulenberg et al. (1996a) examined
distinct trajectories of change in frequent heavy
drinking (i.e., five or more drinks in a row) across four
waves during the transition to young adulthood (ages 18-
24). Using conceptual groupings and cluster analysis, they
found six trajectory groups labeled as Chronic, Decrease,
Increase, Fling, Rare and Never. (About 10% of the sample
was Other.) The mean scores for these trajectory groups
(except the Never group, representing 36% of the sample)
are illustrated in Figure 1. Note the discrepancy between
what is learned from the "total" line versus from the trajectory
group lines.
FIGURE 1. Mean score for 5+ drinks in a row in past 2 weeks by frequent heavy drinking trajectory group
There are important differences in the prevalence of the
trajectory groups according to demographic factors and
student status. Women are underrepresented in the Chronic
and Increase groups and overrepresented in the Never group;
white youths are generally overrepresented in all heavy episodic
drinking groups except the Never group. Compared
with their noncollege agemates, college students are overrepresented
in the Increase and Fling groups and
underrepresented in the Decrease group. Compared with
students who live with their parents, those who live away
and especially those who are active in fraternities or
sororities are overrepresented in the Chronic, Increase and
Fling groups and underrepresented in the Never group
(Schulenberg, 1999; Schulenberg et al., 1996a; see also
Bachman et al., 1997).
By focusing on differential change in alcohol use, we
can see more clearly how a given level of use at one point
in time represents a number of different more or less troublesome
trajectories. Frequent heavy drinking during the first
year of college may reflect continuity of a pattern established
in high school, or it may reflect a newly emergent,
time-limited pattern (see Figure 1). Similarly, as Weber et
al. (1989) found among two groups of high school students
with similarly high levels of substance use, one group had
a lengthy prior history of persistent and severe difficulties,
and the other group had only recent and moderate difficulties.
In these examples, which illustrate the concept of
equifinality (discussed below), different trajectories that lead
to similar endpoints can reflect very different antecedents
and possible remedies (Loeber, 1982; Moffitt, 1993; Moffitt
et al., 1996; Zucker et al., 1995). Likewise, heavy drinking
during the first year of college may or may not reflect a
future escalating trajectory (illustrating multifinality, discussed
below). Although many young people who misuse
substances experience ongoing misuse extending into adulthood,
most desist with the onset of adulthood roles
(Bachman et al., 1997; Jessor et al., 1991). These two distinct
trajectories of misuse stemming from a similar initial
level have different implications for consequences and
remedies.
Risk and protective factors from a developmental
perspective
A more developmentally sensitive understanding of risk
and protective factors will provide a stronger foundation
for addressing fundamental questions about substance use
etiology and intervention (Clayton, 1992; Schulenberg et
al., 2001b). A quarter century of empirical work has yielded
a large and sometimes overwhelming array of substance
use risk and protective factors (e.g., see Hawkins et al.,
1992; Petraitis et al., 1995). The task now for scientists is
to understand more fully how risk and protective factors
are linked with substance use within individuals over time
and across contexts (Bates and Labouvie, 1995; Cicchetti,
1999). Below, we highlight three key issues of concern
when examining risk and protective factors from a developmental
perspective (see also Schulenberg et al., 2001b).
Relationship between risk and protective factors. Risk
and protective factors can be viewed as opposite ends of
the same continuum. An alternative view is that protective
factors moderate or buffer the effects of risk factors (Brook
et al., 1992; Garmezy et al., 1984; Hawkins et al., 1992;
Lonczak et al., 2001); that is, protective factors operate in
the presence of risk factors whose effects they attenuate. A
supportive family context, for example, may have a stronger
protective effect on substance use in the presence of
negative peer influences (Marshal and Chassin, 2000;
Oetting and Beauvais, 1986). Protective factors also may
operate by reducing the likelihood of risk factors (e.g., strong
family relations reduce the presence of negative peer influences
by influencing the adolescent's choice of friends).
Equifinality and multifinality. One of the most compelling
reasons for long-term panel studies on substance use is
to identify why great numbers of individuals do not develop
serious substance misuse problems despite exposure
to significant risk factors, and likewise why many individuals
do develop problems despite little exposure to risk
factors (Andersson, 2000; Cicchetti, 1999; NIAAA, 2000;
Rutter, 1989). The concepts of equifinality and multifinality
highlight the probabilistic nature of risk and protective factors
(Cicchetti and Rogosch, 1996). With equifinality, different
distinct constellations of risk and protective factors
can lead to the same outcome. For example, heavy drinking
in college may be caused, in part, by parental alcoholism
for some young people and by social anxiety for others.
With multifinality, a given constellation of risk and protective
factors can lead to many alternative outcomes. Parental
alcoholism, for example, increases the likelihood of
alcohol misuse and dependence (Sher, 1991) as well as of
becoming an abstainer. No single risk or protective factor
is sufficient or necessary for particular outcomes, thus requiring
conceptualizations that focus on the diversity of
causal connections (Cairns et al., 1998; Cloninger et al.,
1997; Newcomb, 1997; Wachs, 2000).
Robustness and continuity of risk and protective factors.
Very few risk or protective factors are universal, but rather
vary by important demographic and individual characteristics,
such as gender (e.g., Hops et al., 1999; Wilsnack, 1995).
Likewise, very few risk or protective factors are developmentally
continuous. In particular, risk factors for substance
use onset may be quite different from risk factors for substance
use maintenance and escalation (e.g., Ellickson and
Hays, 1991; Newcomb, 1997) and may vary with age at
onset (Brook et al., 1999).
Risk and protective factors can be viewed as being robust
(i.e., predict current levels of and future changes in
substance use), emergent (i.e., predict future changes but
not current levels) or concurrent (i.e., predict current levels
but not changes). For example, Schulenberg et al. (1996b)
found that at age 18 the drinking motivation of "to get
drunk" was a robust risk factor and self-efficacy was an
emergent protective factor with respect to current and future
increases in heavy drinking. But concurrent risk and
protective factors are far more common, and, in longitudinal
studies spanning the transition to young adulthood, most
substance use risk and protective factors are only concurrent
(e.g., Bates and Labouvie, 1997; Gore et al., 1997;
Schulenberg et al., 1996b). Concurrent risk and protective
factors may change in unison with the changes in substance
use, reflecting a continuous association with substance use
and their reciprocal relations (Kandel and Raveis, 1989), or
they may simply be developmentally limited. Concurrent
risk and protective factors may also represent more developmentally
or contextually proximal influences, perhaps
mediating the effects of distal influences (see Hussong and
Chassin, 1997; MacKinnon, 1994; Patterson et al., 1989;
Petraitis et al., 1995).
Developmental Transitions and Health Risks
during Adolescence and Young Adulthood
The passage into young adulthood is a critical time during
which diversity in life trajectories increases (Schulenberg
et al., 2000; Sherrod et al., 1993). For many, this period
begins when the young adult moves away from home to
begin college and live in student residences. As with other
developmental changes, this transition involves both gains
and losses (Baltes, 1987; Cantor and Langston, 1989), such
as new friendship networks, but separation from family and
old friends; more academic choices, but new academic demands;
and increased independence, but decreased parental
guidance and support. Amid all these transitions, alcohol
use and heavy drinking tend to escalate, a co-occurrence
that is far more than coincidental.
In this section and the next, we address this cooccurrence
by examining how various developmental transitions
relate to substance use. Building on the developmental
contextual perspective, we discuss definition and conceptual
issues regarding transitions and examine five conceptual
models concerning the link between transitions and
health risks.
Defining and conceptualizing developmental transitions
Developmental transitions are "the paths that connect us
to transformed physical, mental, and social selves"
(Schulenberg et al., 1997, p. 1). Puberty represents an obvious
major transition, as does moving from high school to
college, from school to work and from being single to getting
married. There are many other more subtle yet significant
transitions. For example, a young adolescent who
usually does what she is told begins to argue persuasively
against her parents' directives; a small same-sex group of
friends becomes folded into a larger group made up of boys
and girls, which in turn is replaced by individual friendships
and dating relationships; and a concrete and typically
unquestioned self-definition becomes more abstract and tentative,
and eventually more hierarchic and future oriented.
Together, these and many other transitions provide the structure
that transforms children into adolescents and adolescents
into young adults.
Individuals can shape their own developmental transitions,
as they act on and are acted on by their contexts
(Lerner, 1982; Scarr and McCartney, 1983). Indeed, the
transition to adulthood years is characterized by increasingly
diverse options, opportunities and constraints, and thus
behavioral choices may influence transition outcomes to a
greater extent than ever before. Developmental transitions
are embedded in a sociocultural context and therefore may
vary by gender, class, culture and historical period. Culturally
based, age-related expectations, or "scripts," shape these
transitions by providing a normative timetable and agenda
(e.g., for employment, parenthood) (Neugarten, 1979). Developmental
transitions can be normative or nonnormative
and can vary in timing, sequence and importance depending
on their prevalence within a given population and on
personal goals and life situations (Baltes, 1987; Nurmi,1997).
Developmental transitions, tasks and trajectories. Developmental
transitions are similar to developmental tasks
(Havighurst, 1952), which are socially and biologically prescribed
psychosocial tasks that "should" be accomplished
during specific sensitive periods across the life span. Although
transitions and tasks are related and sometimes even
overlap (e.g., the task of selecting a mate versus the transition
to marriage), transitions pertain more to the actual process
of change than to the accomplishments that contribute
to and result from the changes. Transitions are also distinct
from trajectories (see Cairns and Cairns, 1994; Crockett
and Crouter, 1995), which refer to patterns of systematic
and successive change over time that can incorporate several
developmental transitions (Elder, 1998). By viewing
transitions as embedded in ongoing individual trajectories,
it is possible to consider transitions as potential turning
points reflecting successive increases or decreases in functioning
(Rutter, 1996).
Discontinuity and continuity. Issues of discontinuity and
continuity are central to understanding the power of major
developmental transitions on individuals' lives (Petersen,
1993; Rutter, 1996). For instance, apparent discontinuities
in functioning across transitions may reflect momentary disturbances,
after which one's ongoing trajectory will resume.
Likewise, change in functioning during a transition that appears
to reflect discontinuity may represent the continuity
of adaptation (i.e., phenotypic discontinuity may reflect genotypic
continuity) (NIAAA, 2000). But consistent with a
developmental-contextual perspective, particularly with the
notion of ecological transitions (Bronfenbrenner, 1979),
major transitions like the transition to college can permanently
alter one's ongoing trajectory of health and well being.
Indeed, such transitions can be viewed as catalysts
or even primary mechanisms for the multifinality of earlier
experiences. For example, although the majority mature out
of their heavy drinking (Bachman et al., 1997), some continue
into adulthood with increasing heavy drinking and
related problems. Differentiating these two groups before
the transition is difficult (e.g., Baer, 1993; Blane, 1979;
Jackson et al., 2001; Windle and Davies, 1999), suggesting
that the transition itself may impact the continuation of
alcohol-related problems into adulthood (see Tarter and
Vanyukov, 1994).
Distal and proximal developmental influences. Closely
tied to issues of continuity and discontinuity are distal and
proximal developmental influences. Developmental transitions
reflect proximal developmental influences. Distal and
proximal influences are often intertwined: Distal influences
may structure proximal influences, and in turn proximal
influences may mediate the effects of distal influences. But
proximal developmental influences in general and developmental
transitions in particular may operate independently
of distal influences or may even disrupt distal influences,
thus setting the stage for discontinuity.
Conceptual models relating developmental transitions
to substance use
Behavioral and lifestyle health risks tend to increase during
adolescence as a direct or indirect function of numerous
developmental transitions. To consider this relationship
between transitions and health risk changes, and specifically
college-relevant transitions and substance use, we
briefly describe five interrelated conceptual models based
on our previous work (Schulenberg and Maggs, 2001;
Schulenberg et al., 1997, 2001b) and that of others (Graber
et al., 1998). The models are summarized in Table 1; intervention
implications are discussed later.
The Overload Model views health risks as a potential
result of experiencing multiple developmental transitions
over a relatively short time. This model is consistent with
cumulative stress theory, drawing attention to the multiple
role changes demanded by major life transitions (Coleman,
1989; Simmons and Blyth, 1987). In the transition to college,
individuals begin as adolescents and end as young
adults; they change from high school to university student
status, sibling to roommate, child in a family to adult in an
apartment or residence hall and so on. When multiple transitions
overwhelm coping capabilities, well-being may suffer.
Health risk behaviors including substance use may serve
as alternative coping strategies (Damphousse and Kaplan,
1998; Pandina et al., 1990; Wills and Hirky, 1996).
The Developmental Mismatch Model highlights how developmental
transitions can alter the match between individuals
and their contexts. Building on person-environment
fit theory, the developing individual is viewed as embedded
in a changing ecological niche, such that the match
between individual developmental needs and opportunities
provided by the context is itself dynamic (e.g., Eccles et
al., 1993; Galambos and Ehrenberg, 1997; Lerner, 1982).
Transitions can improve the match and thus provide opportunities
for increased health, or they can lessen the match
and thus adversely affect health. In many ways, the transition
to college (and to young adulthood more generally)
represents a new beginning with opportunities to make new
friends, enjoy newfound freedom, explore educational and
future career alternatives and experiment with different behaviors
and lifestyles. For most young people, such opportunities
provide an improved match with their developmental
needs, which helps explain why well-being tends to increase
more rapidly for those students who go away to
college (Schulenberg et al., 2000). For others, however,
these opportunities may not match their needs, thus setting
the stage for increased health risks (e.g., by their seeking
fulfillment in unhealthy compensatory contexts). Transitions
may also affect health by altering the match between the
individual's immediate contexts (i.e., the mesosystem level)
(Bronfenbrenner, 1979). For example, if new peer and academic
contexts engender significantly competing goals,
health risks are likely to increase.
The Increased Heterogeneity Model suggests that challenging
transitions magnify existing strengths and weaknesses,
thus increasing interindividual differences in
functioning and adjustment. These differences tend to increase
throughout adolescence between those who cope effectively
with various stressors and those who do not (e.g.,
Kazdin, 1993; Petersen, 1993). Young people already experiencing
difficulties (perhaps including difficulties in negotiating
earlier major transitions) may have more trouble
in negotiating new transitions and fall further behind their
well-functioning peers. For vulnerable individuals who lack
social, academic and organizational skills, moving away
from home to live in an unfamiliar university environment
can be intensely stressful (Compas et al., 1986; Shaver et
al., 1985; Zirkel, 1992). In contrast, socially and academically
confident students may be primed to take advantage
of all that the college experience has to offer. This third
model represents, in part, an elaboration of the first two
models; it focuses on individual differences in ongoing developmental
trajectories and thus interweaves distal and
more proximal developmental influences (e.g., see Cairns
and Cairns, 1994; Caspi et al., 1988; Crockett and Crouter,
1995).
In the Transition Catalyst Model, risk taking in general
is viewed as an important component of negotiating certain
developmental transitions. The idea that some amount of
risk taking is normative is supported by high prevalence
rates and evidence that it may accompany healthy personality
development (e.g., Baumrind, 1987; Silbereisen et al.,
1986). According to Chassin et al. (1989), risk taking and
even deviance can serve "constructive" as well as "destructive"
functions in health and development (see also Jessor
and Jessor, 1977; Silbereisen and Noack, 1986; Spear, 2000).
As Maggs (1997) demonstrated, alcohol use during the transition
to college may help to achieve valued social goals,
such as making new friends, yet may threaten safety and
short- and long-term health and well-being. Alternatively,
substance use can be used to avoid transitions, such as remaining
as a "full-time" undergraduate student for 5, 6 or
more years and thus delaying adult roles and responsibilities.
The Heightened Vulnerability to Chance Events Model
is based on the role of chance in altering the courses of
lives (Bandura, 1982) and thus addresses the question of
why many difficulties are seemingly unpredictable. Just as
there are interindividual differences in receptivity to chance
events, there are also intraindividual fluctuations in this receptivity,
with certain periods along the life span being
more amenable to chance effects. Major developmental transitions
that involve new contexts, such as the transition to
college, may be particularly propitious junctures because
they engender heightened sensitivity to, and exploratory behavior
of, the new context and the self in relation to the
new context. Young people in transition are likely to seek
out, and be open to the effects of, many novel experiences,
which increases their vulnerability to the negative effects
of chance events, including increased substance use and
increased negative consequences of such use.
These five models are not mutually exclusive. Although
some of the models can be viewed as competing ones (especially
the first three), they are more appropriately viewed
as representing the diverse array of connections between
developmental transitions and health risks, especially substance
use. Together, the five models represent only part of
the total relational structure between substance use and developmental
influences, correlates and outcomes. These
models, by focusing on transitions, highlight the more developmentally
proximal and contextually based connections
with substance use, a set of connections that are central to
understanding college drinking. Simply, when searching for
the developmental roots of college drinking, it is often unnecessary
or unproductive to go very far "upstream." This is not
to deny distal and longer term developmental influences
on college drinking, and indeed our Increased Heterogeneity
Model interweaves developmental transition
influences with ongoing health risk trajectories. Clearly,
there are powerful early influences that exert ongoing direct
and indirect effects on individuals' adjustment in general
and alcohol use and misuse in particular (Chassin et
al., 1999b; NIAAA, 2000; Sher et al., 1999; Windle and
Davies, 1999). As we discussed earlier, integrating our
proximal focus with the predominant longer term developmental
focus can yield broader models that more fully capture
the complexities of developmental-substance use
relationships.
Domains of Developmental Transitions and Alcohol Use
We now turn to a consideration of the specific developmental
transitions of adolescence and young adulthood, focusing
on the broad domains of biology, cognition, identity,
affiliations and achievement (see Schulenberg et al., 1997).
We provide a selective review of the empirical literature to
show how these transitions relate to alcohol and other drug
use.
Puberty and physical development
Physical changes. Pubertal development during early
adolescence is characterized by a rapid acceleration in
growth and the development of primary and secondary sex
characteristics. By the end of high school, most adolescents
have attained full adult height and reproductive capacity.
Hormonal changes and societal expectations combine
to increase adolescents' interest in romantic and sexual relationships
(Udry, 1990) and their tolerance of alcohol
(Spear, 1999). The early 20s are also when peak physical
functioning occurs (e.g., heart and lung strength, athletic
performance) (Arnett, 2000), making it more possible to
overcome alcohol's physical effects quickly (Spear, 2000).
Looking (and desiring to be) older. As a result of pubertal
changes, adolescents attain an increasingly adult appearance,
begin to resemble cultural ideals of adult attractiveness
and may be mistaken for young adults, facilitating the illegal
purchase of alcohol (Wagenaar et al., 1996). Individuals
(particularly girls) who mature earlier are more likely
to associate with older, more deviant peers (Magnusson et
al., 1986). These multiple simultaneous transitions may overload
coping capacities (i.e., the Overload Model), setting
the stage for increased alcohol and other drug use. Consistent
with the Transition Catalyst Model, alcohol use can
also be seen as an attempt to appear older (Jessor, 1992):
Adolescents aware of adult status privileges including autonomy
may view the ability to obtain alcohol as a desired
privilege of adulthood.
Cognitive development, perspective taking and decision
making
Normative cognitive changes. Major transformations in
cognitive reasoning abilities occur during early adolescence,
including increases in abstract and hypothetical thinking
and the tendency to view issues as relative rather than absolute
(Keating, 1990). As a result, adolescents often seem
to become more argumentative as they begin to think for
themselves and question authority (Smetana, 1988). Adult
perceptions of reality become viewed as simply one of many
possible perspectives. In addition, teens can now see themselves
from the perspective of peers and are acutely aware
that their own behavior may affect their image and
popularity.
Invincible and invulnerable? Adolescents are commonly
assumed to think themselves invulnerable, believing the
"personal fable" that no harm will come to them (Elkind,
1967). However, research contrasting adolescent with adult
decision making has not supported clear age differences in
invincibility or the personal fable (e.g., Quadrel et al., 1993).
Clearly, with their ability for abstraction, adolescents understand
probabilities better than children and may imagine
possible negative consequences of actions. How adolescents
(and adults) value and weigh the relative costs and benefits
of potentially risky behaviors is an area of active debate
and research (Beyth-Marom and Fischhoff, 1997). For many,
the decision to drink is a given, and decision making becomes
centered on when, with whom and how much to
drink. Such decisions may make the difference between
moderate drinking and heavy drinking, and, at least theoretically,
decision-making models can be useful for understanding
these decisions. Practically, however, such models
may have limited utility given that many alcohol use decisions
occur in social groups when individuals are not sober.
Age-related changes in alcohol outcome expectancies.
Alcohol expectancies refer to the expectations individuals
have for the positive and negative outcomes of drinking
alcohol. With age, adolescents become increasingly aware
of potential benefits of drinking alcohol and become less
convinced of costs or risks (Goldman et al., 1999; Johnson
and Johnson, 1996; Maggs and Schulenberg, 1998; Miller
et al., 1990). The simultaneous awareness of alcohol's costs
and benefits is facilitated by an increased abstraction ability.
These normative age-related changes represent a significant
challenge for prevention because endorsement of
positive alcohol expectancies is a powerful risk factor for
alcohol use and misuse (Goldman, 1994).
Identification of adult hypocrisy. Children may accept
blanket adult statements that alcohol is bad for people under
age 21; college students often view such messages as
hypocritical, especially when they conflict with common
cultural behaviors. As a result, programs and messages targeted
at college students need to be realistic about the
ineffectiveness of prohibition approaches. In many contexts,
harm reduction approaches should be seriously considered (see e.g., Marlatt, 1998).
Identity domain transitions
Adolescents and young adults experience fundamental
changes in their self-definition and identity (Erikson, 1968;
Phinney and Kohatsu, 1997). Ideally, personal identity formation
occurs as individuals, through exploration and commitment,
develop a secure and enduring sense of self that
encompasses an integrated set of personal interests, values,
goals and commitments (Nurmi, 1997). Through a process
of questioning previously taken-for-granted beliefs and assumptions,
older adolescents actively explore alternative
philosophies, behaviors and lifestyles. Although identity exploration
is associated with instability in well-being, as well
as with potentially health-compromising experimentation
and risk taking, subsequent identity achievement predicts
higher levels of well-being and a lower incidence of healthcompromising
behaviors (Jones, 1992).
Although identity exploration is normative and healthy,
it may represent a risk factor for experimentation with risky
behaviors. The role played by alcohol use in adolescents'
and young adults' lives is paradoxical. Consistent with the
Transition Catalyst Model, despite the possibility of serious
harm, drinking also may serve important constructive
functions, such as helping to make friends or to explore
personal identities (Chassin et al., 1989; Jessor, 1992). As
a result, some have questioned the wisdom of attempting to
limit experimentation and exploration because this may leave
individuals without a self-determined commitment to an
identity and to personal values (e.g., Baumrind, 1987;
Marcia, 1994).
Affiliation domain transitions
Relationships with parents. The second decade of life is
a period of significant reorganization and change in family
relationships (Grotevant, 1987). Normative transformations
include increased autonomy and independence from parents,
ideally in a context of continued support and attachment
(Silverberg and Gondoli, 1996). The quantity of
interaction often decreases: Older adolescents spend less
time in family activities (Larson et al., 1996) and more
time in contexts outside the family such as at school, with
peers and at work. Despite decreases in the frequency of
interaction, the quality of relationships typically improves
following the physical departure of the child from the family
home (e.g., Aseltine and Gore, 1993; Pipp et al., 1985).
Alcohol use tends to increase as adolescents become more
individuated from parents (e.g., Baer and Bray, 1999) and
as parental monitoring tends to lessen (Barnes et al., 2000).
However, those who internalize positive parental norms may
make wiser choices in the long term (e.g., Brody et al.,
2000). During college, students continue to seek parental
support and assistance in times of stress. Parent support
predicts commitment to career development and persistence
(Pascarella and Terenzini, 1991). Clearly, students' relationships
with parents continue to play a major protective
role in promoting their development and success.
Sibling influences. Older siblings' substance use predicts
early adolescents' alcohol expectancies (D'Amico and
Fromme, 1997) and subsequent substance use, above and
beyond parental predictors (Duncan et al., 1996; Windle,
2000). Behavior genetic studies also suggest that, unlike
many other sibling similarities and parental influences that
may reflect passive genotype-environment interactions,
sibling similarities in alcohol use involve important environmental
effects (e.g., McGue and Sharma, 1995). Mechanisms
by which siblings impact substance use may include
modeling, direct social influence and access.
Peer relationships. Alcohol use is inextricably linked to
social relationships with peers. During the college years,
many social activities occur in drinking contexts, and these
interactions may be facilitated by alcohol. Sociability expressed
while drinking can serve as a marker of successful
peer relationships and social group bonding (Newcomb and
Bentler, 1988; Silbereisen and Noack, 1986). Normative
age-related increases in the importance of peer relations
and culture heighten exposure to cultural norms and influences
that may (or may not) be compatible with the values
of the family of origin (Berndt, 1992; Brown et al., 1997).
Individuals who move away from home to attend college
often become part of a strongly age-graded world. Many
cultural myths and norms support a legendary period of
partying during the first years of college. However, peer
influences are not monolithic in their power or direction of
influence (e.g., Brown et al., 1997). Individuals tend to seek
out and be selected by peers who have similar goals, values
and behaviors (Kandel et al., 1990).
At least three kinds of peer influences may serve as risk
factors for increased alcohol use. First, susceptibility to peer
influences increases through at least middle adolescence,
making individuals more willing to go along with their
peers' suggestions (e.g., Dielman, 1994; Steinberg and
Silverberg, 1986). The uncertainty of adapting to a new
college environment may temporarily exacerbate such tendencies
(Caspi and Moffitt, 1993). Second, similarities between
adolescents and their friends encourage continuity of
behavior over time (Fisher and Bauman, 1988; Kandel et
al., 1990). Third, perhaps due to cultural myths, students
tend to significantly overestimate the prevalence of drinking
on campus. Such inflated "norms" provide a not-so subtle
form of pro-drinking influence, as individuals may
want to fit in with perceived group behavior (Baer and
Carney, 1993; Prentice and Miller, 1993).
Romantic and sexual relationships. The adolescent years
bring dramatic changes in sexual feelings and identity, as
well as experimentation with romantic relationships and
sexual behaviors. Pubertal changes provide the biological
foundation for these transformations, but there are equally
important cognitive, emotional, interpersonal and social antecedents
as well. Brooks-Gunn and Paikoff (1993) identified
four developmental challenges for adolescents in the
domain of sexuality: becoming comfortable with one's maturing
body, accepting feelings of sexual arousal, understanding
that sexual behaviors should be mutually voluntary
and practicing safe sex. Because these challenges are profoundly
personal yet fundamentally relational, involving
complex feelings, shared behaviors and sometimes confusing
interactions with others, they are likely to remain important
developmental tasks during college and beyond.
At age 18, approximately 70% of adolescents have engaged
in sexual intercourse (Alan Guttmacher Institute,
1994). The majority of these have had sex with only one
partner and do so relatively infrequently. Thus, many have
little sexual experience, confidence or skills when they begin
college. Coupled with a developmentally normative intense
interest in finding a romantic partner, many students'
limited sexual experience makes them likely to experience
sexual situations that may be unplanned, unreciprocated or
nonconsensual. Early in a relationship, safe sex may be
unlikely, in part because of a lack of organization, discomfort
discussing the issue and fear of implying that a partner
is unhealthy.
Alcohol use may be paired with early sexual experiences
in several ways. The desire to get to know potential
partners may lead individuals to seek out social contexts
where alcohol is served, and positive expectancies about
the social and sexual enhancement properties of alcohol
can increase motivations to drink (Cooper and Orcutt, 1997).
Alcohol consumption in turn can make sexual behaviors in
general and unsafe behaviors in particular more likely by
reducing inhibitions, giving courage and providing an "excuse"
for getting wild (Dermen et al., 1998).
Just as new intimate relationships can increase alcohol
use, the transition into more committed relationships, such
as marriage or even engagement, can decrease it (Leonard
and Rothbard, 1999). Indeed, this general "marriage effect"
appears to explain normative age-related decreases in alcohol
and other drug use (Bachman et al., 1997).
Achievement domain transitions
Adolescents and young adults face a series of major educational
and/or occupational transitions. Successful adaptation
to and performance in educational and occupational
domains is healthy development. The acquisition of knowledge,
critical thought and practical skills helps define concurrent
and future optimal development (Clausen, 1991).
In contrast, difficulties in negotiating these critical transitions
can contribute to cumulative and emergent health risks.
School transitions. Before college, adolescents typically
experience transitions to middle school and high school.
Embedded in these formal contextual changes are more
gradual and subtle alterations, including spending the day
with one teacher to moving between classrooms with specialized
instructors (Eccles et al., 1993). Postsecondary education
takes these shifts further, to classes in multiple
buildings with large groups of students, taught by specialized
instructors who may not know each other, let alone
the students.
The majority of American adolescents attend some form
of postsecondary education. College attendance greatly improves
lifetime occupational prospects and earnings and,
when attended full time, also postpones adult roles such as
full-time worker, spouse and parent (Marini, 1987). An extended
passage toward adulthood can have many noneducational
benefits, including an opportunity to learn, explore
ideas and pursue personal and academic interests (Pascarella
and Terenzini, 1991). Likewise, individuals can experiment
with various behaviors, values and lifestyles. In other words,
the college experience can provide a safe haven for exploration,
a developmental moratorium (Arnett, 2000; Sherrod
et al., 1993).
Transitions to new educational settings require major adaptations
that may be stressful but also provide opportunities
for a fresh start (Aseltine and Gore, 1993; Eccles et al.,
1993; Sher et al., 1996). Thus it is a time of both vulnerability
and growth (Compas et al., 1986). Just as the transition
to college engenders important changes in students'
relationships with their families of origin, peers and romantic
partners, it brings dramatic increases in autonomy.
For example, for the first time, students have the legal right
to privacy of their academic records. As a result of the
1977 federal Family Educational Rights Privacy Act, colleges
can release only very limited information about students'
educational records even to the students' parents.
Recent amendments, however, permit the release of information
about alcohol and drug violations for those under
age 21.
Cultural norms promote heavy drinking as a rite of passage
during the undergraduate years (Prentice and Miller,
1993). Films show large groups of students living together,
partying and having a great time. Reputations of campuses
as "party" schools are passed formally (e.g., via college
guides) and informally among social networks. The desire
to make new friends and to participate in the mythical college
experience may lead to socially motivated heavy drinking
(Transition Catalyst Model) (Cooper et al., 1998; Maggs,
1997). Finally, the stressful aspects of adapting to a new
social world and heavier academic demands may also promote
alcohol use to help students relax (Overload Model)
(Windle, 1992).
Work transitions. Paid work is another major achievement
transition. During high school, working more hours is
associated with higher levels of use of alcohol and other
drugs (e.g., Bachman and Schulenberg, 1993; Greenberger
and Steinberg, 1986; Mortimer et al., 1996). There is considerable
disagreement about the causal direction between
work hours and substance use, with one partial explanation
involving "third variables" (e.g., disengagement from
school) that contribute to increased work intensity and substance
use (Bachman and Schulenberg, 1993). Nevertheless,
work hours appear to be causally related to increased
alcohol use among adolescents (Mortimer et al., 1996). Potential
explanations relate to the Overload Model (e.g., stress
of balancing long work hours with other activities) and the
Developmental Mismatch Model (e.g., most adolescent jobs
do not provide developmentally appropriate experiences).
Although part-time work is common during college, little
empirical work has examined the relation between work
intensity and substance use during college. To the extent
that part-time work contributes to additional stress (i.e., the
Overload Model), alcohol and other drug use would be expected
to increase. In contrast, to the extent that part-time
work provides a good match with course work and desired
career path (i.e., the Developmental Mismatch Model), substance
use might decrease as a function of work.
The transition from school to full-time work is associated
with declines in substance use (Bachman et al., 1997;
Wood et al., 2000), although this is less true for high school
students who go directly to full-time work (Schulenberg et
al., 2000). This transition is one defining feature of the
transition to adulthood with its concomitant changes in responsibilities,
freedoms and contexts. Although this transition
is associated with decreased substance use, this decline
appears to be impacted more by the transition into marriage
(Bachman et al., 1997).
Implications for Research and Intervention
Developmental research on substance use etiology and
intervention
Multiwave, contextually sensitive longitudinal research
is essential for gaining a fuller understanding of substance
use etiology and intervention (Eddy et al., 1998; Loeber
and Farrington, 1994; Schulenberg et al., 2001b). Such data
permit researchers to consider complex mediational and reciprocal
models linking risk and protective factors with substance
use over time (Curran and Muthén, 1999; Rutter,
1994; Windle and Davies, 1999) as well as to identify different
(often nonlinear) trajectories of substance use onset
and change (Babor et al., 1992; Cloninger, 1987; Zucker,
1987). Short-term, intensive repeated-measures data are
valuable for examining processes linking proximal influences
such as the transition into college, concurrent risk
factors and substance use. Long-term multiwave panel data
are essential for understanding how distal influences relate
to proximal ones (e.g., how childhood and adolescent risk
and protective factors relate to alcohol and other drug use
during college).
A developmental perspective emphasizes the importance
of taking a long view on intervention effects (Maggs et al.,
1997). Positive short-term effects are important, and enduring
salutary effects on developmental trajectories are especially
important. Often no measurable improvement in
behavior is visible at the conclusion of a preventive intervention
(Dielman, 1994), indicating the need for continued
assessment, as minor alterations in the slope of a trajectory
can result in consequential changes as they accumulate over
many years (Kellam and Rebok, 1992; Maggs and
Schulenberg, 2001). Long-term intervention research provides
opportunities to test etiological theories by altering
the constellation of risk factors and observing whether hypothesized
changes occur (Coie et al., 1993; Dishion et al.,
1999; Kellam and Rebok, 1992; Maggs and Schulenberg,
1998).
Programs and policies regarding college drinking
Developmental transitions represent windows of opportunity
for effecting change. These naturally occurring periods
of disequilibrium can be utilized to try to divert
previously established risky trajectories and encourage
healthy habits, skills and relationships. In this section, we
offer a selective list of program and policy implications to
help illustrate how developmental considerations can and
should come into play when attempting to reduce college
drinking. When appropriate, we make reference to intervention
implications that follow from the five conceptual
models discussed earlier (see Table 1).
Facilitate developmental transitions. Going off to college
reflects several important developmental transitions in
the identity, affiliation and achievement domains. To the
extent that difficulties with these transitions contribute to
increased alcohol and other drug use, then efforts to assist
in successfully negotiating the transitions should translate
into less substance use (Schulenberg et al., 2001b). Consistent
with the Overload Model, preparing young people in
advance of entering college and providing support during
the many transitions should serve to increase coping capacities
to deal with the stress of multiple simultaneous
transitions. Consistent with the Developmental Mismatch
Model, ensuring a good match between a young person's
expectations about college and what the college experience
can actually provide would be beneficial as well. Successful
adaptations to transitions are fundamental aspects of
development. Although some transitions can be difficult, it
is through such challenges that individuals grow, acquiring
advanced characteristics competencies. Gaining a better
understanding of how the world works, broader access to
social support and greater control over one's social context
will likely increase one's ability to avoid or alter detrimental
behaviors.
Intervene at the level of the context and the individualcontext
match. Following from the developmental contextual
perspective, interventions aimed at altering the context
can yield salutary changes in individuals (Maggs et al.,
1997). Examples of contextual targets for alcohol intervention
include changing social norms (e.g., perceived acceptability
of heavy drinking), altering laws and penalties for
violations (e.g., legislative changes for parental notification),
changing marketing practices (e.g., server training)
and providing substance-free housing (e.g., Bennett et al.,
1992; Grossman et al., 1994; Perkins et al., 1999; Wechsler
et al., 2001). Consistent with the Developmental Mismatch
Model, broader-based contextual interventions that attempt
to increase the match between individuals and their contexts
(e.g., career apprenticeship programs) might also prove
effective in reducing heavy drinking and other risky
behaviors.
Balance increased freedoms with increased responsibilities.
A defining feature of human growth is the quest for
increased mastery over oneself and the environment (e.g.,
Harter, 1999; Heckhausen, 1999). This quest requires a balance
of increased freedoms and responsibilities, as too much
of either can thwart the progression of mastery. Once at
college, students may suddenly have more personal freedom
than responsibility, and more peers in the same situation,
thus providing an opportunity for casual substance
use to be transformed into frequent heavy use. Consistent
with the Developmental Mismatch Model, the social role
ambiguity and transience of this period in life may discourage
commitment to social conventions and implicitly encourage
heavy drinking by creating an imbalance of
increased personal freedoms without parallel social responsibilities.
Possible solutions include slowing the pace of
increased freedoms (e.g., dorm curfews for first-year students),
increasing social responsibilities through community
work (see Youniss and Yates, 1997) and involving
students in campus governance and discipline.
Interventions should be varied and developmentally relevant.
Developmentally relevant interventions take into account
what is known about normative developmental
changes and concerns of a given population. As a group,
college students have unique needs simultaneously to build
social lives, form romantic and sexual attachments, maintain
positive relationships with their families of origin, succeed
academically, decide on and progress toward a career
and manage their complex daily lives. Thus simple upward
extensions of high school prevention efforts are less likely
to be effective, whereas programs that incorporate how college
students see drinking problems and possible solutions
are more likely to be effective. Likewise, consistent with
the Transition Catalyst Model (where drinking is viewed as
facilitating transitions), high-quality diversion programs that
provide numerous and varied alternatives to drinking for
meeting social, romantic and stress-reduction goals are likely
to prove effective.
Consistent with the Increased Heterogeneity Model, students
with extensive substance use histories before college
may be at risk for greater adjustment difficulties in general
(e.g., Chassin et al., 1999a). They are unlikely to be influenced
by standard prevention efforts, suggesting the need
for more intensive targeted interventions (e.g., Darkes and
Goldman, 1993). In contrast, for college students on a developmentally
limited trajectory of heavy drinking, adjustment
problems may be neither a cause nor a consequence
of their heavy drinking, and intensive personal interventions
may prove counterproductive; instead, high-quality diversion
programs or harm-reduction approaches may prove
effective (Marlatt et al., 1995).
Reduce negative consequences of heavy drinking. Systematic
broad-based programs and policy changes may eventually
be effective in decreasing the rates of heavy drinking
among the nation's college students, and specific campuses
may be able to effect more localized change. Nevertheless,
given that heavy drinking tends to be culturally embedded
in the transition to young adulthood in general, and the
college experience in particular, it is unlikely that we will
see large reductions in national rates in the short term. This
underscores the importance of attempting to reduce the negative
consequences of heavy drinking (i.e., harm reduction)
(Marlatt et al., 1995). Following from the Transition Catalyst
Model, risk taking plays an essential role in identity
formation (Baumrind, 1987) and in negotiating peer-related
and other developmental transitions (Brown et al., 1997;
Chassin et al., 1989). Consistent with the Heightened Vulnerability
to Chance Events Model, an adaptive strategy in
negotiating the transition to college is to explore one's new
contexts and one's identity in relation to the new contexts,
a strategy that tends to increase the odds of unpredicted
events. Therefore, it is essential to provide students with
strategies for successfully managing risky behaviors and
negotiating chance encounters with accompanying potential
negative consequences.
Conclusion
For most students, heavy drinking and associated problems
tend to peak during college amid the abundance of
explicit and subtle expectations and opportunities to drink
and then to subside as they move into adulthood roles. This
normative shift is quite remarkable: In a few short years,
the excessive drinking and concomitant negative consequences
experienced by many students that would likely
reflect diagnosable alcohol misuse (and often alcohol dependence)
at other points in the life span simply run their
course and stop. For other students, heavy drinking becomes
troublesome and tragic. By understanding how alcohol and
other drug use fits in young people's lives, and specifically
how it is embedded in their numerous developmental transitions,
we can have a stronger foundation for understanding
etiology and for effecting positive change.
Acknowledgments
The authors thank Patrick Johnson, Robert Zucker and the other members
of the Subcommittee Panel for their comments and suggestions on
initial versions of this article. We also thank Jeffrey Arnett, Alison Bryant
and Deborah Safron for their comments and suggestions, and also Tanya
Hart, Virginia Laetz, Patti Meyer and Crystal Pickett for their editorial
and production assistance.
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*This work was supported in part by National Institute
on Alcohol Abuse
and Alcoholism grants R01-AA06324 and R03-AA09143 (PI: J. Schulenberg)
and the Alcoholic Beverage Medical Research Foundation (PI: J. Maggs).
†Jennifer L. Maggs is with Family Studies and Human
Development,
University of Arizona, Tucson, AZ.