Journal
ADDICTION
Volume 110, Issue 2, Pages 269-278Publisher
WILEY-BLACKWELL
DOI: 10.1111/add.12747
Keywords
Adolescence; alcohol; causality; co-twin control; longitudinal; propensity score; twins
Categories
Funding
- NIAAA NIH HHS [R37 AA009367, R01 AA009367] Funding Source: Medline
- NIDA NIH HHS [R01 DA005147, R01 DA013240, R37 DA005147] Funding Source: Medline
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AimsTo determine whether early adolescent alcohol use contributes to adult alcohol use, misuse and other adult substance-related and social outcomes. DesignIn a longitudinal study of twins assessed at target ages 11, 14 and 24 years, two techniques adjusted for confounding factors: a propensity score (PS) adjusting for the effects of measured background covariates and co-twin control (CTC) adjusting for confounding by unmeasured (including genetic) factors shared within early alcohol exposure-discordant pairs. SettingThe community-based Minnesota Twin Family Study. ParticipantsA total of 1512 (50.3% female) twins. MeasurementsEarly adolescent alcohol exposures, adult substance-related and social outcomes and background variables reflecting behavioral, familial and environmental characteristics. FindingsBackground covariates unbalanced between those with and without early alcohol exposure were balanced through PS-based weighting, leaving several adult outcomes related to substance use or social functioning remaining significantly associated with early alcohol exposure. Similarly, the within-pair individual-level component of a CTC indicated that early alcohol-exposed twins had higher risk than their non-exposed co-twins for several, but not all, of the same adult outcomes. For example, early alcohol use was associated with an adult index of alcohol use in both PS-weighted (=0.57, P<0.001) and CTC (=0.21, P=0.031) analyses. ConclusionsEarly alcohol exposures predict adult alcohol problems and related outcomes, despite stringent adjustment for measured and non-measured sources of potential confounding using propensity score and co-twin control. Contrasting the methods indicated that exposure effect estimates from PS application were likely biased by unmeasured confounding factors.
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