Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation


Arts and Sciences



First Advisor

Dr. Gregory T. Smith


Separate externalizing and internalizing pathways to problem drinking have been described. However, internalizing and externalizing are substantially correlated, thus, there is good reason to believe that these two forms of dysfunction behaviors do not operate independently.

We tested an integrative developmental model of transactions among internalizing symptomatology, externalizing personality, and psychosocial learning in the prediction of both drinking problems and future internalizing symptoms. To do so, we studied a large sample (n = 1910, 49.9% female) of children over a critical developmental period, from the spring of 5th (last year elementary school) grade through the spring of 9th grade (first year of high school). Using a battery of self-report questionnaires, we assessed demographics, pubertal status, negative urgency, depressive symptoms, positive drinking expectancies, and drinking behavior. Specifically, the present study tested whether internalizing symptomatology (depressive symptoms) in elementary school predicts a classic externalizing pathway ( to problem drinking in middle school, and whether problem drinking in middle school predicts increased depressive symptomatology in highschool.

Structural equation modeling yielded significant findings for hypothesized direct and indirect pathways, with overall good model fit (CFI = .94; SRMR = .05; RMSEA = .05, 90% CI .04-.05): elementary school depressive symptomatology predicted middle school drinking problems (mediated by negative urgency and psychosocial learning) and middle school drinking problems predicted increased risk for depressive symptoms in high school, pointing to a reciprocal relationship between internalizing and externalizing dysfunction.

The present study incorporated internalizing symptomatology into a traditional externalizing model of drinking risk, and demonstrated a reciprocal relationship between internalizing and externalizing dysfunction during adolescence. These findings are particularly noteworthy when considered in a developmental framework. The present study highlights the need to integrate both internalizing and externalizing forms of dysfunction into models of substance use risk.

Digital Object Identifier (DOI)