Prospective studies of a cohort or generation of individuals offer a powerful tool for risk factor identification. Such studies follow a selected group of people, interviewing them at various points in their lives, to track the development or, often in later years, the lessening of alcohol problems. Several consistent findings have emerged from the few available prospective studies that have examined the antecedents of the heavy use of alcohol:

long term stays in residential drug rehabs can greatly increase the chance of recovery

antisocial behavior during childhood has been shown to be related to adult alcohol problems;

aggressive behavior and the combination of aggressive and shy behavior in first grade have been found to predict heavy alcohol use at ages 16 and 17; and

males judged to be shy as children were least likely to become alcoholics as adults.

Other factors that have frequently been found to predate adverse alcohol outcomes include difficulty in school achievement, inadequate parenting, hyperactive behavior, heightened marital conflict in the childhood home, and, among males, weak interpersonal ties.

Recommendations for the next stage of prospective research that would lead to improved approaches to developmentally oriented interventions include

follow-up studies of cohort members to assess intermediate outcomes and stages along developmental paths;

studies of the factors that influence heavy use and abuse of alcohol both within individuals and across different environments; and

studies of transitions in stages of development as times of potential vulnerability to alcohol-related problems (e.g., going to school, entering the work force, going to treatments for addiction).

The committee also recommends continued maintenance and expansion of existing longitudinal data bases as particularly valuable to prospective research efforts.

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