Does Alcohol Use Predict Violent Behaviors? The Relationship Between Alcohol Use and Violence in a Nationally Representative Longitudinal Sample

• Author: Wesley G. Jennings,Jennifer M. Reingle,Mildred M. Maldonado-Molina
• Published date: 01 April 2011
• Date: 01 April 2011
• DOI: http://doi.org/10.1177/1541204010384492
• Published By: Sage Publications, Inc.
• Subject Matter: Articles

Articles
Youth Violence and Juvenile Justice
9(2) 99-111
Does Alcohol Use Predict
ª The Author(s) 2011
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DOI: 10.1177/1541204010384492
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Relationship Between
Alcohol Use and Violence
in a Nationally Representative
Longitudinal Sample
Mildred M. Maldonado-Molina1, Jennifer M. Reingle1, and
Wesley G. Jennings2
Abstract
The current study examined the relationship between alcohol and violence using a longitudinal
survey of adolescents ages 11–26. Data were derived from 10,828 adolescents in the National
Longitudinal Study of Adolescent Health (Add Health) Waves I-III. Survey logistic regression was
used to examine the relationship between alcohol use and violence. Even after adjustment for base-
line, consistent alcohol use predicted violence in young adulthood (OR ¼ 1.41; 95% CI [1.03, 1.91]);
however, violence was not predictive of problematic alcohol use. Overall, consistent alcohol use
appears to be a predictor of serious physical violence, whereas physical violence does not predict
problematic alcohol use.
Keywords
alcohol, violence, youth, adolescents
Introduction
Violence and alcohol consumption among adolescents is an important public health problem.
Violence and physical aggression are linked to unintentional injuries and homicide, two of the lead-
ing causes of death among young people (Center for Disease Control and Prevention, 2009). Alcohol
use is often described as the drug of choice among adolescents (Johnston, O’Malley, Bachman,
& Schulenberg, 2009). Furthermore, alcohol is a key contributor to the leading causes of death
among those 10 to 24 years old—motor-vehicle mortality, suicide, and other unintentional injuries
(Centers for Disease Control and Prevention, 2007).
1University of Florida, Gainesville, FL, USA
2University of South Florida, Tampa, FL, USA
Corresponding Author:
Mildred M. Maldonado-Molina, 1329 SW 16th St, Gainesville, FL 32610, USA
Email: maldonado@ichp.ufl.edu

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Youth Violence and Juvenile Justice 9(2)
The association between violence and alcohol consumption has been well studied in the
criminological and public health literature. At least four explanations have been proposed to explain
the relationship between alcohol and violence: (a) psychopharmacological, meaning that the
intoxicating effects of alcohol cause people to be violent to gain resources to support their drug/
alcohol use (Goldstein, 1985); (b) the relationship is causal, in that alcohol use causes violence,
because aggressive people self-select into situations that encourage alcohol consumption (Johnston,
O’Malley, & Eveland, 1978); (c) the relationship is reciprocal, and the arrow between alcohol use
and violence may point in either or both directions (White, Loeber, Stouthamer-Loeber, & Farrington,
1999); or (d) the relationship is spurious, as problem behaviors cluster as part of a more general
problem behavior syndrome (Jessor, Donovan, & Costa, 1991).
Few longitudinal studies have attempted to address the directionality of the alcohol–violence
relationship, and the findings have been mixed. Dembo and colleagues (1991) conducted a cohort
study of detained juvenile delinquents and found that alcohol use predicted violent behavior, and
violence was a significant predictor of drug use (e.g., cocaine, marijuana) at the 10- to 15-month
follow-up. Similarly, Ellickson, Tucker, and Klein (2003) followed a cohort of seventh graders in
California and Oregon through age 23 to evaluate the effects of early alcohol use. They found that
early alcohol users were more likely to be delinquent and use other drugs in middle and high school
compared to nondrinkers in seventh grade. At age 23, early alcohol users were at an increased risk
for substance misuse, violence, and criminality (Ellickson, Tucker, & Klein, 2003). Another long-
itudinal study conducted using the first two follow-up surveys of the National Longitudinal Study of
Adolescent Health (Add Health) found that alcohol use was a significant predictor of physical vio-
lence 2 years later (Resnick, Ireland, & Borowsky, 2004).
Despite the well-documented relationship between alcohol consumption as a predictor of violent
behavior, another body of literature suggests that the violence predicts alcohol use. For example,
Windle (1990) used National Longitudinal Youth Survey data to assess the impact of various anti-
social behaviors at ages 14–15 on other delinquent behaviors 4 years later. The results suggested that
general delinquency (a function of the frequency of nonsubstance-related delinquent behavior) was a
significant predictor of alcohol consumption. Similarly, a study of adolescents ages 12–18 evaluated
the effects of early alcohol use among a sample of 218 males and 213 females (White, Brick, &
Hansell, 1993). White, Brick, and Hansell (1993) found that early aggression in males predicted
alcohol consumption and alcohol-related aggressive behavior; however, more specific levels of
alcohol use were not significantly associated with later aggression. In support of these findings, data
from the same study were reanalyzed to evaluate the complex relationships between alcohol use,
aggression, and alcohol-related aggression over time using structural equation models (White &
Hansell, 1996). They found that early initiation of alcohol use predicted physically aggressive behavior.
Several studies provide support for a third theoretical explanation for the association between
violence and alcohol use, that a bidirectional relationship exists. First, D’Amico, Edelen, Miles, and
Morral (2008) conducted a study of high-risk juveniles in the Los Angeles juvenile probation system
between the ages of 13 and 17. They found that substance use predicted delinquency (a scale of drug-
related crime, property crime, and interpersonal violent crime) and delinquency predicted substance
use. This study was not specific to alcohol use, and adolescents were only followed for a period of
1 year. In an 8-year study of high school aged African Americans in Michigan, Xue, Zimmerman,
and Cunningham (2009) tested the bidirectionality of alcohol use and violent behavior. Their results
indicated that early violence (e.g., group fighting, hitting a teacher or supervisor, using a knife or gun
to get something from a person, etc.) significantly predicted later alcohol use, and early alcohol use
predicted future violent behavior. Among 15- to 19-year-old urban Mexican Americans and
European Americans selected from a large health maintenance organization, Brady, Tschann, Pasch,
Flores, and Ozer (2008) noted reciprocal relationships between alcohol use and violence when ado-
lescents were older. For example, perpetration of violence at age 18 significantly predicted alcohol

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Maldonado-Molina et al.
101
use at age 19; however, violence at 15 did not predict alcohol use at age 19. Similarly, alcohol use at
age 15 did not predict violent behavior at age 19, whereas alcohol use at age 18 significantly pre-
dicted perpetration of violence. Although these studies have consistent findings within ethnic
groups, the limited external validity must be considered when applying findings to these groups
at the population level.
In light of the findings from longitudinal studies that have tested the relationship between alcohol
and violence, most studies drew samples from juvenile justice systems or schools, which may pres-
ent a selection bias or limited external validity. Considering the breadth of research conducted on
this topic, nationally representative studies of youth must be conducted to inform national preven-
tion interventions that may reduce the risk of violence or alcohol use at the population level. Addi-
tionally, many studies have tested the relationship between alcohol and general delinquency, rather
than serious physical violence. Acknowledging these issues, in this particular study, we utilized the
Add Health to test the relationship between alcohol use and violence in a nationally representative
sample of youth ages 11 to 26. The benefit of using this data set is that at age 11, many adolescents
have not yet begun using alcohol or participating in violence. Many of the recent literature discussed
above have used samples of older adolescents, which may be problematic due to previous concurrent
use of alcohol and participation in violent behavior. If these behaviors are already intertwined, it
may be difficult to tease out the independent effect of each behavior. Therefore, the current study
is an important contribution to the literature because of the large, geographically diverse and nation-
ally representative sample, the young age at which youth were recruited to participate in the survey,
and the longitudinal design, which allows for an evaluation of changes in behaviors over time.
The purpose of this study is to evaluate the relationship between serious violence and problematic
alcohol use. Specifically, we tested the effects of consistently high use of alcohol, initiation or desis-
tance from alcohol use, or no use of alcohol during adolescence on violent behaviors...