Childhood cognitive measures as predictors of alcohol use and problems by mid-adulthood in a non-Western cohort.

Developmental models of the etiology of alcohol problems have proposed several pathways for how childhood cognitive deficits relate to later alcohol problems. Deviance proneness models purport that underlying behavioral disregulation manifests in part as cognitive deficits and poor academic performance in childhood and later as alcohol problems in adulthood (see Gorenstein & Newman, 1980; Sher, 1991; Zucker, Chermack, & Curran, 2000). Alternative models have proposed more direct paths—that high intelligence and academic success can lead to both increased likelihood of being a lifetime drinker by placing individuals in heavier drinking environments (e.g., college) as well as decreased likelihood of developing alcohol problems via better opportunities in adulthood that may buffer against problems (see Johnson, Hicks, McGue, & Iacono, 2009). Conversely, pressure to maintain academic achievement may result in distress (e.g., Stoeber & Rambow, 2007), which in turn can lead to alcohol use and problems (Crum et al., 2006; Schulenberg, Bachman, O’Malley, & Johnston, 1994). It is also possible that multiple processes are involved, with both behavioral undercontrol and contextual factors contributing to the link between early cognitive deficits and later alcohol involvement. General population sample studies have demonstrated that relatively higher IQs are typically found among low-to-moderate drinkers compared with abstainers and heavy drinkers (see Anstey, Windsor, Rodgers, Jorm, & Christensen, 2005; Muller et al., 2013 for reviews). In longitudinal studies, higher childhood IQ has been positively associated with alcohol use and higher consumption levels in early and later adulthood (Johnson et al., 2008; Kanazawa & Hellberg, 2010). For example, in a U.S. national sample of young adults assessed over a 5-year interval, higher verbal IQ predicted increased risk for subsequent drinking and decreased risk for problems among drinkers even after covarying for socioeconomic status (Windle & Blane, 1989). This is consistent with a prospective study of a general Scottish sample that found higher verbal IQ at 11 years was associated with alcohol problems 40 years later after covarying for socioeconomic position (Batty, Deary, & Macintyre, 2006). Taken together, these studies suggest that higher IQ, and in particular verbal IQ, is predictive of increased likelihood of being a lifetime drinker and decreased likelihood of alcohol-related problems later in life, and that these associations are not accounted for by sociodemographic correlates of higher verbal abilities. Academic achievement is also a potential childhood cognitive predictor of subsequent alcohol involvement. Support for poor academic achievement associated with subsequent alcohol use and problems also has been found in longitudinal studies and general samples with varying ranges of follow-up (see, e.g., Duncan, Duncan, Biglan & Ary, 1998; Hawkins, Catalano, & Miller, 1992; Schulenberg et al., 1994). For example, Hayatbakhsh et al. (2011) demonstrated that poorer school performance at age 14 years predicted alcohol problems 21 years later in a general sample of Australian students, although already at age 14 over 60% of the sample indicated drinking in the past week. Studies that examine academic achievement in younger samples are needed to help clarify if poor academic achievement is a predictor of subsequent alcohol involvement or just a consequence of early alcohol use. In this study, we present longitudinal data from a birth cohort sample who were assessed at age 11 years on measures of cognitive and academic ability (prior to the typical age of onset of alcohol use) and then approximately 25 years later on lifetime alcohol use and alcohol use disorder (AUD) symptoms. The sample is from the island of Mauritius (a middle-income eastern African nation), allowing for the examination of these relationships in a non-western society that values education and academic performance (the population has an 89% literacy rate and public primary and secondary education are free; CIA Factbook, 2014; SACMEQ, 2012), but where childhood cognitive performance is not linked to heavy drinking environments as it often is in Western societies (e.g., college; Slutske et al., 2004). However, as in Western societies, both intelligence and school success in Mauritius may enable individuals to obtain financial and personal resources that increase the likelihood and opportunities for social drinking, even if buffering against risk for alcohol problems (see Johnson et al., 2009; Muller et al., 2013). Such contextual factors may affect relationships between childhood cognitive performance and subsequent alcohol involvement; thus, examining these associations in novel societies such as Mauritius will help determine the generalizability of the developmental models that have been generated using data primarily from Western societies (see Luczak et al., 2014). Given our prior findings with this sample that found gender and an index of psychosocial adversity (based on familial, housing, and environmental variables) were associated with IQ (Liu, Raine, Venables, & Mednick, 2003; Lynn, Raine, Venables, Mednick, & Irwing, 2005), and that being Muslim was protective for lifetime drinking but not for alcohol problems among drinkers (Luczak et al., 2014), we recognize the importance of including gender, psychosocial adversity, and Muslim religion when examining the link between cognition and alcohol use in this sample.