Sandler, 2008). This suggests that dormitory life and the fraternity/sorority system, with their lack of parental oversight and consistent exposure to peer models, may create powerful norms encouraging use (Brown, Wang, and Sandler, 2008). For those who do not attend college, antisocial behavior and lack of commitment to conventional adult roles appear to be pathways to abuse.

Underage Drinking

Although not all those who drink in their youth develop substance abuse or substance dependence, underage drinking has received significant public health attention, given the prevalence of drinking among those under the legal drinking age, problematic drinking patterns, and their deleterious effects. A brief discussion of factors related to underage drinking provides an illustration of the developmental aspects of a problem behavior of significant public health concern and similarities with the trajectory of some MEB disorders. The likelihood of serious alcohol dependence as an adult is greatly increased the earlier that young people start drinking (Grant and Dawson, 1997; Gruber, DiClemente, et al., 1996).

Almost one-third of young people between the ages of 12 and 20 report recent drinking, with the majority engaging in binge drinking (five or more drinks), when they drink. Although at lower rates than those in older age groups, drinking is reported by youth as young as age 12, with patterns of heavy drinking increasing with age (National Research Council and Institute of Medicine, 2004b). After age 25, rates of overall drinking, as well as rates of frequent and heavy drinking, steadily decline.

Alcohol use by children and adolescents is influenced over the developmental course by genetics, family, peers, neighborhood, and broader social contexts through norm development, alcohol expectancies, and availability (see the review by Zucker, Donovan, et al., 2008). Risks are apparent as early as ages 3 to 5 years, when children develop the understanding that adults drink alcoholic beverages and learn norms about its use (e.g., men drink more than women).

Children whose parents are drinkers are more likely to be drinkers, and their own drinking correlates well with their perception of their parents’ drinking. This may occur because parents model drinking and help children develop positive expectancies about the effects of alcohol. Children are also exposed to positive images of alcohol use from television and movies. Among adolescents, positive alcohol expectancies are related to initiation of alcohol use.

As children grow older, peer influences become stronger. Peers provide opportunities for modeling of and encouragement for alcohol use. Media and peer culture depicts drinking as a positive part of social life. Adoles-



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