***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Conflicting reports exist on the direction of the relationship between  social anxiety ( SA ) and alcohol/cigarette use ( AU/CU ) and alcohol/nicotine dependence ( AD/ND ) , with both positive and negative associations reported . A prospect i ve , longitudinal sample of Finnish twins ( n = 1,906 ) was used to test potential explanations for these discrepancies . Specifically , this study used  peer , parent , and teacher ratings of SA  , and a clinical interview screening item for social anxiety disorder ( SAD-Sc )  to examine associations between SA and AU/CU and AD/ND from early adolescence into young adulthood . Peer-rated SA was negatively associated with AU , CU , and AD from age 14 through age 22 , implying a protective effect ( β = -0.01 to -.03 ) . Teacher- and parent-rated SA associations were in the same directions but weaker or nonsignificant , indicating that aspects of SA that are recognizable by peers may be most relevant to AU/CU . Self-reported SAD-Sc was also negatively associated with AU , but positively associated with AD symptoms in young adulthood ( β = 0.38 ) . Our findings partially support the existence of different associations between SA and AU versus AD , but only in the context of SAD-Sc rather than trait SA . Neither trait SA nor SAD-Sc significantly predicted ND symptoms , although SAD-Sc was associated with both cigarette abstinence and daily smoking . These findings suggest that adolescent SA is modestly associated with lower AU/CU , although there may be some individuals with more severe SA who develop alcohol problems later in life . There was little evidence of a common underlying liability contributing to both SA and alcohol/cigarette use . ( PsycINFO Data base Few prospect i ve studies have examined the relation between early adolescent conduct disorder ( CD ) symptoms and the development of alcohol use disorders ( AUD ) by young adulthood . The relative contribution of other forms of adolescent psychopathology ( i.e. , attention-deficit hyperactivity disorder , depression , anxiety/withdrawal ) to the development of AUD also remains poorly understood . There is some suggestion that the co-occurrence of conduct disorder symptoms with other forms of psychopathology may interact synergistically in predicting later alcohol use problems . The current study explores these issues using data on 506 boys from the oldest sample of the Pittsburgh Youth Study ( PYS ) . Consistent with prior research , early conduct disorder symptoms emerged as a consistent predictor of increased AUD symptoms and an alcohol dependence diagnosis by young adulthood . In contrast , adolescent boys with high levels of anxiety/withdrawal had lower levels of AUD symptoms and were less likely to develop alcohol dependence by young adulthood . Increased depression in early adolescence was associated with higher AUD symptoms and alcohol abuse and dependence diagnoses by young adulthood , but only for boys with high levels of conduct disorder symptoms . No evidence was found for a relation between attention-deficit hyperactivity disorder symptoms and AUD symptoms or diagnoses after controlling for co-occurring psychopathology This prospect i ve study tested the assertion that psychopathology would predict both adolescent alcohol use and problem use , whereas socialization factors would predict only use , and explored mechanisms by which predictors led to problem use in a community sample of families ( N = 216 ) .  Externalizing symptoms , parental alcoholism , peer influences , and parental support  were indirectly related to negative consequences through their effects on use level . Externalizing symptoms , internalizing symptoms , peer influences , and parental approval of use directly predicted consequences , controlling for the indirect effects through use level . Internalizing pathology potentiated the relation between consumption and consequences , whereas parental support and control mitigated this relation . Collectively , findings provided mixed support for the assertion that psychopathology would predict both use and problem use , whereas socialization factors would predict only use AIMS To examine the prospect i ve relationships between childhood externalizing and internalizing disorders and substance use in early adolescence . DESIGN Longitudinal , community-based study of twins ( aged 11 at intake ; aged 14 at follow-up ) . SETTING AND PARTICIPANTS The sample was composed of twins participating in the Minnesota Twin Family Study , an epidemiological sample of twins and their families representative of the state population of Minnesota . A total of 699 twin girls and 665 twin boys participated at both time-points . MEASUREMENTS Twins participated in in-person , life-time diagnostic assessment s of the following childhood DSM III-R externalizing and internalizing disorders at age 11 : conduct disorder , oppositional defiant disorder , attention deficit hyperactivity disorder , major depressive disorder and in addition , for girls only , overanxious disorder and separation anxiety disorder . At ages 11 and 14 , substance use and abuse were assessed . FINDINGS Externalizing psychopathology predicted having tried alcohol , nicotine and cannabis by age 14 as well as regular and advanced experience with these substances . Internalizing disorders showed weak effects , with only major depression at age 11 showing a significant relationship with substance use at age 14 . CONCLUSION The results suggest that externalizing psychopathology is a robust prospect i ve predictor of a variety of early onset substance use behaviors and is systematic ally related to degree of substance use involvement . The results also suggest that depression may predict initiation of licit substance use in early adolescence BACKGROUND Longitudinal studies are needed to resolve inconsistencies in previous findings regarding antecedents of alcoholism . OBJECTIVE To investigate genetic and environmental risk factors for alcoholism . DESIGN A 4-year longitudinal cohort study . SETTING General community . PARTICIPANTS A population -based cohort was r and omly selected from 4 aboriginal groups in Taiwan . Cohort subjects free from any alcohol use disorder at phase 1 ( n=499 ) were reassessed approximately 4 years later ( phase 2 ) . The percentage of participants who completed the study was 98.4 % . MAIN OUTCOME MEASURES A st and ardized semistructured clinical interview for alcoholism and other psychiatric comorbidity was used in both phases of the study . The main outcome measure was the incidence of alcohol use disorder . Specific risk factors examined included sociodemographic factors , family history of alcoholism , extent of acculturation , psychiatric comorbidity , and alcohol-metabolizing genes . RESULTS Using Cox proportional hazards regression analysis , the risk for alcoholism was significantly higher among subjects who were male ( odds ratio [ OR ] , 2.78 ; 95 % confidence interval [ CI ] , 1.79 - 4.32 ) , aged 15 to 24 years ( OR , 5.05 ; 95 % CI , 2.06 - 6.18 ) , unmarried ( OR , 1.60 ; 95 % CI , 1.03 - 2.49 ) , and employed ( OR , 2.25 ; 95 % CI , 1.34 - 3.77 ) and had a higher educational level ( OR , 1.76 ; 95 % CI , 1.12 - 2.75 ) , a family history of alcoholism ( OR , 1.73 ; 95 % CI , 1.06 - 2.83 ) , and a higher extent of cultural assimilation ( OR , 2.07 ; 95 % CI , 1.28 - 3.35 ) . Two specific risk pathways emerged on multivariate analysis : the highest risk was among subjects aged 25 to 34 years with anxiety disorders ( OR , 16.86 ; 95 % CI , 3.98 - 71.41 ) , and the other was among men with the less active ADH2 * 1 gene ( OR , 5.87 ; 95 % CI , 2.73 - 12.60 ) . CONCLUSION Based on incidence cases of alcoholism among aboriginal Taiwanese , this study confirms the significant roles of anxiety disorders and of the ADH2 * 1 allele as antecedents of alcoholism among specific age and sex groups OBJECTIVE There is little research examining alcohol use disorder ( AUD ) symptoms ( based on criteria from the Diagnostic and Statistical Manual of Mental Disorders , Fifth Edition [ DSM-5 ] ) in young adulthood . We assessed symptom structure at 24 years using latent class analysis ( LCA ) , examining relationships between class membership and ( a ) concurrent alcohol use and DSM-5 AUD severity and ( b ) adolescent risk factors . METHOD A stratified , r and om sample of 1,943 adolescents ages 14 - 15 years was recruited from 44 secondary schools in Victoria , Australia , and interviewed during adolescence and young adulthood . We report findings on drinkers who completed the AUD module ( N = 1,268 ; 51 % male ) . RESULTS Data clearly fit a three-class , dimensional model , comprising " mild symptoms " ( 63.2 % ) , " moderate symptoms " ( 32.2 % ) , and " severe symptoms " ( 4.6 % ) classes . Class membership was vali date d by concurrent drinking patterns and in reasonable agreement with DSM-5 AUD severity categories . Relative to mild symptoms class membership , moderate symptoms class membership increased odds of adolescent alcohol problems ( odds ratio [ OR ] = 2.0 , 95 % CI [ 1.2 , 3.5 ] ) and persisting anxiety/depression symptoms ( OR = 1.9 , 95 % CI [ 1.2 , 3.1 ] ) . Daily smoking ( OR = 2.6 , 95 % CI [ 1.1 , 5.9 ] ) , persisting anxiety/ depression symptoms ( OR = 2.5 , 95 % CI [ 1.3 , 5.0 ] ) , and antisocial behavior ( OR = 3.2 , 95 % CI [ 1.5 , 6.8 ] ) increased odds of severe symptoms class membership . Adolescent daily smoking ( OR = 0.3 , 95 % CI [ 0.11 , 0.81 ] ) and antisocial behavior ( OR = 0.3 , 95 % CI [ 0.14 , 0.64 ] ) were less likely among members of the moderate symptoms class , relative to the severe symptoms class . CONCLUSIONS We found support for a dimensional AUD typology like that in DSM-5 . Young adults with more severe AUD symptoms had a different adolescent risk profile than those in the low and moderate classes . These findings provide a focus for preventive intervention in adolescence to limit the severity of AUDs in young adulthood OBJECTIVE The purpose of the study was to examine the relationship between panic attack and the onset of specific mental disorders and severe psychopathology across the diagnostic spectrum among adolescents and young adults . METHOD Data were drawn from the Early Developmental Stages of Psychopathology Study ( N=3,021 ) , a 5-year prospect i ve longitudinal study of psychopathology among youths ages 14 - 24 years at baseline in the community .  Multiple logistic regression analyses were used to examine the associations between panic attacks at baseline , comorbid mental disorders in adolescence , and the risk of mental disorders across the diagnostic spectrum at follow-up . RESULTS The large majority of subjects with panic attacks at baseline developed at least one DSM-IV mental disorder at baseline ( 89.4 % versus 52.8 % of subjects without panic attacks ) . Subjects with panic attacks at baseline had significantly higher baseline levels of any anxiety disorder ( 54.6 % versus 25.0 % ) , any mood disorder ( 42.7 % versus 15.5 % ) , and any substance use disorder ( 60.4 % versus 27.5 % ) , compared to subjects without panic attacks at baseline . Preexisting panic attacks significantly increased the risk of onset of any anxiety disorder , social phobia , specific phobia , generalized anxiety disorder , any substance use disorder , and any alcohol use disorder at follow-up in young adulthood , and these associations persisted after adjustment for all comorbid mental disorders assessed at baseline . More than one-third ( 37.6 % versus 9.8 % ) of the subjects with panic attack at baseline met the criteria for at least three mental disorders at follow-up during young adulthood . CONCLUSIONS Panic attacks are associated with significantly increased odds of mental disorders across the diagnostic spectrum among young persons and appear to be a risk factor for the onset of specific anxiety and substance use disorders . Investigation of key family , environmental , and individual factors associated with the onset of panic attacks , especially in youth , may be an important direction for future research Background Both early alcohol debut , behavioural and health problems are reported to enhance adolescence substance use . This prospect i ve study investigate the influence of behavioural and health problems on adolescents ' alcohol and drug use . Method Prospect i ve population based cohort study of 2 399 adolescents attending the Young-HUNT study , aged 13 - 15 at baseline in 1995/97 , and 17 - 19 at follow-up 4 years later . Exposure variables were self reported conduct problems , attention problems , anxiety and depressive symptoms , and muscular pain and tension . Outcome variables at follow-up were frequent alcohol use and initiation of drug use . Associations were estimated by logistic regression models , influence of gender and drinking status at baseline were controlled for by stratification . Results At follow-up 19 % of the students drank alcohol once a week or more frequently . Baseline conduct problems ( OR 2.2 , CI 1.7 - 3.0 ) and attention problems ( OR 1.5 , CI 1.2 - 2.0 ) increased the risk for frequent alcohol use at follow-up in the total population . 
    Output:
    
FINDINGS The narrative synthesis revealed some evidence for a positive association between anxiety and later alcohol use disorders .
Associations of anxiety with later drinking frequency/quantity and binge drinking were inconsistent .
Evidence to date is suggestive , but far from conclusive of a positive association between anxiety during childhood and adolescence and subsequent alcohol use disorder