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Alcohol transitions (first: drink, intoxication, alcohol use disorder [AUD] symptom, AUD diagnosis), internalizing, and externalizing phenotypes came from the Semi-Structured Assessment for the Genetics of Alcoholism. EF was measured with the Tower of London and Visual Span Tasks. Polygenic scores (PGS) were computed for alcohol-related and behavioral phenotypes. Cox models estimated associations among PGS, behavior, and alcohol milestones.<\/jats:p><\/jats:sec><jats:sec id=\"S003329172400076X_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Externalizing phenotypes (e.g. conduct disorder symptoms) were associated with future initiation and drinking problems (hazard ratio (HR)\u2a7e1.16). Internalizing (e.g. social anxiety) was associated with hazards for progression from first drink to severe AUD (HR\u2a7e1.55). Initiation and AUD were associated with increased hazards for later depressive symptoms and suicidal ideation (HR\u2a7e1.38), and initiation was associated with increased hazards for future conduct symptoms (HR = 1.60). EF was not associated with alcohol transitions. Drinks per week PGS was linked with increased hazards for alcohol transitions (HR\u2a7e1.06). Problematic alcohol use PGS increased hazards for suicidal ideation (HR = 1.20).<\/jats:p><\/jats:sec><jats:sec id=\"S003329172400076X_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>Behavioral markers of addiction vulnerability precede and follow alcohol transitions, highlighting dynamic, bidirectional relationships between behavior and emerging addiction.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s003329172400076x","type":"journal-article","created":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T09:27:39Z","timestamp":1715246859000},"page":"2644-2657","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":8,"title":["Alcohol milestones and internalizing, externalizing, and executive function: longitudinal and polygenic score associations"],"prefix":"10.1017","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0320-7907","authenticated-orcid":false,"given":"Sarah 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