Importance: The development of an alcohol use disorder in adolescence is associated with increased risk of future alcohol dependence. The differential associations of risk factors with alcohol use over the course of 8 years are important for preventive measures.

Question: Are there differential associations of personality, social factors, brain functioning, and familial risk with alcohol misuse (AM) trajectories in adolescents?

Findings: In this cohort study of 2040 adolescents that investigated alcohol misuse trajectories over the course of 8 years, psychosocial resources (lower frequency of life events realted to family and sexuality and higher socioeconomic status) were initially associated with a lower general risk for alcohol misuse but with an increased risk over the course of 8 years. Personality characteristics (higher impulsivity, risk-taking, and extraversion) were associated with a higher risk of alcohol misuse on average, as well as a higher risk for alcohol misuse development; there was no association with brain functioning.

Meaning: These findings indicate that known risk factors contribute differentially to future AM, which may inform individualized interventions.