Aims
This study examined the association between automatic processes and drinking behavior in relation to individual differences in response inhibition in young adolescents who had just started drinking. It was hypothesized that strong automatic behavioral tendencies toward alcohol-related stimuli (alcohol-approach bias) were associated with higher levels of alcohol use, especially amongst adolescents with relatively weak inhibition skills.

Design
To test this hypothesis structural equation analyses (standard error of mean) were performed using a zero inflated Poisson (ZIP) model. A well-known problem in studying risk behavior is the low incidence rate resulting in a zero dominated distribution. A ZIP-model accounts for non-normality of the data.

Setting
Adolescents were selected from secondary Special Education schools (a risk group for the development of substance use problems).

Participants
Participants were 374 adolescents (mean age of M = 13.6 years).

Measurements
Adolescents completed the alcohol Approach Avoidance Task (a-AAT), the Stroop Colour Naming Task (Stroop) and a questionnaire that assessed alcohol use.

Findings
The ZIP-model established stronger alcohol-approach tendencies for adolescent drinkers (P < 0.01) and the interaction revealed a stronger effect of alcohol-approach tendencies on alcohol use in the absence of good inhibition skills (P < 0.05).

Conclusion
Automatically-activated cognitive processes are associated with the drinking behavior of young, at-risk adolescents. It appears that alcohol-approach tendencies are formed shortly after the initiation of drinking and particularly affect the drinking behavior of adolescents with relatively weak inhibition skills. Implications for the prevention of problem drinking in adolescents are discussed.