This prospective 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.