BOX 2.1 Categories of Risk Factors

Individual Predisposing Factors:

Early and persistent antisocial, aggressive, or rebelliousness behavior

Impulsiveness, low self-control, sensation-seeking

Low levels of social and emotional competency

Informal Controls:

Attachments to parents and other individuals

School success/attachment to school/commitment to education or work

Belief in rules in general

Social Influences to Use:

Association with/exposure to drug-using models: parents, siblings, or peers

Low levels of parental supervision and monitoring

Parental/sibling attitudes favorable to drug use

Psycho-social work environment

Perceived Norms Favoring Drug Use:

Lax or inconsistently enforced laws limiting the possession, use or sales of drugs

Unclear or inconsistent messages about substance use

Inconsistent application of consequences for use

Incorrect perceptions of the prevalence of use

Suspected risk factors can be organized into the clusters shown in Box 2.1.9 Early-established personality characteristics (e.g., irritable temperament, harm-avoidant personality traits, social anxiety, maladaptive or aggressive behavior in early elementary school) may predispose some individuals to seek dangerous thrills or constrain their capabilities for recognizing and avoiding risky situations. People with psychiatric disorders, including depression, attention deficit disorder, and anxiety disorders, have higher risks of using and abusing drugs. Individuals with these characteristics may be more likely to experiment with drugs, to continue using drugs, and to fail to reduce drug use in the face of persistently harmful consequences.

Certain individuals may also be at higher risk of becoming drug users due to inherited traits. While not definitive, a mounting body of evidence suggests that the genetic pathways are related to the adverse conse-


These characteristics, conditions, and processes are reviewed in detail elsewhere (Anthony and Helzer, 1995; Gottfredson, 2000; Gottfredson, et al., 1996; Hansen and O’Malley, 1996; Hawkins et al., 1992; 1995; Institute of Medicine, 1994, 1996, 1997) and are not repeated here.

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