Pathways of Addiction Opportunities in Drug Abuse Research (1996) / Chapter Skim
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5. Etiology
5. Etiology
Pages 117-138
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From page 117... ...
Two general categories of variables have been examined -- risk factors and protective factors -- although research, to date, has focused primarily on risk factors associated with drug use rather than on abuse and dependence. Risk factors are related to the probability of an individual's developing a disease or to vulnerability, which is a predisposition to a specific disease process (IOM, 1994b)
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From page 118... ...
Unfortunately less is known about protective factors. The accomplishments noted below are representative of advances in the field and are not meant to document all risk factors or protective factors that have been identified.
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From page 119... ...
. The high recurrence of alcoholism among offspring of parents with alcoholism demonstrates that family history is one of the most potent predictors of vulnerability to alcohol abuse, which results to some extent from genetic factors (Merikangas, 1990; Pickens et al., 1991)
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From page 120... ...
Cross-adoption studies of children of alcoholics who were raised by nonalcoholic adoptive parents have shown a three- to fourfold increased risk for alcohol abuse and dependence compared to adoptees whose parents were not alcoholics (Schuckit et al., 1972; Goodwin et al., 1973; Cadoret et al., 1980; Bohman et al., 1981; Cloninger et al., 1981)
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From page 121... ...
Several studies comparing alcoholics with nonalcoholics have found decreased platelet MAO activity levels among alcohol abusers (von Knorring et al., 1985; Pandey et al., 1988; Tabakoff et al., 1988)
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From page 122... ...
Additionally, many of these studies fail to control for parental alcoholism, psychiatric disorders, or other risk factors, and many of them do not distinguish between use and abuse. Given those limitations, a selection of studies that demonstrate risk factors contributing to psychological vulnerability for drug use is presented below.
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From page 123... ...
Although studies have observed that early antisocial behaviors and deviance are risk factors for drug abuse (Robins, 1966; Elliott et al., 1985; Kaplan et al., 1986; Robins and McEvoy, 1990) , the two most common psychopathologies that have been identified repeatedly are depression and antisocial personality (Cadoret et al., 1980; Alterman et al., 1985; Deykin et al., 1987; Block et al., 1988; Muntaner et al., 1989; Grove et al., 1990)
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From page 124... ...
. High rates of externalizing disorders have been observed in clinical and epidemiological samples of both adult and adolescent drug abusers (Rounsaville and Kleber, 1985, 1986; Helzer and Pryzbeck, 1988; Ross et al., 1988; Weiss et al., 1988)
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From page 125... ...
. Among young Native Americans, many of whom are physically isolated on reservations, the primary risk factors for alcohol and illicit drug use are socialization links, family problems, and family dysfunction (Swaim et al., 1989)
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From page 126... ...
Among Mexican Americans, it has been noted that several risk factors such as low socioeconomic status, higher school dropout rates, and residing in barrios in large cities exacerbate drug use (Padilla et al., 1979; Carter and Wilson, 1991)
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From page 127... ...
Therefore, to advance progress in this area of research there is a need for multidisciplinary studies on the variables associated with the development of drug abuse. Protective Factors Although risk reduction is the goal of many prevention programs, another approach is to enhance protective factors.
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From page 128... ...
Risk Factors Numerous longitudinal studies have identified the childhood antecedents of adolescent drug use (e.g., Kellam et al., 1983; Pulkkinen, 1983; Baumrind and Moselle, 1985; Block et al., 1986; Brook et al., 1986a)
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From page 129... ...
Prospective longitudinal studies, especially of samples at high risk for drug abuse, would be useful in identifying risk factors and in discriminating between risk factors specifically associated with drug abuse and those that emanate from the broader context of deviant behavior. Additional work is also needed on the role of risk factors and protective factors at discrete developmental stages, particularly the transition from adolescence to adulthood, which has received scant attention.
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From page 130... ...
A family history of drug abuse is one of the most important risk factors for the development of drug abuse. However, the extent to which the increased risk is attributable to genetic factors involved in the metabolic, physiological, or subjective effects of drugs or to shared environmental factors such as impaired family relationships, negative role modeling, or, indirectly, transmission of psychopathology, should be examined.
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From page 131... ...
1986a. Dynamics of childhood and adolescent personality traits and adolescent drug use.
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1992. Psychosocial risk factors in the transi tion from moderate to heavy use or abuse of drugs.
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1992. Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention.
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1985. On processes of peer influence in adolescent drug use: A developmental perspective.
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1989. Prevention of alcohol and drug abuse: A critical review of risk factors and prevention strategies.
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1978. Sturdy childhood predictors of adult antisocial behavior: Replications from longitudinal studies.
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1991. Childhood risk factors and adolescent drug and alcohol abuse.
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1990. A longitudinal study of antisocial behaviors in early adolescence as predic tors of late adolescent substance use: Gender and ethnic group differences.
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