In 1996 the Institute of Medicine (IOM, 1996) issued a report on pathways to addiction. Although focused on the use of illegal drugs, the recommendations of the committee are equally applicable to more socially condoned, but still addictive, substances such as alcohol. The IOM (1996) report articulated the types of research that would be needed to expand the understanding of the etiology of drug use disorders, including the following: (a) multidisciplinary research to investigate the combined effects of biological, psychosocial, and contextual factors as they relate to the development of drug use, abuse, and dependence; (b) studies of sufficient duration to enable follow-up of participants in determining the role of risk and protective factors related to the transition from drug use to abuse to dependence; (c) research investigating the role of family factors in the etiology of drug use and abuse; (d) examination of psychopathology as a precursor to drug use and abuse in adolescents and adults; (e) studies of risk and protective factors related to drug use and abuse, especially during discrete developmental stages; and (f) investigation of childhood risk and protective factors that are associated with drug abuse and dependence. In reflecting on these comprehensive goals, striking similarities emerge with respect to these research foci and the field of developmental psychopathology (Cicchetti & Cohen, 1995; Cicchetti & Toth, 1991). Specifically, the principles that guide inquiries conceptualized within a developmental psychopathology framework can be applied toward the conduct of studies designed to address the agenda generated by the IOM (1996) report on substance abuse.

The etiology of early age onset substance use disorder (SUD), an Axis I psychiatric illness, is examined from the perspective of the multifactorial model of complex disorders. Beginning at conception, genetic and environment interactions produce a sequence of biobehavioral phenotypes during development which bias the ontogenetic pathway toward SUD. One pathway to SUD is theorized to emanate from a deviation in somatic and neurological maturation, which, in the context of adverse environments, predisposes to affective and behavioral dysregulation as the cardinal SUD liability-contributing phenotype. Dysregulation progresses via epigenesis from difficult temperament in infancy to conduct problems in childhood to substance use by early adolescence and to severe SUD by young adulthood.

Within the last decade, many investigators have focused on the physical, neurodevelopmental, and neuropsychological effects of prenatal cocaine exposure on infants and young children. Although inconclusive on many crucial issues, published studies reveal the beginnings of a profile of possible cocaine-related effects on neuropsychological functions subserving arousal and attention regulation. That profile is informed by preclinical studies in which important factors such as duration and type of exposure as well as environmental conditions may be more adequately controlled. In the developing brain, there are a number of candidate mechanisms that account for how prenatal cocaine exposure may interfere with neural ontogeny. This review focuses on the monoamine system, one of the primary sites of action of cocaine in the adult. In the developing organism, monoamines play critical trophic roles through all phases of central nervous system (CNS) ontogeny—cell proliferation, neural migration, growth, maturation, and synaptogenesis. Because of their trophic role in CNS ontogeny, cocaine effects on developing nervous system may be mediated in part through effects on monoamine system ontogeny. In turn, these effects may be expressed behaviorally in disrupted patterns of arousal and attention regulation given that these domains are connected intimately to monoaminergic systems.

The course of severe depressive symptoms from pregnancy to 6 months postpartum, as well as the occurrence of severe paranoid symptoms prenatally, were examined by the Millon Clinical Multiaxial Inventory I and the Beck Depression Inventory, in 78 women who were heavy, chronic cocaine users and who retained custody of their children after birth. Six months postpartum, the quality of caregiving was observed and assessed in the home, and the children were assessed on the Bayley MDI Index in the laboratory. Mothers who were depressed and paranoid prenatally, regardless of whether the depression continued to 6 months postpartum, were less sensitive in caregiving than women without severe symptoms of paranoia or depression during pregnancy or those who reported only depression that lifted by 6 months postpartum. Mothers who were depressed prenatally and continued to be depressed by 6 months postpartum, regardless of the presence or absence of paranoia, had infants who earned lower Bayley MDI scores than the offspring of women without severe psychological symptoms or women whose depression had lifted. Severe depressive symptoms during pregnancy, if they did not continue to 6 months postpartum, did not appear to adversely influence either caregiving or infant functioning.

We examined how family and child risk factors jointly affected stability and change in externalizing behavior over time in a prospective study of eventual alcohol use disorder. Study participants were community-recruited alcoholic and control families, and their initially preschool-aged male and female children (N = 335). Family risk varied as a function of both parental alcoholism (ALC) and antisocial personality disorder (ASPD) and was evaluated for both parents. Child risk was characterized by a set of risky temperament attributes pertaining to high activity, high reactivity, and low attention span. Externalizing behavior was used as the proxy indicator for later alcohol problems. For children in the high family risk group (involving current ALC in both parents or current ALC + ASPD comorbidity or both), child risk when children were 3–5 years old (Wave 1) directly predicted externalizing behavior when children were 6–8 years old (Wave 2), even when Wave 1 child risk was controlled for. In addition, parents' negative interaction with children at Wave 1 mediated the effect of child risky temperament on Wave 2 externalizing behavior. No such pattern was observed in the low family risk group, where only autostability effects were predictive of outcomes at Wave 2. The importance of nesting structure as an ingredient in the epigenesis of risk was discussed. Its particular relevance in understanding the process of risk transmission among offspring from antisocial alcoholic families was emphasized.

The purpose of this study was to examine the relationship between fathers' alcoholism and the quality of parent–infant interactions during free play. A related goal was to study the potential mediating or moderating role of comorbid parental psychopathology, such as depression and antisocial behavior, difficult infant temperament, and parental aggression. The sample consisted of 204 families with 12-month-old infants (104 alcoholic and 100 control families), recruited from New York State birth records. Results indicated that fathers' alcoholism was associated with a number of other risk factors (depression, antisocial behavior, and family aggression). Fathers' alcoholism was also associated with more negative father–infant interactions as indicated by lower paternal sensitivity, positive affect, verbalizations, higher negative affect, and lower infant responsiveness among alcoholic fathers. As expected, fathers' depression mediated the relationship between fathers' alcoholism and sensitivity, while maternal depression mediated the association between maternal alcohol problems and maternal sensitivity. Parents' psychopathology did not moderate the association between alcoholism and parent-infant interactions. The results from the present study suggest that the origins of risk for later maladjustment among children of alcoholic fathers are apparent as early as infancy and highlight the role of comorbid parental risk factors.

In this 2-year prospective study, psychopathology and competence among drug abusers' offspring were examined in relation to characteristics of their neighborhoods. The sample consisted of 77 children of cocaine and opioid addicts with a mean age of 12.3 years at baseline and 14.2 years at follow-up. Outcomes examined included psychiatric diagnoses, dimensional symptom indices, and aspects of everyday behavioral competence. Links involving neighborhood variables varied by gender, wherein boys reflected greater deterioration than girls when neighborhoods had high crime rates and high proportions of low-income households. Conversely, girls appeared to benefit more than boys from the presence of professional adults in the community. Overall, neighborhood indicators accounted for more variability in changes in child adjustment over time than did indices of maternal psychopathology. Findings are discussed in terms of developmental changes in the salience of exosystemic and familial forces, and implications for interventions are outlined.

This study examined the developmental associations between substance use and violence. We examined the trends in each behavior throughout adolescence, how the behaviors covaried over time, and the symmetry of associations taking into account frequency and severity of each behavior. We also examined whether changes in one behavior affected changes in the other behavior over time. Six years of annual data were analyzed for 506 boys who were in the seventh grade at the first assessment. Concurrent associations between frequency of substance use and violence were relatively strong throughout adolescence and were somewhat stronger for marijuana than alcohol, especially in early adolescence. Type or severity of violence was not related to concurrent alcohol or marijuana frequency, but severity of drug use was related to concurrent violence frequency. Depending, to some degree, on the age of the subjects, the longitudinal relationships between substance use and violence were reciprocal during adolescence and slightly stronger for alcohol and violence than for marijuana and violence. Further, increases in alcohol use were related to increases in violence; however, when early alcohol use was controlled, increases in marijuana use were not related to increases in violence. Only in early adolescence was the longitudinal relationship between marijuana use and later violence especially strong. The strength of the longitudinal associations between violence and substance use did not change when common risk factors for violence and substance use were controlled. Overall, the data lend more support for a reciprocal than for a unidirectional association between substance use and violence. Prevention efforts should be directed at aggressive males who are multiple-substance users in early adolescence.

Epidemiological research shows some ethnic-group differences in the prevalence of substance use. This approach does not address the question of whether there are ethnic-group differences in the models that are needed to understand the development of substance use. For this question we need to understand the relations between psychological constructs and their trajectories over time. In this paper we describe some approaches to studying ethnic-group differences in the predictors of substance use that illustrate probing for mediators, multisample analyses of structural models, and an experimental trial of a preventive intervention. Our studies found some ethnic-group differences in the structure of constructs and the relations between variables, but many similarities. The challenge for researchers is using appropriate research methods for studying ethnicity, uncovering the basis for ethnic-group differences when they occur, knowing when statistical differences are meaningful, and acknowledging when developmental models are comparable.

This study of over 1,000 adolescents focused on common and distinctive correlates of four subgroups—no problem, depressed only, heavy drinking only, and mixed (depressed and heavy drinking). Correlates were evaluated from the domains of personal dispositions (e.g., temperament), interpersonal relations (e.g., parent and peer), stressful life events, and other problem behaviors (e.g., delinquency, substance use). The no-problem subgroup differed from the other three subgroups in the direction of healthier functioning on almost all measures. The mixed subgroup reported the most pervasive, low levels of functioning, with the highest levels of childhood externalizing problems and stressful life events, the lowest levels of family social support, and high levels of delinquency and substance use. The depressed-only subgroup reported a more internalized pattern characterized by childhood avoidance problems, a difficult temperament (e.g., inflexibility, withdrawal, low task orientation), interpersonal stressors, and poor coping strategies. The heavy-drinking-only subgroup was characterized by higher drinking levels by primary caregivers and lower levels of family cohesion as reported by primary caregivers. The 1-year prospective findings were generally consistent with the concurrent findings in that variables that were associated with transitions toward and away from depression and heavy drinking were associated with specific transitions (e.g., childhood externalizing problems were associated with the transition from no problem to heavy drinking).

Objectives in this research were to examine contextual differences in correlates of substance use among high school students. The focus was on two broad categories of adjustment indices: personal psychopathology (internalizing and externalizing problems) and behaviors reflecting social competence (academic achievement, teacher-rated classroom behaviors, and peer acceptance or rejection). Associations between drug use and each of these constructs were examined in two sociodemographically disparate groups: teens from affluent, suburban families (n = 264), and low socioeconomic status adolescents from inner-city settings (n= 224). Results indicated that suburban youth reported significantly higher levels of substance use than inner-city youth. In addition, their substance use was more strongly linked with subjectively perceived maladjustment indices. Comparable negative associations involving grades and teacher-rated behaviors were found in both groups, and among suburban males only, substance use showed robust positive associations with acceptance by peers. Results are discussed in terms of developmental perspectives on adolescent deviance, contextual socializing forces, and implications for preventive interventions and treatment.

One variant of substance-use disorder is characterized by behavioral disinhibition. In this report, we martial evidence for a model for the development of this variant. We hypothesize that genetic liability for this variant is reflected in a spectrum of risk indicators linked to the inability or unwillingness to inhibit behavioral impulses. Included in this spectrum are personality traits suggesting low constraint, and externalizing psychopathology, including conduct, oppositional defiant, and attention-deficit disorder in children and antisocial personality disorder and behavior in adults. We further hypothesize that these individual differences in behavioral disinhibition are manifestations of underlying central nervous system processes associated with various psychophysiological anomalies, some of which may index genetic risk for substance abuse. Support for the model is derived from the analysis of findings from the Minnesota Twin Family Study, an epidemiological investigation of approximately 2,700 adolescent twins and their parents.

Although it is well documented that intrapersonal and interpersonal risk factors are related to the frequency of marijuana use, much less is known about the initiation of marijuana use. This paper reports on a longitudinal study of the personality, family, peer, and ecological predictors of marijuana onset. Survival analysis was applied to a sample of nonusers of illegal drugs, followed from age 9 years to the 20s. The major findings indicate that (a) youngsters who are unconventional are at a higher risk for marijuana initiation; (b) youngsters who associate with peers who use marijuana or who smoke tobacco themselves are at increased risk for marijuana initiation; (c) youngsters who identify with their parents are less likely to begin marijuana use; and (d) the predictors related to marijuana onset emerged during preadolescence, early adolescence, middle adolescence, late adolescence, and the 20s. Results are discussed within the framework of a family interactional perspective of development. Implications for prevention are discussed.

The current paper uses data from a longitudinal study of a high-risk sample to test the relation between adolescent alcohol and drug use and later young adult autonomy, positive activity involvement, and perceived competence. Participants (children of alcoholics and demographically matched controls) were assessed in three annual interviews in adolescence (mean age: 12.7 years at Time 1) and then again 5–7 years later, in young adulthood (median age: 20 years). Path analyses and latent growth curve models tested the effects of adolescent substance use on both self-reported and collateral-reported outcomes, controlling for correlated risk factors (parental alcoholism, adolescent psychopathology, and parental support), preexisting levels of the outcome, and concurrent young adult substance use. Results showed that adolescent drug use had a significant, unique negative effect on later autonomy and perceived competence. Alcohol use effects were more complex. Adolescent heavy drinking was associated with less positive adult outcomes, but more so in collateral reports than in self-reported outcomes. Moreover, young adult heavy drinking was either uncorrelated with or positively correlated with higher levels of perceived competence, suggesting different developmental significance of alcohol use in adolescence than in young adulthood.

In 1987, we began a longitudinal study of the offspring of alcoholic parents and have been following this group of young adults from their freshman year in college throughout their transition into later young adulthood. The goal of this review is to highlight some of the findings we consider most important and relevant to the development of pathological alcohol involvement in young adulthood. Courses of pathological alcohol involvement in young adulthood are outlined. Predictors of both the development and course of pathological alcohol use in young adulthood are also addressed, including family history of alcoholism, personality, alcohol use motivations, and role transitions. While certainly a problem in its own right, pathological alcohol involvement can also affect the attainment of important life tasks and success in various life roles. Consequently, we also examine the effects of pathological alcohol involvement on later role transitions and role attainment. Finally, prevention, policy, and treatment issues surrounding this stage of life are discussed.

This paper explores the parenting of drug-dependent women and the contributions of comorbid psychopathology to their parenting. A sample of 32 children whose mothers were dependent on opioid drugs during pregnancy and 37 children whose mothers were not drug users were followed from birth to middle childhood. Multivariate regression analyses were conducted contrasting whether maternal substance abuse or psychopathology was more closely linked to parenting behaviors and continuity in parenting over time. Maternal drug dependence was related to whether mothers were able to remain primary caregivers for their children over time, even after controlling for psychopathology. Maternal drug use was related to unresponsive and negative parenting behavior during mother–infant interaction, but this relation was largely accounted for by the effects of comorbid maternal psychopathology on parenting, particularly symptoms of antisocial and related personality disorders. For those children whose mothers continued to care for them into middle childhood, perceptions of their mothers as rejecting were related to maternal antisocial personality and maternal depression. Substance-abuse treatment for women should be integrated with interventions addressing their mental health and parenting needs.