Future Directions in the Developmental Science of Addictions

Abstract

This article addresses important future directions for the study of addictions, emphasizing the incorporation of developmental perspectives into how we think about substance use and disorder as unfolding processes over time and context for a heterogeneous group of individuals. These perspectives articulate complexities in the developmental processes that underlie change and continuity in human behavior over time. We consider two key developmental concepts, namely, “time” and “heterogeneity.” We argue that a lack of attention to time sampling creates ambiguity in the meaning of time-linked assessments, challenges in discerning which of multiple clocks may govern behavior, and the inability in some instances to distinguish which of multiple etiological processes may be driving behavior within our samples. Moreover, artificial divisions among disorders that commonly co-occur with substance use are a barrier to the further integration of the study and treatment of addictions with that of psychopathology. Similar to recent changes in the study of psychiatric disorders more broadly, we argue that identifying common deficits among commonly comorbid disorders, rather than patterns of comorbidity per se, is key to identifying early emerging risk factors for substance use and disorder, with important implications for identifying risk populations and developmental periods as well as potentially malleable intervention targets. Attention to time sampling in theory-driven research designs and attempts to identify more homogenous groups of individuals who use and eventually abuse substances over time are two examples of ways to better understand some of the complexity underlying the development of addictions.

Acknowledgments

The preparation of in this publication was supported by the National Institutes of Health under award number R01DA015398 through the National Institute on Drug Abuse (Co-PIs, Andrea Hussong and Patrick Curran) and T32-HD07376, an institutional training grant funded by the National Institute of Child Health and Human Development and administered through the Center for Developmental Science, University of North Carolina at Chapel Hill, which supported Alison Burns. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Notes

¹Although some may argue that there are addiction processes that are relatively stable and thus not governed by development, a developmental perspective would argue that unfolding processes are still at work in maintaining the continuity of behavior over time.

²One may argue that we often have a zero-point in studies of substance use if we catch a sample prior to initiation to observe the onset of drinking for everyone. However, the risk processes that underlie the emergence of drinking are difficult to pinpoint in time (see Heterogeneity section). Even more so, it is difficult to align samples to capture the point of drinking initiation at a single time point for all (though some examples can be noted, as per our example in Hussong et al., 2008) and even more difficult to align samples to capture the point of onset for the risk mechanism per se for all.

³The actual support for an evocative parenting hypothesis with respect to the association between parental monitoring and adolescent substance use, however, is quite mixed. This is perhaps because many studies rely on measures of parental monitoring that confound adolescent self-disclosure with parental monitoring behaviors. In these studies, when adolescents use substances, parental monitoring is more likely to decrease perhaps because adolescents are simply less likely to disclose their use (relative to their nonuse). However, when adolescents do use substances and parents find out about that use, harsh and inconsistent parenting is more likely to occur (Conger & Rueter, 1996).

⁴This is an important point of potential divergence between some public health approaches to understanding and preventing substance use as a form of risk behaviors, which may have limited contextual and intrapersonal precursors, and a developmental science approach which may view early risk factors for substance use as a heterotypic form of a shared underlying deficit.

⁵Although developed in the context of IDA, moderated nonlinear factor analysis may be used to address issues of heterotypic continuity in single study designs as well.