Revisiting the Concepts of Risk and Protective Factors for Understanding the Etiology and Development of Substance Use and Substance Use Disorders: Implications for Prevention

Abstract

Over the past 20 years we have accumulated a greater knowledge and understanding of the genetic, neurobiological, and behavioral factors that may be associated with young people initiating the use of drugs and other substances and to progressing from use to abuse and dependence. This knowledge suggests that individuals may be “predisposed” to substance use disorders (SUD) and that the actual engagement in these behaviors depends on their environmental experiences from micro to macro levels. This paper summarizes this knowledge base and supports a developmental framework that examines the interaction of posited genetic, psychological, and neurobiological “predispositions” to SUD and those environmental influences that exacerbate this vulnerability.

Keywords :

• development
• environment
• genetics
• neurobiology
• protection
• psychopathology
• risk
• vulnerability

THE AUTHORS

Zili Sloboda is currently the Director of Research and Development of JBS International, Inc., a company focused on understanding the specific health, social, and education needs of people across the lifespan. Dr. Sloboda was trained in medical sociology at New York University and in mental health and epidemiology at the Johns Hopkins University Bloomberg School of Public Health. The majority of her research has been related to the delivery of health-related services to youth and adults and epidemiology. She is an expert on the prevention of substance abuse by adolescents and has broad experience in research related to at-risk youth. More recently, while at the Institute for Health and Social Policy at The University of Akron, she served as Principal Investigator on a large national multisite evaluation of an innovative school-based substance abuse prevention program delivered by Drug Abuse Resistance Education (D.A.R.E.) officers. Prior to The University of Akron, Dr. Sloboda worked for more than 10 years at the National Institute on Drug Abuse (NIDA) in the capacity of Program Officer and Chief of the Prevention Research Branch and then Director of the Division of Epidemiology and Prevention Research. This Division's focus was on the development and support of national research programs in HIV/AIDS epidemiology and prevention and drug abuse epidemiology and prevention. She has spent the last 15 years working toward forming more collaboration between U.S. and international researchers and was instrumental in establishing the International Epidemiology Work Group and the International HIV/AIDS Prevention Work Group, and was an original founder of the Society for Prevention Research. She is widely published in the area of drug abuse and has coedited the Handbook of Drug Abuse Prevention: Theory, Science, and Practice, and edited Epidemiology of Drug Abuse.

Meyer D. Glantz, Ph.D., is currently the Associate Director for Science of the Division of Epidemiology and Prevention Research (DESPR) of the National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH). Dr. Glantz received his doctorate from Harvard University in 1979. Prior to coming to NIDA, he worked as a researcher and clinician at the Veterans Administration Clinic in Boston. At NIDA, Dr. Glantz had previously served as the Chief of the Epidemiology Research Branch and as the Head of the Vulnerability Research Program. He is the author of numerous articles and chapters on substance abuse, drug abuse etiology, cognitive therapy, prevention, and developmental psychopathology and has edited several volumes. In addition to a range of current research activities, Dr. Glantz is a collaborator in the National Comorbidity Survey Replication Study and the World Mental Health Survey Consortium Project. He currently maintains a private clinical practice in the Washington D.C. area, supervises other clinicians, and has taught at several area universities.

Ralph Tarter obtained a Ph.D. degree in biological psychology at the University of Oklahoma Health Science Center in 1971. He subsequently obtained a Master's degree in policy analysis at the University of Pittsburgh in 1988. He is a licensed clinical psychologist specializing in neuropsychology with specific expertise in addiction. Since 1989, he has been Director of the NIDA-funded Center for Education and Drug Abuse Research (CEDAR). This longitudinal study of 775 families is directed at explicating the etiology of addiction within a developmental framework. He has published 280 peer refereed articles, 80 book chapters, 11 books, and two special issues pertaining to addiction. He has been awarded first prize by the British Medical Association for his book Substance Abuse: Neurobehavioral Pharmacology, in 1999. In 2001, he was given the Service Award by the Society for Prevention Research. In 2004, he was named University Scholar by Research Triangle Institute. Currently, Dr. Tarter is a member of the editorial board of four journals. When not actively engaged in research and administration, he socializes in the dog park with his wife and their border collie.