Academic journal article Alcohol Research

Adolescents at Risk for Substance Use Disorders: Role of Psychological Dysregulation, Endophenotypes, and Environmental Influences

Academic journal article Alcohol Research

Adolescents at Risk for Substance Use Disorders: Role of Psychological Dysregulation, Endophenotypes, and Environmental Influences

Article excerpt

Adolescents with alcohol-related problems often also use cigarettes and marijuana. Furthermore, early childhood characteristics that increase the risk for adolescent alcohol use disorders also increase the risk for problematic drug use. Identifying these characteristics early in childhood can be important for the prevention of alcohol and other drug (ADD) use disorders. As a result, researchers are seeking to identify liability factors and observable characteristics (i.e., phenotypes) that can predict substance use disorders (SUDS) across drug categories. Other studies are focusing on endophenotypes--characteristics that cannot be openly observed but which link a person's genetic makeup, or genotype, and disease. Both predictive behavioral phenotypes and endophenotypes may reveal pathways connecting heritable predispositions and early environmental influences to later SUDS. One suggested predictive phenotype is psychological dysregulation, which is characterized by cognitive, behavioral, and emotional difficulties in childhood. An endophenotype that has been studied extensively is a particular brain wave called the P300 event-related potential. For people who are at high risk of ADD use based on these characteristics, adverse environmental conditions frequently lead to SUDS. Given the strong evidence that childhood psychological dysregulation predicts problematic ADD use, effective interventions for preventing adolescent SUDS may need to target the environmental features that put adolescents with this behavioral constellation at increased risk. KEY WORDS: Adolescent; childhood; problematic alcohol use; alcohol use disorder (AUD); substance use disorder (SUD); heredity risk factors; environmental risk factors; behavioral phenotype; endophenotype; psychological dysregulation

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Adolescence is the developmental period of highest risk for the onset of problematic alcohol and other drug (AOD) use. Some experimentation with alcohol may be considered normal during adolescence; however, people who engage in binge drinking or who have developed alcohol use disorders typically also engage in other drug use, most frequently cigarettes and marijuana. AOD use behaviors are multifaceted and complex and are influenced by a multiplicity of genetic and environmental liabilities.

Risk factors for adolescent AOD use and substance use disorders (SUDS) can be conceptually divided into heritable, environmental, and phenotypic factors (Clark and Winters 2002). Heritable risk factors are reflected in familial patterns of SUDS and other psychiatric disorders. Environmental risk factors include family-related characteristics, such as family functioning, parenting practices, and child maltreatment, as well as other contextual factors, such as peer influences, substance availability, and consumption opportunities. These heritable and environmental factors then interact to determine a person's observable characteristics and behaviors (i.e., phenotypes), such as AOD use. Therefore, understanding common genetic and environmental liabilities for adolescent AOD use is critical for developing effective prevention and intervention efforts. To better understand and to identify specific risk factors for adolescent SUDS, researchers have conducted longitudinal studies with high-risk children whom they followed through young adulthood.

One essential aspect of such studies is the choice of a suitable phenotype to study. A phenotype is an observable characteristic in a person that is the product of an interaction between the person's genetic makeup (i.e., genotype) and environmental influences (Gottesman and Gould 2003). Most phenotypes are determined by multiple genes and environmental factors as well as by random variation. Accordingly, it can be difficult to select appropriate phenotypes that are relevant for a given genetic study. For example, the same genotype in several people might result in different phenotypes, depending on the environmental influences to which the people are exposed and random variation; likewise, the same phenotype might result from several different combinations of genes. …

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