Development and Psychopathology


Developmental Approaches to Substance Use and Abuse

Etiology of early age onset substance use disorder: A maturational perspective


RALPH TARTER a1c1, MICHAEL VANYUKOV a2, PETER GIANCOLA a3, MICHAEL DAWES a2, TIMOTHY BLACKSON a4, ADA MEZZICH a2 and DUNCAN B. CLARK a2
a1 Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania
a2 Center for Education and Drug Abuse Research (CEDAR), Department of Psychiatry, University of Pittsburgh Medical School
a3 Department of Psychology, University of Kentucky
a4 Department of Human Development and Family Studies, Penn State University

Abstract

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.


Correspondence:
c1 Address correspondence and reprint requests to: Ralph E. Tarter, Ph.D., Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213.