The authors suggest that the most promising route to effective strategies for the prevention of adolescent alcohol and other drug problems is through a risk-focused approach. This approach requires the identification of risk factors for drug abuse, identification of methods by which risk factors have been effectively addressed, and application of these methods to appropriate high-risk and general population samples in controlled studies. The authors review risk and protective factors for drug abuse, assess a number of approaches for drug abuse prevention potential with high-risk groups, and make recommendations for research and practice.

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Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention.

ContextModifiable behavioral risk factors are leading causes of mortality in
the United States. Quantifying these will provide insight into the effects
of recent trends and the implications of missed prevention opportunities.ObjectivesTo identify and quantify the leading causes of mortality in the United
States.DesignComprehensive MEDLINE search of English-language articles that identified
epidemiological, clinical, and laboratory studies linking risk behaviors and
mortality. The search was initially restricted to articles published during
or after 1990, but we later included relevant articles published in 1980 to
December 31, 2002. Prevalence and relative risk were identified during the
literature search. We used 2000 mortality data reported to the Centers for
Disease Control and Prevention to identify the causes and number of deaths.
The estimates of cause of death were computed by multiplying estimates of
the cause-attributable fraction of preventable deaths with the total mortality
data.Main Outcome MeasuresActual causes of death.ResultsThe leading causes of death in 2000 were tobacco (435 000 deaths;
18.1% of total US deaths), poor diet and physical inactivity (400 000
deaths; 16.6%), and alcohol consumption (85 000 deaths; 3.5%). Other
actual causes of death were microbial agents (75 000), toxic agents (55 000),
motor vehicle crashes (43 000), incidents involving firearms (29 000),
sexual behaviors (20 000), and illicit use of drugs (17 000).ConclusionsThese analyses show that smoking remains the leading cause of mortality.
However, poor diet and physical inactivity may soon overtake tobacco as the
leading cause of death. These findings, along with escalating health care
costs and aging population, argue persuasively that the need to establish
a more preventive orientation in the US health care and public health systems
has become more urgent.

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Actual causes of death in the United States, 2000.

Psychology has long been enamored of the dark side of human existence, rarely exploring a more positive view of the mind. What has psychology contributed, for example, to our understanding of the various human virtues? Regrettably, not much. The last decade, however, has witnessed a growing movement to abandon the exclusive focus on the negative. Psychologists from several subdisciplines are now asking an intriguing question: "What strengths does a person employ to deal effectively with life?" The Handbook of Positive Psychology provides a forum for a more positive view of the human condition. In its pages, readers are treated to an analysis of what the foremost experts believe to be the fundamental strengths of humankind. Both seasoned professionals and students just entering the field are eager to grasp the power and vitality of the human spirit as it faces a multitude of life challenges. The Handbook is the first systematic attempt to bring together leading scholars to give voice to the emerging field of positive psychology.

Handbook of positive psychology

Many lines of evidence, including epidemiologic data and extensive clinical and experimental studies, indicate that early life events play a powerful role in influencing later susceptibility to certain chronic diseases. This review synthesizes evidence from several disciplines to support the contention that environmental factors acting during development should be accorded greater weight in models of disease causation.

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Effect of In Utero and Early-Life Conditions on Adult Health and Disease

This paper provides a review and critique of empirical research on perceived discrimination and health. The patterns of racial disparities in health suggest that there are multiple ways by which racism can affect health. Perceived discrimination is one such pathway and the paper reviews the published research on discrimination and health that appeared in PubMed between 2005 and 2007. This recent research continues to document an inverse association between discrimination and health. This pattern is now evident in a wider range of contexts and for a broader array of outcomes. Advancing our understanding of the relationship between perceived discrimination and health will require more attention to situating discrimination within the context of other health-relevant aspects of racism, measuring it comprehensively and accurately, assessing its stressful dimensions, and identifying the mechanisms that link discrimination to health.

/pdf/discrimination-and-racial-disparities-in-health-evidence-and-5dn893hio4.pdf

Discrimination and racial disparities in health: evidence and needed research

The purpose of this monograph was to propose a framework, family interactional theory, for explaining the psychosocial aspects of adolescent drug use. Three themes are stressed: (a) the extension of developmental perspectives on drug use, (b) the elucidation of family (especially parental) influences leading to drug use, and (c) the exploration of factors that increase or mitigate adolescents' vulnerability to drug use. We present a developmental model with two components; the first deals with adolescent pathways to drug use, and the second incorporates childhood factors. The model was tested in two studies: one cross-sectional study of 649 college students and their fathers, and one longitudinal study of 429 children and their mothers. The subjects were given self-administered questionnaires containing scales measuring the personality, family, and peer variables outlined in the model. The results of each study supported the hypothesized model, with some differences between parental influences. We also found that individual protective factors (e.g., adolescent conventionality, parent-child attachment) could offset risk factors (e.g., peer drug use) and enhance other protective factors, resulting in less adolescent marijuana use. Implications of the findings for prevention and treatment, future research, and public policy are discussed.

The psychosocial etiology of adolescent drug use: a family interactional approach.

Methods: Using data from a community-based sample of 736 adults (50% female) from upstate New York, the subjects were interviewed at the mean ages of 14, 16, 22, and 27 years. Psychiatric disorders, measured by ageappropriate versions of the University of Michigan Composite International Diagnostic Interview, and participant’s drug use were assessed. Results: Adolescent and young adult tobacco use was significantly associated with an increased risk of alcohol dependence and substance use disorders at a mean age of 27 years, but not with new episodes of major depressive disorder. Earlier alcohol use significantly predicted later major depressive disorder, alcohol dependence, and substance use disorders in the late 20s, as did early marijuana use and other illicit drug use. Except for the effect of tobacco use on major depressive disorder, early drug use was significantly related to later psychiatric disorders, even after statistically controlling for age, sex, parental educational level, family income, and prior episodes of major depressive disorder and substance use disorders. Conclusions: Our results suggest that early drug use is associated with and predicts later psychiatric disorders. Preventive implications stem from the importance of studying a range of psychiatric disorders in the context of substance use assessed over a wide age range. Arch Gen Psychiatry. 2002;59:1039-1044

https://jamanetwork.com/journals/jamapsychiatry/articlepdf/206845/YOA10037.pdf

Drug use and the risk of major depressive disorder, alcohol dependence, and substance use disorders.

OBJECTIVES: The purpose of this study was to assess the relation of early adolescent marijuana use to late adolescent problem behaviors, drug-related attitudes, drug problems, and sibling and peer problem behavior. METHODS: African American (n = 627) and Puerto Rican (n = 555) youths completed questionnaires in their classrooms initially and were individually interviewed 5 years later. Logistic regression analysis estimated increases in the risk of behaviors or attitudes in late adolescence associated with more frequent marijuana use in early adolescence. RESULTS: Early adolescent marijuana use increased the risk in late adolescence of not graduating from high school; delinquency; having multiple sexual partners; not always using condoms; perceiving drugs as not harmful; having problems with cigarettes, alcohol, and marijuana; and having more friends who exhibit deviant behavior. These relations were maintained with controls for age, sex, ethnicity, and, when available, earlier psychosocial measures. CONC...

The risks for late adolescence of early adolescent marijuana use.

Objective The aims of this study were (1) to examine the childhood, early adolescent, and late adolescent predictors of young adult drug use and delinquency; and (2) to explore the effects of drug use on delinquent behavior. Method Data were gathered during the course of a 20-year longitudinal study of children representative of the Northeast. Data were gathered on childhood aggression, early and late adolescent drug use and delinquency, and young adult drug use and delinquency. Results Overall, the results were consistent with our proposed model. Childhood aggression had an adverse effect on young adult drug use and female deviant behavior. Drug use and delinquency during early and late adolescence served as the mediator between childhood aggression and young adult drug use. Moreover, adolescent drug use was associated with later delinquency. Conclusions The findings indicated that childhood aggression was related to both young adult drug use and delinquency. Second, there was stability of drug use and delinquency between early adolescence and young adulthood. Third, drug use during early adolescence had an impact on delinquency not only in early adolescence, but also in late adolescence and young adulthood.

Martin Whiteman

Papers

The psychosocial etiology of adolescent drug use: a family interactional approach.

Drug use and the risk of major depressive disorder, alcohol dependence, and substance use disorders.

The risks for late adolescence of early adolescent marijuana use.

Young Adult Drug Use and Delinquency: Childhood Antecedents and Adolescent Mediators

Dynamics of childhood and adolescent personality traits and adolescent drug use.