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.

The adolescent brain and age-related behavioral manifestations

In this study, we describe a psychobiological model of the structure and development of personality that accounts for dimensions of both temperament and character. Previous research has confirmed four dimensions of temperament: novelty seeking, harm avoidance, reward dependence, and persistence, which are independently heritable, manifest early in life, and involve preconceptual biases in perceptual memory and habit formation. For the first time, we describe three dimensions of character that mature in adulthood and influence personal and social effectiveness by insight learning about self-concepts. Self-concepts vary according to the extent to which a person identifies the self as (1) an autonomous individual, (2) an integral part of humanity, and (3) an integral part of the universe as a whole. Each aspect of self-concept corresponds to one of three character dimensions called self-directedness, cooperativeness, and selftranscendence, respectively. We also describe the conceptual background and development of a self-report measure of these dimensions, the Temperament and Character Inventory. Data on 300 individuals from the general population support the reliability and structure of these seven personality dimensions. We discuss the implications for studies of information processing, inheritance, development, diagnosis, and treatment. (Arch Gen Psychiatry. 1993;50:975-990)

https://jamanetwork.com/HttpHandlers/ArticlePdfHandler.ashx?journal=PSYCH&articleId=496431&pdfFileName=archpsyc_50_12_008.pdf

A Psychobiological Model of Temperament and Character

Part I. From There to Here - Theoretical Background: 1. From visiousness to viciousness: theories of intergroup relations 2. Social dominance theory as a new synthesis Part II. Oppression and its Psycho-Ideological Elements: 3. The psychology of group dominance: social dominance orientation 4. Let's both agree that you're really stupid: the power of consensual ideology Part III. The Circle of Oppression - The Myriad Expressions of Institutional Discrimination: 5. You stay in your part of town and I'll stay in mine: discrimination in the housing and retail markets 6. They're just too lazy to work: discrimination in the labor market 7. They're just mentally and physically unfit: discrimination in education and health care 8. The more of 'them' in prison, the better: institutional terror, social control and the dynamics of the criminal justice system Part IV. Oppression as a Cooperative Game: 9. Social hierarchy and asymmetrical group behavior: social hierarchy and group difference in behavior 10. Sex and power: the intersecting political psychologies of patriarchy and empty-set hierarchy 11. Epilogue.

http://catdir.loc.gov/catdir/samples/cam032/98044356.pdf

Social Dominance: An Intergroup Theory of Social Hierarchy and Oppression

• A systematic method for clinical description and classification of both normal and abnormal personality variants is proposed based on a general biosocial theory of personality. Three dimensions of personality are defined in terms of the basic stimulus-response characteristics of novelty seeking, harm avoidance, and reward dependence. The possible underlying genetic and neuroanatomical bases of observed variation in these dimensions are reviewed and considered in relation to adaptive responses to environmental challenge. The functional interaction of these dimensions leads to integrated patterns of differential response to novelty, punishment, and reward. The possible tridimensional combinations of extreme (high or low) variants on these basic stimulusresponse characteristics correspond closely to traditional descriptions of personality disorders. This reconciles dimensional and categorical approaches to personality description. It also implies that the underlying structure of normal adaptive traits is the same as that of maladaptive personality traits, except for schizotypal and paranoid disorders.

https://jamanetwork.com/journals/PSYCH/articlepdf/494070/archpsyc_44_6_014.pdf

A systematic method for clinical description and classification of personality variants: A proposal.

• The inheritance of alcoholism was studied in 862 Swedish men adopted by nonrelatives at an early age. Both the congenital and postnatal backgrounds of the adoptees modify their risk for alcohol abuse. We distinguish two forms of alcoholism that have distinct genetic and environmental causes and differ in their association with criminality, severity of alcohol abuse, and the frequency of expression in biological mothers. Postnatal milieu determines the frequency and severity of expression of the common type of susceptibility in both men and women. In contrast, the less common type is highly heritable in men but is seldom expressed in mothers of affected men.

Inheritance of alcohol abuse. Cross-fostering analysis of adopted men

431 children (233 boys, 198 girls) born in Stockholm, Sweden, had a detailed behavioral assessment at 11 years of age, including a detailed interview with their school teachers, and at age 27 years were reevaluated to identify alcoholism or alcohol abuse. Specific predictions from a neurobiological learning theory about the role of heritable personality traits in susceptibility to alcohol abuse were tested in this prospective longitudinal study. Three dimensions of childhood personality variation were identified and rated without knowledge of adult outcome. These three dimensions (novelty-seeking, harm avoidance, and reward dependence) were largely uncorrelated with one another, and each was predictive of later alcohol abuse. Absolute deviations from the mean of each of the three personality dimensions were associated with an exponential increase in the risk of later alcohol abuse. High novelty-seeking and low harm avoidance were most strongly predictive of early-onset alcohol abuse. These two childhood variables alone distinguished boys who had nearly 20-fold differences in their risk of alcohol abuse: the risk of alcohol abuse varied from 4 to 75% depending on childhood personality.

Childhood personality predicts alcohol abuse in young adults.

The inheritance of alcohol abuse was studied in 913 Swedish women adopted by nonrelatives at an early age. There was a threefold excess of alcohol abusers among the adopted daughters of alcoholic biological mothers compared with other daughters. In addition, there was an excess of alcohol abuse among the daughters of biological fathers with alcohol abuse that was mild and not associated with criminality. However, fathers with extensive treatment for both alcoholism and criminality had no excess of alcoholic daughters. This confirms the heterogeneity among alcoholics noted in earlier work with adopted sons, which found that the latter type of criminal alcoholics also had no excess of alcoholic mothers. Imitation of alcohol abuse by adoptive parents did not increase later alcohol abuse by adopted women. The importance of nonfamilial environments and maternal effects is demonstrated for alcohol abuse in women.

Maternal inheritance of alcohol abuse. Cross-fostering analysis of adopted women.

Background: Two forms of alcoholism with distinct clinical features and mode of inheritance were first distinguished in the Stockholm Adoption Study. This involved a large sample of children born in Stockholm, Sweden, who were adopted at an early age and reared by nonrelatives. Type 1 alcoholism had adult onset and rapid progression of dependence without criminality, whereas type 2 had teenage onset of recurrent social and legal problems from alcohol abuse. Methods: A replication study was carried out with 577 men and 660 women born in Gothenburg, Sweden, and adopted at an early age by nonrelatives. The genetic and environmental backgrounds of the adoptees were classified by the exact procedures calibrated by discriminant analysis in the original study. Results: Both type 2 and severe type 1 alcoholism were confirmed as independently heritable forms of alcoholism in male adoptees. The lifetime risk of severe alcoholism was increased 4-fold in adopted men with both genetic and environmental risk factors characteristic of type 1 alcoholism compared with the others (11.4% vs 3.0%). Neither genetic nor environmental risk factors for type 1 alcoholism by themselves were sufficient to cause alcoholism. In contrast, the risk of type 2 alcoholism was increased 6-fold in adopted sons with a type 2 genetic background compared with others, regardless of their postnatal environment (10.7% vs 2.0%). The sons with a type 2 genetic background in the replication sample had no excess of type 1 alcoholism, and vice versa. There was no increased risk of mild abuse in adopted men regardless of their genetic or environmental background. Conclusion: Type 1 and type 2 alcoholism are clinically distinct forms of alcoholism with causes that are independent but not mutually exclusive.

Replication of the Stockholm Adoption Study of Alcoholism: Confirmatory Cross-Fostering Analysis

The interaction of congenital and postnatal antecedents of criminality was studied in 862 Swedish men adopted at an early age by nonrelatives. Most explained variability was due to differences between the genetic predispositions of the adoptees, but substantial contributions were also made by postnatal environment, either alone or in combination with specific genetic subtypes. There was no overlap between the congenital antecedents of alcoholism and nonalcoholic criminality, but some postnatal variables were common to criminality and one type of alcoholism that is limited to expression in men, according to earlier studies. Low social status alone was not sufficient to lead to criminality, but did increase risk in combination with specific types of genetic predisposition. Unstable preadoptive placements contributed to the risks of both petty criminality and male-limited alcoholism, but not to other types of alcohol abuse. We discuss these results in terms of their clinical and social implications.

Sören Sigvardsson

Papers

Inheritance of alcohol abuse. Cross-fostering analysis of adopted men

Childhood personality predicts alcohol abuse in young adults.

Maternal inheritance of alcohol abuse. Cross-fostering analysis of adopted women.

Replication of the Stockholm Adoption Study of Alcoholism: Confirmatory Cross-Fostering Analysis

Predisposition to petty criminality in Swedish adoptees. II. Cross-fostering analysis of gene-environment interaction.