Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

25. Adolescent Substance Abuse 563Increased behavioral activity level is noted in both youth at high risk for substanceabuse and those having an SUD (Tarter, Laird, Mostefa, Bukstein, &Kaminer, 1990). Other temperamental trait deviations found in high-risk youthinclude reduced attention span persistence (Schaeffer, Parson, & Yohman,1984), increased impulsivity (Noll, Zucker, Fitzgerald, & Curtis, 1992; Shedler& Block, 1990), and negative affect states such as irritability (Brook, Whiteman,Gordon, & Brook, 1990) and emotional reactivity (Blackson, 1994).Tarter, Kirisci, Hegedeus, Mezzich, and Yanyukov (1994) developed a difficulttemperament index to classify adolescent alcoholics. Those adolescents with adifficult temperament displayed a high conditional probability to develop psychiatricdisorders such as conduct disorder, attention-deficit/hyperactivity disorder,anxiety disorders, and mood disorders (Tarter et al., 1994).Environmental TheoriesThe evidence supporting genetic and, presumably, biological factors in alcoholismand substance abuse is paralleled by evidence supporting the role ofpsychosocial, familial, peer, and other environmental and interactional variables.Problem behavior theory, formulated by Jessor and associates, explains substanceuse as a component of a “deviance syndrome” or “proneness” to problembehavior (Jessor, 1987). Together, the personality system, the perceived environmentsystem, and the behavior system generate a dynamic state called“proneness,” which specifies the likelihood of occurrence of normative developmentor problem behavior that departs from the social and legal norms.Also, longitudinal studies have documented that personality characteristicssuch as aggressiveness and rebelliousness are predictive factors that precedethe use of substances and can be identified in preschoolers. Kandel (1982)made two pivotal contributions. She formulated four broad classes of predictors:(1) parental influences, (2) peer influences, (3) adolescent beliefs and values,and (4) adolescent involvement in various shared activities. Kandel also conceptualizedthe “gateway” theory to adolescent substance use and abuse.According to Kandel (1982, 2003), alcohol and marijuana are pivotal “gateway”substances, and she formulated several distinct developmental stages inthe initiation and progression of substance use by adolescents, including (1)beer or wine, (2) cigarettes or hard liquor, (3) marijuana, and (4) other illicitsubstances. Participation in each stage is a necessary but not a sufficient conditionfor progression into a latter stage. Problem drinking may take placebetween marijuana and other illicit drug use; therefore, it represents an additionalstage in the transition of substance use (Donovan & Jessor, 1983).Morral, McCaffrey, and Paddock (2002) argued that a marijuana gateway effectto hard drugs might exist, particularly among specific ethnic groups such asAfrican Americans, although a common factor model may suffice to explainthis association.