ArticlePsychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors2026
Familial risk factors required to predict earlier adolescent substance use in youth with externalizing disorders.
Article in Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveExternalizing behaviors and family history of substance-use disorders (SUDs) are well-established childhood predictors of adolescent and adult substance use/SUDs. These two risk factors frequently co-occur and are often confounded in developmental research. This study aimed to disentangle these risk factors and determine to what extent familial-SUD history enhances risk for substance-use/SUD development in youth with externalizing disorders.
methodSUD risk status of substance-naïve youth (
resultsHR youth-initiated substance use earlier than both PC youth (adjusted hazard ratio; aHR = 2.31, CI = [1.39, 3.83]) and TDC youth (aHR = 2.68, CI = [1.38, 5.19]). HR youth also transitioned more rapidly than PC/TDC youth to problematic substance use (aHR's 2.16/2.32, CI's [1.19-3.91, 1.05-5.11]) and to risky substance use (aHR's 2.50/2.56, CI's 1.34, 4.59/1.15, 5.67). PC and TDC youth did not differ in substance-use trajectories.
conclusionsAlthough there is considerable support for an externalizing behavioral phenotype in youth as a driver toward adolescent substance use, this predictive association was found to manifest only in the context of familial-SUD history. Familial SUD status may warrant particular consideration in the identification of and intervention with youth at risk for SUDs. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
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