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In studying how substance abuse begins and progresses, researchers have identified risk factors that increase a person's likelihood of abuse and protective factors that reduce the risk. These risk and protective factors are different at different stages of a child's development. There are some that occur prenatally, such as genetic predisposition and alcohol exposure in utero, but the most critical behavioral risks become evident in early childhood and more critical in the middle school years. At each stage, there are factors that are pertinent to the individual child and others that reflect interaction with the family and peers. The National Research Council and Institute of Medicine have provided guidance on these factors.
Tips to Recognize Risk and Protective Factors for Substance Abuse
Early Childhood Risk Factors
- Individual: Difficult temperament, lack of self-control, early indications of aggressive behavior
- Family: Lack of warmth and nurturing from caregivers, poor attachment, caregiver unpredictability, parental substance abuse
Early Childhood Protective Factors
- Individual: Self-regulation (ability to self-soothe), ability to make friends and get along with others, mastery of language and communication skills
- Family: Development of strong attachment parental bond, reliable support and consistent discipline from caregivers
Middle Childhood Risk Factors
- Individual: Poor impulse control, persistent behavior problems, attention deficit hyperactivity disorder, sensation seeking, anxiety, depression, antisocial behavior
- Family: Permissive parenting, parent-child conflict, low parental warmth, harsh or inconsistent discipline, child abuse/maltreatment, substance use or favorable attitudes toward use among parents or siblings, inadequate supervision, low parental aspirations for child, family dysfunction, domestic violence
Middle Childhood Protective Factors
- Individual: Mastery of basic academic skills (reading, writing, math); ability to follow rules at home, in school, in public; ability to make friends and have good peer relationships
- Family: Consistent discipline, language-based (rather than physical) discipline, extended family support, trusting and predictable family relationships
There are risk and protective factors that occur in the school, peer and community environments as well. For example, safe neighborhoods and schools with positive teacher expectations, effective classroom management, policies to reduce bullying and healthy peer attitudes toward substance abuse provide a healthy environment that can reduce risk.
These risk and protective factors have different effects at different stages of development. For example, peer pressure is more significant as a risk factor in older children and a strong parent-child relationship will be most protective when developed in early childhood. But at all stages, appropriate intervention and preventive measures can redirect behavior and avert later problems. While a risk factor may not affect all children equally, the more risk factors a child is exposed to, the more serious the danger. "Not surprisingly, parents play the lead role in identifying and addressing risk," says Mr. Glawe. "Parents who are concerned about a young child's risk should seek help at an early stage. With professional help and with the support of the school and others in the community, the balance between risk factors and protective factors can be changed and the likelihood of problems developing can be drastically reduced."
Josh Glawe, L.C.S.W., provides individual, family, marital, and group therapy and specializes in adolescent disorders.
Morris Psychological Group, P.A. offers a wide range of therapy and evaluation services to adults, children and adolescents.
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