A developmental cascade model for early adolescent onset substance use: The role of early childhood stress

Backgrounds and aims: Despite the link between stress and addictive behavior in adulthood, little is known about how early life stress in families predicts the early emergence of substance use in adolescence. This study tested a developmental cascade model, proposing that early stressful life events and negative parent-child interaction covary, and both disrupt the refinement of inhibitory control, which evolves into problem behavior in middle/late childhood and subsequent substance use exploration in early adolescence. Methods: Data came from the Early Steps Multisite study, a community sample of at-risk families in the metropolitan US areas of Pittsburgh (Pennsylvania), Eugene (Oregon), and Charlottesville (Virginia) with children aged 2 at the start of the study and 14 at the last measurement (N = 364). Structural equation modeling was used to test the proposed model. Results: Early stressful life events and negative parent-child interaction assessed at ages 2 to 5 were negatively related to inhibitory control at ages 7 and 8. Low levels of inhibitory control were prognostic of childhood problem behavior at ages 9 and 10. Finally, late childhood problem behavior was associated with substance use at age 14. Parental drug use was directly related to substance use at age 14. Conclusions: Early life stress may disrupt child inhibitory control, which can cascade into behavioral and peer problem behavior in childhood and, in turn, heighten the risk for early adolescent substance use.