HIV Insight: Understanding Addiction as a Developmental Disorder: An Argument for a Developmentally Informed Multilevel Approach

Substance abuse and drug addiction are two of the most common psychopathologies among the general population. While a host of risk factors are associated with the onset of drug abuse and drug addiction, there is a growing body of evidence pointing to the powerful influence of early adverse experiences, both child neglect and maltreatment, as well as drug use and abuse in parents and/or primary caretakers. We consider the case for drug addiction as a developmental disorder, outlining the need to consider the role of genetic, epigenetic, and neurobiological factors alongside experiences of adversity at key stages of development. Such a multilevel approach within a developmental framework has the potential to reframe our understanding of how addiction emerges and is maintained, and is essential if we are to identify the mechanisms underlying this disorder to better inform effective treatment and prevention across the generations.

… Substance abuse and drug addiction are two of the most common psychopathologies among the general population. Across potential drugs of abuse, prevalence estimates in adult populations for drug abuse and dependence range from 1.4 % for 12-month to 7.7 % for lifetime drug abuse [1]. When the behavioral addictions are also considered (e.g., gambling, overeating), there is significant overlap in natural history, comorbidity, response to treatment, and etiologic mechanisms with drug use and abuse [2]. Many addictions begin in adolescence, which appears to be an especially vulnerable time for the onset of drug use and abuse and the transition to addiction [3]. There are also robust associations between the age of onset of drug use and abuse and the severity and chronicity of addiction [4]. While there are a host of risk factors associated with the onset of drug abuse and drug addiction, there is a growing body of evidence pointing to the influence of early adverse experiences, both child neglect and maltreatment, as well as drug use and abuse in parents and/or primary caretakers. Taken together, each of these lines of evidence suggest that drug addiction (and perhaps addictions more generally) may be construed as developmental disorders, that is, as disorders with experiential and gene by experience antecedents relating to early caregiving and exposure to adverse and/or contexts characterized by deprivation….

Full article at: http://goo.gl/P6RzfR

By: E. J. McCrory and L. Mayes corresponding author