In 2012, SAMHSA’s Center for the Application of Prevention Technologies (CAPT) reviewed literature concerning risk and protective factors for substance abuse and mental health disorders. Existing research and data suggest that there are number of common or shared risk and protective factors throughout life that impact both substance abuse and mental health outcomes. The four examples provided below illustrate some shared risk and protective factors for childhood through young adulthood; there are other shared risk and protective factors for adulthood and older adulthood.
Examples of Shared Risk Factors
- Definition: This indicator includes poor grades, poor/low academic performance or achievement, and school failure.
- Risk Factor for: Poor grades/achievement is a risk factor for: depression1; substance abuse2,3,6; binge drinking in adulthood4; drug use among boys (related to IQ decline from age 11 to 18)3; adolescent drug use/abuse3; and increased alcohol and drug use between 7th and 9th grades5.
- Age Group(s): Early childhood through adolescence.
Family History of Substance Use Disorders
- Definition: Family history of substance use disorders can include, but is not limited to, exposure during childhood to: parental substance abuse; parental alcoholism; growing up in a household in which there is substance abuse; family drug behavior; parental and/or sibling modeling of drug/alcohol use.
- Risk Factor for: Co-occurring disorders1,7; non-comorbid major depressive episode8; non-comorbid substance use disorder8; comorbid* PTSD + substance use disorder8; comorbid PTSD + major depressive episode8; alcohol, cocaine, or opioid dependence8; mood and anxiety disorders9; family history of substance abuse is a risk factor for lifetime alcohol use10; current alcohol use10; current binge drinking5,10; lifetime marijuana use10; current marijuana use10; increased alcohol and drug use between 7th and 9th grades5; early onset of drinking and persistence of alcohol use disorders11; substance abuse1,3,12.
- Age Group(s): Youth (Infancy through Adolescence) and Young Adult.
Examples of Shared Protective Factors
Parental Support and Bonding
- Definition: This indicator includes, but is not limited to: parents as a source of social support, parent and family bonding, relationship with the main caregiver, bonding to a family with healthy beliefs and clear standards, meaningful opportunities to contribute to the family, family connectedness, child attachment to parent, and recognition/acknowledgement of efforts to bond with or contribute to the family. See also the protective factors of parental encouragement, and of positive parental involvement and reinforcement.
- Protective Factor for: Substance use/abuse2,13,14; problem alcohol use in adulthood9; lifetime mood and anxiety disorders9; drug use and initiation of drug use3; suicidal thoughts14; smoking initiation15.
- Age Group(s): Youth and young adults.
Participation in Social Activities
- Definition: Participation in social activities includes, but is not limited to, regular participation in organized school, neighborhood, or community sports, arts, or clubs outside of regular school and/or work hours. See also the protective factors of volunteering and participation in religious/spiritual activities.
- Protective Factor for: Substance abuse2,18; lifetime mood and anxiety disorders16; stress and depression9; alcohol and marijuana use18; depression & anxiety18.
- Age Group(s): Youth through adulthood.
*Comorbid = a disease that occurs simultaneously with another; co-occurring
- National Research Council and Institute of Medicine. (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities (O’Connell, M. E., Boat, T., & Warner, K. E., Eds.) Washington, DC: National Academies Press.
- Wright, D., & Pemberton, M. (2004). Risk and Protective Factors for Adolescent Drug Use: Findings from the 1999 National Household Survey on Drug Abuse (DHHS Publication No. SMA 04–3874, Analytic Series A–19). Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies.
- Hawkins, J. D., Catalano, R. F., & Miller, J. Y. (1992). Risk and Protective Factors for Alcohol and Other Drug Problems in Adolescence and Early Adulthood: Implications for Substance Abuse Prevention. Psychological Bulletin. 112(1), 64-105.
- Courtney, K.E. & Polich, J. (2009). Binge Drinking in Young Adults: Data, Definitions, and Determinants. Psychological Bulletin. 135(1), 142-156.
- Chassin, L., Pitts, S. C., & Prost, J. (2002). Binge Drinking Trajectories from Adolescence to Emerging Adulthood in a High-Risk Sample: Predictors and Substance Abuse Outcomes. Journal of Consulting and Clinical Psychology. 70(1), 67-78. Retrieved on December 15, 2011, from http://dionysus.psych.wisc.edu/lit/articles/ChassinL2002b.pdf
- National Institute on Drug Abuse. (2003). Preventing Drug Use among Children and Adolescents: A Research-Based Guide for Parents, Educators, and Community Leaders. Second Edition. Bethesda, MD: National Institutes of Health.
- Missouri Department of Mental Health, Division of Comprehensive Psychiatric Services. (n.d.). CPS facts: Co-occurring disorders in adults. Retrieved December 15, 2011, from http://dmh.mo.gov/docs/mentalillness/CoOccurringadults.pdf
- Kilpatrick, D. G., Ruggiero, K. J., Acierno, R., Saunders, B. E., Resnick, H. S., & Best, C. L. (2003). Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity: Results from the National Survey of Adolescents. Journal of Consulting and Clinical Psychology. 71(4), 692-700.
- Douglas, K. R., Chan, G., Gelernter, J., Arias, A. J., Anton, R. F., Weiss, R. D., Brady, K., Poling, J., Farrer, L., & Kranzler, H. R. (2010). Adverse childhood events as risk factors for substance dependence: Partial mediation by mood and anxiety disorders. Addictive Behaviors. 35(1), 7-13. Retrieved on December 15, 2011, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2763992/
- Harris Abadi, M., Shamblen, S. R., Thompson, K., Collins, D. A., & Johnson, K. (2011). Influence of risk and protective factors on substance use outcomes across developmental periods: A comparison of youth and young adults. Substance Use & Misuse. 46(13), 1604-1612.
- Chassin, L., Flora, D. B., & King, K. M. (2004). Trajectories of alcohol and drug use and dependence from adolescence to adulthood: The effects of parent alcoholism and personality. Journal of Abnormal Psychology, 113(4), 483-498.
- Weitzman, M., Rosenthal, D. G., & Liu, Y. H. (2011). Paternal depressive symptoms and child behavioral or emotional problems in the United States. Pediatrics. 128(6), 1126-34. Retrieved on December 15, 2011, from http://pediatrics.aappublications.org/content/early/2011/11/04/peds.2010-3034.full.pdf+html
- Substance abuse prevention research. (n.d.). Retrieved from http://www.nebraskaprevention.gov/SAPR.htm
- Resnick, M.D., Bearman, P.S., Blum, R.W., Bauman, K.E., Harris, K.M., et al (1997). Protecting adolescents from harm: findings from the National Longitudinal Study on Adolescent Health. JAMA. 278(10), 823-832.
- Fleming, C.B., Kim, H., Harachi, T.W., and Catalano, R.F. (2001). Family processes for children in early elementary school as predictors of smoking initiation. Journal of Adolescent Health. 30(3), 184-189.
- Risk & Protective Factor Framework. (n.d.). Retrieved from http://www.hsd.state.nm.us/Synar/pdf/Hawkins%20and%20Catalano%20Risk%20a...
- Dumont, M. & Provost, M.A. (1999). Resilience in adolescents: protective role of social support, coping strategies, self-esteem, and social activities on experience of stress and depression. Journal of Youth and Adolescence, 28(3), 343-363. http://link.springer.com/article/10.1023%2FA%3A1021637011732
- Benson, P. L., Scales, P. C., Hamilton, S. F., & Sesma, A., Jr. (with Hong, K. L., & Roehlkepartain, E. C.). (2006). Positive youth development so far: Core hypotheses and their implications for policy and practice. Search Institute Insights & Evidence, 3(1), 1–13.
Developed under the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for the Application of Prevention Technologies contract. Reference #HHSS277200800004C. For training and/or technical assistance purposes only.