Etiology of early age onset substance use disorder: A maturational perspective

The etiology of early age onset substance use disorder (SUD), an Axis I psy chiatric illness, is examined from the perspective of the multifactorial mo del of complex disorders. Beginning:at,conception,genetic and environment i nteractions produce a sequence of biobehavioral phenotypes during developme nt which bias the ontogenetic pathway toward SUD. One pathway to SUD is the orized to emanate from a deviation in somatic and neurological maturation, which, in the context of adverse environments, predisposes to affective and behavioral dysregulation as the cardinal SUD liability-contributing phenot ype. Dysregulation progresses via epigenesis from difficult temperament in infancy to conduct problems in childhood to substance use by early adolesce nce and to severe SUD by young adulthood.