The Ontogenic Process Model of Substance Use Disorders

The communication presents an explication of the Ontogenic Process Pathway Model for the development of substance use disorders. The model posits that the core predisposing biological vulnerability is trait impulsivity first manifested in preschool in its most extreme expression in Attention-Deficit/Hyperactivity Disorder. This vulnerability can progress into increasingly severe manifestations of antisocial behavior in a rough temporal sequence depending upon transactions with various environmental risk factors such as coercive parenting, association with antisocial peers, neighborhood criminality. The sequence of disorders following Attention-Deficit/Hyperactivity Disorder are Oppositional Defiant Disorder in elementary school, Conduct Disorder in middle school, and Substance Use Disorder in adolescence/early adulthood. In conclusion, the model presents a developmental pathway leading to substance abuse that is solidly anchored in developmental theory and robustly supported by empirical research