Iacono William G, Malone Stephen M, McGue Matt
Department of Psychology, University of Minnesota, Minneapolis, Minnesota 55455, USA.
Annu Rev Clin Psychol. 2008;4:325-48. doi: 10.1146/annurev.clinpsy.4.022007.141157.
Research on substance use disorders is often compartmentalized, focused on understanding addiction to one substance or substance class at a time. Although this approach has contributed significantly to knowledge about addictions, early-onset substance use disorders appear to share common etiology with each other and with other disorders, traits, behaviors, and endophenotypes associated with behavioral disinhibition. We propose that a common genetic liability to behavioral disinhibition underlies the co-occurrence of these externalizing attributes. This liability is expressed in part through brain mechanisms related to cognitive control, impulsivity, and sensitivity to reward, all of which are maturing during adolescence. During this important transitional period, problem behaviors emerge, including the initiation of substance use. Exposure to various environmental risks further amplifies the risk associated with the common liability, increasing the likelihood of addiction generally. Specific environmental and genetic factors ultimately contribute to the differentiation among externalizing disorders.
对物质使用障碍的研究往往是分散的，一次专注于理解对一种物质或一类物质的成瘾。尽管这种方法对成瘾知识有重大贡献，但早发性物质使用障碍似乎彼此之间以及与其他与行为抑制相关的障碍、特质、行为和内表型有共同的病因。我们提出，行为抑制的共同遗传易感性是这些外化属性共现的基础。这种易感性部分通过与认知控制、冲动性和奖励敏感性相关的大脑机制表现出来，所有这些在青春期都在发育。在这个重要的过渡时期，出现了问题行为，包括开始使用物质。接触各种环境风险进一步放大了与共同易感性相关的风险，总体上增加了成瘾的可能性。特定的环境和遗传因素最终导致外化障碍之间的差异。
