Second, these risk processes are also expected to be developmentally cumulative. Thus, by late adolescence, we posit that these youth will show continued internalizing symptoms, poor social functioning, positive expectancies and coping motives for substance use, and moderate to heavy substance use (likely, in part, as a means of self-medication). These adolescent risk factors in turn mediate the relation between temperament and internalizing symptoms in childhood and Negative Affect SUDs in adulthood. With young adulthood, mechanisms underlying dependence and addiction (e.g., Baker et al., 2004) may begin to function as the previously separable behaviors of internalizing symptoms and substance use become fused into a single form of problem behavior. Adolescents showing all of these markers of progression along this pathway are expected to be at greatest risk for Negative Affect SUDs with the transition to adulthood.
