The current cascade model is primarily psychosocial in conceptualization. Further research in this area would benefit from incorporating a more multidisciplinary appreciation of the biological contributions to the developmental progressions we have identified contributing to substance abuse problems (Brown et al., 2009; Zucker, 2006). Increasingly, the biological sequelae of child maltreatment are being documented. For example, the chronic stress associated with child maltreatment has been shown to influence neuroendocrine dysregulation (Cicchetti & Rogosch, 2001a, 2001b; Cicchetti, Rogosch, Gunnar, & Toth, 2010; DeBellis, 2001; Heim, Newport, Mletzko, Miller, & Nemeroff, 2008; Trickett, Noll, Susman, Shenk, & Putman, 2010) and psychopathology, and aberrations in the physiological regulation of stress may then extend to vulnerabilities for substance use and abuse directly or through associations with other forms of psychopathology. Neurophysiological atypicalities in the processing of emotions among maltreated children (Cicchetti & Curtis, 2005; Pollak, Cicchetti, Klorman, & Brumaghim, 1997; Pollak, Klorman, Thatcher, & Cicchetti, 2001) also may influence social information processing and social functioning, as well as behavioral adjustment, thereby contributing to the developmental cascade toward substance use problems and vulnerability to addiction
