Chunk #11 — Epigenesis: The Developmental Cascade of Risk, Heterogeneity of Developmental Course, and Possible Indirect Genetic Effects on the Disinhibition Pathway
The brief etiologic summary provided at the beginning of this article enumerates some of the major mediators and moderators of the disinhibitory pathway between early childhood risk and adult disorder. A risk-cumulation additive model would predict that the greater the number of risk factors present, the more likely the SUD endpoint. However, recent work based on long-term, multiwave prospective studies and a dynamic cascade model of risk (cf. Dodge et al, 2009), shows that simple additivity of risk only provides a crude model of risk flow. Timing/sequencing of risk aggregation, density of risk pathway, developmental role demands at outcome, and intermediate risk-offset opportunities are all essential to the probability of a risky outcome (Dubow et al. 2008; Merline, Jager, & Schulenberg, 2008; Pitkänen et al., 2008).
