Stressful life events also are risk factors for the onset and escalation of substance use (Novins and Mitchell, 1998; Petraitis et al. 1995; van den Bree and Pickworth, 2005; Wills et al. 1996; Windle and Wiesner, 2004). Important risk factors for substance abuse include poor family environment (e.g. poor care by family, single parent family, dysfunctional parent-child relationship, family conflict; Ellickson et al. 2004b; Flory et al. 2004), traumatic events (e.g. death of parent or sibling, divorce or serious illness of parent, victim of a crime; Hoffmann, 1995; Nation and Heflinger, 2006; von Sydow et al. 2002; Windle and Wiesner, 2004), and interpersonal as well as intrapersonal events (e.g. accidents or illness, breaking up with a friend, relocation; Brown, 1989; Novins and Mitchell, 1998; Windle and Wiesner, 2004). Thus, stressful life experiences (both traumatic and interpersonal) often cause mental or physical distress, and are thought to increase the likelihood of adolescent substance use involvement and suicidal behaviors.
