Our goal was to define an internalizing pathway to SUDs, particularly Negative Affect SUDs, which is guided by the extant literature and integrated through the tenants underlying the Developmental Psychopathology framework. The internalizing pathway outlines a process of heterotypic continuity to identify the early emergence of a risk process underlying Negative Affect SUDs and to track its progression over development. The pathway holds implications for target populations, periods of development, and risk processes, and thus informs the development of preventive interventions. However, the development of these prevention programs requires a greater degree of specificity than the current model provides. Being able to identify when (the pre-school years), who (children of alcoholic parents) and what distal factors to target (internalizing symptoms), begs the question of what risk processes underlie these target factors and how we might most effectively interrupt them. These needs define a research agenda that connects our understanding of broad developmental pathways leading to psychopathology with the demands of early preventive programs designed to alter the lifecourse of children at risk for following such detrimental pathways.
