September 27, 1995

The Application of Resiliency and Risk Research to the Development of Preventive Interventions


Meyer Glantz, Ph.D.

Chair,Resiliency and Risk Workgroup,
Associate Director for Science, DEPR


Summary of Recommendations

Longitudinal research has produced significant information about the etiology of drug abuse and some of the resiliency and risk factors which influence an individual's drug involvement; some of this information has been used to improve the development of effective prevention programming. The NIDA Resiliency and Risk Workgroup convened a group of senior researchers with expertise in areas of drug abuse and related research to determine how the further application of available research based data can advance prevention effectiveness beyond current levels. The meeting took place September 11, 1995, and was chaired by Dr. Alan Leshner, Director of the National Institute on Drug Abuse. Following is a summary of the recommendations of the panel.

The major recommendations of the group advocated the development of prevention interventions which target:

  1. family function and parenting
  2. early problematic childhood characteristics
  3. psychological skills enhancement

The most consensual of the group's recommendations was a definitive endorsement for the further development and expansion of prevention programs which focus on the family. Drawing on a variety of research findings showing the strong drug abuse resilience and risk influence of the family on children and adolescents, the panel strongly encouraged the development of preventive interventions which respond to the individual in the context of their particular family. In other words, a significant part of the origin of drug abuse is often the abusers' families' dysfunctions and inadequacies and a significant factor in resistance is often the positive characteristics and influences of the family. Therefore, the panel's first major recommendation was that interventions should be directed at mitigating these family problems and/or enhancing family strengths. This would necessitate, more often than not, intervening with and probably "treating," not just the individual but the family. The family would not merely be the medium for intervention but would be a direct target of the intervention. The "family" would include extended, non-traditional and surrogate families. Strengthening family identity and long term activities was suggested as an integral part of this goal.

Relatedly, the panel considered that for a variety of reasons, many parents are not fulfilling the role of socializing and directing the behavior of their children. The implication of this is that drug abuse and other related antisocial behaviors are at least in part attributable to inadequate parenting. This suggests that drug abuse preventions must attempt to strengthen parenting responsibility and effectiveness particularly as related to socialization processes.

The panel noted that available research shows that conduct and affective disorders are predispositional to drug abuse. The panel discussed that research indicates that a range of potentially problematic early childhood characteristics often presage and may be diathetic to drug abuse. This includes not only numerous early diagnosable psychopathological disorders but also, premorbid conditions, sub-threshold conditions and components of psychopathologies. Research indicates that these types of early childhood characteristics are often associated with individuals who progress to more severe levels of drug involvement. The panel felt that children with such characteristics could often be identified early in their lives, prior to the exacerbation of their conditions and prior to their drug involvement. The second major recommendation of the panel was the development of prevention programs which identify and ameliorate these early childhood characteristics. The panel also stressed the need to recognize the common occurrence of multiple problem behaviors and the inter relationship of these behaviors, and the importance of not conceptualizing or targeting drug abuse as an isolated behavior.

The last major recommendation derives from research findings which indicate that deficits or impairments in certain abilities are commonly characteristic of and probably predispositional to drug involvement. The panel inferred from this that interventions which fostered these skills might enhance children's and adolescents's resistance to drug involvement.

The skill areas proposed in the third major recommendation as intervention targets were:

  1. executive/cognitive function including goal setting, analysis, planning, organization and problem solving;
  2. affect regulation including both impulse control and techniques for adaptively coping with and controlling strong negative feelings
  3. positive reinforcement approach skills.

This last skill area refers to the observation that many drug abusers' coping skills and defenses are oriented around escape from problems and negative affects rather than being based on active positive coping involving approach.

A point raised by the panel was that some of the naturally occurring transitions in society and developmental characteristics of children and adolescents are not taken into account in many cases. For example, having children go to the same school for eight years and then transferring to high school for four years rather then having them make the typical additional transition to middle or junior high schools seems to facilitate better function in a number of ways. Keeping the first eight years of students together seems to foster protection of the younger students by the older ones and not having school transitions co-occur with critical developmental transitions seems to avoid exacerbation of some potential difficulties. Recognition of and accommodation to these types of developmental factors could facilitate better function and greater resistance to drug involvement.

The panel also recommended the further development of prevention programs which facilitate children and adolescents bonding with prosocial groups and which encourage self acceptance, healthy self esteem, and positive self standards and expectations. Relatedly, the panel also noted the importance of peers as influences on drug involvement and the potential of peer based interventions for prevention, particularly interventions where peers themselves are the intervenors. A logical extension of these concepts is the need for attractive alternative activities, organizations and opportunities and the importance of ensuring that children and adolescents who wish to change their associations and join prosocial interpersonal networks and groups be accepted. Schools were identified as important foci for intervention.

Combining and extending some of the general concepts of the above recommendations, the panel supported the concept of interventions which promote adult liaisons and which help to organize parents and others into supportive groups. Taking this concept further, communities might be aided to function as active empowered social communities which have a sense of identity, cohesion and responsibility, which act for the protection, well-being and betterment of the community, and which guide, protect and ensure the conduct of the members of the community including all of the adults, adolescents and children. An idealized concept of a village was the model for this recommendation and the suggestion was made that these types of efforts already "naturally" occur and should be studied to determine how they function and how their principles can be extended to other groups and areas.

The last set of recommendations related to the science and research of intervention. The panel strongly encouraged the development of better measures of drug involvement liability, drug use, and drug use patterns and the development of measurements sensitive to change. They encouraged a meta-study of prevention and the principles of preventive intervention. The group called for more etiological research to extend and validate current findings and hypotheses and endorsed efforts to distill identified protective and risk influences into a limited number of functional patterns with principles describing the interaction of the factors within the patterns.


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