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Mind & Brain, the Journal of Psychiatry It is important to note that the SAAF had a positive effect on

high genetic risk (as represented by the serotonin transporter gene) that is not specific to substance use or addiction. It is quite plausible that there are some common mechanisms in brain function that cause the use of substances in adoles- cence. For example, some researchers focus on the construct of behavioral disinhibition (which includes cognitive control, impulsivity, and sensitivity to reward) as representing a common genetic liability to externalizing behavioral pro- blems along with substance use.46 However, these authors do suggest that there may be specificity as well in terms of genetic reactivity to specific substances. As such, the potential of incorporating specific plausible genes related to risk for substance use into intervention studies is thus a potentially exciting direction for future research.

Although concepts and methods are still very much works

in progress, such as integrating environmental measures in genome-wide association studies,47,48 the utility of consider- ing inclusion with substance-specific genetic markers in intervention studies is clearly worth considering. This work will of course dovetail with the emerging database on specific genes of relevance for reactivity to substances in both adults and adolescents.33,4952

Concluding Remarks What are the especially important messages for intervention

scientists and practitioners? First, there should be a sense of energy that comes from the multiple converging perspectives that argue for the importance of psychosocial interventions aimed at reducing adolescent substance use. Furthermore, it is intriguing that genetic epidemiological work provides some of the strongest evidence supporting the role of the psychosocial environment as an etiological factor for initiation of substance use as well as level of use in adolescence. There is a synergy between this perspective and the empirical base supporting it, and the content areas targeted by many of the leading and empirically supported family-based psychosocial interven- tions. And finally, we are now seeing in the literature theoretical models and empirical studies that bring genetics into psychosocial interventions in order to examine how these approaches may specifically benefit youth at high risk for risky behavior including substance use. Taken together, this is an exciting time for psychosocial interventions focused on adolescent substance use. Much of the enthusiasm for their potential efficacy comes from considerations of how they may, in the future, prevent the development of substance abuse and dependence by providing a developmentally timed, and environmentally delivered, blockade to gene expression. As such, intervention scientists and practitioners now have many reasons to, at least conceptually, consider the critical im- portance of their work in the postgenomic era.

Funding: This work was supported in part by a grant from the National Institutes of Health (Grant No. AA017659).


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