Desperately driven and no brakes: Developmental stress exposure and subsequent risk for substance abuse
Open accessAbstract
Adverse life events are associated with a wide range of psychopathology, including an increased risk for substance abuse. In this review, we focus on the inter-relationship between exposure to adversity and brain development, and relate this to enhanced windows of vulnerability. This review encompasses clinical and preclinical data, drawing evidence from epidemiological studies, morphometric and functional imaging studies, and molecular biology and genetics. The interaction of exposure during a sensitive period and maturational events produces a cascade that leads to the initiation of substance use at younger ages, and increases the likelihood of addiction by adolescence or early adulthood. A stress-incubation/corticolimbic dysfunction model is proposed based on the interplay of stress exposure, development stage, and neuromaturational events that may explain the seeking of specific classes of drugs later in life. Three main factors contribute to this age-based progression of increased drug use: (1) a sensitized stress response system; (2) sensitive periods of vulnerability; and (3) maturational processes during adolescence. Together, these factors may explain why exposure to early adversity increases risk to abuse substances during adolescence.
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Andersen and Teicher identify abuse, parental loss, and household dysfunction as implicated in producing a cascade of physiological and neurohumoral events that alter trajectories of brain development such that this altered development creates a significant vulnerability for drug abuse.
“all of which they identify as implicated in producing 'a cascade of physiological and neurohumoral events that alter trajectories of brain development' (p. 517) such that this altered development creates a significant vulnerability for drug abuse.”
From A COMPREHENSIVE REVIEW OF THE LITERATURE ON THE IMPACT OF EXPOSURE TO INTIMATE PARTNER VIOLENCE FOR CHILDREN AND YOUTH (2014) · cites this paper as Andersen and Teicher, 2009
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredAndersen and Teicher describe drug abuse as a developmental disorder and offer compelling evidence for their claims by reviewing the findings of more than 190 studies relevant to the understanding of the impact of early life exposure to adversity on brain development published between 1978 and 2007.
“Andersen and Teicher describe drug abuse as a developmental disorder and offer compelling evidence for their claims by reviewing the findings of more than 190 studies relevant to the understanding of the impact of early life exposure to adversity on brain development published between 1978 and 2007.”
From A COMPREHENSIVE REVIEW OF THE LITERATURE ON THE IMPACT OF EXPOSURE TO INTIMATE PARTNER VIOLENCE FOR CHILDREN AND YOUTH (2014) · cites this paper as Andersen and Teicher, 2009
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredYouth with a trauma history may start using substances earlier than peers without trauma.
“Youth with a history of trauma may begin using substances at earlier ages than non-traumatized peers [14]”
Adolescents exposed to chronic stress or trauma often struggle with self-regulation because adversity triggers neuro-biological events that alter development of the stress response system, impairing self-regulation in response to stress.
“Adolescents exposed to chronic stress or trauma often struggle with self-regulation: adversity triggers neuro-biological events that alter development of the stress response system (Andersen, 2003; Andersen & Teicher, 2009; Shonkoff et al., 2009; Teicher et al., 2002), impairing a child’s ability to self-regulate in response to stress (Blair, 2010; West et al., 2001).”
From Positive impacts of a universal trauma-informed intervention on student mental health: The Project POWER trial (2025) · cites this paper as Andersen & Teicher, 2009
Andersen and Teicher (2009) state that the interaction of exposure during a sensitive period and maturational events produces a cascade that leads to the initiation of substance use at younger ages, and increases the likelihood of addiction by adolescence or early adulthood.
“interaction of exposure [to childhood adversity] during a sensitive period and maturational events produces a cascade [italics ours] that leads to the initiation of substance use at younger ages, and increases the likelihood of addiction by adolescence or early adulthood”
From A COMPREHENSIVE REVIEW OF THE LITERATURE ON THE IMPACT OF EXPOSURE TO INTIMATE PARTNER VIOLENCE FOR CHILDREN AND YOUTH (2014) · cites this paper as Andersen and Teicher, 2009
Andersen and Teicher's definition of childhood adversity includes exposure to witnessing domestic violence and they place this stress on par with abuse, parental loss, and household dysfunction.
“Their definition of childhood adversity includes exposure to witnessing domestic violence and they place this stress on par with abuse, parental loss, and household dysfunction”
From A COMPREHENSIVE REVIEW OF THE LITERATURE ON THE IMPACT OF EXPOSURE TO INTIMATE PARTNER VIOLENCE FOR CHILDREN AND YOUTH (2014) · cites this paper as Andersen and Teicher, 2009
Childhood maltreatment is associated with increased severity of substance use disorder and may also increase the number or frequency of relapse.
“childhood maltreatment is associated with increased severity of substance use disorder and may also increase the number or frequency of relapse.9”
From Ventral striatum dysfunction in children and adolescents with reactive attachment disorder: functional MRI study (2015) · cites this paper as [9]
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Feasibility and Preliminary Outcomes of a School-Based Mindfulness Intervention for Urban Youth
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“Subcortical structures, with their earlier maturation, are often dysfunctional before later-developing cortical structures (Andersen and Teicher, 2009).”
Self-citationTeicher, M. H., & Parigger, A. (2015) · PLOS ONE · doi:10.1371/journal.pone.0117423 · Cited by 421 · see citing works
Self-citationMcCrory, E. J., Gerin, M. I., & Viding, E. (2017) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12713 · Cited by 402 · see citing works
Stress and the adolescent brain
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Drugs as instruments: A new framework for non-addictive psychoactive drug use
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The triadic model perspective for the study of adolescent motivated behavior
Ernst, M. (2014) · Brain and Cognition · doi:10.1016/j.bandc.2014.01.006 · Cited by 240 · see citing works
Developmental origins of brain disorders: roles for dopamine
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Child maltreatment and the development of substance use and disorder
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Stress in adolescence and drugs of abuse in rodent models: role of dopamine, CRF, and HPA axis
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The effects of early life stress on reward processing
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“To understand the pre-age 7 effects of exposure to IPV we turn to Andersen and Teicher (2009), who conducted an extensive review of the recently reported effects of early stress on brain development in order to examine the causal links between such developmental stress exposure and subsequent risk for substance abuse.”
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Cortisol administration induces global down-regulation of the brain's reward circuitry
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“Youth with a history of trauma may begin using sub-stances at earlier ages than non-traumatized peers [14] and onset of use during early adolescence is strongly associated with subsequent development of SUDs and SUD severity [15, 16].”
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Mendelson, T., Clary, L. K., Musci, R. J., Sheridan, S., Webb, L., Sibinga, E., Mmari, K., Welna, A., & Ialongo, N. (2025) · Journal of School Psychology · doi:10.1016/j.jsp.2025.101469 · Cited by 3 · see citing works
- Authors
- Andersen, S. L., & Teicher, M. H.
- Affiliations
- Harvard University (US)
- Corresponding author
- Andersen, Susan L.
- Venue
- Neuroscience & Biobehavioral Reviews
- Publisher
- Elsevier BV
- Published
- 2009-04
- Volume
- 33
- Issue
- 4
- Pages
- 516-524
- ISSN
- 0149-7634 (ISSN-L)
- PMC
- PMC2688959
- OpenAlex
- W2035487697
- Cited by
- 326
- References
- 196
- Citations by year
- 2026: 6 · 2025: 13 · 2024: 7 · 2023: 15 · 2022: 16 · 2021: 20 · 2020: 23 · 2019: 13 · 2018: 22 · 2017: 26 · 2016: 28 · 2015: 20 · 2014: 22 · 2013: 29 · 2012: 23
- FWCI
- 1.53
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Neuroscience & Biobehavioral Reviews (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5r01da017846-14)
- National Institute of Mental Health (R01 MH-66222, R01MH091114, R01MH066222)
- National Institute on Drug Abuse (R01DA-017846, R01DA016934, R01DA015403)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- life events, substance abuse, addiction risk, sensitive period, brain development, neuromaturation, adolescence, childhood adversity, drug-seeking behavior
- MeSH terms
- Adolescent, Age Factors, Animals, Child, Developmental Disabilities, Disease Models, Animal, Humans, Hypothalamo-Hypophyseal System, Pituitary-Adrenal System, Risk, Stress, Psychological, Substance-Related Disorders
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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