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Youth Risk & Protective Factors

Risk and Protective Factors for Later Life Substance Abuse, Health and Social Problems in Childhood Development



Adverse childhood experiences (ACEs) are stressful or traumatic experiences, including abuse, neglect and a range of household dysfunction such as witnessing domestic violence, or growing up with substance abuse, mental illness, parental discord, or crime in the home. ACEs are strongly related to development and prevalence of a wide range of health problems, including substance abuse, throughout the lifespan.

When children are exposed to chronic stressful events, neurodevelopment can be disrupted. Disruption in early development of the nervous system may impede a child’s ability to cope with negative or disruptive emotions and contribute to emotional and cognitive impairment. Over time, and often during adolescence, the child adopts coping mechanisms, such as substance use. Eventually, this contributes to disease, disability and social problems, as well as premature mortality.


  • ACEs are common. For example, 28% of Kaiser participants reported physical abuse and 21% reported sexual abuse. Substance abuse and mental illness of a parent and divorce or separation were also common events.
  • ACEs cluster. Almost 40% of the Kaiser sample reported two or more ACEs and 12.5% experienced four or more. Because ACES cluster, many subsequent studies now look at the cumulative effects of ACES rather than the individual effects of each.
  • ACEs have a dose-response relationship with many health problems. Participants in the ACE Study were followed over time. Findings demonstrated that a person’s cumulative ACE score has a strong, graded relationship to numerous health, social, and behavioral problems throughout their lifespan, including substance use and abuse. Also, many ACE-related problems tend to be co-morbid or co-occurring.

Theory and theoretical frameworks in the substance use prevention field have been evolving over time, often through induction based on applied empirical research. Among the most important developments in substance abuse prevention theory and programming in recent years has been a focus on risk/protective factors as a unifying descriptive and predictive framework.

Put simply, one often tested and supported hypothesis deriving from this framework is that the more risk factors a child or youth experiences, the more likely s/he will experience substance abuse and related problems in adolescence or young adulthood. Researchers have also found that the more the risks in a child's life can be reduced, the less vulnerability that child will have to subsequent health and social problems (Hawkins, Catalano, & Miller, 1992).

However, research has also demonstrated that exposure to even a significant number of risk factors in a child's life does not necessarily mean that substance use or other problem behaviors will follow inevitably. Many children and youth growing up in presumably high-risk families and environments emerge relatively free of problems. The reason for this, according to many researchers, is the presence of protective factors in these young people's lives. Protective factors balance and buffer risk factors (Hawkins et al., 1992). Taken together, these data enhance our understanding of how and why youth initiate substance use as well as provide some direction for preventing, decreasing, or eliminating use.

Risk and protective factors exist at every level at which an individual interacts with others and the society around him or her. The individual brings a set of qualities or characteristics to each interaction, and these factors act as a filter, coloring the nature and tone of these interactions-positive or negative. One way to organize these factors is by life domain. Specifically, six life domains in which interactions occur have been identified, as listed below. Within each domain, subdomains of risk and protective factors have been identified through decades of research; these are listed in the parentheses below.

Six Life Domains  

Other Resources

  • Individual (biological and psychological dispositions, attitudes, values, knowledge, skills, problem behaviors)
  • Peer (norms, activities)
  • Family (function, management, bonding)
  • School (bonding, climate, policy, performance)
  • Community/Society (bonding, norms, resources,         awareness/mobilization, policy/sanctions)

Adolescent Development and Pathways to Problem Behavior

Children of Substance Abusers: Overview of Research Findings

Dr. Gabor Mate speaking at the Neuroplasticity and Education: Strengthening the Connection  (Video)

Nadine Burke - TEDMED Talk   (Video)

Drug Abuse and Child Welfare Articles - Chooper's Guide


Risk FactorsProtective Factors
  • Thinks most friends use
  • Association with drug-using peers
  • Certain physical, emotional or personality traits
    • Inherited genetic vulnerability
    • Low self esteem
    • Psychological disturbances
    • Inappropriate coping responses
    • Violence/ aggression
    • Risk taking propensity/impulsivity
    • Alienation and rebelliousness
    • Rejection of pro-social values/religion
    • Lack of peer refusal skills
  • Early and persistent problem behaviorsAcademic Failure
    • Early sexual activity/teen pregnancy
    • Begins using at a young age
    • Early anti-social behavior
    • Peer rejection in elementary grades
  • Less involved in recreational, social and cultural activities
  • Lack of information on positive health behaviors
    • Lack of information on drug-related topics
  • Knowledge regarding risks associated with substance abuse/use
  • Negative attitudes toward substances and substance use
  • Bonding to pro-social culture
  • Positive relationships with adultsSocial competence
    • Views parents, teachers, doctors, law enforcement officers and other adults as allies
  • Youth involvement in alternative activities
  • Sense of well-being/self confidence
  • Has positive future plans

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Risk FactorsProtective Factors
  • Reinforcement of negative norms and expectations within peer group
  • Thinks alcohol and drug use is "cool"
  • Inappropriate sexual activity among peers
  • Ties to deviant peers/gang involvement
  • Involved in substance-free activities
  • Friends disapprove of alcohol and other drug use

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Risk FactorsProtective Factors
  • Family members with a history of alcohol or other drug abuse
  • Family members don't spend much time together
  • Parents have trouble keeping track of teens, who they're with and where they go
  • Lack of clear rules and consequences regarding alcohol and other drug use
  • Parents use drugs, involve youth in their use ("Get me a beer, would you?") or tolerate use by youth
  • Parents have trouble setting consistent expectations and limits
  • Family conflict/abuse
  • Loss of employment
  • Close family relationships
  • Consistency of parenting
  • Education is valued and encouraged, and parents are actively involved
  • Copes with stress in a positive way
  • Clear expectations and limits regarding alcohol and other drug use
  • Encourages supportive relationships with caring adults beyond the immediate family
  • Share family responsibilities, including chores and decision making
  • Family members are nurturing and support each other

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Risk FactorsProtective Factors
  • Lack of clear expectations, both academic and behavioral
  • Students lack commitment or sense of belonging at school
  • High numbers of students who fail academically at school
  • Parents and community members not actively involved
  • Positive attitudes toward schoolCommunicates high academic and behavioral expectations
    • School bonding
    • Regular school attendance
  • Encourages goal-setting, academic achievement and positive social developmentFosters active involvement of students, parents and community members
    • Tutoring available
    • Positive instructional climate
    • Provides leadership and decision making opportunities for students
    • Sponsors substance-free events
    • School responsive to students' needs

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Risk FactorsProtective Factors
  • Alcohol and other drugs readily availableLaws and ordinances are unclear or inconsistently enforced
    • Irresponsible servers and sellers
    • Affordability
  • Norms are unclear or encourage use
  • Residents feel little sense of "connection" to community
  • Neighborhood disorganization
  • Rapid changes in neighborhood populations
  • High unemployment
  • Residents at or below the poverty level
  • Extreme economic deprivation
  • Lack of strong social institutions
  • Lack of monitoring youths' activities
  • Inadequate media portrayals
    • Misleading advertising
  • Pro-use messages
  • Opportunities exist for community involvement
  • Community religious composition
  • Laws and ordinances are consistently enforced
  • Informal social control
  • Policies and norms encourage non-use
  • Community service opportunities available for youth
  • Resources (housing, healthcare, childcare, jobs, recreation, etc.) are available
  • Comprehensive risk focused programs available
    • Programs for parents of children and adolescents
    • Early childhood and family support programs
    • Widely supported community prevention efforts exist

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Source: Bureau of Substance Abuse Services within the Department of Public Health. Commonwealth of Massachusetts