SAMHSA - Risk and Protective Factors

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Variable risk factors

include income level, peer group, adverse childhood experiences (ACEs), and employment status

Individual-level risk factors

may include a person's genetic predisposition to addiction or exposure to alcohol prenatally

Individual-level protective factors

might include positive self-image, self-control, or social competence

Risk and Protective Factors Exist in Multiple Contexts

• In relationships, risk factors include parents who use drugs and alcohol or who suffer from mental illness, child abuse and maltreatment, and inadequate supervision. In this context, parental involvement is an example of a protective factor. • In communities, risk factors include neighborhood poverty and violence. Here, protective factors could include the availability of faith-based resources and after-school activities. • In society, risk factors can include norms and laws favorable to substance use, as well as racism and a lack of economic opportunity. Protective factors in this context would include hate crime laws or policies limiting the availability of alcohol

Universal preventive interventions

• take the broadest approach and are designed to reach entire groups or populations • universal prevention interventions might target schools, whole communities, or workplaces

Selective interventions

• target biological, psychological, or social risk factors that are more prominent among high-risk groups than among the wider population • examples include prevention education for immigrant families with young children or peer support groups for adults with a family history of substance use disorders

Indicated preventive interventions

• target individuals who show signs of being at risk for a substance use disorder. • include referral to support services for young adults who violate drug policies or screening and consultation for families of older adults admitted to hospitals with potential alcohol-related injuries

Risk and Protective Factors Are Influential Over Time

Risk and protective factors can have influence throughout a person's entire lifespan. For example, risk factors such as poverty and family dysfunction can contribute to the development of mental and/or substance use disorders later in life. Risk and protective factors within one particular context—such as the family—may also influence or be influenced by factors in another context. Effective parenting has been shown to mediate the effects of multiple risk factors, including poverty, divorce, parental bereavement, and parental mental illness. The more we understand how risk and protective factors interact, the better prepared we will be to develop appropriate interventions.

Risk and Protective Factors Are Correlated and Cumulative

Risk factors tend to be positively correlated with one another and negatively correlated to protective factors. In other words, people with some risk factors have a greater chance of experiencing even more risk factors, and they are less likely to have protective factors. Risk and protective factors also tend to have a cumulative effect on the development—or reduced development—of behavioral health issues. Young people with multiple risk factors have a greater likelihood of developing a condition that impacts their physical or mental health; young people with multiple protective factors are at a reduced risk. These correlations underscore the importance of: • Early intervention • Interventions that target multiple, not single, factors

Individual Factors Can Be Associated With Multiple Outcomes

Though preventive interventions are often designed to produce a single outcome, both risk and protective factors can be associated with multiple outcomes. For example, negative life events are associated with substance use as well as anxiety, depression, and other behavioral health issues. Prevention efforts targeting a set of risk or protective factors have the potential to produce positive effects in multiple areas.

Protective factors

characteristics associated with a lower likelihood of negative outcomes or that reduce a risk factor's impact. Protective factors may be seen as positive countering events

Risk factors

characteristics at the biological, psychological, family, community, or cultural level that precede and are associated with a higher likelihood of negative outcomes


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