A retrospective sibling study of childhood adjustment in adults with substance use disorders.

PURPOSE: : Research has suggested that people who develop serious substance use disorders have delinquent traits as children before using any illicit drugs. This study was designed to retrospectively identify differences in antisocial and delinquent behavior between siblings discordant for serious substance use disorders. METHODS: : A retrospective survey was conducted of 50 pairs of adult siblings who were discordant for serious substance use disorders. The self-report early delinquency scale (SRED) was used to retrospectively assess delinquent traits in childhood and adolescence. RESULTS: : The mean SRED 29 (illegal item) score in treatment seeking opiate-dependent people (mean age = 33.5 years) was 19.6 (standard error [SE] = 0.9) compared with 4.8 (SE = 0.6) in same-sex, nonsubstance-dependent siblings (P < 0.0001; paired Wilcoxon test). The mean SRED 58 (norm violation) score in treatment seeking opiate-dependent people was 36.8 (SE = 1.7) compared with 10.5 (SE = 1.4) in same-sex siblings (P < 0.0001; paired Wilcoxon test). Forty percent of patients were expelled from school compared with 12% of siblings (Yates-corrected χ = 8.78; P = 0.003). Ninety-six percent of patients reported problems with the police as adolescence compared with 48% of controls (Yates-corrected χ = 26.24; P < 0.0001). Police problems in substance users predated first use of illicit substances by 5.5 years. CONCLUSIONS: : The study used a validated instrument and objective reports to confirm significantly higher rates of delinquent behavior and social dysfunction in childhood for substance users compared with nonsubstance-dependent siblings. The delinquent behaviors usually predated serious substance misuse.