Childhood proactive and reactive aggression: Differential risk for substance use?

The link between child/adolescent aggression and substance use is an important area of study, as child aggression is a strong risk factor for substance use — a major public health concern for which few successful interventions are available. A better understanding of the link between aggression and substance use could help to refine and develop more effective and perhaps more targeted prevention and intervention strategies. One way to further understand the link between aggression and substance use may be to distinguish between proactive and reactive functions of aggression. Indeed, there is growing evidence to suggest that proactively aggressive behavior is more strongly linked to substance use, particularly problem drinking, than reactive aggression. However, further investigation is needed to fully understand these associations. This paper presents a thorough review of the available research, outlines gaps in the literature, and offers suggestions for future research.

► We review relations between proactive and reactive aggression and substance use.
► Proactive aggression is more strongly linked to substance use, particularly alcohol.
► Links between reactive aggression and substance use may depend on peer rejection.
► However, further research is needed to draw firm conclusions.