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ARTICLE IN PRESS JID: NEUPSY [m6+;July 2, 2020;5:55] European Neuropsychopharmacology (2020) 000, 1–17

www.elsevier.com/locate/euroneuro

REVIEW

Social interaction reward: A

resilience approach to overcome

vulnerability to drugs of abuse

Rana EL Rawas∗, Inês M. Amaral, Alex Hofer

Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Medical

University Innsbruck, Experimental Addiction Research Unit, Innrain 66 a-6020, Innsbruck, Austria

Received 24 July 2019; received in revised form 10 January 2020; accepted 10 June

2020 Available online xxx

KEYWORDS

Drug addiction; Stress; Social interaction; Resilience; Reward; Vulnerability

Abstract Drug addiction is a multifactorial disorder resulting from the complex interaction between

biological, environmental and drug-induced effects. Generally, stress is a well-known risk

factor for the development of drug addiction and relapse. While most of the research focuses

on risk factors that increase the vulnerability to drugs of abuse, recent studies are focusing

on the areas of strength/positive coping approaches that can increase resistance to drugs of

abuse. In this review, we concentrate on resilience, seen as a dynamic process, which can

allow individuals to positively adapt within the context of a specific risk for psychiatric

illness. Here, we discuss the effects of social stress in animal models on drug use,

particularly cocaine. In contrast, we suggest social interaction reward when available as an

alternative to drug use as an approach contracting negative stress effects and increasing

resistance to drug use. Indeed, interventions, which aim at enhancing resilience to stress

through the facilitation of social interaction and the enhancement of social support, could be

particularly effective in helping people cope with stress and preventing drug use problems or

relapse. Finally, understanding the neurobiological mechanisms underlying protective factors

such as social interaction reward should provide the basis for future evidence-based

interventions targeting substance abuse and stress-related pathologies. © 2020 Elsevier B.V. and ECNP. All rights reserved.

∗ Corresponding author.

E-mail address: [email protected] (R. EL Rawas). https://doi.org/10.1016/j.euroneuro.2020.06.008 0924-977X/© 2020 Elsevier B.V. and ECNP. All rights reserved.

1. Drug addiction and resilience Drug addiction is a chronic, relapsing disorder defined as

compulsive drug seeking and taking that continues despite

significant negative consequences (Hyman and

Please cite this article as: R. EL Rawas, I.M. Amaral and A. Hofer, Social interaction reward: A resilience approach to overcome

vulnera-bility to drugs of abuse, European Neuropsychopharmacology, https://doi.org/10.1016/j.euroneuro.2020.06.008

https://doi.org/10.1016/j.euroneuro.2020.06.008

http://www.elsevier.com/locate/euroneuro

mailto:[email protected]



ARTICLE IN PRESS JID: NEUPSY [m6+;July 2, 2020;5:55]

2 R. EL Rawas, I.M. Amaral and A. Hofer

Fig. 1 Vulnerability to drug addiction results from the interaction between biological factors, environmental factors and drug-induced

effects at different levels (Morrow and Flagel, 2016). Drugs of abuse inherently activate the mesolimbic dopaminergic system (↑ VTA; ↑

NAc). Repeated drug exposure in addition to a delayed maturation of the PFC circuits during adolescence also contributes to a loss of

control and self-regulation (↓ PFC), increasing thereby vulnerability to drug use (↑ vulnerability). Personal-ity traits such as novelty

seeking (Leyton et al., 2002) and risk taking behavior (Galvan et al., 2007) are positively associated with mesolimbic dopamine activity

mainly in the accumbens region. Increased vulnerability to drug use is also potentiated by personal-ity traits including impulsivity,

novelty seeking, and risk taking. Negative environment mainly stress predisposes toward addictive behavior by enhancing dopaminergic

activity. Positive environmental factors induce stress buffering and oppose drug-induced ef-fects by reducing the incentive salience of

drug-associated stimuli, thereby enhancing resilience. Genetic factors affect this system through modulation of genes expression

involved in dopaminergic activity, neural plasticity as well as personality traits, inducing a genetic vulnerability or genetic resilience.

Epigenetic factors, particularly DNA methylation and post- translational modification of histone proteins, affect chromatin remodeling

and subsequently genes expression. Oxytocin is a neuropeptide that exerts a stress-buffering effect, increase social stable attachments

and interacts with neurotransmitters involved in the reward circuits in the brain. ↓: potentiation, ┴: inhibition. KOR, kappa opioid

receptors; BDNF, brain-derived neurotrophic factor; D2r, dopamine type 2 receptor; DAT, dopamine transporter; PFC, prefrontal cortex;

VTA, ventral tegmental area.

Malenka, 2001). However, not all individuals who experiment

with drugs of abuse become addicted and only a small

percentage of individuals who engage in drug taking meet the

criteria of drug dependence (Deroche-Gamonet et al., 2004;

Baler and Volkow, 2006; Enoch, 2006). An individual’s

vulnerability to engage in addictive behav-iors is highly

complex and multifactorial resulting from the interaction

between biological, environmental factors and the direct drug

induced effects (Kreek et al., 2005). Research has started to

investigate how personality and psychological traits, genetic

(and epigenetic) factors, and environmental factors influence

brain circuits and individual behavior to engender a

vulnerable or resilient phenotype to drug addiction (Fig. 1).

Family and twin epidemiological studies show that genes

contribute to the vulnerability to addictive disease with

estimates of heritability of 30–60%,

first demonstrated with alcoholism (Kreek et al., 2005). For

example, vulnerability or resistance in response to specific

types of drugs such as cocaine can be due to pre-existing

genetic and epigenetic modifications (Cadet, 2016) of kappa

opioid receptors (KOR) or dynorphin genes (Butelman et al.,

2012). Indeed, Kreek and colleagues presented a working

model in 2012, in which high pre-existing expression of the

dynorphin gene associated with KOR/dynorphin high tone

resulted in decreased vulnerability during the initial acqui-

sition/escalation phase in models of addiction trajectory. By

contrast, it was postulated that high KOR/dynorphin tone in

other stages in the addiction cycle (e.g., in with-

drawal/abstinence, or relapse), may conversely intensify

vulnerability (Butelman et al., 2012). In rodents, there are

inbred strains and selectively bred lines that readily self-

administer cocaine, suggesting a genetic vulnerability,





Social interaction reward: A resilience approach to overcome vulnerability to drugs of abuse 3

in contrast to strains that do not readily self-administer

cocaine suggesting genetic resistance (Kosten et al., 1997).

Interestingly, after a prolonged period of drug intake, a

restricted number of rodents (20% – vulnerable addict rats)

develop addiction-like behaviors, although the largest

percentage (40%- resistant non-addict rats) maintains a

controlled drug intake (Deroche-Gamonet et al., 2004;

Kasanetz et al., 2010). Since vulnerable and resistant rats do

not differ in the amount of drugs taken (Deroche-Gamonet et

al., 2004), comparing these two groups of animals allows one

to identify the biological changes specifically associated with

the transition to addiction in vulnerable individuals (Kasanetz

et al., 2010). Indeed, during the early phase of cocaine self-

administration, synaptic plasticity in the nucleus accumbens

(NAc) was not impaired by cocaine, but during the late phase

of cocaine self-administration, a normal synaptic plasticity

was progressively recovered in resistant animals, whereas it

was persistently lost in vulnerable animals (Kasanetz et al.,

2010). This persistent impairment in synaptic plasticity in the

NAc could explain the loss of control on drug intake observed

in vulnerable rats. Furthermore, variations in personality

traits, such as impulsivity, risk taking, nov-elty seeking, and

stress reactivity may contribute to the initiation of drug use

as well as the transitions from ini-tial use to regular use and

addiction (Kreek et al., 2005; Jasinska et al., 2014). Each of

these personality dimensions may have, in part, its own

genetic basis (Kreek et al., 2005). However, evidence of

increased genetic vulnerability to addiction does not denote

that addiction will definitely occur. Many factors, specifically

environmental factors such as stress (Koob and Le Moal, 1997;

Piazza and Le Moal, 1998; Sinha, 2001), a stimulant positive

environment (Solinas et al., 2010, 2019), or the availability of

drugs, strongly influence the development of drug abuse or

addic-tion. Conversely, a ’genetically resistant’ individual

may be more sensitive to the effects of drugs under specific

environmental conditions (Kreek et al., 2005). Increased

vulnerability to addiction also depends considerably on age

and developmental stage at which the exposure to drugs or

adverse environmental stimuli occur (Volkow et al., 2019).

Indeed, adolescents seem to be more susceptible to drug

taking due to the brain maturation period, par-ticularly in the

prefrontal cortex circuitry which has been implicated in the

self-regulation process (Volkow et al., 2019). Although it is

not easy to parse cause from con-sequence when it comes to

identify the neurobiological mechanisms underlying drug

addiction, all drugs of abuse share the ability to activate the

mesolimbic dopamine system (Di Chiara and Imperato, 1988;

Hyman et al., 2006). Some studies raise the issue of the

possibly causal role of baseline individual differences in

striatal dopamine re-ceptors. Indeed, healthy non-drug-

abusing individuals with relatively low levels of D2 dopamine

receptors (D2r) in the striatum experience the stimulant

methylphenidate drug as pleasurable, while those with

significantly higher levels find it unpleasant (Volkow et al.,

1999). Furthermore, when compared to control subjects,

cocaine abusers show sig-nificant decreases in D2r availability

which persists several months after detoxification (Volkow et

al., 1993), a reduced dopamine release in the striatum, and a

reduced ’high’ (Volkow et al., 1997). Drug exposure also

contributes to a

loss of self-control. Indeed, decreases in D2r availability

are associated with a reduced glucose metabolism in the

prefrontal cortex, which plays a key role in impulsivity and

loss of control over drug taking behavior (Volkow et al.,

1993). Studies in addiction suggest that low D2r

availability and dopamine release in the striatum are

neurobiological markers of increased impulsivity which

itself is considered as an endophenotype predictive for

addiction potential (Trifilieff and Martinez, 2014).

Interestingly, Tops and col-leagues postulated that a well-

developed oxytocin system is in a position to decrease

vulnerability, for example by decreasing drug reward,

increasing social reward, and reducing stress response

(Buisman-Pijlman et al., 2014; Tops et al., 2014) see also

Ferrer-Pérez et al. (2019a) – Fig. 1. As a complement, individuals have different levels of

resilience or varied ways in which they are able to uti-lize

personal or environmental resources to their benefit (Stainton

et al., 2019). Over years, resilience has been conceptualized

as a trait, a process, and an outcome (Southwick et al.,

2014). A considerable number of defini-tions of resilience

exists depending on how it is conceived. Commonly, resilience

refers to a positive and successful adaptation within the

context of significant and severe adversity or stress (Luthar et

al., 2000; Windle et al., 2011; Rutten et al., 2013; Sarkar and

Fletcher, 2014; Southwick et al., 2014). It is also seen as “the

capacity of individuals to navigate their way to the

psychological, social, cultural, and physical resources that

sustain their well-being and their capacity individually and

collectively to negotiate for these resources to be provided

and experi-enced in culturally meaningful ways” (Ungar,

2011). Others define resilience as “a dynamic capability

which can allow people to thrive on challenges given

appropriate social and personal contexts” (Howe et al., 2012)

and as “an interactive concept that refers to a relative

resistance to environmental risk experiences or the

overcoming of stress or adversity” (Rutter, 2006). Present

definitions converge around three main factors: first, the

presence of a specific risk for the development of psychiatric

illness; second, the influence of protective factors that

surpass this risk; and finally, a more positive outcome than

might be expected in the context of such a risk (Windle et al.,

2011; Sarkar and Fletcher, 2014; Stainton et al., 2019). Thus,

these defini-tions consider resilience as a dynamic process by

which individuals positively adapt to adversity as opposed to

the personality characteristic of the individual (Rutten et al.,

2013; Stainton et al., 2019). One debate in the field has been

whether resilience should be considered a “trait”

phenomenon, which is stable, or a “state” phenomenon,

which is dynamic. Resilience as a trait phenomenon concen-

trates mainly on personality aspects (such as self-esteem,

coping strategies, social skills, and confidence) which can be

already resourceful before the exposure to adversity. Masten

and Barnes suggest that resilience is not a trait, although

individual differences in personality or cognitive skills clearly

contribute to adaptive capacity (Masten and Barnes, 2018).

Fergus and Zimmerman (2005) divided the components of

resilience into assets and resources. Assets refer to the

positive factors that reside within the individual or

personality aspects. Resources are also positive factors,

particularly the social environmental influences that are






external to the individual. Indeed, the process of

resilience implies the benefit from both the assets and the

resources available under a certain changeable physical

state in order to improve the outcomes within the context

of a specific risk for psychiatric illness (Fergus and

Zimmerman, 2005; Stainton et al., 2019). Stainton and

colleagues clarified that the process of resilience is not

stable but rather dynamic and fluctuates across

circumstances and time, and that the engagement in this

process can be taught through training the individuals at

risk for psychiatric illness how to engage with the

protective factors associated with positive outcomes. Resilience is also defined as “bouncing back from ad-

versity” (Benda, 2003) and as “being able to stay on the

path toward recovery from addiction” (Rudzinski et al.,

2017). In the model of addiction and recovery from drug

use (Harris et al., 2011), resilience is characterized by

coping cycles of recovery leading to abstinence/recovery

from drug use, whereas the lack of resilience is demon-

strated by compulsive cycles of substance dependence

lead-ing to relapse/drug use. Accordingly, resilience-based

re-covery interventions focus on the interaction between

per-sonal and external positive resources (social support),

which can maintain long-term resistance against drug

effects (Rudzinski et al., 2017). Southwick and co-workers

stressed the importance of social support as a protective

factor, identifying various beneficial aspects such as the

size and extent of the individual’s social network, the

frequency of social interactions, the perception that social

interactions have been beneficial, emotional and cognitive

social sup-port, etc. (Southwick et al., 2016). This review focuses on social resilience approaches,

which boost resistance against drugs of abuse, particularly

cocaine. We suggest that positive social interaction when

offered as an alternative to drugs of abuse can lead to a

resistant phenotype and improve positive coping strategies

against stress. On the behavioral experimental level,

animal models can be used to investigate the effects of

addictive drugs (Zernig et al., 2007) and stress-related

mechanisms (Sarter and Bruno, 2002). In this review, we

will discuss the impact of social stress (risk factor) and

positive social in-teraction (protective factor) in animal

models on cocaine abuse.

2. Animal models of social stress The lack of social support during social exclusion from

peer groups, social subordination in bullying, and peer

pres-sure can increase the risk of developing a psychiatric

ill-ness. These negative social factors markedly increase

the likelihood of substance use (Bauman and Ennett, 1996;

Swadi, 1999; Cacioppo and Hawkley, 2009; Karelina and

DeVries, 2011). This section gives an overview on the im-

pact of social stress and peer pressure on cocaine’s effects

in animal models. In order to have a better overview of

the impact of social stress on cocaine self-administration

and preference, we have summarized the findings of this

part in a tabular form. In Tables 1–3, we recapitulate the

findings of the influence of social isolation, social defeat

stress and social hierarchy, respectively on cocaine

intake/ preference.

2.1. Social isolation In experimental animals, social isolation is a model of social

exclusion from peer groups and loneliness (Cacioppo and

Hawkley, 2009; Buwalda et al., 2011). In rats, social iso-lation

has the most potent effects during the earliest stage of

adolescence, immediately after weaning (P25-P45) (Einon and

Morgan, 1977). Indeed, it has been reported that during this

development phase including juvenile and adolescent stages,

social structure is built and social play is highly abundant and

most rewarding (Einon and Mor-gan, 1977). Post-weaning

social isolation in rats enhances intravenous self-

administration of cocaine (Schenk et al., 1987; Ding et al.,

2005) only at the lowest dose of cocaine used (Boyle et al.,

1991; Howes et al., 2000). It has been suggested that

adolescent isolation leads to greater im-pulsivity or

motivation for cocaine in adult rats, thereby increasing the

vulnerability to cocaine (Schenk et al., 1987; Ding et al.,

2005). In contrast, it has also been reported that isolation

does not affect self-administration of cocaine (Bozarth et al.,

1989) or even results in lower levels of cocaine self-

administration (Hill and Powell, 1976; Phillips et al., 1994;

Howes et al., 2000). In the majority of studies showing

enhanced cocaine self-administration in isolated reared

animals, very low doses were used which may be insufficient

to support self-administration in social rats (Howes et al.,

2000). It has been suggested that an increased dopaminergic

function in the NAc might underlie the enhanced propensity of

isolated rats to self-administer low doses of cocaine (Howes et

al., 2000). However, it is unclear why isolated rats show a

retarded acquisition at higher doses (1.5 mg/kg i.v). One

possibility is that isolated rats become more sensitive to the

aversive effects of higher doses leading to a lower intake

(Neisewander et al., 2012). It is also probable that at these

higher doses, tolerance to the anxiogenic effects of cocaine

develop more slowly in isolated than in social rats (Howes et

al., 2000). In addition, animals are more sensitive to isolation

effects during rearing than in adulthood (Bozarth et al.,

1989), resulting in a lack of effect on cocaine self-

administration. Together, these findings indicate that post-

weaning social isolation alters the sensitivity to the effects of

cocaine. However, how re-socialization may influence the

later vulnerability for cocaine self-administration after a pe-

riod of social isolation remains to be clarified. Indeed, early

social isolation (P21-P42) followed by re-socialization until

adulthood results in an enhanced acquisition of self-

administration of a low dose of cocaine, but the sensitivity to

cocaine reinforcement is not altered in isolated rats

(Baarendse et al., 2014). In addition, isolated rats display an

increased motivation for cocaine under a progressive ratio

schedule of reinforcement (Baarendse et al., 2014). The last

mentioned study suggests that social isolation en-hances the

vulnerability for drug addiction later in life. In the

conditioned place preference (CPP) paradigm, isolated rats

from weaning to adulthood (P21–P63) were insensitive to

cocaine, whereas the group-housed animals showed peak

effects at the lowest dose of this drug (Schenk et al., 1986).

These data highlight the effects of the early environment on

drug sensitivity in adults (Schenk et al., 1986). However,

socially isolated rats from weaning to adolescence (P23–43)

expressed CPP to cocaine possibly due to an up-regulation






Table 1 Summary of effects of social isolation stress on cocaine choice/self administration and preference. ↑ increase; ↓ de-

crease; ↔ no change; > higher; < lower. Paradigm Species Duration of Effect Reference

isolation

self-administration - rats PD 21 to 63 isolated rats (n = 13) > grouped (n = 8) Schenk et al.,

(0.1–1.0 g/kg/infusion) rats in acquisition of cocaine self 1987

administration

self-administration- rats PD 22 to 55 isolated (n = 7) and grouped (n = 11) Ding et al., 2005

(0.5 mg/kg/infusion) rats acquired stable cocaine

self-administration. isolated ↑ numbers of lever presses, cocaine

infusions, numbers of incorrect lever

presses; ↓ intervals of inter-reinforcement for cocaine.

self-administration- rats PD 21 to 63 at the 0.04 dose, isolated rats ↑ rates of Boyle et al., 1991

(0.04, 0.08, 0.16, 0.32, cocaine self-administration than

and grouped subjects (n = 31). 0.64 mg/kg/infusion)

↔ isolated (n = 10) and grouped

self-administration- rats PD 63 to 91 Bozarth et al.,

(1 mg/kg/injection) (n = 14) learned cocaine 1989 self-administration with equal speed;

↔ levels of cocaine were self-administered by both groups.

two-bottle choice – rats PD 20 to 100 animals reared in the enriched Hill and

cocaine environment (n = 6) > cocaine than Powell, 1976

(0.1 mg/ml) / water. animals reared in an impoverished one

(n = 5). self-administration- rats PD 21 to 140 socially reared animals (n = 6) acquired Phillips et al.,

(1.5 mg/kg infusion) the cocaine self-administration 1994

response faster than isolation reared

animals (n = 6) Isolation reared animals (n = 5/group) were less sensitive to the reinforcing

properties of cocaine.

self-administration- rats PD 21 to 81 isolation-reared rats showed an Howes et al., 2000

(0.083, 0.25 and enhanced sensitivity to self-administer

1.5 mg/kg) the lowest dose of cocaine but showed

retarded acquisition at the highest

dose (n = 25/group). self-administration- rats PD 21–43 then acquisition of cocaine Baarendse et al.,

(0.083, re-socialization self-administration ↑ in isolated rats 2014 0.25 mg/infusion) from PD 43–84 (n = 14) during both (0.083 mg/infusion) and

(0.25 mg/infusion) sessions than social

rats (n = 13). Breakpoints under the PR schedule of

reinforcement ↑in isolated rats compared with social rats for both

unit doses (social rats during -

0.083 mg/infusion: n = 12; 0.25 mg/infusion: n = 11), isolated

rats - 0.083 mg/infusion: n = 13;

0.25 mg/infusion: n = 11).

CPP - (0.31, 0.62, 1.25 or rats PD 21–63 isolated rats (n = 84) were insensitive to Schenk et al.,

2.5 mg/kg) cocaine whereas the group-housed 1986

animals (n = 84) showed peak effects at the lowest dose.

CPP- (5 and 10 mg/kg) rats PD 23–43 cocaine CPP was established in response Zakharova et al.,

to 5 or 10 mg/kg cocaine in isolated 2009

rats (n = 7). (continued on next page)






Table 1 (continued)

Paradigm Species Duration of Effect Reference isolation

self-administration – mice PD 21–80 male mice (n = 16–19/group) exhibited Fosnocht et al., (0.6 mg/kg/infusion) an increase in responding on the 2019

active wheel for cocaine, but female

mice did not (n = 11–13/group). isolation led to an increase in

responding on a progressive ratio

schedule for cocaine in both male and

female mice (n = 10–18/group). isolation caused a potentiated

reinstatement of drug seeking in both

male and female mice

(n = 8–12/group). self-administration – mice PD 56–96 or PD C57 BL/6 J strain, the isolated (n = 11) van der Veen

(1 mg/kg/infusion) 56–77 then and ex-group-housed (n = 12) mice ↔ et al., 2007 grouped from PD of self-infusions in acquisition

77–96 DBA strain, the ex-group-housed

(n = 9) mice showed ↑ cocaine intake during acquisition compared to the

isolated (n = 12) mice. two-choice test - cocaine mice PD 21–113 isolated DBA < oral cocaine intake as Morse et al., 1993

(40 mg%) / water. compared to C57BL6/J CPP- (3.125 mg/kg) mice PD 21–36 isolated mice did not acquire cocaine Ribeiro Do Couto

CPP (n = 12) et al., 2009 self-stimulation rats PD 50–92 isolated rats showed a ↓ in lever press Somalwar et al.,

activity and ↑ the ICSS thresholds as 2020 compared to group-housed rats

(n = 6–7)

of tyrosine hydroxylase activity and dopamine transporter

levels in the NAc (Zakharova et al., 2009). The housing con-

ditions and the age of animals vary across these studies. By

reaching adult age and thereby getting larger, it is possible

that group housed rats may increase stress levels due to

crowding effects (Zakharova et al., 2009). Indeed, adult male

rats have been shown to have higher corticosterone levels

under crowded conditions (Brown, 1995), which can impact on

the rewarding effects of cocaine. In mice, adolescent-onset social isolation increases co-

caine self-administration and motivation for cocaine in males

and potentiates cue-induced reinstatement of drug seeking in

both sexes (Fosnocht et al., 2019). In addition, the last

mentioned study reported that adolescent social isolation

increases cocaine-induced activation of several brain regions

previously implicated in stress and reward-related behavior

(Fosnocht et al., 2019). It seems that some strains of mice are

more sensitive to the effects of social isolation on cocaine

self-administration. Indeed, social iso-lation has been shown

to decrease cocaine intake in DBA but not in C57 mice (van

der Veen et al., 2007). Consis-tent with these findings, Morse

and coworkers showed a decrease in oral cocaine intake in

isolated DBA compared to C57BL/6J mice (Morse et al., 1993).

These results re-veal the implication of gene–environment

interactions in the vulnerability to cocaine reinforcing effects.

It seems that DBA mice are stress-responsive and vulnerable

regard-ing psychostimulant-induced responses, whereas

C57BL/6J

mice are not (van der Veen et al., 2007), possibly affect-

ing sensitivity to cocaine. Indeed, C57BL/6J mice and DBA

differ in the activity of the mesocorticolimbic

dopaminergic neurons (Puglisi-Allegra and Cabib, 1997)

that are thought to modulate psychostimulants reinforcing

effects. In addi-tion, social stress-induced corticosterone

levels might play a more important role in DBA than in C57

mice in the behavioral responses to cocaine (Kamakura et

al., 2016; Lee et al., 2018). Another study supports the

suggestion that isolated animals at adolescent age may be

less sensitive to cocaine. Isolated adolescent mice did not

acquire CPP after a low dose of cocaine, which was

effective in inducing CPP in grouped animals (B Ribeiro Do

Couto et al., 2009). More-over, social environmental

manipulation between grouping and isolation appears to

be more adverse in mice than con-stant housing in one of

the two conditions (van der Veen et al., 2007; Ribeiro Do

Couto et al., 2009). This environ-mental switch triggers

stress in rodents that can affect co-caine’s effects (Ribeiro

Do Couto et al., 2009; Nader et al., 2012a). Social isolation also induces depression-like symptoms such

as anhedonia (decreased ability to experience plea-sure)

(Wallace et al., 2009). Indeed, socially isolated rats showed a

reduced motivation to press a lever for electri-cal self-

stimulation in the pursuit of ‘wanting’ a reward, suggesting

motivational anhedonia (Somalwar et al., 2020). Altogether,

these studies suggest that social isolation af-fects brain

reward and stress systems. Under some genetic






Table 2 Summary of effects of social defeat stress on cocaine self administration and preference. ↑ increase; ↓ decrease; ↔ no

change; > higher; < lower. Paradigm Species Effect Reference

self-administration – rats defeated rats (n = 13) acquired cocaine Tidey and

(0.75 mg/kg/infusion) self-administration in half the time of Miczek, 1997

non-defeated rats (n = 11) self-administration- rats high-responder (HR) non-defeated (n = 8) animals Kabbaj et al., 2001

(0.25 mg/kg/infusion) self-administered more cocaine than the

low-responder (LR) non-defeated (n = 8) animals.

Following social defeat, the acquisition of

cocaine self-administration is significantly

delayed in HR rats (n = 8) and enhanced in LR rats (n = 8). self-administration- rats during 24-h cocaine self-administration binges, Covington and

(0.75 mg/kg/infusion) social-defeat stress ↑ cocaine intake (n = 8). Miczek, 2001

Social defeat ↔ the breakpoint for cocaine self-administration during the progressive ratio

(n = 8–10) self-administration- rats during the 24 h binge, stressed rats (n = 8) Covington et al., 2005

(0.3 mg/kg/infusion) self-administered significantly more total

cocaine than unstressed rats (n = 9). self-administration- rats social defeat ↑ increased the breakpoint for Covington and

(0.3 mg/kg/infusion) cocaine self-administration (low dose) during Miczek, 2005

the progressive ratio (n = 17–20) self-administration- rats social defeat ↑ cocaine infusions obtained during Burke and

(0.3 mg/kg/infusion) PR in pair-housed rats (n = 13). Miczek, 2015

social defeat ↑ the number of binge infusions in

pair-housed rats (n = 11).

self-administration- rats social defeat stress induced ↑ break points for Quadros and

(0.3 mg/kg/infusion); cocaine and produced persistent, escalated Miczek, 2009

24-h variable dose binge cocaine taking during a 24-h binge (n = 25). - (0.2, 0.4, and

0.8 mg/kg/infusion)

social defeat stress ↑ rates of cocaine

self-administration (1.0, mice Han et al., 2015

0.6 and self-administration at low cocaine dose - mild

0.3 mg/kg/infusion) socially defeated (n = 18), moderate socially defeated (n = 11) and control (n = 14) mice.

self- administration mice intermittent social defeat stress ↑ cocaine Arena et al., 2019

(0.3 mg/kg/infusion) self-administration (n = 14); control (n = 12). continuous social stress increased cocaine

self-administration in a subpopulation of mice

and ↓ cocaine self-administration in another subpopulation of mice (n = 13); control (n = 9).

self-administration rats chronic social defeat ↓ accumulated significantly Miczek et al., 2011

(0.75 mg/kg/infusion) less cocaine during the 24 h continuous access;

responded less on a PR schedule of cocaine

reinforcement - stressed (n = 9) and controls (n = 8); ↓ sugar preference - stressed rats

(n = 24) and controls (n = 24) ; and intake-

stressed rats (n = 7) and controls (n = 7).

self-administration- rats cocaine infusions during the binge was ↑ in rats Shimamoto et al.,

(0.3 mg/kg/infusion) with greater saccharin intake (n = 4) than in 2015

rats with lower saccharin inatke (n = 14) and in

the non-stressed controls (n = 13). self-administration- rats after episodic social defeat stress, stressed Holly et al., 2012

(0.3 mg/kg/infusion) females (n = 10) “binged” significantly longer

than stressed males (n = 8). (continued on next page)






Table 2 (continued)

Paradigm Species Effect Reference

CPP (1 mg/kg) mice after intermittent social defeat stress, mice Ferrer-Pérez et al.,

housed in group of 4 per cage developped 2019b

cocaine CPP (n = 12) but not animals housed with a female (n = 20) or with a familiar male

since adolescence (n = 12).

CPP (15 mg/kg) mice acute social defeat stress ↑ CPP to cocaine McLaughlin et al.,

(n = 22–23). 2006

CPP (5 mg/kg) rats acute social defeat stress ↑ CPP to cocaine Tovar-Díaz et al.,

(n = 7–8). 2018

CPP (1 mg/kg or mice social defeat ↑ CPP to cocaine (1 mg/kg) in adults Montagud-

25 mg/kg) (n = 12) but no CPP expressed in adolescent Romero et al.,

mice at the same dose (n = 13). 2015

Adults (n = 15) needed > number of extinction sessions for the 25 mg/kg cocaine-induced CPP

to be extinguished than adolescents (n = 16). CPP (50 mg/kg) mice acute social defeat ↑ vulnerability to Ribeiro Do Couto reintatement of cocaine CPP after priming with et al., 2009

cocaine (25 mg/kg) and (12.5 mg/kg) – (n = 9). CPP (15 mg/kg) mice acute social defeat stress produced reinstatement Bruchas et al., 2011

of cocaine preference (n = 8–20).

Table 3 Summary of effects of social ranking stress on cocaine choice/self administration and preference. ↑ increase; ↓ de-

crease; ↔ no change; > higher; < lower. Species Effect Reference

monkeys dominant ↑ D2r Morgan et al., 2002

subordinate ↔ D2r

cocaine is reinforcing in subordinate but not dominant monkeys (n = 20) monkeys cocaine choice > in subordinate Czoty et al., 2004b

monkeys ↑ D2/D3r availability after reorganization in subordinate; Czoty et al., 2017

↑↑ D2/D3r availability in those that became dominant;

↔ D2/D3r availability in formerly dominant compared to their previous cocaine self-administration, the potency of

cocaine as a reinforcer decreased in 9 of 11 monkeys (n = 12) monkeys ↔ between social ranks in either D2r function or the reinforcing effects of Czoty et al., 2004a

cocaine in socially housed monkeys with extensive histories of cocaine

self-administration.

↔ D1r function (n = 21) monkeys during abstinence: ↑ D2r availability in the caudate nucleus in dominant vs Czoty et al., 2010

subordinate monkeys.

↑ Average latency to touch a novel object in dominant monkeys compared to subordinates (n = 12)

monkeys following social confrontation: ↑ sensitivity to the reinforcing effects of Gould et al., 2017

cocaine in subordinate; ↓ sensitivity to the reinforcing effects of cocaine

in dominant (n = 15)

monkeys ↑ D2/D3r availability in dominant female but ↑ vulnerability to cocaine Nader et al., 2012b

reinforcement (n = 16)

rats ↑ rates of intravenous cocaine self-administration in dominant male rats Jupp et al., 2016

↑ D2/D3r binding in NAc shell and dorsal striatum of dominant rats;

↑ DAT and ↓dopamine in the NAc shell (n = 6/group) mice submissive mice displayed an aversion to cocaine; dominant mice Yanovich et al., 2018

expressed cocaine CPP. After chronic mild stress: submissive mice displayed a marked increase in

cocaine CPP; dominant mice ↔ preference as non-stressed mice. Only in submissive mice, stress ↓ D1 and D2r receptors in the hippocampus






and experimental conditions, these effects likely

contribute to enhanced vulnerability to cocaine

(Neisewander et al., 2012).

2.2. Social defeat stress

Social defeat stress in experimental animals can model as-

pects of physical abuse and bullying (Buwalda et al., 2011).

One relevant rodent model based on the establishment of a

territory by a resident male is the resident-intruder model in

which brief intermittent episodes of defeat stress occur

between a non-aggressive unfamiliar animal (intruder) placed

into the home cage of an aggressive animal (resi-dent). Then,

the resident will attack the intruder, who will experience an

aggressive and antagonistic social interaction (“social

defeat”). The intruder can either be removed from the cage

of the resident or be placed into a protective insertion in the

resident’s cage in order for the defeated rat to be exposed to

the resident’s threat (Tornatzky and Miczek, 1993; Newman

et al., 2018). Thus, the intruder is considered as the

“defeated” or the “subordinate” and the resident is

considered as the “dominant”. Social defeat stress may be

acute and occur in a single defeat episode, chronic and occur

daily over repeated episodes, or intermittent that consists of

episodes every few days. Exposure to social defeat stress can double the rate of

cocaine self-administration acquisition (Tidey and Miczek,

1997). In rats which had previously experienced so-cial

defeat, exposure to olfactory, auditory, and visual cues of

an aggressive resident rat increases NAc dopamine re-

lease (Tidey and Miczek, 1997). These findings support the

idea that exposure to social defeat stress induces neuro-

chemical changes in the mesolimbic dopaminergic system

(Tidey and Miczek, 1996; Han et al., 2015) which may, in

turn, render an animal more “vulnerable” to drug use. So-

cial defeat also plays a role of equalizer of individual dif-

ferences in drug-taking behavior (Kabbaj et al., 2001). In-

deed, high responsive (HR; exhibit high locomotor activity

in a novel environment) non-defeated rats self-administer

more cocaine than low responsive (LR) non-defeated rats.

Following social defeat, the acquisition of cocaine self-

administration is significantly delayed in HR rats and en-

hanced in LR rats (Kabbaj et al., 2001). Intermittent so-

cial defeat stress can also increase progressive ratio

break-points (Covington and Miczek, 2001, 2005; Quadros

and Miczek, 2009; Burke and Miczek, 2015) and increase

cocaine self-administration in mice (Han et al., 2015). Social defeat stress during adolescence or adulthood

enhances cocaine intake (binge access to cocaine, 24 h)

(Covington and Miczek, 2001; Covington et al., 2005;

Burke and Miczek, 2015) with female rats having a signif-

icantly longer “binge” duration than males (Holly et al.,

2012). In contrast, under limited access conditions, social

defeat stress exposure does not persistently change how

defeated animals value cocaine (Newman et al., 2018). In-

deed, the facilitation of cocaine intake for 24 h by so-cial

defeat is not associated with a shift in demand for cocaine

(Leonard et al., 2017). Social defeat stress ap-pears to

disrupt the mechanisms that control the mainte-nance or

termination of cocaine self-administration bouts, resulting

in prolonged binges that often persist beyond 24 h

(Newman et al., 2018). By contrast, rats exposed to chronic

social defeat stress for five continuous weeks accumulate

significantly less cocaine during the 24 h continuous ac-cess

session, stop self-administering cocaine sooner, and re-spond

less on a progressive ratio schedule of cocaine rein-forcement

than their contemporary controls (Miczek et al., 2011).

Continuously defeated animals also show a lower saccharin

preference and intake compared to non-defeated rats,

suggesting that intense, prolonged social stress may induce an

anhedonia-like profile (Miczek et al., 2011). These behavioral

changes are paralleled by a suppression of dopamine release

in the NAc and Brain Derived Neu-rotrophic Factor (BDNF)

expression in the ventral tegmen-tal area (VTA). The opposite

is observed in episodically de-feated rats (Miczek et al.,

2011). Another study differen-tiated between two phenotypes

of female rats, one with greater saccharin intake and another

one with lower sac-charin intake during chronic social defeat

stress exposure (Shimamoto et al., 2015). These two

phenotypes exhibited a distinct pattern with respect to

subsequent cocaine self-administration as well as

extracellular dopamine release in the NAc in response to an

acute cocaine challenge. In-deed, females with greater

saccharin intake exhibited in-creased cocaine self-

administration during a 24 h binge and a blunted NAc

dopamine response to a cocaine challenge (Shimamoto et al.,

2015). In line with individual differences in how rodents

respond to chronic social stress, continu-ous social stress in

mice produces a bimodal divergent re-sponse for cocaine by

substantially increasing cocaine self-administration and

sucrose intake in a subpopulation of mice and decreasing

cocaine self-administration and su-crose intake in another

subpopulation of mice (Arena et al., 2019). These data

indicate a vulnerability to cocaine use based upon the

individual’s response to stress experience (Krishnan et al.,

2007; Arena et al., 2019). In a CPP paradigm, acutely socially defeated mice

(McLaughlin et al., 2006) and rats (Tovar-Díaz et al., 2018)

showed a significant potentiation of place-preference for the

cocaine-paired chamber. Interestingly, social defeat stress

alters cocaine-induced CPP depending on the age at which it

has been experienced (Montagud-Romero et al., 2015).

Indeed, adolescent mice (P29–32) exposed to social defeat

show a reduction in cocaine-induced CPP, whereas adult mice

(P50–53) exposed to social defeat show an in-crease in

cocaine-induced CPP (Montagud-Romero et al., 2015).

Moreover, a higher number of extinction sessions is required

to extinguish cocaine-induced CPP in adult mice as compared

to adolescent mice (Montagud-Romero et al., 2015). These

results show that following social defeat stress adolescent

mice are less sensitive to cocaine induced CPP. As concluded

by Montagud-Romero and coworkers, sub-jects that

experience reduced levels of drug reward may increase their

consumption in order to achieve reward-ing effects, thereby

increasing their vulnerability to de-velop addiction

(Montagud-Romero et al., 2015). In addi-tion, acute exposure

to social stress can reinstate a previ-ously extinguished

preference for drug-paired stimuli in a CPP paradigm (Ribeiro

Do Couto et al., 2009; Bruchas et al., 2011). After

intermittent social defeat stress, male mice housed in

standard conditions (adult mice, 4 per cage) de-veloped

cocaine CPP (Ferrer-Pérez et al., 2019b). However, mice

housed with a female or with a familiar male since






adolescence did not develop CPP to the same cocaine dose

(Ferrer-Pérez et al., 2019b). These data suggest that hous-

ing conditions are crucial in defining the individual’s re-

sponse to cocaine. Using a social defeat model adapted to explore individual

differences, Krishnan and colleagues identified the reward

circuit as an important neural substrate in the manifesta-tion

of stress vulnerability. Indeed, they showed that after

segregation of mice subjected to social defeat into a sus-

ceptible (socially avoidant) and an unsusceptible (socially

interactive) phenotype, only susceptible mice demon-strated

an increase in BDNF in the NAc caused by enhanced VTA

dopamine neuron excitability (Krishnan et al., 2007). These

susceptible mice also showed a deficit in natural reward

evaluated by sucrose preference, coincident with an increase

to a low dose of cocaine CPP, while unsuscepti-ble mice

showed neither of these changes. Also, increased VTA BDNF

signaling is necessary for the susceptibility to the aversive

effect of social defeat stress (Berton et al., 2006; Krishnan et

al., 2007) and is facilitating the effects of social defeat stress

on compulsive cocaine-taking behavior (Wang et al., 2016).

Thus, variability of BDNF expression in the VTA may act as an

intrinsic risk factor in the propensity to develop compulsive

cocaine-taking behavior following stressful life events (Wang

et al., 2016). The same group suggested a model in which

preventing the increase in NAc BDNF or BDNF signaling in the

NAc was sufficient to reduce vulnerability and promote a

resilient phenotype (Berton et al., 2006; Krishnan et al., 2007,

2008). Another study also showed that basal levels of FosB in

the NAc determine an individual’s initial vulnerability to social

defeat stress, and that the degree of FosB induction in

response to chronic stress determines susceptible vs. resilient

responses to that stress (Vialou et al., 2010). Indeed,

increased FosB associated with decreased AMPA glutamate

receptor function in the NAc promotes resilience to social

defeat whereas decreased FosB associated with increased

AMPA function in the NAc contributes to stress susceptibility

(Vialou et al., 2010). Furthermore, in a study analyzing

upstream regulators of genes differentially ex-pressed after

chronic social defeat stress, estrogen receptor

α (ERα) was identified as the top regulator of pro-resilient

transcriptional changes in the NAc (Lorsch et al., 2018).

Interestingly, overexpression of ERα in the NAc promotes

stress resilience (Lorsch et al., 2018). Altogether, these studies show that acute and intermit-

tent social defeat stress increases cocaine intake as well

as cocaine self-administration and preference to cocaine-

associated cues. Moreover, social defeat increases the vul-

nerability to drug reinstatement (Ribeiro Do Couto et al.,

2006, 2009).

2.3. Social hierarchy

The position in the social hierarchy can be expected to

impact on the vulnerability to the reinforcing effects of

cocaine. Indeed, socially subordinate male cynomolgus

monkeys have been shown to self-administer more total co-

caine relative to dominant monkeys (Morgan et al., 2002).

Using a choice procedure to assess the relative reinforcing

strength of cocaine in group-housed male cynomolgus

monkeys with extensive cocaine self-administration his-tories,

most subordinate monkeys were more sensitive to the relative

reinforcing strength of cocaine than domi-nant monkeys

(Czoty et al., 2004b). In contrast to males, dominant female

monkeys acquired cocaine reinforce-ment at significantly

lower doses than their subordinate consexuals (Nader et al.,

2012b). Interestingly, if male monkeys’ social ranks were

manipulated by reorganizing social groups, the potency of

cocaine as a reinforcer de-creased in most monkeys as

compared to their previous self-administration (Czoty et al.,

2017). Consistently, after the first exposure to group housing,

monkeys’ social rank significantly influenced cocaine

reinforcement with domi-nant male monkeys showing

considerably reduced cocaine self-administration acquisition

rates. However, after long-term cocaine self-administration,

the differences in drug intake between dominant and

subordinate male monkeys disappeared (Czoty et al., 2004a)

but re-appeared after a period of extended abstinence (Czoty

et al., 2010). During abstinence, average latency to touch a

novel object was also significantly higher in dominant

monkeys compared to subordinates or individually housed

monkeys (Czoty et al., 2010). These findings suggest that

social dominance can lead to longer latencies in reaction to

novelty, a personality trait associated with low vulnerability

to cocaine abuse (Czoty et al., 2010). It has also been

reported that de-pending on an individual’s social status, the

same social experience could have divergent effects on

cocaine self-administration. Indeed, following social

confrontation in which monkeys were serving as an intruder in

another social group, subordinate monkeys showed increased

sensitivity to the reinforcing effects of cocaine, while

dominant monkeys showed decreased sensitivity to the

reinforcing effects of cocaine (Gould et al., 2017). In male

rats, social dominance assessed by using resource competition

for a highly palatable liquid was associated with higher rates

of intravenous cocaine self-administration (Jupp et al., 2016).

Next to obvious species differences, the discrepancy in the

method used to assess social dominance between non-human

primates and rats in the latter study could explain the

diverging results between male monkeys and male rats (Jupp

et al., 2016). Using selectively bred stress-resilient (socially

dominant) and stress-vulnerable (socially submis-sive) mice,

Yanovich et al. showed the latter displayed an aversion to

cocaine, whereas dominant mice expressed cocaine CPP.

Following chronic mild stress, submissive mice displayed a

marked increase in cocaine CPP, whereas dominant mice did

not differ in preference from their non-stressed state

(Yanovich et al., 2018). These results suggest that social

submission is associated with vulnerability to stress- induced

increases of cocaine preference.

D2r/D3r availability in the basal ganglia is associated

with vulnerability to cocaine abuse (Morgan et al., 2002).

With continued exposure to cocaine, the initial social

rank-related differences in D2r/D3r availability disappear

(Czoty et al., 2004a) and re-emerge after a period of ab-

stinence (Czoty et al., 2010). Dominant female monkeys

show significant increases in D2r/D3r availability following

social rank formation but they are more vulnerable to co-

caine reinforcement (Nader et al., 2012b). Thus, the di-

rect relationship between D2r/D3r availability and vulner-

ability in females is opposite to that observed in males and






suggests that D2r/D3r changes alone may not be sufficient to

alter sensitivity to cocaine reinforcement (Nader et al.,

2012b). Similar to non-human primates, differences in the

rate of self-administered cocaine between dominant and

subordinate rats may be mediated by striatal dopaminer-gic

systems. Indeed, D2r/D3r binding was elevated in the NAc

shell and dorsal striatum of dominant rats when com-pared to

subordinate rats and was accompanied by elevated dopamine

transporter and reduced dopamine content in the NAc shell

(Jupp et al., 2016). In mice, stress-induced de-creases in D1r

and D2r expression in the hippocampus was only observed in

submissive mice as compared to dominant mice (Yanovich et

al., 2018). In summary, these studies sug-gest that social

conditions can alter parameters in the re-ward system such as

dopaminergic receptors availability on GABAergic neurons

(Morgan et al., 2002; Nader et al., 2008; Czoty et al., 2017),

which may subsequently affect vulnera-bility to the

reinforcing effects of cocaine.

Altogether, these findings are consistent with studies

reporting that the rewarding effects of drugs and social

interaction are enhanced when combined with one another

(Thiel et al., 2008, 2009; Watanabe, 2011). Thiel and

colleagues have investigated the interactions between drug

and social rewards in adolescent rats and have shown that the

drug experience alone (cocaine) and a low number of social

pairings alone failed to produce CPP in early adolescent male

rats. In contrast, the combined experience of drug exposure

and social interaction resulted in a CPP response (Thiel et al.,

2008). These results indicate that drug reward interacts

synergistically with social reward in the CPP paradigm. Yet,

another study investigating the same cocaine dose and social

interaction protocol found an additive rather than a

synergistic effect of cocaine and social interaction (Grotewold

et al., 2014). The discrepancy between these studies may be

due to a difference in the age (early vs. late adolescence) of

the investigated rats. In general, these findings suggest that

the subjective effects of drugs are stronger in a social

context.

2.4. Peer pressure – social interaction within the

drug context It is well known that peer pressure can facilitate drug use

among adolescents in social contexts (Valente et al., 2007; El

Rawas and Saria, 2016). In rats, socially housed animals

influence the drug self-administration behavior of their

partners. Indeed, relative to individually housed control rats,

cocaine self-administration is facilitated in socially housed

rats if both members of the pair have access to cocaine.

However, cocaine self-administration is inhibited if only one

member of the pair has access to cocaine (Smith, 2012).

Consistently, a rat self-administering cocaine will choose to

respond on a lever in close proximity to an-other rat self-

administering cocaine rather than on a lever in close

proximity to a rat, which is not self-administering cocaine

(Smith and Pitts, 2014). These studies suggest that rats

increase the amount of time they spend in proximity to a

social partner with a shared history of drug exposure (Smith

and Pitts, 2014). In a complementary study inves-tigating

whether a shared history of drug exposure would influence

the choice of a social partner, adolescent male rats were

treated with either cocaine or saline and their preference for

a cocaine-treated rat or a saline-treated rat was measured in

a partner preference test. Interestingly, rats showed an

increase in the time spent with similarly treated partners.

Indeed, cocaine-treated rats expressed a preference to the

cocaine-treated partner after condi-tioning. These findings

show that a shared history of drug exposure is sufficient to

establish a social preference for one individual over another

(Smith et al., 2015). Likewise, it has been shown that rats can

behaviorally discrimi-nate between drug-associated and non-

drug-associated conspecifics (Dingess et al., 2017). Using a

custom social interaction chamber in which rats were able to

interact with two distinct conspecifics via holes in a boundary

wall, Dingess and coworkers have shown that rats exhibit

more interactive and investigative behavior towards a partner

which was consistently present during cocaine conditioning

than towards a partner which was present when the rat was

"sober" (Dingess et al., 2017).

3. Social interaction as an alternative

to drug use Findings from the literature indicate that social stress is

in-volved in creating a vulnerable phenotype to cocaine

abuse. Drug use (including cocaine) is often considered as

a daily stressor or risk factor for resilience (Rudzinski et

al., 2017). The question is how to prevent these risk

factors and en-hance the protective factors through

increasing the re-silience capability against drug abuse.

The most investi-gated external protective factor is social

support at the family, school, and community level that is

considered as a key external factor for resilience

(Southwick et al., 2016; Rudzinski et al., 2017). In this

context, positive peer connections and supportive

relationships with friends are of major interest. Indeed, in

the presence of a peer environment supporting non-use of

drugs, a substance abuse prevention program has been

shown to be effec-tive (Valente et al., 2007). Therefore,

we suggest social interaction reward as a protective factor

allowing effec-tive coping to build resilience against drug

abuse. In the next section, we will review studies that

investigated so-cial interaction reward in rodents as an

alternative to drugs. In rodents, the positive emotional effects of so-cial

interaction with a weight–matched male conspecific have

been found to be rewarding in a CPP paradigm (Calcagnetti

and Schechter, 1992; Van den Berg et al., 1999; Douglas et

al., 2004; Thiel et al., 2008, 2009; Trezza et al., 2009; Fritz

et al., 2011b; Kummer et al., 2011, 2014; El Rawas et al.,

2012a; Peartree et al., 2012; Yates et al., 2013; Salti et al.,

2015). These studies have shown that so-cial play is likely to

be the most pleasurable component in social interaction as

rats prefer the environments paired with playful partners over

the ones paired with non-playful partners (Calcagnetti and

Schechter, 1992; Trezza et al., 2009) or an inanimate object

(Pinheiro et al., 2016). More specifically, physical contact or

“touch” appears to be the most rewarding sensory component

of social interaction (Kummer et al., 2011; Peartree et al.,

2012). Indeed, rats






spent 79% of test time in direct contact with each others

(Kummer et al., 2014). Although mice spend less time in

direct contact with each others (17%), social interaction is

found to be rewarding in both mice and rats (Kummer et

al., 2014). In general, increasing the availability of alternative, non-

drug reinforcers can significantly disrupt the acquisition and

maintenance of cocaine use and abuse (Higgins, 1997). In-

terestingly, some studies have investigated the influence of

the presence of a conspecific on drug self-administration in

rats. In socially housed rats having simultaneous access to

cocaine, cocaine consumption was significantly higher as

compared to socially housed rats paired with a rat without

access to cocaine (Peitz et al., 2013). These findings suggest

that the presence of an abstaining peer decreases the rein-

forcing strength of cocaine (Peitz et al., 2013) and therefore

support the meaning of social interventions in drug abuse

prevention. We have found that four social interaction episodes with a

male adult conspecific completely reversed cocaine CPP and

were even able to prevent reacquisition of cocaine CPP (Fritz

et al., 2011b; Bregolin et al., 2017). These protective effects

of social interaction were paralleled by effects on the brain

circuitry known to be involved in drug reinforce-ment and

reward. Indeed, social interaction during extinc-tion of

cocaine CPP reversed cocaine CPP-reinstatement-associated

Zif268 expression in the NAc shell, the cen-tral and

basolateral amygdala, and the ventral tegmen-tal area (Fritz

et al., 2011b). Furthermore, social interac-tion during

extinction of cocaine CPP also reduced cocaine-CPP-

stimulated FosB expression in the NAc shell and core and

increased pCREB (cAMP response element binding pro-tein)

expression in the NAc shell and the cingulate cortex area 1

(Cg1) (El Rawas et al., 2012b). These findings sug-gest that

social interaction, if offered in a context that is clearly

distinct from the previously drug-associated ones, may

profoundly decrease the incentive salience of drug-associated

contextual stimuli (Fritz et al., 2011b). In par-allel with our

findings, Ribeiro Do Couto and coworkers found that after

extinction of cocaine CPP, social interac-tion with a non-

aggressive male before the reinstatement test took place

blocked the reinstating effects of cocaine priming (Ribeiro Do

Couto et al., 2009). These results sug-gest that a brief social

interaction also acts as an alternative reinforcer that prevents

the reinstatement of cocaine-CPP (Ribeiro Do Couto et al.,

2009). However, if mice encounter four conditionings of

cocaine after social interaction CPP has already been

established, CPP to cocaine re-emerges (Bregolin et al.,

2017). These findings mean that preven-tion by social

interaction is ineffective if not maintained in a drug-free

state, and that a subsequent history of cocaine can overcome

the protective effects of social interaction and relapse to

cocaine can occur. Indeed, one session of so-cial interaction is

not strong enough to prevent against the persistence of

cocaine CPP (Bregolin et al., 2017). To re-verse cocaine CPP,

social interaction interventions require a long learning process

in an alternative, drug-free context (Bregolin et al., 2017).

Recently, Venniro and coworkers have introduced an

operant model of choice between drugs and voluntary

social interaction in rats (Venniro et al., 2018). When the

two rewards were presented as a series of mutually ex-

clusive choices, operant social reward prevented drug-self

administration, even in rats that met criteria for addic-tion

(Venniro et al., 2018). In a modified variant of the standard

CPP procedure, a rewarding stimulus considered as reference

can be compared to a different stimulus referred to

“reference-conditioning” (Reichel et al., 2010), thereby

increasing the sensitivity to detect conditioned re-ward as

compared to standard CPP procedure. When social interaction

reward is compared to cocaine in CPP, both stim-uli produce

equal CPP (Fritz et al., 2011b; Kummer et al., 2014). These

findings suggest that social interaction re-ward has the same

conditioned reward value of cocaine (Kummer et al., 2014; El

Rawas and Saria, 2016). When social interaction was made

available as an alternative to cocaine, pre-acquisition

lesioning the NAc core or the ba-solateral amygdala shifted

the animals’ preference toward social interaction CPP,

whereas a bilateral NAc shell lesion shifted the preference

toward cocaine CPP (Fritz et al., 2011a). These findings

suggest a role of the NAc shell in mediating social interaction

associated conditioned stimuli and a role of the NAc core and

the basolateral amyg-dala in mediating cocaine-associated

conditioned stimuli (Fritz et al., 2011a). Remarkably, the

possibility to posi-tively socially interact in an alternative

context completely reverses increased-preference to cocaine

in rats receiv-ing intracerebroventricular injection of

corticosterone releasing factor before cocaine conditioning in

the cocaine-associated compartment (Lemos et al., 2020). It

is also of importance to identify how this protective factor

exerts its influence on cocaine’s effects. Indeed, we also

found that social interaction reward decreases stress markers

to the level of naïve non-treated and non-stressed animals

(Salti et al., 2015; Lemos et al., 2020). A recent study has

investigated the effects of the availability of social

interaction with an unfamiliar mouse during the CPP test in

the non-cocaine associated compartment once the condi-

tioning to cocaine was already established, on cocaine CPP

(Sampedro-Piquero et al., 2019). It was found that when mice

had the option to choose between a cocaine-paired

compartment and a compartment where an unfamiliar

juvenile mouse was placed, animals spent more time in the

social compartment, actively interacting with the animal.

In summary, these results suggest that the presence of

social interaction as a mutual choice can be considered as

a protective factor allowing positive coping to build

resilience against drugs effects.

4. Conclusion and outlook In conclusion, being able to resist to drug use depends mostly

on the interaction between risk factors and protec-tive

factors at different stages of life. Interventions aiming at

enhancing resilience that result in enhanced social sup-port

could be particularly effective in helping people cope with

risk factors and preventing the onset of drug use prob-lems

and relapse. However, resilience is not permanent; in-

dividuals may undergo stages in life in which fluctuations can

occur (Southwick et al., 2014). The important goal of

resistance is to change the balance between risk and pro-

tective factors in order that the effects of protective factors

outweigh those of risk factors.






How might these risk factors and protective factors in-

teract? Braverman suggested three possible interactions:

first, a protective factor might serve to reduce or lessen

the potential negative impact of a risk variable. Second, a

protective factor might have its effect by providing the

ability to cope with the risk directly. A third possibility is

that certain factors might reduce the actual exposure to

the risk, as opposed to neutralizing its negative effects

(Braverman, 2001). However, as there is no exposure to

the risk variable at all in the third possibility, the interac-

tion between the exposure to the risk and the ability to

adapt successfully despite the exposure is limited. Since

positive social interaction appears to have anti-stress ef-

fects (Lemos et al., 2020), we suppose that the first type

of interaction is the one occurring in our model. Which specific factors should be targeted by intervention

programs? Resilience-based recovery programs and inter-

ventions focus on both internal strengths and external re-

sources. For drug abuse, school-based interventions based on

a combination of social competence and social influ-ence

approaches have shown protective effects against drug use

(Das et al., 2016). In addition, peer support groups in-cluded

in addiction treatment are promising (Tracy and Wal-lace,

2016). Finally, Bloomberg et al. recommended that youth

programs should focus on fostering social interaction and

participation in community activities (Bloomberg et al.,

1994). How social interaction reward mediates its protective ef-

fects? Basic research on animal models should be conducted

in order to understand the neurobiological mechanisms un-

derlying the beneficial effects of social interaction reward in

promoting resilience against substance abuse and stress. As a

possible candidate, we propose the kappa opioid re-ceptor.

Interestingly, unlike other areas that produce neg-ative

effects (Bruchas et al., 2010), kappa opioid recep-tor

activation is reported as rewarding in the rostrodorsal shell

hotspot region (Castro and Berridge, 2014). Further-more,

within the NAc shell region, it was found that photo-

stimulation of dynorphinergic cells in the ventral NAc shell

drives aversion via kappa opioid receptor activation and in

contrast, photo-stimulation of dynorphinergic cells in the

dorsal NAc shell drives preference/reward behavior also via

kappa opioid receptor activation (Al-Hasani et al., 2015).

Based on these findings, we propose that the anti-stress ef-

fects of social interaction might be mediated by the kappa

opioid receptor system in the ventral NAc shell through a de-

crease in the activation of the stress MAPK P38 (Salti et al.,

2015). In parallel, we propose that the rewarding effects of

social interaction might be mediated by the kappa opioid

receptor in the dorsal NAc shell through an increase in the

Extracellular-signal Regulated Kinase (ERK). In summary, understanding the neurobiological mech-

anisms underlying protective factors which enhance re-

silience should provide the basis for future evidence-based

interventions targeting substance abuse and stress-related

pathologies.

Role of funding source

The work in this paper is supported by the Austrian

Science Fund (FWF): P27852-B21 and T758-BBL.

Contributors Rana El Rawas wrote the first draft of the manuscript. All

authors contributed to the final manuscript.

Conflict of Interest The authors declare that they have no conflicts of interest.

Acknowledgments The authors wish to thank Dr. Kai K. Kummer for the

helpful comments.

References Al-Hasani, R., McCall, J.G., Shin, G., Gomez, A.M., Schmitz, G.P.,

Bernardi, J.M., Pyo, C.-.O., Park Il, S., Marcinkiewcz, C.M.,

Crowley, N.A., Krashes, M.J., Lowell, B.B., Kash, T.L., Rogers,

J.A., Bruchas, M.R., 2015. Distinct subpopulations of nu-cleus

accumbens dynorphin neurons drive aversion and reward.

Neuron 87, 1063–1077. Arena, D.T., Covington, H.E., DeBold, J.F., Miczek, K.A., 2019.

Per-sistent increase of I.V. cocaine self-administration in a

subgroup of C57BL/6J male mice after social defeat stress.

Psychophar-macology 236, 2027–2037. Baarendse, P.J.J., Limpens, J.H.W., Vanderschuren, L.J.M.J.,

2014. Disrupted social development enhances the motivation

for co-caine in rats. Psychopharmacology 231, 1695–1704. Baler, R.D., Volkow, N.D., 2006. Drug addiction: the neurobiology

of disrupted self-control. Trends Mol. Med. 12, 559–566. Bauman, K.E., Ennett, S.T., 1996. On the importance of peer

influ-ence for adolescent drug use: commonly neglected

considera-tions. Addiction 91, 185–198. Benda, B.B., 2003. Discriminators of suicide thoughts and

attempts among homeless veterans who abuse substances.

Suicide Life Threat. Behav. 33, 430–442. Berton, O., McClung, C.A., Dileone, R.J., Krishnan, V., Renthal,

W., Russo, S.J., Graham, D., Tsankova, N.M., Bolanos, C.A.,

Rios, M., Monteggia, L.M., Self, D.W., Nestler, E.J., 2006.

Essen-tial role of BDNF in the mesolimbic dopamine pathway

in social defeat stress. Science 311, 864–868. Bloomberg, L., Meyers, J., Braverman, M.T., 1994. The

importance of social interaction: a new perspective on social

epidemiology, social risk factors, and health. Health Educ. Q.

21, 447–463 dis-cussion 465-9. Boyle, A.E., Gill, K., Smith, B.R., Amit, Z., 1991. Differential ef-

fects of an early housing manipulation on cocaine-induced ac-

tivity and self-administration in laboratory rats. Pharmacol.

Biochem. Behav. 39, 269–274. Bozarth, M.A., Murray, A., Wise, R.A., 1989. Influence of hous-ing

conditions on the acquisition of intravenous heroin and co-

caine self-administration in rats. Pharmacol. Biochem. Behav.

33, 903–907. Braverman, M.T. (2001). Applying Resilience Theory to the Pre-

vention of Adolescent Substance Abuse. FOCUS. Retrieved

from http://4h.ucanr.edu/files/1232.pdf Bregolin, T., Pinheiro, B.S., El Rawas, R., Zernig, G., 2017. Pre-

ventive strength of dyadic social interaction against reacqui-

sition/reexpression of cocaine conditioned place preference.

Front. Behav. Neurosci. 11, 225. doi:10.3389/fnbeh.2017.00225.



http://dx.doi.org/10.13039/501100002428

http://dx.doi.org/10.13039/501100002428

http://dx.doi.org/10.13039/501100002428

http://dx.doi.org/10.13039/501100002428

http://refhub.elsevier.com/S0924-977X(20)30193-0/sbref0001



























































http://4h.ucanr.edu/files/1232.pdf

https://doi.org/10.3389/fnbeh.2017.00225




Brown, K., 1995. Effects of housing on male and female rats:

crowding stresses males but calms females. Physiol. Behav.

58, 1085–1089. Bruchas, M.R., Land, B.B., Chavkin, C., 2010. The

dynorphin/kappa opioid system as a modulator of stress-

induced and pro-addic-tive behaviors. Brain Res. 1314, 44–55. Bruchas, M.R., Schindler, A.G., Shankar, H., Messinger, D.I., Miy-

atake, M., Land, B.B., Lemos, J.C., Hagan, C.E., Neumaier, J.F.,

Quintana, A., Palmiter, R.D., Chavkin, C., 2011. Selective p38α

MAPK deletion in serotonergic neurons produces stress resilience in

models of depression and addiction. Neuron 71, 498–511. Buisman-Pijlman, F.T.A., Broadbear, J.H., Sarnyai, Z., 2014.

Guest editorial. Pharmacol. Biochem. Behav. 119, 1–2. Burke, A.R., Miczek, K.A., 2015. Escalation of cocaine self-

adminis-tration in adulthood after social defeat of adolescent

rats: role of social experience and adaptive coping behavior.

Psychophar-macology 232, 3067–3079. Butelman, E.R., Yuferov, V., Kreek, M.J., 2012. κ -opioid recep-

tor/dynorphin system: genetic and pharmacotherapeutic

impli-cations for addiction. Trends Neurosci. 35, 587–596. Buwalda, B., Geerdink, M., Vidal, J., Koolhaas, J.M., 2011. Social

behavior and social stress in adolescence: a focus on animal

models. Neurosci. Biobehav. Rev. 35, 1713–1721. Cacioppo, J.T., Hawkley, L.C., 2009. Perceived social isolation

and cognition. Trends Cogn. Sci. 13, 447–454. Cadet, J.L., 2016. Epigenetics of Stress, Addiction, and Resilience:

therapeutic Implications. Mol. Neurobiol. 53, 545–560. Calcagnetti, D.J., Schechter, M.D., 1992. Place conditioning

reveals the rewarding aspect of social interaction in juvenile

rats. Phys-iol. Behav. 51, 667–672. Castro, D.C., Berridge, K.C., 2014. Opioid hedonic hotspot in nu-

cleus accumbens shell: mu, delta, and kappa maps for

enhance-ment of sweetness “liking” and “wanting”. J.

Neurosci. 34, 4239–4250. Covington, H., Miczek, K., 2001. Repeated social-defeat stress,

co-caine or morphine. Psychopharmacology 158, 388–398. Covington, H.E., Kikusui, T., Goodhue, J., Nikulina, E.M., Ham-

mer, R.P., Miczek, K.A., 2005. Brief social defeat stress: long

lasting effects on cocaine taking during a binge and zif268

mRNA expression in the amygdala and prefrontal cortex.

Neuropsy-chopharmacology 30, 310–321. Covington, H.E., Miczek, K.A., 2005. Intense cocaine self-admin-

istration after episodic social defeat stress, but not after ag-

gressive behavior: dissociation from corticosterone activation.

Psychopharmacology 183, 331–340. Czoty, P., Morgan, D., Shannon, E., Gage, H.D., Nader, M.,

2004a. Characterization of dopamine D1 and D2 recep-tor

function in socially housed cynomolgus monkeys self-

administering cocaine. Psychopharmacology 174, 381–388.

doi:10.1007/s00213-003-1752-z. Czoty, P.W., Gage, H.D., Nader, M.A., 2010. Differences in D2

dopamine receptor availability and reaction to novelty in so-

cially housed male monkeys during abstinence from cocaine.

Psychopharmacology 208, 585–592. Czoty, P.W., Gould, R.W., Gage, H.D., Nader, M.A., 2017. Effects

of social reorganization on dopamine D2/D3 receptor

availability and cocaine self-administration in male

cynomolgus monkeys. Psychopharmacology 234, 2673–2682. Czoty, P.W., McCabe, C., Nader, M.A., 2004b. Assessment of the rel-

ative reinforcing strength of cocaine in socially housed monkeys

using a choice procedure. J Pharmacol. Exp. Ther. 312, 96–102. Das, J.K., Salam, R.A., Arshad, A., Finkelstein, Y., Bhutta, Z.A., 2016.

Interventions for adolescent substance abuse: an overview of

systematic reviews. J. Adolesc. Health 59, S61–S75. Deroche-Gamonet, V., Belin, D., Piazza, P.V., 2004. Evidence for

addiction-like behavior in the rat. Science 305, 1014–1017 (80-). Di Chiara, G., Imperato, A., 1988. Drugs abused by humans pref-

erentially increase synaptic dopamine concentrations in the

mesolimbic system of freely moving rats. Proc. Natl. Acad. Sci. USA 85, 5274–5278.

Dingess, P.M., Deters, M.J., Darling, R.A., Yarborough, E.A.,

Brown, T.E., 2017. A method for evaluating cocaine-induced

so-cial preference in rats. J. Biol. Methods 4, 66. Douglas, L.A., Varlinskaya, E.I., Spear, L.P., 2004. Rewarding

prop-erties of social interactions in adolescent and adult male

and female rats: impact of social versus isolate housing of

subjects and partners. Dev. Psychobiol. 45, 153–162. Einon, D.F., Morgan, M.J., 1977. A critical period for social

isolation in the rat. Dev. Psychobiol. 10, 123–132. El Rawas, R., Klement, S., Kummer, K.K., Fritz, M., Dechant, G.,

Saria, A., Zernig, G., 2012a. Brain regions associated with the

acquisition of conditioned place preference for cocaine vs. so-

cial interaction. Front. Behav. Neurosci. 6, 63. El Rawas, R., Klement, S., Salti, A., Fritz, M., Dechant, G., Saria,

A., Zernig, G., 2012b. Preventive role of social interac-tion for

cocaine conditioned place preference: correlation with

FosB/DeltaFosB and pCREB expression in rat mesocorticolimbic

areas. Front. Behav. Neurosci. 6, 8. El Rawas, R., Saria, A., 2016. The two faces of social interaction

reward in animal models of drug dependence. Neurochem.

Res. 41, 492–499. Enoch, M.-.A., 2006. Genetic and environmental influences on the

development of alcoholism: resilience vs. risk. Ann. N. Y.

Acad. Sci. 1094, 193–201. Fergus, S., Zimmerman, M.A., 2005. Adolescent resilience: a

frame-work for understanding healthy development in the

face of risk. Annu. Rev. Public Health 26, 399–419. Ferrer-Pérez, C., Castro-Zavala, A., MÁ, Luján, Filarowska, J.,

Ballestín, R., Miñarro, J., Valverde, O., Rodríguez-Arias, M.,

2019a. Oxytocin prevents the increase of cocaine-related re-

sponses produced by social defeat. Neuropharmacology 146,

50–64. Ferrer-Pérez, C., Reguilón, M.D., Manzanedo, C., Miñarro, J., Ro-

dríguez-Arias, M., 2019b. Social housing conditions modulate

the long-lasting increase in cocaine reward induced by inter-

mittent social defeat. Front. Behav. Neurosci. 13, 148. Fosnocht, A.Q., Lucerne, K.E., Ellis, A.S., Olimpo, N.A., Briand,

L.A., 2019. Adolescent social isolation increases co-caine

seeking in male and female mice. Behav. Brain Res. 359, 589–

596.

Fritz, M., El Rawas, R., Klement, S., Kummer, K., Mayr, M.J.,

Eggart, V., Salti, A., Bardo, M.T., Saria, A., Zernig, G., 2011a.

Differential effects of accumbens core vs. shell lesions in a rat

concurrent conditioned place preference paradigm for cocaine

vs. social interaction. PLoS One 6, e26761. Fritz, M., El Rawas, R., Salti, A., Klement, S., Bardo, M.T., Kemm-

ler, G., Dechant, G., Saria, A., Zernig, G., 2011b. Reversal of

cocaine-conditioned place preference and mesocorticolimbic

Zif268 expression by social interaction in rats. Addict. Biol. 16,

273–284. Galvan, A., Hare, T., Voss, H., Glover, G., Casey, B.J., 2007. Risk–

taking and the adolescent brain: who is at risk? Dev. Sci. 10,

F8–F14. Gould, R.W., Czoty, P.W., Porrino, L.J., Nader, M.A., 2017. Social

status in monkeys: effects of social confrontation on brain

func-tion and cocaine self-administration.

Neuropsychopharmacology 42, 1093–1102. Grotewold, S.K., Wall, V.L., Goodell, D.J., Hayter, C., Bland,

S.T., 2014. Effects of cocaine combined with a social cue on

condi-tioned place preference and nucleus accumbens

monoamines after isolation rearing in rats.

Psychopharmacology 231, 3041–3053. Han, X., Albrechet-Souza, L., Doyle, M.R., Shimamoto, A., De-

Bold, J.F., Miczek, K.A., 2015. Social stress and escalated drug

self-administration in mice II. Cocaine and dopamine in the nu-

cleus accumbens. Psychopharmacology 232, 1003–1010.







































































https://doi.org/10.1007/s00213-003-1752-z






























































































































Harris, K.S., Smock, S.A., Wilkes, M.T., 2011. Relapse resilience: a

process model of addiction and recovery. J. Fam. Psychother. 22 (3), 265–274.

Higgins, S.T., 1997. The influence of alternative reinforcers on

co-caine use and abuse: a brief review. Pharmacol. Biochem.

Behav. 57, 419–427. Hill, S.Y., Powell, B.J., 1976. Cocaine and morphine self-admin-

istration: effects of differential rearing. Pharmacol. Biochem.

Behav. 5, 701–704. Holly, E.N., Shimamoto, A., DeBold, J.F., Miczek, K.A., 2012. Sex

differences in behavioral and neural cross-sensitization and es-

calated cocaine taking as a result of episodic social defeat

stress in rats. Psychopharmacology 224, 179–188. Howe, A., Smajdor, A., Stöckl, A., 2012. Towards an

understanding of resilience and its relevance to medical

training. Med. Educ. 46, 349–356. Howes, S.R., Dalley, J.W., Morrison, C.H., Robbins, T.W., Everitt,

B.J., 2000. Leftward shift in the acquisition of cocaine self-

administration in isolation-reared rats: relationship to ex-

tracellular levels of dopamine, serotonin and glutamate in the

nucleus accumbens and amygdala-striatal FOS expression. Psy-

chopharmacology 151, 55–63. Hyman, S.E., Malenka, R.C., 2001. Addiction and the brain: the

neu-robiology of compulsion and its persistence. Nat. Rev.

Neurosci. 2, 695–703. Hyman, S.E., Malenka, R.C., Nestler, E.J., 2006. Neural

mechanisms of addiction: the role of reward-related learning

and memory. Annu. Rev. Neurosci. 29, 565–598. Jasinska, A.J., Stein, E.A., Kaiser, J., Naumer, M.J., Yalachkov,

Y., 2014. Factors modulating neural reactivity to drug cues in

addic-tion: a survey of human neuroimaging studies. Neurosci.

Biobe-hav. Rev. 38, 1–16. Jupp, B., Murray, J.E., Jordan, E.R., Xia, J., Fluharty, M.,

Shrestha, S., Robbins, T.W., Dalley, J.W., 2016. Social domi-

nance in rats: effects on cocaine self-administration, novelty

reactivity and dopamine receptor binding and content in the

striatum. Psychopharmacology 233, 579–589. Kabbaj, M., Norton, C.S., Kollack-Walker, S., Watson, S.J., Robin-son,

T.E., Akil, H., 2001. Social defeat alters the acquisition of cocaine

self-administration in rats: role of individual differences in

cocaine-taking behavior. Psychopharmacology 158, 382–387. Kamakura, R., Kovalainen, M., Leppäluoto, J., Herzig, K.-.H.,

Mäkelä, K.A., 2016. The effects of group and single housing

and automated animal monitoring on urinary corticosterone

levels in male C57BL/6 mice. Physiol. Rep. 4, e12703. Karelina, K., DeVries, A.C., 2011. Modeling social influences on

hu-man health. Psychosom. Med. 73, 67–74. Kasanetz, F., Deroche-Gamonet, V., Berson, N., Balado, E.,

Lafour-cade, M., Manzoni, O., Piazza, P.V., 2010. Transition to

addiction is associated with a persistent impairment in

synaptic plasticity. Science 328, 1709–1712. Koob, G.F., Le Moal, M., 1997. Drug abuse: hedonic homeostatic

dysregulation. Science 278, 52–58 (80-). Kosten, T.A., Miserendino, M.J.D., Haile, C.N., DeCaprio, J.L.,

Jat-low, P.I., Nestler, E.J., 1997. Acquisition and maintenance

of in-travenous cocaine self-administration in Lewis and

Fischer in-bred rat strains. Brain Res. 778, 418–429. Kreek, M.J., Nielsen, D.A., Butelman, E.R., LaForge, K.S., 2005.

Genetic influences on impulsivity, risk taking, stress

responsivity and vulnerability to drug abuse and addiction.

Nat. Neurosci. 8, 1450–1457. Krishnan, V., et al., 2007. Molecular adaptations underlying

suscep-tibility and resistance to social defeat in brain reward

regions. Cell 131, 391–404. Krishnan, V., Graham, A., Mazei-Robison, M.S., Lagace, D.C., Kim, K.-

.S., Birnbaum, S., Eisch, A.J., Han, P.-.L., Storm, D.R., Zachariou,

V., Nestler, E.J., 2008. Calcium-sensitive adenylyl cyclases in

depression and anxiety: behavioral and biochemi-

cal consequences of isoform targeting. Biol. Psychiatry 64,

336– 343. Kummer, K., Klement, S., Eggart, V., Mayr, M.J., Saria, A.,

Zernig, G., 2011. Conditioned place preference for social

inter-action in rats: contribution of sensory components.

Front. Be-hav. Neurosci. 5, 80. Kummer, K.K., Hofhansel, L., Barwitz, C.M., Schardl, A., Prast,

J.M., Salti, A., El Rawas, R., Zernig, G., 2014. Differences in

social interaction- vs. cocaine reward in mouse vs. rat. Front.

Behav. Neurosci. 8, 363. Lee, Y.-.A., Obora, T., Bondonny, L., Toniolo, A., Mivielle, J., Ya-

maguchi, Y., Kato, A., Takita, M., Goto, Y., 2018. The effects

of housing density on social interactions and their correlations

with serotonin in rodents and primates. Sci. Rep. 8, 3497. Lemos, C., Salti, A., Amaral, I.M., Fontebasso, V., Singewald, N.,

Dechant , G., Hofer, A., El Rawas, R., 2020. Social Interac-tion

Reward in Rats Has Anti-Stress Effects. Addiction Biology

(e12878) doi:10.1111/adb.12878. Leonard, M.Z., DeBold, J.F., Miczek, K.A., 2017. Escalated

cocaine “binges” in rats: enduring effects of social defeat

stress or in-tra-VTA CRF. Psychopharmacology 234, 2823–2836. Leyton, M., Boileau, I., Benkelfat, C., Diksic, M., Baker, G.,

Dagher, A., 2002. Amphetamine-induced increases in extra-

cellular dopamine, drug wanting, and novelty seeking: a

PET/[11C]raclopride study in healthy men. Neuropsychophar-

macology 27, 1027–1035. Lorsch, Z.S., et al., 2018. Estrogen receptor α drives pro-resilient

transcription in mouse models of depression. Nat. Commun. 9,

1116. Luthar, S.S., Cicchetti, D., Becker, B., 2000. The construct of re-

silience: a critical evaluation and guidelines for future work.

Child Dev. 71, 543–562. Masten, A., Barnes, A., 2018. Resilience in children:

developmental perspectives. Children 5, 98. McLaughlin, J.P., Li, S., Valdez, J., Chavkin, T.A., Chavkin, C.,

2006. Social defeat stress-induced behavioral responses are

mediated by the endogenous kappa opioid system.

Neuropsychopharma-cology 31, 1241–1248. Miczek, K.A., Nikulina, E.M., Shimamoto, A., Covington, H.E.,

2011. Escalated or suppressed cocaine reward, tegmental

BDNF, and accumbal dopamine caused by episodic versus

continuous social stress in rats. J. Neurosci. 31, 9848–9857. Montagud-Romero, S., Aguilar, M.A., Maldonado, C., Man-zanedo,

C., Miñarro, J., Rodríguez-Arias, M., 2015. Acute social defeat

stress increases the conditioned rewarding effects of co-caine

in adult but not in adolescent mice. Pharmacol. Biochem.

Behav. 135, 1–12.

Morgan, D., Grant, K.A., Gage, H.D., Mach, R.H., Kaplan, J.R.,

Prioleau, O., Nader, S.H., Buchheimer, N., Ehrenkaufer, R.L.,

Nader, M.A., 2002. Social dominance in monkeys: dopamine D2

receptors and cocaine self-administration. Nat. Neurosci. 5,

169–174. Morrow, J.D., Flagel, S.B., 2016. Neuroscience of resilience and

vul-nerability for addiction medicine. Prog. Brain Res. 233, 3–

18. doi:10.1016/bs.pbr.2015.09.004. Morse, A.C., Gene Erwin, V., Jones, B.C., 1993. Strain and

housing affect cocaine self-selection and open-field locomotor

activity in mice. Pharmacol. Biochem. Behav. 45, 905–912. Nader, J., Chauvet, C., Claudia, C., El, Rawas R, Favot, L., Jaber,

M., Thiriet, N., Solinas, M., 2012a. Loss of environmental

enrichment increases vulnerability to cocaine addiction. Neu-

ropsychopharmacology 37, 1579–1587. Nader, M.A., Czoty, P.W., Gould, R.W., Riddick, N.V., 2008.

Positron emission tomography imaging studies of dopamine

receptors in primate models of addiction. Philos. Trans. R.

Soc. B Biol. Sci. 363, 3223–3232. Nader, M.A., Nader, S.H., Czoty, P.W., Riddick, N.V., Gage, H.D.,

Gould, R.W., Blaylock, B.L., Kaplan, J.R., Garg, P.K.,
































































































































https://doi.org/10.1111/adb.12878




















































https://doi.org/10.1016/bs.pbr.2015.09.004
























Davies, H.M.L., Morton, D., Garg, S., Reboussin, B.A., 2012b.

Social dominance in female monkeys: dopamine receptor func-

tion and cocaine reinforcement. Biol. Psychiatry 72, 414– 421.

Neisewander, J.L., Peartree, N.A., Pentkowski, N.S., 2012. Emo-

tional valence and context of social influences on drug abuse-

re-lated behavior in animal models of social stress and

prosocial interaction. Psychopharmacology 224, 33–56. Newman, E.L., Leonard, M.Z., Arena, D.T., de Almeida, R.M.M.,

Miczek, K.A., 2018. Social defeat stress and escalation of co-

caine and alcohol consumption: focus on CRF. Neurobiol.

Stress 9, 151–165. Peartree, N.A., Hood, L.E., Thiel, K.J., Sanabria, F., Pen-tkowski,

N.S., Chandler, K.N., Neisewander, J.L., 2012. Limited

physical contact through a mesh barrier is sufficient for social

reward-conditioned place preference in adolescent male rats.

Physiol. Behav. 105, 749–756. Peitz, G.W., Strickland, J.C., Pitts, E.G., Foley, M., Tonidandel,

S., Smith, M.A., 2013. Peer influences on drug self-

administration. Behav. Pharmacol. 24, 114–123. Phillips, G.D., Howes, S.R., Whitelaw, R.B., Wilkinson, L.S., Rob-

bins, T.W., Everitt, B.J., 1994. Isolation rearing enhances the

locomotor response to cocaine and a novel environment, but

impairs the intravenous self-administration of cocaine. Psy-

chopharmacology 115, 407–418. Piazza P, V., Le Moal, M., 1998. The role of stress in drug self-ad-

ministration. Trends Pharmacol. Sci. 19, 67–74. Pinheiro, B.S., Seidl, S.S., Habazettl, E., Gruber, B.E., Bregolin,

T., Zernig, G., 2016. Dyadic social interaction of C57BL/6 mice

versus interaction with a toy mouse. Behav. Pharmacol. 27,

279–288. Puglisi-Allegra, S., Cabib, S., 1997. Psychopharmacology of

dopamine: the contribution of comparative studies in inbred

strains of mice. Prog. Neurobiol. 51, 637–661. Quadros, I.M.H., Miczek, K.A., 2009. Two modes of intense

cocaine bingeing: increased persistence after social defeat

stress and increased rate of intake due to extended access

conditions in rats. Psychopharmacology 206, 109–120. Reichel, C.M., Wilkinson, J.L., Bevins, R.A., 2010. Reference

place conditioning procedure with cocaine: increased

sensitivity for measuring associatively motivated choice

behavior in rats. Be-hav. Pharmacol. 21, 323–331. Ribeiro Do Couto, B., Aguilar, M.A., Lluch, J., Rodríguez-Arias, M.,

Miñarro, J., 2009. Social experiences affect reinstatement of

cocaine-induced place preference in mice.

Psychopharmacology 207, 485–498. Ribeiro Do Couto, B., Aguilar, M.A., Manzanedo, C., Ro-dríguez-

Arias, M., Armario, A., Miñarro, J., 2006. Social stress is as

effective as physical stress in reinstating morphine-induced

place preference in mice. Psychopharmacology 185, 459–470. Rudzinski, K., McDonough, P., Gartner, R., Strike, C., 2017. Is

there room for resilience? A scoping review and critique of

substance use literature and its utilization of the concept of

resilience. Subst. Abuse Treat. Prev. Policy 12, 41. Rutten, B.P.F., Hammels, C., Geschwind, N., Menne-Lothmann,

C., Pishva, E., Schruers, K., van den Hove, D., Kenis, G., van

Os, J., Wichers, M., 2013. Resilience in mental health: linking

psycho-logical and neurobiological perspectives. Acta

Psychiatr. Scand. 128, 3–20. Rutter, M., 2006. Implications of resilience concepts for scientific

understanding. Ann. N. Y. Acad. Sci. 1094, 1–12. Salti, A., Kummer, K.K., Sadangi, C., Dechant, G., Saria, A., El

Rawas, R., 2015. Social interaction reward decreases p38

activa-tion in the nucleus accumbens shell of rats.

Neuropharmacology 99, 510–516. Sampedro-Piquero, P., Ávila-Gámiz, F., Moreno Fernández, R.D.,

Castilla-Ortega, E., Santín, L.J., 2019. The presence of a so-cial

stimulus reduces cocaine-seeking in a place preference con-

ditioning paradigm. J. Psychopharmacol. 33 (12), 1501–1511. doi:10.1177/0269881119874414.

Sarkar, M., Fletcher, D., 2014. Psychological resilience in sport

per-formers: a review of stressors and protective factors. J.

Sports Sci. 32, 1–16. Sarter, M., Bruno, J.P., 2002. Animal models in biological psychiatry.

In: Haenen, D’, H., H.A., den Boer, J.A., Willner, P. (Eds.). In:

Biological Psychiatry, 1. Wiley, Chichester, pp. 37–44. Schenk, S., Hunt, T., Malovechko, R., Robertson, A., Klukowski,

G., Amit, Z., 1986. Differential effects of isolation housing on

the conditioned place preference produced by cocaine and

am-phetamine. Pharmacol. Biochem. Behav. 24, 1793–1796. Schenk, S., Lacelle, G., Gorman, K., Amit, Z., 1987. Cocaine self--

administration in rats influenced by environmental conditions:

implications for the etiology of drug abuse. Neurosci. Lett. 81,

227–231. Shimamoto, A., Holly, E.N., Boyson, C.O., DeBold, J.F., Miczek,

K.A., 2015. Individual differences in anhedonic and accumbal

dopamine responses to chronic social stress and their link to

cocaine self-administration in female rats.

Psychopharmacology 232, 825–834. Sinha, R., 2001. How does stress increase risk of drug abuse and

relapse? Psychopharmacology 158, 343–359. Smith, M.A., 2012. Peer influences on drug self-administration:

so-cial facilitation and social inhibition of cocaine intake in

male rats. Psychopharmacology 224, 81–90. Smith, M.A., Pitts, E.G., 2014. Social preference and drug self-ad-

ministration: a preclinical model of social choice within peer

groups. Drug Alcohol Depend. 135, 140–145. Smith, M.A., Strickland, J.C., Bills, S.E., Lacy, R.T., 2015. The ef-

fects of a shared history of drug exposure on social choice. Be-

hav. Pharmacol. 26, 631–635. Solinas, M., Belujon, P., Fernagut, P.O., Jaber, M., Thiriet, N.,

2019. Dopamine and addiction: what have we learned from 40

years of research. J. Neural. Transm. 126, 481–516. Solinas, M., Thiriet, N., Chauvet, C., Jaber, M., 2010. Prevention

and treatment of drug addiction by environmental enrichment.

Prog. Neurobiol. 92, 572–592. Somalwar, A.R., Choudhary, A.G., Balasubramanian, N.,

Sakharkar, A.J., Subhedar, N.K., Kokare, D.M., 2020. Co-

caine- and amphetamine-regulated transcript peptide

promotes reward seeking behavior in socially isolated rats.

Brain Res. 1728, 146595. Southwick, S.M., Bonanno, G.A., Masten, A.S., Panter-Brick, C.,

Yehuda, R., 2014. Resilience definitions, theory, and chal-

lenges: interdisciplinary perspectives. Eur. J. Psychotraumatol.

5, 25338. Southwick, S.M., Sippel, L., Krystal, J., Charney, D., Mayes, L.,

Pietrzak, R., 2016. Why are some individuals more resilient than

others: the role of social support. World Psychiatry 15, 77–79. Stainton, A., Chisholm, K., Kaiser, N., Rosen, M., Upthegrove, R.,

Ruhrmann, S., Wood, S.J., 2019. Resilience as a multimodal

dy-namic process. Early Interv. Psychiatry 13, 725–732. Swadi, H., 1999. Individual risk factors for adolescent substance

use. Drug Alcohol Depend. 55, 209–224.

Thiel, K.J., Okun, A.C., Neisewander, J.L., 2008. Social reward–

conditioned place preference: a model revealing an

interaction between cocaine and social context rewards in

rats. Drug Alco-hol Depend. 96, 202–212. Thiel, K.J., Sanabria, F., Neisewander, J.L., 2009. Synergistic

inter-action between nicotine and social rewards in adolescent

male rats. Psychopharmacology 204, 391–402. Tidey, J.W., Miczek, K.A., 1996. Social defeat stress selectively

al-ters mesocorticolimbic dopamine release: an in vivo

microdial-ysis study. Brain Res. 721, 140–149. Tidey, J.W., Miczek, K.A., 1997. Acquisition of cocaine self-

admin-istration after social stress: role of accumbens

dopamine. Psy-chopharmacology 130, 203–212.




































































































https://doi.org/10.1177/0269881119874414



































































































Tops, M., Koole, S.L., Ijzerman, H., Buisman-Pijlman, F.T.A.,

2014. Why social attachment and oxytocin protect against

addiction and stress: insights from the dynamics between

ventral and dor-sal corticostriatal systems. Pharmacol.

Biochem. Behav. 119, 39–48. Tornatzky, W., Miczek, K.A., 1993. Long-term impairment of

auto-nomic circadian rhythms after brief intermittent social

stress. Physiol. Behav. 53, 983–993. Tovar-Díaz, J., Pomrenze, M.B., Kan, R., Pahlavan, B., Morikawa,

H., 2018. Cooperative CRF and α1 adrenergic signaling in the

VTA promotes NMDA plasticity and drives social stress

enhancement of cocaine conditioning. Cell Rep. 22, 2756–

2766. Tracy, K., Wallace, S.P., 2016. Benefits of peer support groups in

the treatment of addiction. Subst. Abuse Rehabil. 7, 143– 154. Available at: https://www.dovepress.com/benefits-of-

peer-support-groups-in-the-treatment-of-addiction-peer-

reviewed-article-SAR . Trezza, V., Damsteegt, R., Vanderschuren, L.J.M.J., 2009. Con-

ditioned place preference induced by social play behav-ior:

parametrics, extinction, reinstatement and disruption by

methylphenidate. Eur. Neuropsychopharmacol. 19, 659–669. Trifilieff, P., Martinez, D., 2014. Imaging addiction: D2 receptors

and dopamine signaling in the striatum as biomarkers for

impul-sivity. Neuropharmacology 76, 498–509 Pt B. Ungar, M., 2011. The social ecology of resilience: addressing con-

textual and cultural ambiguity of a nascent construct. Am. J.

Orthopsychiatry 81, 1–17. Valente, T.W., Ritt-Olson, A., Stacy, A., Unger, J.B., Okamoto,

J., Sussman, S., 2007. Peer acceleration: effects of a social

network tailored substance abuse prevention program among

high-risk adolescents. Addiction 102, 1804–1815. Van den Berg, C.L., Pijlman, F.T., Koning, H.A., Diergaarde, L.,

Van Ree, J.M., Spruijt, B.M., 1999. Isolation changes the

incentive value of sucrose and social behaviour in juvenile and

adult rats. Behav. Brain Res. 106, 133–142. van der Veen, R., Piazza, P.V., Deroche-Gamonet, V., 2007.

Gene-environment interactions in vulnerability to cocaine

intra-venous self-administration: a brief social experience

affects in-take in DBA/2J but not in C57BL/6J mice.

Psychopharmacology 193, 179–186. Venniro, M., Zhang, M., Caprioli, D., Hoots, J.K., Golden, S.A.,

Heins, C., Morales, M., Epstein, D.H., Shaham, Y., 2018. Voli-

tional social interaction prevents drug addiction in rat models.

Nat. Neurosci. 21, 1520–1529. Vialou, V., et al., 2010. FosB in brain reward circuits mediates

resilience to stress and antidepressant responses. Nat.

Neurosci. 13, 745–752.

Volkow, N.D., Fowler, J.S., Wang, G.-.J, Hitzemann, R., Lo-gan,

J., Schlyer, D.J., Dewey, S.L., Wolf, A.P., 1993. Decreased

dopamine D2 receptor availability is associated with reduced

frontal metabolism in cocaine abusers. Synapse 14, 169–177.

Volkow, N.D., Michaelides, M., Baler, R., 2019. The neuroscience

of drug reward and addiction. Physiol. Rev. 99, 2115–2140. Volkow, N.D., Wang, G.-.J., Fowler, J.S., Logan, J., Gatley, S.J.,

Hitzemann, R., Chen, A.D., Dewey, S.L., Pappas, N., 1997. De-

creased striatal dopaminergic responsiveness in detoxified co-

caine-dependent subjects. Nature 386, 830–833. Volkow, N.D., Wang, G.J., Fowler, J.S., Logan, J., Gatley, S.J., Gif-

ford, A., Hitzemann, R., Ding, Y.S., Pappas, N., 1999. Prediction

of reinforcing responses to psychostimulants in humans by brain

dopamine D2 receptor levels. Am. J. Psychiatry 156, 1440–1443. Wallace, D.L., Han, M.-.H., Graham, D.L., Green, T.A., Vialou, V.,

Iñiguez, S.D., Cao, J.-.L., Kirk, A., Chakravarty, S., Kumar, A.,

Krishnan, V., Neve, R.L., Cooper, D.C., Bolaños, C.A., Barrot, M.,

McClung, C.A., Nestler, E.J., 2009. CREB regulation of nucleus

accumbens excitability mediates social isolation–induced behav-

ioral deficits. Nat. Neurosci. 12, 200–209. Wang, J., Bastle, R.M., Bass, C.E., Hammer, R.P., Neisewander,

J.L., Nikulina, E.M., 2016. Overexpression of BDNF in the

ventral tegmental area enhances binge cocaine self-

administration in rats exposed to repeated social defeat.

Neuropharmacology 109, 121–130. Watanabe, S., 2011. Drug-social interactions in the reinforcing

property of methamphetamine in mice. Behav. Pharmacol. 22,

203–206. Windle, G., Bennett, K.M., Noyes, J., 2011. A methodological re-

view of resilience measurement scales. Health Qual. Life Out-

comes 9, 8. Ding, Y., Kang, L., Li, B., Ma, L., 2005. Enhanced cocaine self-ad-

ministration in adult rats with adolescent isolation experience.

Pharmacol. Biochem. Behav. 82, 673–677. Yanovich, C., Kirby, M.L., Michaelevski, I., Yadid, G., Pinhasov, A.,

2018. Social rank-associated stress vulnerability predisposes

individuals to cocaine attraction. Sci. Rep. 8, 1759. Yates, J.R., Beckmann, J.S., Meyer, A.C., Bardo, M.T., 2013. Con-

current choice for social interaction and amphetamine using

conditioned place preference in rats: effects of age and

housing condition. Drug Alcohol Depend. 129, 240–246. Zakharova, E., Miller, J., Unterwald, E., Wade, D., Izenwasser,

S., 2009. Social and physical environment alter cocaine

conditioned place preference and dopaminergic markers in

adolescent male rats. Neuroscience 163, 890–897. Zernig, G., Ahmed, S.H., Cardinal, R.N., Morgan, D., Acquas, E.,

Foltin, R.W., Vezina, P., Negus, S.S., Crespo, J.A., Stöckl, P.,

Grubinger, P., Madlung, E., Haring, C., Kurz, M., Saria, A.,

2007. Explaining the escalation of drug use in substance

dependence: models and appropriate animal laboratory tests.

Pharmacology 80, 65–119.



























https://www.dovepress.com/benefits-of-peer-support-groups-in-the-treatment-of-addiction-peer-reviewed-article-SAR






























































































































Basic Research Journal of Education Research and Review ISSN 2315-6872 Vol. 3(4) pp. 35-44 June 2014 Available online http//www.basicresearchjournals.org Copyright ©2014 Basic Research Journal

Case Report

Adolescent resilience, social support and drug abuse a case of Koboko District, West Nile, Uganda

Amandru S. W1, Bantu, E

2, Mwebi, B

2, OKwara, M

2, Onderi, H*

2

1Makerere University, Uganda.

2Jaramogi Oginga Odinga University of Science and Technology, Kenya.

*Corresponding author: E-mail: [email protected]

Accepted 27 June, 2014

ABSTRACT

The study investigated the relationship between social support, resilience and drug abuse. A correlation research

design was used, and adolescents between the age group of 14-23 years in four secondary schools in Koboko Town

Council were randomly selected using a simple random sampling technique and 50 respondents were selected from

each school bringing the total to 200 respondents. A three set structured questionnaire which measured adolescent

resilience, social support and drug abuse was used to find out the relationship between the variables. The study

findings showed a significant positive relationship between social support and resilience r = -.157; p = .029. Since the

p value (.029) is smaller than the level of significance (.05), the hypothesis was retained; and found no relationship

between social support and drug abuse r = .045; p = .303. Since the p value (.303) is greater than the level of

significance (.05), the hypothesis was rejected; and no relationship between resilience and drug abuse r = .068; p =

.223. Since the p value (.223) is greater than the level of significance (.05), the hypothesis was rejected. These

findings led into conclusions that other factors apart from social support and resilience are believed to play a major

role in adolescent drug abuse. It was therefore recommended that issues of adolescent development can and should

be considered when designing and implementing preventive drug education programs.

Keywords: Resilience, Social Support, Drug Abuse, Koboko Diatrict, West Nile, Uganda

INTRODUCTION

Drug abuse has been with us for some time and it is one of the biggest causes of morbidity and mortality among adolescents in Uganda. It is estimated that five percent of Ugandans are dependant on drugs with over 68 percent being secondary students from senior five and senior three (Kamugisha, 1998). Drugs refer to both prescribed and non-prescribed chemical substances. Abused drugs include narcotic pain medications, marijuana, heroine, cocaine, sedatives, stimulants and drugs that cause hallucinations. The effects of these drugs on the adolescents are many and among others include: disorientation of the mind, stealing, lack of respect for

authority, idleness early teenage pregnancy, and school drop out. The situation of drug abuse has continued to increase with serious abuse of illicit drugs such as herbal cannabis, heroin, methaqualone, and recently khat (Uganda: Country Profile, n.d.).

Despite the obvious threats from use of illicit drugs to global health, many governments particularly the developing countries, Uganda inclusive, have not taken significant action to reduce its toll. Though Uganda has voiced concern over the increasing rate of drug abuse, it has been observed that there is reluctance to put in place stringent drug control measures and regulations to track

Published by Basic Research Journal of Education Research and Review

the culprits. This is evidenced by the presence of illicit cultivation of plants, which are prominent in the remote areas of western, central and northern regions of the country, and the scale and consumption of illicit drugs in public places without restriction, and most of the drug abusers in the rural settings are the adolescents.

A drug abuser is a person who uses illegal drugs in a manner that conflicts with the direction given by a physician or not. (United Nations Office on Drugs and Crime, as cited in Uganda: Country Profile, n.d). This is because the scale of the threat is underestimated due to limited research about drug abuse (Mpabulungi, 2003).

Adolescence is a period of physical and psychological development from the onset of puberty to maturity and in terms of age it is the period between the ages of 13-23years.It is also a period marked by the desire to experiment new things in life including drug abuse.

Peer influence is also found to be one of the biggest factors in adolescent development. In a situation where parents are unable to exercise their authority, adolescents are more likely to become peer oriented (Kobasa, 1979). The desire to be like other peers in terms of interest, attitudes and values leaves the adolescents with little decisions to resist drug abuse. Adolescents in Uganda experience an overwhelming amount of loss and stress as a result of wars, death and even alcohol and drug abuse. Despite these adversities, many children display incredible resilience (Eggun and Vaughan, 1997).

Resilience describes the characteristics of those who adapt relatively well despite challenging circumstances. Adolescents who are less resilient may dwell on problems, feel victimized, become overwhelmed and turn to unhealthy coping mechanisms such as substance abuse, whereas resilient adolescents tend to possess certain characteristics such as problem solving skills and a realistic sense of personal control, which are known to prevent them from drug abuse (Thomsen, 2002).

In general, the more social support one can draw upon from family and friends, the more flexible and resilient one can be in stressful situations. Social support is the physical and emotional comfort given to us by our families and peers. It is a way of knowing that we are part of a community of people who love and care for us. Lack of social support can make one feel insecure or rejected, and can increase vulnerability to outside influences (Dolbier and Steinhard, as cited in Straughan, 1989).

Purpose

The study investigated the relationship between social support, resilience and drug abuse.

Onderi et al. 36

Objectives

The objectives of the study found out: 1. The relationship between social support and resilience. 2. The relationship between social support and drug abuse 3. The relationship between resilience and drug abuse.

Scope

Geographically, the study was restricted to rural adolescents living in Koboko District in northern Uganda. Koboko in particular was chosen because the Criminal Investigation Department hosts an anti narcotics unit, stationed at ten of the major border points in Uganda, and Koboko is one of the points that borders Congo and Sudan (Uganda: Country Profile, n.d). This gives a clear picture that uses of illegal drugs do exist at this border point. Reports from the Criminal Investigation Department Koboko (2006) revealed that out of every ten criminal cases report weekly at the police station, four of the cases were usually drug abuse related.

Conceptually, the study was limited to social support, resilience, and drug abuse. Social support considered the four functional support systems, namely informational support, tangible support, affectionate support and positive social interaction (Sherbourne and Stewart, 1991). Resilience was restricted to external resources, protective factors and risk factors, internal personal strengths, interpersonal relationships and social skills (Grotberg, 1995). Drug abuse considered individuals’ use of drugs for other purposes other than those required for medical purposes. The amount taken, effects felt and the feelings they have about drug abuse was considered.

Conceptual Framework

Figure 1 depicts the possible relationship between the independent variables and the dependent variable. Social support and resilience are the independent variables while drug abuse is the dependent variable.

From Figure 1, resilience is looked at as a strength that can assist people in positive life adaptation (Masten and Reed, 2005). Resilient individuals can withstand life’s challenges and resist the influence to abuse drugs. With positive support, they can develop a greater internal locus of control and optimism about their ability to create positive outcomes for themselves and others while resisting unhealthy life’s challenges including drug abuse. Resilient individuals are known to have internal


37. Basic Res. J. Educ. Res. Rev.

Figure 1. Relationship between adolescent resilience, social support and drug abuse.

Resilience

Drug abuse

Social support

resources, which describe them as friendly and easily able to seek social support from others. On the other hand, adolescents may distance themselves from others, fail to seek social support and turn to drug abuse as a way of solving their problems. With positive social support, an individual’s overall resilience is enhanced.

Hypotheses

The study tested the hypotheses that: 1. There is a positive relationship between social support and resilience 2. There is a negative relationship between social support and drug abuse 3. There is a negative relationship between resilience and drug abuse

METHODOLOGY

This chapter looked at the research design, study population, sampling strategy, procedure, instruments, and analysis.

Research design

The research under study was quantitative in nature and a correlational research design; in particular the spearman’s rank order correlation was used. A correlation was used because it is a suitable method in finding out any relationship between variables.

Study population

The study considered secondary school adolescents living in Koboko Town Council. This group was chosen because it was easily reached. According to weekly reports from the Criminal Investigations Department Koboko District (2006), out of every ten cases that are drug related, four are secondary school students. Koboko Town Council is located along the high way leading to Sudan and other links to Congo where major entertainment and commercial activities, both legal and illegal, including selling of drugs, takes place in the open markets, making it easy for students to access. The study

did not consider nationality and religious background, but it considered age and sex of the respondents.

Sampling strategy

There were approximately ten secondary schools in Koboko Town Council and from these schools, four were selected using a simple random sampling technique in which names of all the secondary schools in the town council were written on pieces of paper and every even number was picked until the four schools were got. From the four selected schools, a class was selected using a simple random sampling technique where the classes in the schools were written on pieces of paper and shaken in a bowl and a class drawn. Since the classes had more than 100 students, the researcher used the class register to selected 50 students from each class using a simple random sampling technique in which every even number was picked until the 50 respondents were got. This was done in the rest of the schools until the target sample of 200 students was met.

Instruments

A questionnaire was used for this study. It consisted of three sections which measured social support, resilience, and drug abuse. No back translation was needed because respondents were expected to speak English.

Resilience scale

The researcher used the 25-item Resilience Scale (RS) that measures the degree of an individuals resilience, which is considered a positively personality characteristic that enhances individual adaptation. All items were positively worded and accurately reflect the verbatim statements made by participants in the initial study on resilience conducted by Wagnild and Young (1993). The scale has a reliability coefficient alpha of .83, indicating that the scale is sufficiently reliable (Neill ND Dias, 2001).

Originally, the scale was worded on a seven-point scale from 1 “strongly disagree” to 7 “strongly agree”, with possible scores ranging from 25 to 175 and higher scores reflecting higher resilience. However, the researcher adopted the typical Likert scale that allows for five


responses, ranging from 1 “strongly disagree” to 5 “strongly agree”. This is because of concern that the respondents are rural adolescents from poor educational background who might get confused with the many options, and in the end find it difficult to make fewer distinctions or an appropriate choice. It is also supported by the fact that the typical Likert scale does not allow for more than five responses. Respondents will be asked to circle the number which best indicates their feelings about each statement. Possible scores ranged from 25 to 125, with higher scores reflecting higher resilience (see Appendix C).

Social support scale

The Social Support Scale is a brief multidimensional, self-administered questionnaire, comprised of four functional support scales (emotional, affectionate, tangible and positive social interaction) and an overall functional social support index. The scale is reliable (all alpha > 0.91) and fairly stable over time (Sherbourne and Stewart, 1991). The four functional support scales consist of 18 items. However, the general scale has 19 items (one additional item inclusive). All items are positively worded with scale scores ranging from 19-95. Higher scores indicate more support.

To obtain a score for each subscale, the average of the scores for each item in the subscale is calculated. To obtain an overall social support index, the averages of all the scores for all the 19 items are calculated. Responses are coded on a five-point scale ranging from 1 “None of the time’’ to 5 “All of the time” (see Appendix C).

Drug abuse scale

The Drug Abuse Screening Test (DAST) is a self-report 20-item questionnaire designed for population screening, clinical case finding and treatment evaluation research. The DAST yields a quantitative index of the degree of consequences related to drug abuse. The instrument takes approximately five minutes to administer. Alpha reliability was extremely high at .95 (Skinner, 1982). The DAST score is computed by summing all items that are endorsed in the direction of increased drug abuse problems. Two items: number 4 (I can get through the week without using drugs) and number 5 (I am always able to stop using drugs when I want to) are keyed for a “disagree” response. The other remaining 18 items are keyed for “agree” response. For example, if a respondent circled “agree” for item 1, he/she would receive a score of 1, whereas a respondent who circled “disagree” for item 1 would receive a zero score. With items 4 and 5, a score of 1 would be given for a “disagree” response and a score of 0 for “agree” response. When each item has been scored in this fashion, the DAST total score is

Onderi et al. 38

simply the sum of the 20 item scores. The total score ranged from 0 to 20 with higher score indicating substantial drug abuse (see Appendix C, Section D).

Reliability and validity

A pilot study was conducted to determine the reliability of the scales. In Midia Sub-county in Koboko District, the three scales (social support, resilience and drug abuse) were administered to 20 respondents who were known to be similar in characteristics to the population under study. These students were selected from one secondary school that was randomly selected using a simple random technique. Cronbach’s alpha coefficient was use to determine each scale’s reliabilities. The scores were (.87) for social support, (.85) for resilience and (.90) for drug abuse and since the reliabilities for the scales were .70 and above, they were considered to be reliable for the study.

Procedure

The researcher had two days to visit each selected school. On the first day, administrators were informed that their schools were chosen randomly for the study and their permission was sought to carry out the research. The class from which the study was conducted was also made known to them for purposes of prior arrangement.

On the second day, the researcher reported to the school administration and proceeded to the chosen class with the help of a class teacher who introduced the researcher to the class. The researcher then briefed the classes about the whole purpose of the exercise and sought their consent in participating before distributing the questionnaire to all the students found in that class. Participants were asked to read the instructions carefully and reminded that it was not an examination and therefore there were no wrong or right answers. They were told not to write their names anywhere on the questionnaire for purposes of protecting their identity or maintaining confidentiality. They were also urged to feel free to give their responses by answering to all questions without skipping any number.

The whole exercise was done in 25 minutes. The researcher collected the questionnaires and thanked the respondents for participating in the exercise. The same procedure was applied to the other selected schools.

Data Analysis

The data was edited, coded and analyzed using SPSS. Descriptive statistics were employed. Frequencies and percentages of respondents were computed. The first,



Table 1. Sex of the Respondents

Item Responses Frequency Percentage

Sex Female 92 46.0

Male 108 54.0

Total 200 100.0

Table 2. Age of the Respondents

Item Responses Frequency percentage

Age 14-15 yrs 20 10.0

16-17 yrs 76 38.0

18-19 yrs 98 49.0

20-23 yrs 6 3.0

Total 200 100.0

Table 3. Social support and Resilience

Spearman’s (rho) Total resilience

Total Social support Correlation coefficient -.157 Significance (1-tailed) .029 N 200

and third hypotheses were analyzed by the use of Spearman’s rank order correlation coefficient. This was because resilience, social support, and drug abuse consisted of data that are ordinal in nature.

RESULTS

This chapter presents results of the data that was coded and analyzed using SPSS. The purpose of the study was to test the hypotheses under study and present findings. A correlational research design was used and the statistics used to test the hypotheses was the Spearman’s rank order correlation coefficient. Frequencies and percentages of the respondents’ bio-data were also presented.

Table 1 shows males as the majority with 54 percent compared to their female counterparts who comprised 46 percent.

Table 2 shows that majority of the respondents were within the age bracket of 18-19, followed by 16-17, while the least was 20 years and above. This is in line with the study population that targeted adolescents.

The mean score for resilience

The mean score for adolescents in resilience is 47.0700, with a standard deviation of 14.3817, and a range of 47.

The mean score for Social Support

The mean score for adolescents in Social Support is 38.0400, standard deviation of 10.3883, and a range of 36.

The mean score for drug abuse

The mean score for adolescents in drug abuse is 38.7600, standard deviation of 11.1529, and a range of 35.

Hypothesis testing

Research hypotheses one to three were tested using the Spearman’s rank order correlation coefficient in order to establish the significance of the relationship between variables whose scales have ordinal properties.

Testing hypothesis one

The first hypothesis stated that “There is a positive relationship between social support and resilience”. Spearman’s rank order correlation coefficient was used to test the hypothesis in order to establish the relationship between variables. The results in Table 3 show a significant positive relationship between social support


Onderi et al. 40

Table 4. Social support and Drug Abuse

Spearman’s (rho) Total drug abuse

Total Social support Correlation coefficient .045 Significance (1-tailed) .303

N 200

Table 5. Resilience and Drug Abuse

Spearman’s (rho) Total drug abuse

Total resilience Correlation coefficient .068 Significance (1-tailed) .223 N 200

and resilience (r = -.157; p = .029). Since the p value (.029) is smaller than the level of significance (.05), the hypothesis is retained and it is concluded that there is a significant positive relationship between social support and resilience. This means when individuals’ social support is high, their resilience is high.

Testing hypothesis two

The second hypothesis stated that “There is a negative relationship between social support and drug abuse”. Spearman’s rank order correlation coefficient was used to test the hypothesis in order to establish the relationship between variables. The results in Table 4 show no significant relationship between social support and drug abuse (r = .045; p = .303). Since the p value (.303) is greater than the level of significance (.05), the hypothesis is rejected and it is concluded that there is no significant relationship between social support and drug abuse.

Testing hypothesis three

The third hypothesis stated that “There is a negative relationship between resilience and drug abuse”. Spearman’s rank order correlation coefficient was used to test the hypothesis in order to establish the significance of the relationship between variables. Findings in Table 5 show no significant relationship between resilience and drug abuse (r = .068; p = .223). Since the p value (.223) is greater than the level of significance (.05), the hypothesis is rejected and it is concluded that there is no significant relationship between resilience and drug abuse.

Limitations

The following limitations were sighted in the study There was administrative interference during the study

process and this posed a threat and fear in the students which the researcher believed have influenced the results significantly. However, the researcher addressed it by assuring confidentiality of the results since no names were required, and that findings are strictly for academic purposes. Nevertheless, once harm done, it is not easy to undo.

Generally there was a sense of discomfort and uneasiness manifested by some of the respondents particularly when filling the drug abuse questionnaire. It is feared that the section was not answered truthfully hence affecting the results significantly.

Other limitations could be attributed to biases in the respondents towards sensitive areas and in this case the drug abuse questionnaire as they try to figure out the purpose of the study. They might have chosen to be uncooperative in fear of being scrutinized. This could be true as Lippa(1994) examined that when subjects possess strong characteristics that are silent cues that inappropriately suggest how subjects should behave, subject bias is likely to crop in.

DISCUSSION, CONCLUSION AND RECOMMENDATIONS

This chapter presents discussion, conclusion and recommendations from the study findings. Both boys and girls within the age bracket of 14 through 23 years were considered. Social support, resilience and drug abuse were the variables under study, with social support and resilience as the independent variables and drug abuse as the dependent variable. Hypotheses were formulated for each variable and results presented.

Discussion of Results

The research investigated three hypotheses and findings from the study indicated that hypotheses one was retained, while hypotheses two and three were rejected.



Social support and resilience

Hypothesis one stated that “There was a positive relationship between social support and resilience”. The study findings indicated a significant positive relationship between social support and resilience. However, it should be noted that the relationship between social support and resilience indicated that the results show a true effect of the relationship between the variables and it is unlikely that they may simply be due to chance. The findings did agree with previous studies which portrayed that warmth in the parent-child relationship is related to positive outcomes for children (Kamuhanda, 1999). In a similar study, social support has also been clearly identified as a critical aspect in positive outcomes for the youth and a factor in promoting resilience (Werner and Smith, 1982). This trend is attributed to the powerful positive influences that parents and peers have in the lives of adolescents.

Peers have a strong influence on the development of any child (Capella and Weinstein, 2001). Natural observations and personal experience indicate that most adolescents discuss issues openly with their fellow peers, especially if there is a warm relationship between them (Night, 2008). Peer interactions that are not positive result into rejection, alienation and loss of self esteem. If this occurs in early adolescence, it can result in low resilience in adolescents (Hawkins, 1992).

The desire to know and learn from others helps adolescents to discover new ways of handling issues in life, which could have contributed to the outcome of the results. This is supported by researchers like Bowlby (1988), who found out that the ability to think abstractly and use complex reasoning may lead adolescents to practice these new decision- making skills with the peers. With this in mind, one can conclude that peer support may be substantial in building adolescent resilience.

Although the importance of peer group is well recognized, the nature of the peer group is important. Peer influence may be even more powerful in situations where the adolescent receives little or no social support. In instances like these, the peer group may make up for the lack of other forms of support, including family support. But if the adolescent does not experience a sense of belonging, acceptance, and is unable to forge an identity and absorb certain values through the peer group, then they develop non-resilient qualities which are prone to influences of drug use and abuse (Donald et al., as cited in Smith, Capella and Weinsten 2001).

Social support and drug abuse

The second hypothesis stated that “There is a negative relationship between social support and drug abuse”. Results did not support the hypothesis, which is in line with previous research findings.

Rutter (1985) stated that individuals who get positive

social support from peers and families are less likely to abuse drugs. Those who do not get any positive social support from peers and families may compromise their capacities to learn to behave in healthy situations and may feel comfortable with their peers who hold similar interest, luring them into drug abuse.

The researcher attributed the findings that indicated no relationship between social support and drug abuse to many factors and among these could be fear of acceptance, which could have played a major role in determining the outcome of the results. The researcher based this on the fact that drug abuse is illegal in Uganda. Most adolescents either use them stubbornly or without knowing the negative effects on their health; more so, they maybe enjoying benefits of drug abuse like maintaining a group of friends.

Respondents could have decided not to cooperate and rejected the fact that they have or were once involved in drug abuse. Therefore acceptance and or acknowledging drug abuse may result into punishment by authority figures, rejection, or loss of friends. This is in agreement with Hawkins (1992) who portrayed that adolescent’s affiliation with friends who hold similar views, interests and attitudes are substantially associated with adolescent drug abuse.

Most of the adolescents may be casual or occasional users of drugs not abusers. Hence their understanding of abuse may influence their answers on questionnaire. This may be supported by the fact that knowledge of drugs of abuse among communities in West Nile and particular Koboko is limited, and there may be limited information on what is termed as abuse of certain types of drugs. This is supported by Mpabulungi (2003) who acknowledged that the scale of the threat of drug abuse in Uganda is being underestimated due to limited research (Another difference in the results maybe attributed to attitudes of the students towards drug abuse. This is simply because adolescents may know that they are abusing drugs, but they may not care of the consequences on them, and or may further be enjoying the mood-elevating effects. The Awake Magazine (2001) revealed that negative signs of drugs abuse in adolescents do not just seem to scare them. They tend to have an “it won’t happen to me” attitude. They are full of vitality that they do believe that their health will not be affected. This feeling of invulnerability is very common in adolescence (Hawkins, 1982). Many are simply unaware of the dangers, and others think it happens to older people, not to them.

A similar study compared alcohol-related attitude scores with the drinking pattern of 3,568 Pennsylvania adolescents. Not surprisingly, attitudes towards drinking were closely related with actual use pattern. Abstainers were mostly negative in their attitudes towards drinking (Brown and Skittington, 1987).

This is further supported by findings from WHO (2000), which indicated that adolescents tend to be risk takers as


they feel invulnerable and experience stress associated with their transition into adulthood, which is a time in adolescence when most substance use is initiated. This perspective recognizes the fact that as children reach early adolescence, they experience increased vulnerability, invulnerability and morbidity. They also experiment with potential lifestyles, and seek independence (often in the form of rebellion) from adult authority figures. This may not be surprising in that an adolescent’s decision to use drugs probably depends on his or her attitude towards that particular drug.

The Kakwa and Lugbara culture do not seem to stop young men from smoking or drinking alcohol. It is considered manly and a sign that one is independent. This is in line Peterson and Leigh (1990), who acknowledged the role of culture, so that drug abuse is not only an individual/ environmental phenomenon but a common value that has been upheld. They argued that values, beliefs, attitudes and everyday practices which are associated with drug abuse are shaped by culture. Once people in the community do it, then it is not a crime for others to try it too.

Resilience and drug abuse

The third hypothesis stated that “There is a negative relationship between resilience and drug abuse”. This is not supported by the study findings that indicated no significant relationship between resilience and drug abuse. This differ from findings reported by Jassor (1978), who portrayed resilience as a behavior that young people exhibit in making their decisions not to use drugs and putting this into practice despite exposure to drugs and other risk factors.

However, this could vary because people can be resilient in some contexts but find difficulties when the context and nature of the risk presented change. Hawkins (1992) supported this idea by saying that adolescents vary in their abilities to manage life’s challenges. While most of them demonstrate sturdiness in the face of adversity, others faced with similar circumstances do not fare well.

Another significant factor that might have affected the outcome of the results could be the self-esteem of the adolescents. This is because most of the respondents looked very shy and uneasy when given the questionnaires to fill. This is supported by the DARE programmme (1994) that asserts that children with low self-esteem are at most risk for drug abuse. In this case, peer influence could have cropped in during the exercise of answering the questionnaires.

Conclusions

Generally, the study revealed a positive relationship

Onderi et al. 42

between social support and resilience. However, it revealed no relationship between social support and drug abuse, and also no relationship between resilience and drug abuse. This means that fostering more positive social support could result in high levels of social support and high levels of resilience and low levels of drug abuse. Hawkins (1992) argued that resilience is not extraordinary but it is present in all human beings. Other factors apart from resilience and social support may play a major role in adolescent drug abuse

Recommendations

This study is an initial step in understanding the nature and levels of social support and resilience in determining the levels of drug abuse among adolescents in Koboko District. Based on the findings, the following recommendations were made to help policy makers, researchers and the community utilize the findings appropriately.

Since social support was found to show a significant positive relationship with resilience. Professionals who assess only for problems within the individual or the family may overlook existing strengths and coping abilities. Therefore institutions such as schools and the community need to be involved in supporting the adolescents so that they can learn to build on their skills to be resilient and emerge even stronger in the absence of social support from peers and families.

As this study did not reveal a significant relationship between social support and drug abuse, Sutherland and Shephard (2001) indicated that young people reported personal problems that put them into further risk of drug abuse. These include problematic family relationships and substance use within the family.

Therefore, programmes that included the presentation of information, value clarification, and assertiveness training could be set up by the district local government with intent to develop behavioral and cognitive competences to help youngsters deal more effectively with adverse social and environmental influences.

The district local government needs to take serious steps to reinforce the earlier on established anti-drug bylaws that are now weak and the punishment not deterrent enough. This could be done by putting an end to drug abuse right from the growers through to consumers by the imposition of fines, trials in court and punishment by the law. The police could also be strengthened to look into the causative factors to crime so that they can find appropriate mechanisms in combating drug-induced crimes and find solutions through counseling rather than punishment and or merely keeping drug abusers away from society.

Civil society organizations, and other stakeholders at District level could come up with projects and programmes that would engage adolescents in more



constructive, healthy and future-oriented activities that would keep them off from more risk factors that would overwhelm and put them to the risk of drug abuse. This could be done by lobbying for policies that included life-skills education to be incorporated into the education curriculum at all levels so that adolescents are well equipped with negotiation and decision-making skills known to protect them from influences to drug abuse.

The Department of Community Services could be strengthened, enabled and proactive on community issues and approaches with special emphasis on drug abuse among adolescents in its programmes. Programs that would incorporate values clarification exercises could help students discuss differences in lifestyles, attitudes, and values. This is in line with Aseltine (1995) who revealed that adolescents often were surprised to find they held values and attitudes different from those of their peers. This learning experience helped them define their identities relative to those of their peers. By being sensitive to these issues, adolescents would learn more about themselves.

Lastly, adolescence is a period of transition often characterized by considerable distress and confusion. Youngsters are confronted with being relatively autonomous, developing stable identities, maintaining positive self-concepts, and establishing diverse interpersonal competencies. At the same time, they are uncertain of their roles and depend heavily on feedback from peers to affirm their evolving identities. Thus these issues of adolescent development can and should be considered when designing and implementing preventive drug education programs.

Areas for further research

Compared to this study, statistics from other literature indicate that almost two-thirds of drugs of abuse come from family members and friends (Ouma, as cited in Aseltine, 1995). This brings the researcher to suggest further investigations into how parenting styles play a role in determining levels of drug abuse among adolescents, particularly in Koboko District, and other areas for comparative purposes. Schneider and Young (1996) investigated parenting in relation to parent-youth relationships and its effect on substance abuse and it was found out that adolescent drug users reported no warm feeling towards parents, while non-abusers considered it more important to get along with parents and perceived parents as role models. By contrast, abusers come from distant parent-child relationship (especially fathers), where parents were cold and not encouraging. Qualitative research could also be considered in finding out an in-depth knowledge of drug use and abuse among adolescents. This could consider their attitudes and values, which could help further in determining levels of drug abuse among adolescents.

The study focused only on adolescents in secondary school. Similar studies could explore the experiences of adolescents out of school.

REFERENCES

Aseltine RH (1995). A reconsideration of parental and peer influence on

adolescent deviance. J. Health and Soc. Behavior, 36, 103-121. Ashby T, Vaughan R (1989). Support and substance use in early

adolescents. J. Behavior Med.12, 413-417. Awake Magazine (2001). Watch Tower Bible and Tract Society of

Pennsylvania, Vol 10, 25-27. Beck AT, Wright FD, Newman CT, Lessie BS (1993). Cognitive therapy

of substance abuse. New York: Guilford. Blum D (1998). Finding strength to overcome anything. Psychology

Today. New York, Sussex Publishers,Retrieved March 16, 2006, from htpp://www.psytoday.com/articles

Bowlby J (1988). A secure base: Parent-child attachment and healthy

human development. New York: Basic Books. Boyden J (2003). Children under fire: Challenging assumptions about

children’s resilience. Children, Youth, and Environments, 13. Spring 2003. Retrieved on August, 23, 2005, from http://colorado.edu/journals/cye

Brooks R (2000). Self-esteem and resilience in children. A parent’s guide to helping kids with learning difficulties. Retrieved on March 16, 2007, from http://www.Schwblearning.org.pdfs

Brown P, Skittington E (1987). Patterns of marijuana and alcohol use

attitudes for Pennsylviania 11th graders. Intern. J. Addict. 22, 567-573. Capella EW, Weinstein RS (2001). Turning point around reading

achievement: Predictors of high school students’ academic resilience. J. Educ. Psychol. 93,758-71.

Clayton R (1992). Transitions in drug use: Risk and protective factors, Washington DC: American Psychological Association.

Criminal Investigations Department (2006). File report, Koboko District, Uganda, Koboko.

Eggun N, Vaughan J (2007). Uganda, Tororo. Retrieved October 29, 2008, from http://www.asunews.asu.educ/20080915_uganda

Gamezy N (1985). Stress-resistant children: The search for protective factors. In J. E. Stevenson (Ed). Recent research in developmental psychopathology. Oxford, Pergamon Press.

Granquist L (1994). More on DARE. Retrieved August 25, 2009, from http://www.soc.libraries.talk.drugs

Gregory AL, Leskin MC (1989). Resilience-recovery factors in post war among female and male Vietnam veterans’ hardness post war social support and additional stressful life events. J. Personality and Soc. Psychol. 74, 420-434.

Grotberg EH (1995). The international resilience project: Promoting resilience in children. Citivan Internal Research Center. Institute for Mental Health Initiatives, Washington, DC Retrieved on January 20, 2007, from http://www.resistant.uiuc.edu

Hawkins JD, Catalano RF, Miller JY (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implication for substance abuse prevention. J. Children in Contemp. Soc. 18, 181-199.

Jassor H (1978). Predictive factors and young adolescents dependency to abstain from alcohol use. A model using two waves of intervention study data. J. Comm. Psychol. 24, 749-770.

Kamugisha A (1998). Press coverage of drug abuse. A case study of the Monitor, New Vision and Crusader (1996-1997). Unpublished dissertation, Makerere University, Kampala, Uganda.

Kamuhanda R (1999). Parental adolescent’s relationship and pre-marital

sex. Un published master’s thesis, Makerere University, Kampala,

Uganda.

Kandel D (1973). Adolescent Marijuana Use: “Role of parent and

peers”. J. Adolesc. 3(181):1067-1068. Kaplan B, Robins C (1984). Pathways to adolescent drug use: Self-

derogation, peer influence, weakening of social controls. J. Health and Soc. Behavior, 25, 270-289.


Kasirye R (2000). Drug and Substance Abuse: A guide for parents and

teachers. Uganda, Kampala. Uganda Development Link (UYDL). Kasirye R (2000). Interface of substance abuse and child prostitution:

Intervening in the lives of slum and street children in Kampala, Uganda Youth Development Link, Uganda, Kampala.

Kobasa S (1979). Stressful life events, personality, and health: An inquiry into hardness. J. personality and soc. Psycho.37, 1-11.

Lippa AR (1994). Introduction to Social Psychology, (2nd ed). Pacific Grove, California, Brooks/cole Publishing Company.

Lirri E, Nafula J (2008, March 27). Realities of war in northern Uganda. The daily Monitor, p. 13.

Mastern A, Reed M (2005). Resilience in development. Handbook of positive psychology. (pp.74-88). Oxford: Oxford University Press.

Mpabulungi L (2003). Parliamentary research service reports on the results of the global youth tobacco survey in Uganda. Retrieved February 19, 2007, from

http://www.cdc.gov/tobacco/global/GYTS/reports/afro/2003/uganda04 .html Neill JT, Dias KL (2001). Adventure education and resilience: The

double-edged sword. Journal of Adventure Education and Outdoor Learning, 1, 35-42.

Newman IM, Ward JM (1989). The influence of parental attitudes and behaviors on early adolescent cigarette smoking. J. School Health, 59, 150-152.

Peterson GW, Leigh GK (1990). The family and social competence in adolescence. In T. Gullotta, G. Adams, & R. Montemayor (Eds.), Developing social competency in adolescence. London: Sage Publications.

Proof M (1990). Changing youth in a changing society. Massachusetts: Harvard University. Cambridge Press.

Rooks K(1990). Social relationships as a source of companionship:

Implication for older adults psychological well-being. New York: Wiley.

Rutter M (1985). Resilience in the face of adversity: Protective factors

and resistance to psychiatric disorders. Bri. J. Psych.147, 598-611.

Onderi et al. 44

Schneider BH, Younger AJ (1996). Adolescent-parent attachment and

adolescents' relations with their peers. J. Youth and Soc. 28, 95-108. Sherbourne CD, Stewart AL (1991). Medical outcomes study: Social

support survey. Social Science and Medicine, 43, 705-714. Retrieved December 12, 2005, from http: www.rand.org/health/survey_tools/mos_socialsupport_sc

Skinner HA (1982). The drug abuse screening test. Centre for addiction and mental health, Canada, Toronto. Retrieved June, December 14, 2006 from http://www.drtepp/pdf/substance_abuse.pdf

Straughan J (1989). It can’t happen to me. A mother’s fight against drug abuse. Cape Town, South Africa: Struik Publishers.

Takala J, Pyynanen OP, Lethovirta E, Turakka H (1993). The relationship between mental health and drug use. J. Psych. Scandinavica, 88, 256-258.

Thomsen K (2002). Building resilient students: Integrating resiliency into what you already know and do. California: Crown.

Uganda: Country Profile. (n.d.). United Nation’s office on drugs and crime. Retrieved October 16, 2006, from http://www.undoc.org/Kenya/an/Country_Profile_Ug.html

Wagnid GM, Young HM (1993). Development and psychometric evaluation of Resilience Scale. J. Nursing Measur. 2, 165-178. Retrieved March 10, 2005, from http://wilderdom.com/pdf

Waller MA (2001). Resilience in ecosystem context: Evaluation of the concept. Ame. J. Orthopsych. 71, 290-297.

Werner EE, Smith RS (1982). Vulnerable but invincible: A longitudinal study of resilient children and youth. New York: Adams, Bannister, Cox. Retrieved February 11, 2006, from http://www.nwrel.org

Werner EE, Smith RS (1992). Overcoming the odds: High-risk children from birth to adulthood. Ithaca, New York, Cornell University Press.

WHO (1990). Programme on substance abuse. Preventing substance abuse in families: A WHO Position Paper”. Geneva, 1993.pp 22.

WHO (2000). Dependence, non-communicable diseases and mental health. Department of mental health and substance abuse. Guide to drug abuse epidemiology, Geneva.1, 10-12


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