Application of person-centered medicine in addiction

Main Article Content

Ralph Tarter
Levent Kirisci
Ty Ridenour
Debra Bogen


This article discusses human individuality within a lifespan developmental perspective.  The practical application of an individual differences framework for diagnosis, prevention and treatment of addiction is described.  A brief overview of the methods conducive to knowledge development within the rubric of person-centered medicine that are available to practitioners working in office and clinic settings concludes the discussion.

Article Details

Fourth Geneva Conference on Person-centered Medicine: Person-centered special developments
Author Biography

Ralph Tarter, Pittsburg University

Ralph Tarter, Ph.D., M.P.A., is a clinical neuropsychologist having special interest in addiction.  His research has focused on etiology and prevention of addictions spanning the use of genetic, neuroscience and behavioral science methodologies.  He currently is Director of the Center for Education and Drug Abuse Research funded by NIH and is Professor of Pharmaceutical Sciences, Psychiatry and Psychology at the University of Pittsburgh.For many years, Dr. Tarter has been researching the etiology of addiction. This project involves tracking 775 families in order to learn about the unique combination of individual and environmental factors that bias the developmental trajectory to addiction.  This line of investigation is presently being extended to designing individualized prevention and treatment strategies that are grounded in an understanding of the causes and impacts of individual differences on development of psychopathology.  As a clinical psychologist, this perspective is occasionally called upon in forensic situations, particularly when a capital offense has been committed by a minor involving at the time of the crime substance use or intoxication.My clinical and research activities related to addiction join biological psychology and health psychology.  I have been very involved in quality of life studies, particularly in relation to liver transplantation.  In addition, I have been involved in research on nutrition and brain-behavior relationships in clinical samples.  Much of my skill has been devoted to health policy issues catalyzed in part by graduate training and Masters degree in policy analysis.I graduated from Concordia University in Montreal, Canada in 1966 when I obtained a B.A. degree.  I received the Masters degree in Clinical Psychology from Dalhousie University in 1968 and a Ph.D. in biological psychology/neuropsychology from the University of Oklahoma Health Sciences Center in 1971.  During the course of my career, I have published 280 peer refereed articles, 80 book chapters, co-edited 11 books and 2 special issues of journals.   I currently serve as Associate Editor of one journal and board member of four journals.


Cone, J.D. (1986). Idiographic, nomothetic, and related perspectives in behavioral assessment. In Conceptual Foundations of Behavioral Assessment (Eds. R.O. Nelson and S.C. Hayes), pp. 111-128. New York: Guilford.

Ridenour, T.A., Reid, E.E. & Chilenski, S.M. (2012). Developmental momentum and liability to behavioral problems: Natural histories of risk factors in youth experiencing chronic stress. In press.

Tarter, R., Vanyukov, M., Giancola, P., Dawes, M., Blackson T., Mezzich, A. & Clark, D. (1999). Etiology of early age onset substance abuse: A maturational perspective. Development and Psychopathology 11, 657-683.

Tarter, R., Horner, M., Ridenour, T. (2012). Lifespan developmental perspective of substance use disorder etiology. In Addiction Syndrome Handbook (ed. H. Shaffer). Washington, DC: American Psychological Press. In press.

Chen, Y-C., Prescott, C.A., Walsh, D., Patterson, D.G., Riley, B.P., Kendler, K.S. & Kuo, P-H. (2011). Different phenotypic and genotypic presentations in alcohol dependence: Age at onset matters. Journal of Studies on Alcohol and Drugs 72, 752-762.

Kendler, K.S., Jacobson, K.C., Prescott, C.A. & Neale, M.C. (2003). Specificity of genetic and environmental risk factors for use and abuse/dependence of cannabis, cocaine, hallucinogens, sedatives, stimulants and opiates in male twins. American Journal of Psychiatry 160, 687-695.

Cloninger, C., Bohman, M. & Sigvardson, S. (1981). Inheritance of alcohol abuse: cross fostering analysis of adopted men. Archives of General Psychiatry 36, 861-868.

Iacono, W.G., Malone, S.M. & McGue, M. (2008). Behavioral disinhibition and the development of early onset addiction: Common and specific influences. Annual Reviews in Clinical Psychology 4, 325-348.

Tarter, R., Kirisci, L., Gavaler, J., Reynolds, M., Kirisci, L., Clark, D., Moss, H. & Vanyukov, M. (2009). Prospective study of the association between abandoned dwellings and testosterone level on the development of behaviors leading to cannabis use disorder in boys. Biological Psychiatry 65, 116-121.

Vanyukov, M., Tarter, R., Kirisci, L., Kirillova, G., Maher, B. & Clark, D. (2003). Liability to substance use disorders. 1. Common mechanisms and manifestations. Neuroscience and Biobehavior Reviews 27, 507-515.

Vanyukov, M., Kirisci, L., Tarter, R., Simkevitz, H., Kirillova, G., Maher, B., & Clark, D. (2003). Liability to substance use disorders: 2. A measurement approach. Neuroscience and Biobehavior Reviews 27, 517-526.

Tarter, R. & Vanyukov, M. (1994). Stepwise developmental model of alcoholism etiology. In: The Development of Alcohol Problems: Exploring the Biopsychosical Matrix of Risk. (Eds. R. Zucker, G. Boyd, & J. Howard). NIAAA Monograph 26 (DHHS Publication No. 94-3495).

Eckerrode, J., Campa, M., Luckey, D.W., Henderson, C.R., Jr., Cole, R., Kitzman, H., Anson, E., Sidora-Arcoleo, K., Powers, J. & Olds, D. (2010). Long-term effects of prenatal and infancy nurse home visitation on the life course of youths: 19-year follow-up of a randomized trial. Archives of Pediatrics and Adolescent Medicine 164, 9-15.

Rice, J., Cloninger, J. & Reich, T. (1980). General causal models for sex differences and the familial transmission of the multi-factorial traits: An application to human spatial visualizing ability. Social Biology 26, 36-47.

Kirisci, L., Tarter, R., Ridenour, T., Reynolds, M. & Vanyukov, M. (2012). Which cannabis users subsequently develop cannabis use disorder ? Drug and Alcohol Dependence. In press.

Tarter, R. (1990). Evaluation and treatment of adolescent substance abuse: A decision tree method. American Journal of Drug and Alcohol Abuse 16, 1-46.

Ridenour, T.A., Clark, D.B. & Cottler, L.B. (2009). Reliability and validity of the Assessment of Liability and Exposure to Substance use and Antisocial behavior (ALEXSA) in 9 to 12 year old students. American Journal of Drug and Alcohol Abuse 35, 242-252.

Ridenour, T.A., Minnes, S., Maldonado-Molina, M.M., Clark, D.B., Tarter, R.E. & Reynolds, M.D. (2011). Psychometrics and cross-cultural comparisons of the Illustration-based Assessment of Liability and Exposure to Substance use and Antisocial behavior© for children. Open Journal of Family Studies 4 (Supplement 1-M2), 17-26.18.

Guyatt, G.H., Haynes, R.B., Jaeschke, R.Z., Cook, D.J., Green, L., Naylor, C.D., Wilson, M.C. & Richardson, W.S. (2000). Users’ guides to the Medical Literature: XXV. Evidence-based medicine: Principles for applying the Users’ Guides to patient care. Journal of the American Medical Association 284, 1290–1296.

Biglan, A., Ary, D. & Wagenaar, A.C. (2000). The value of interrupted time-series experiments for community intervention research. Prevention Science 1, 31–49.

Charfield, C. (2004). The Analysis of Time Series: An Introduction (6th ed.). Chapman & Hall/CRC: Boca Raton, FL.

Ridenour, T.A., Hall, D.L. & Bost, J.E. (2009). A Small Sample Randomized Clinical Trial Methodology Using N-of-1 Designs and Mixed Model Analysis. American Journal of Drug and Alcohol Abuse 35, 260-266.

Molenaar, P.C.M., Sinclair, K.O., Rovine, M.J., Ram, N. & Corneal, S.E. (2009). Analyzing developmental processes on a individual level using non-stationary time series modeling. Developmental Psychology 45, 260–271.

Sterman, J. D. (2000). Business Dynamics: Systems Thinking and Modeling for a Complex World. Boston: McGraw-Hill.