dividuals in their 20s. Those with inhalant use disorder extending into adulthood often
have severe problems: substance use disorder s, antisocial personality disorder, and sui-
cidal ideation with attempts. 
Risk and Prognostic Factors 
Temperamental. Predictors of progression from nonuse of inhalant s, to use, to inhalant
use disorder include comorbid non-inhalant substance use disorders and either conduct
disorder or antisocial personality disorder. Other predictors are ea rlier onset of inhalant
use and prior use of mental health services. 
Environmental. Inhalant gases are widely and legally available, increasing the risk of mis-
use. Childhood maltreatment or  trauma also is associated with youthful progression from
inhalant non-use to inhalant use disorder. 
Genetic and physiological. Behavioral disinhibition  is a highly heritable general propensity
to not constrain behavior in socially acceptable  ways, to break social norms and rules, and to
take dangerous risks, pursuing rewards excessi vely despite dangers of  adverse consequences.
Youths with strong behavioral disinhibition show  risk factors for inhala nt use disorder: early-
onset substance use disorder, multiple substa nce involvement, and ea rly conduct problems.
Because behavioral disinhibition is under stro ng genetic influence, youths in families with
substance and antisocial problems are at elevated risk for i nhalant use disorder.
Culture-Related Diagnostic Issues
Certain native or aboriginal communities have  experienced a high prevalence of inhalant
problems. Also, in some countr ies, groups of homeless children in street gangs have ex-
tensive inhalant use problems.
Gender-Related Diagnostic Issues
Although the prevalence of inhalant use disord er is almost identical in adolescent males
and females, the disorder is very rare among adult females.
Diagnostic Markers