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Three trajectory classes culminating in substance use disorder (SUD) were discerned in a longitudinal study of boys from ages 10–12 to 22 years. Neurobehavior disinhibition, parental SUD, socioeconomic status, and affiliation with deviant peers were measured at baseline. Approval of socially nonnormative behavior was measured at ages 10–12, 12–14, 16, and 19 years. Two high-risk trajectories, indicated by increasing approval of antisociality and progressive social maladjustment during adolescence (SUD rate = 72.7%) and stable high level of disturbance (SUD rate = 85%), were identified. Individual characteristics (neurobehavior disinhibition) in conjunction with contextual factors (low socioeconomic status, parental SUD, affiliation with deviant friends) promote approval of antisociality during adolescence and a high rate of SUD by young adulthood.