Exploring the complex inter-relations between internalising symptoms, executive functioning and alcohol use in young adults

A review of factors influencing drinking behaviours in young Australian adults using a behavioural framework approach

ISSUES

Young adults (aged 18-24 years) are more likely to binge drink than any other age group in Australia. These behaviours expose young adults to possible adverse events, with potential for acute harms.

APPROACH

A behavioural framework (capability, opportunity, motivation-behaviour [COM-B model]) was used to explore factors that influence the drinking behaviours of young Australian adults. Potential studies were identified by searching four online data bases. Content pertaining to factors moderating young adults' alcohol consumption behaviours (either increasing or decreasing alcohol consumption) in an Australian population was extracted. Factors were then categorised/mapped into the six sub-components of the COM-B model. A narrative synthesis/discussion was subsequently undertaken.

KEY FINDINGS

Factors increasing or reducing alcohol consumption behaviours were identified across all components of the COM-B model. Overall, alcohol consumption behaviours appear strongly influenced by physical and social opportunities, and young adults have reflective and automatic motivations (i.e., habitual processes, emotional responding and analytical decisional making that directs behaviour) to consume alcohol with purpose and/or reason.

IMPLICATIONS AND CONCLUSION

The use of a behavioural framework (e.g., the COM-B model) facilitates an integrated understanding of factors influencing alcohol consumption behaviours. Future harm minimisation strategies need to consider the interrelated, contemporary factors underpinning a young adult's decision to consume alcohol within the context of modern Australian society.

Trauma-informed prevention programmes for depression, anxiety, and substance use among young people: protocol for a mixed-methods systematic review

BACKGROUND

Mental ill-health and substance use bear a substantial burden and harm on young people and often arise from co-occurring and compounding risk factors, such as traumatic stress. Trauma-informed prevention of mental ill-health and substance use demonstrates significant promise in reducing this burden. A systematic literature review is required to identify and summarise the effectiveness, feasibility, acceptability, and design principles underpinning existing trauma-informed mental ill-health and/or substance use prevention programmes for young people aged 12-24 years.

METHODS

MEDLINE, Embase, CINAHL, PsychINFO, and Cochrane Library will be searched from 2012 through September 2022. Reference lists of included articles will be citation-chained. Title and abstracts will be screened and two reviewers will review articles full-text. One reviewer will extract data from eligible articles using a piloted data extraction form, and 20% of the data will be verified by a second reviewer. Risk of bias will be assessed using the Cochrane risk-of-bias tool for randomised trials (RoB 2), Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I), and The Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies and The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research (CASP), depending on the study type. Characteristics of existing trauma-informed mental ill-health and/or substance use prevention programmes for young people will be summarised narratively. Effectiveness, feasibility, and acceptability will be qualitatively described and summarised, with proportions and effect sizes quantitatively synthesised, where possible.

DISCUSSION

Trauma-informed approaches to prevention demonstrate significant promise, yet to date, no study has systematically summarised and synthesised the available literature. To fill this gap, the present review will systematically identify and summarise the effectiveness, feasibility, acceptability, and design principles underpinning existing trauma-informed mental health and/or substance use prevention programmes for young people aged 12-24. This review will inform the development, adaptation, evaluation, and implementation of future trauma-informed mental ill-health and substance use prevention programmes for young people. Findings will inform critical efforts to interrupt and prevent already elevated trajectories of mental ill-health, substance use, and related harms among those young people exposed to adversity.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42022353883.

Promising vulnerability markers of substance use and misuse: A review of human neurobehavioral studies

Substance use often begins, and noticeably escalates, during adolescence. Identifying predictive neurobehavioral vulnerability markers of substance use and related problems may improve targeted prevention and early intervention initiatives. This review synthesizes 44 longitudinal studies and explores the utility of developmental imbalance models and neurobehavioral addiction frameworks in predicting neural and cognitive patterns that are associated with prospective substance use initiation and escalation among young people. A total of 234 effect sizes were calculated and compared. Findings suggest that aberrant neural structure and function of regions implicated in reward processing, cognitive control, and impulsivity can predate substance use initiation, escalation, and disorder. Functional vulnerability markers of substance use include hyperactivation during reward feedback and risk evaluation in prefrontal and ventral striatal regions, fronto-parietal hypoactivation during working memory, distinctive neural patterns during successful (fronto-parietal hyperactivation) and failed response inhibition (frontal hypoactivation), and related cognitive deficits. Structurally, smaller fronto-parietal and amygdala volume and larger ventral striatal volume predicts prospective substance misuse. Taken together, the findings of this review suggest that neurobehavioral data can be useful in predicting future substance use behaviors. Notably, little to no research has empirically tested the underlying assumptions of widely used theoretical frameworks. To improve the reliability and utility of neurobehavioral data in predicting future substance use behaviors, recommendations for future research are provided. This article is part of the special issue on 'Vulnerabilities to Substance Abuse.'

A biological framework for emotional dysregulation in alcohol misuse: from gut to brain

Alcohol use disorder (AUD) has been associated with impairments in social and emotional cognition that play a crucial role in the development and maintenance of addiction. Repeated alcohol intoxications trigger inflammatory processes and sensitise the immune system. In addition, emerging data point to perturbations in the gut microbiome as a key regulator of the inflammatory cascade in AUD. Inflammation and social cognition are potent modulators of one another. At the same time, accumulating evidence implicates the gut microbiome in shaping emotional and social cognition, suggesting the possibility of a common underlying loop of crucial importance for addiction. Here we propose an integrative microbiome neuro-immuno-affective framework of how emotional dysregulation and alcohol-related microbiome dysbiosis could accelerate the cycle of addiction. We outline the overlapping effects of chronic alcohol use, inflammation and microbiome alterations on the fronto-limbic circuitry as a convergence hub for emotional dysregulation. We discuss the interdependent relationship of social cognition, immunity and the microbiome in relation to alcohol misuse- from binge drinking to addiction. In addition, we emphasise adolescence as a sensitive period for the confluence of alcohol harmful effects and emotional dysregulation in the developing gut-brain axis.

Problems experienced by children from families with histories of substance misuse: An ABCD study®

BACKGROUND

There are significant knowledge gaps of the vulnerabilities faced by youth from families with histories of alcohol or substance misuse. This study aimed to provide a comprehensive assessment of problems experienced by substance-naive children with positive family histories of substance misuse (FHP).

METHODS

Baseline data from up to 11,873 children (52.1 % male), aged 9.0-10.9 years (M = 9.9 ± 0.6), enrolled in the US-based Adolescent Brain Cognitive Development Study® were utilized. Mixed models tested cross-sectional associations between family history of substance misuse, assessed categorically and continuously, with neurobiological, cognitive, behavioral, and psychological outcomes, when controlling for confounding factors, including family history of psychopathology, and correcting for multiple comparisons.

RESULTS

One in four (26.3 %) youth were categorized as FHP (defined as ≥ one parent or ≥ two grandparents with misuse history). Controlling for confounding, FHP youth exhibited thinner whole cortices and greater surface area in frontal and occipital regions than youth with no such history (|ds|≥0.04, ps<.001). FHP youth experienced greater psychopathology and sleep disturbance (|ds|≥0.36, ps<.001) and were more likely to be diagnosed with multiple mental disorders (odds ratios≥1.22, ps<.001), with severity of effects dependent on family history density of substance misuse. Differences in cognition, impulsivity, and motivation were non-significant. Psychopathology, mental disorders, and sleep disturbance were negatively correlated with various neural indices (|rs|=0.01-0.05, ps<.05).

CONCLUSIONS

At age 9-10 years, FHP youth can experience numerous problems, with psychopathology and mental disorders being some of the most significant. Therefore, prevention efforts should target psychopathology vulnerabilities in FHP children.