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Yuan W, Chen M, Wang DW, Li QH, Yin YY, Li B, Wang HR, Hu J, Gong YD, Yuan TF, Yu TG. Computational markers of risky decision-making predict for relapse to alcohol. Eur Arch Psychiatry Clin Neurosci 2024; 274:353-362. [PMID: 37148307 DOI: 10.1007/s00406-023-01602-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 03/29/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Relapse remains the major challenge in treatment of alcohol use disorder (AUD). Aberrant decision-making has been found as important cognitive mechanism underlying relapse, but factors associated with relapse vulnerability are unclear. Here, we aim to identify potential computational markers of relapse vulnerability by investigating risky decision-making in individuals with AUD. METHODS Forty-six healthy controls and fifty-two individuals with AUD were recruited for this study. The risk-taking propensity of these subjects was investigated using the balloon analog risk task (BART). After completion of clinical treatment, all individuals with AUD were followed up and divided into a non-relapse AUD group and a relapse AUD group according to their drinking status. RESULTS The risk-taking propensity differed significantly among healthy controls, the non-relapse AUD group, and the relapse AUD group, and was negatively associated with the duration of abstinence in individuals with AUD. Logistic regression models showed that risk-taking propensity, as measured by the computational model, was a valid predictor of alcohol relapse, and higher risk-taking propensity was associated with greater risk of relapse to drink. CONCLUSION Our study presents new insights into risk-taking measurement and identifies computational markers that provide prospective information for relapse to drink in individuals with AUD.
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Affiliation(s)
- Wei Yuan
- Department of Addiction Medicine, Shandong Mental Health Center, Jinan, 250014, China
| | - Meng Chen
- Brain and Cognitive Neuroscience Research Center, Liaoning Normal University, Dalian, 116029, China
| | - Duan-Wei Wang
- Department of Addiction Medicine, Shandong Mental Health Center, Jinan, 250014, China
| | - Qian-Hui Li
- Division of Gastroenterology, Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, 518107, China
| | - Yuan-Yuan Yin
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Bin Li
- Department of Addiction Medicine, Shandong Mental Health Center, Jinan, 250014, China
| | - Hai-Rong Wang
- Department of Addiction Medicine, Shandong Mental Health Center, Jinan, 250014, China
| | - Ji Hu
- School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China
| | - Yuan-Dong Gong
- Department of Addiction Medicine, Shandong Mental Health Center, Jinan, 250014, China.
| | - Ti-Fei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu, China.
| | - Tian-Gui Yu
- Department of Addiction Medicine, Shandong Mental Health Center, Jinan, 250014, China.
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Crum KI, Aloi J, Blair KS, Bashford-Largo J, Bajaj S, Zhang R, Hwang S, Schwartz A, Elowsky J, Filbey FM, Dobbertin M, Blair RJ. Latent profiles of substance use, early life stress, and attention/externalizing problems and their association with neural correlates of reinforcement learning in adolescents. Psychol Med 2023; 53:7358-7367. [PMID: 37144406 PMCID: PMC10625649 DOI: 10.1017/s0033291723000971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
BACKGROUND Adolescent substance use, externalizing and attention problems, and early life stress (ELS) commonly co-occur. These psychopathologies show overlapping neural dysfunction in the form of reduced recruitment of reward processing neuro-circuitries. However, it is unclear to what extent these psychopathologies show common v. different neural dysfunctions as a function of symptom profiles, as no studies have directly compared neural dysfunctions associated with each of these psychopathologies to each other. METHODS In study 1, a latent profile analysis (LPA) was conducted in a sample of 266 adolescents (aged 13-18, 41.7% female, 58.3% male) from a residential youth care facility and the surrounding community to investigate substance use, externalizing and attention problems, and ELS psychopathologies and their co-presentation. In study 2, we examined a subsample of 174 participants who completed the Passive Avoidance learning task during functional magnetic resonance imaging to examine differential and/or common reward processing neuro-circuitry dysfunctions associated with symptom profiles based on these co-presentations. RESULTS In study 1, LPA identified profiles of substance use plus rule-breaking behaviors, attention-deficit hyperactivity disorder, and ELS. In study 2, the substance use/rule-breaking profile was associated with reduced recruitment of reward processing and attentional neuro-circuitries during the Passive Avoidance task (p < 0.05, corrected for multiple comparisons). CONCLUSIONS Findings indicate that there is reduced responsivity of striato-cortical regions when receiving outcomes on an instrumental learning task within a profile of adolescents with substance use and rule-breaking behaviors. Mitigating reward processing dysfunction specifically may represent a potential intervention target for substance-use psychopathologies accompanied by rule-breaking behaviors.
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Affiliation(s)
- Kathleen I Crum
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Division of Neuroimaging, Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA
| | - Joseph Aloi
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Karina S Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Johannah Bashford-Largo
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Sahil Bajaj
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Ru Zhang
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Soonjo Hwang
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, USA
| | - Amanda Schwartz
- Department of Psychology, University of North Dakota, Grand Forks, ND, USA
| | - Jaimie Elowsky
- Department of Psychology, University of Nebraska - Lincoln, Lincoln, NE, USA
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Matthew Dobbertin
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - R James Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
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Aloi J, Kwon E, Hummer TA, Crum KI, Shah N, Pratt L, Aalsma MC, Finn P, Nurnberger J, Hulvershorn LA. Family history of substance use disorder and parental impulsivity are differentially associated with neural responses during risky decision-making. FRONTIERS IN NEUROIMAGING 2023; 2:1110494. [PMID: 37554652 PMCID: PMC10406275 DOI: 10.3389/fnimg.2023.1110494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 05/29/2023] [Indexed: 08/10/2023]
Abstract
Background Risky decision-making is associated with the development of substance use behaviors during adolescence. Although prior work has investigated risky decision-making in adolescents at familial high risk for developing substance use disorders (SUDs), little research has controlled for the presence of co-morbid externalizing disorders (EDs). Additionally, few studies have investigated the role of parental impulsivity in offspring neurobiology associated with risky decision-making. Methods One-hundred twenty-five children (28 healthy controls, 47 psychiatric controls with EDs without a familial history of SUD, and 50 high-risk children with co-morbid EDs with a familial history of SUD) participated in the Balloon Analog Risk Task while undergoing functional magnetic resonance imaging. Impulsivity for parents and children was measured using the UPPS-P Impulsive Behavior Scale. Results We found that individuals in the psychiatric control group showed greater activation, as chances of balloon explosion increased, while making choices, relative to the healthy control and high-risk groups in the rostral anterior cingulate cortex (rACC) and lateral orbitofrontal cortex (lOFC). We also found a positive association between greater activation and parental impulsivity in these regions. However, within rACC, this relationship was moderated by group, such that there was a positive relationship between activation and parental impulsivity in the HC group, but an inverse relationship in the HR group. Conclusions These findings suggest that there are key differences in the neurobiology underlying risky decision-making in individuals with EDs with and without a familial history of SUD. The current findings build on existing models of neurobiological factors influencing addiction risk by integrating parental factors. This work paves the way for more precise risk models in which to test preventive interventions.
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Affiliation(s)
- Joseph Aloi
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Elizabeth Kwon
- Department of Public Health, Baylor University, Waco, TX, United States
| | - Tom A. Hummer
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Kathleen I. Crum
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Nikhil Shah
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Lauren Pratt
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Matthew C. Aalsma
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Peter Finn
- Department of Psychology, Indiana University-Bloomington, Bloomington, IN, United States
| | - John Nurnberger
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Leslie A. Hulvershorn
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
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Hubbard NA, Miller KB, Aloi J, Bajaj S, Wakabayashi KT, Blair RJR. Evaluating instrumental learning and striatal-cortical functional connectivity in adolescent alcohol and cannabis use. Addict Biol 2023; 28:e13258. [PMID: 36577718 PMCID: PMC10173870 DOI: 10.1111/adb.13258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 11/03/2022] [Accepted: 11/08/2022] [Indexed: 12/03/2022]
Abstract
Adolescence is a vulnerable time for the acquisition of substance use disorders, potentially relating to ongoing development of neural circuits supporting instrumental learning. Striatal-cortical circuits undergo dynamic changes during instrumental learning and are implicated in contemporary addiction theory. Human studies have not yet investigated these dynamic changes in relation to adolescent substance use. Here, functional magnetic resonance imaging was used while 135 adolescents without (AUD-CUDLow ) and with significant alcohol (AUDHigh ) or cannabis use disorder symptoms (CUDHigh ) performed an instrumental learning task. We assessed how cumulative experience with instrumental cues altered cue selection preferences and functional connectivity strength between reward-sensitive striatal and cortical regions. Adolescents in AUDHigh and CUDHigh groups were slower in learning to select optimal instrumental cues relative to AUD-CUDLow adolescents. The relatively fast learning observed for AUD-CUDLow adolescents coincided with stronger functional connectivity between striatal and frontoparietal regions during early relative to later periods of task experience, whereas the slower learning for the CUDHigh group coincided with the opposite pattern. The AUDHigh group not only exhibited slower learning but also produced more instrumental choice errors relative to AUD-CUDLow adolescents. For the AUDHigh group, Bayesian analyses evidenced moderate support for no experience-related changes in striatal-frontoparietal connectivity strength during the task. Findings suggest that adolescent cannabis use is related to slowed instrumental learning and delays in peak functional connectivity strength between the striatal-frontoparietal regions that support this learning, whereas adolescent alcohol use may be more closely linked to broader impairments in instrumental learning and a general depression of the neural circuits supporting it.
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Affiliation(s)
- NA Hubbard
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE
| | - KB Miller
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE
| | - J Aloi
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
| | - S Bajaj
- Center for Neurobehavioral Research in Children, Boys Town National Research Hospital, Boys Town, NE
| | - KT Wakabayashi
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE
| | - RJR Blair
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
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A Meta-Analysis of fMRI Studies of Youth Cannabis Use: Alterations in Executive Control, Social Cognition/Emotion Processing, and Reward Processing in Cannabis Using Youth. Brain Sci 2022; 12:brainsci12101281. [PMID: 36291215 PMCID: PMC9599849 DOI: 10.3390/brainsci12101281] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/19/2022] [Accepted: 09/21/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Adolescent cannabis use (CU) is associated with adverse health outcomes and may be increasing in response to changing cannabis laws. Recent imaging studies have identified differences in brain activity between adult CU and controls that are more prominent in early onset users. Whether these differences are present in adolescent CU and relate to age/developmental stage, sex, or cannabis exposure is unknown. Methods: A systematic review and subsequent effect-size seed-based d mapping (SDM) meta-analysis were conducted to examine differences in blood-oxygen-level-dependent (BOLD) response during fMRI studies between CU and non-using typically developing (TD) youth. Supplemental analyses investigated differences in BOLD signal in CU and TD youth as a function of sex, psychiatric comorbidity, and the dose and severity of cannabis exposure. Results: From 1371 citations, 45 fMRI studies were identified for inclusion in the SDM meta-analysis. These studies compared BOLD response contrasts in 1216 CU and 1486 non-using TD participants. In primary meta-analyses stratified by cognitive paradigms, CU (compared to TD) youth showed greater activation in the rostral medial prefrontal cortex (rmPFC) and decreased activation in the dorsal mPFC (dmPFC) and dorsal anterior cingulate cortex (dACC) during executive control and social cognition/emotion processing, respectively. In meta-regression analyses and subgroup meta-analyses, sex, cannabis use disorder (CUD) severity, and psychiatric comorbidity were correlated with brain activation differences between CU and TD youth in mPFC and insular cortical regions. Activation differences in the caudate, thalamus, insula, dmPFC/dACC, and precentral and postcentral gyri varied as a function of the length of abstinence. Conclusions: Using an SDM meta-analytic approach, this report identified differences in neuronal response between CU and TD youth during executive control, emotion processing, and reward processing in cortical and subcortical brain regions that varied as a function of sex, CUD severity, psychiatric comorbidity, and length of abstinence. Whether aberrant brain function in CU youth is attributable to common predispositional factors, cannabis-induced neuroadaptive changes, or both warrants further investigation.
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Luo X, Yang JJ, Buu A, Trucco EM, Li CSR. Alcohol and cannabis co-use and longitudinal gray matter volumetric changes in early and late adolescence. Addict Biol 2022; 27:e13208. [PMID: 36001427 PMCID: PMC9413216 DOI: 10.1111/adb.13208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 05/23/2022] [Accepted: 06/22/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Previous studies have characterized the impact of substance use on cerebral structure and function in adolescents. Yet, the great majority of prior studies employed a small sample, presented cross-sectional findings, and omitted potential sex differences. METHODS Using data based on 724 adolescents (370 females) curated from the NCANDA study, we investigated how gray matter volumes (GMVs) decline longitudinally as a result of alcohol and cannabis use. The impacts of alcohol and cannabis co-use and how these vary across assigned sex at birth and age were examined. Brain imaging data comprised the GMVs of 34 regions of interest and the results were evaluated with a Bonferroni correction. RESULTS Mixed-effects modeling showed faster volumetric declines in the caudal middle frontal cortex, fusiform, inferior frontal, superior temporal (STG), and supramarginal (SMG) gyri, at -0.046 to -0.138 cm3 /year in individuals with prior-year alcohol and cannabis co-use, but not those engaged in alcohol or cannabis use only. These findings cannot be explained by more severe alcohol use among co-users. Further, alcohol and cannabis co-use in early versus late adolescence predicted faster volumetric decline in the STG and SMG across assigned sex at birth. CONCLUSIONS Findings highlight the longitudinal impact of alcohol and cannabis co-use on brain development, especially among youth reporting early adolescent onset of use. The volumetric decline was noted in cortical regions in support of attention, memory, executive control, and social cognition, suggesting the pervasive effect of alcohol and cannabis co-use on brain development.
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Affiliation(s)
- Xi Luo
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston, Houston, TX
| | - James J. Yang
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston, Houston, TX
| | - Anne Buu
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX
| | - Elisa M. Trucco
- Department of Psychology, Florida International University, Miami, FL
- Department of Psychiatry, University of Michigan, Ann Arbor, MI
| | - Chiang-Shan R. Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT
- Wu Tsai Institute, Yale University, New Haven, CT
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Jarcho JM, Wyngaarden JB, Johnston CR, Quarmley M, Smith DV, Cassidy CM. Substance Abuse in Emerging Adults: The Role of Neuromelanin and Ventral Striatal Response to Social and Monetary Rewards. Brain Sci 2022; 12:352. [PMID: 35326308 PMCID: PMC8946041 DOI: 10.3390/brainsci12030352] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/17/2022] [Accepted: 03/03/2022] [Indexed: 11/30/2022] Open
Abstract
Perturbations in dopamine system function may increase risk of substance use disorder (SUD). We recently demonstrated that neuromelanin (NM) MRI signal in the substantia nigra, a non-invasive index of dopamine system function, is elevated in long term cocaine users (Cassidy et al., 2020). However, it is unclear whether elevated NM-MRI signal is linked to risk of SUD, or is a byproduct of long-term drug use. Our prior work failed to show relations between NM-MRI signal and functional engagement of ventral striatum during a monetary reward task. However, social experiences are commonly linked to drug use and relapse. Given that, NM-MRI signal may be more closely linked to ventral striatal engagement during social, rather than monetary reward processing. Emerging adults (n = 33, 21.88 ± 4.35 years) with varying levels of substance abuse, but without SUD, underwent NM-MRI and fMRI during social and monetary reward processing tasks. Voxelwise analysis within the substantia nigra (SN) demonstrated lower NM-MRI signal was associated with more severe substance abuse. Lower right ventral striatal engagement to social reward was also associated with more severe substance abuse. This relation was moderated by SN NM-MRI signal such that diminished striatal response to reward was associated with greater substance abuse among those with low NM-MRI signal, but lower substance abuse among those with high NM-MRI signal. Unexpectedly, higher right ventral striatal engagement during monetary reward was associated with more severe substance abuse. This relation was moderated by SN NM-MRI signal such that greater striatal response to reward was associated with greater substance abuse among those with low NM-MRI signal. Taken together, we provide preliminary evidence that, in emerging adults, low rather than high dopamine system function may increase risk of substance abuse, and strengthen the association between substance use and the brain's sensitivity to social and monetary outcomes in different ways.
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Affiliation(s)
- Johanna M. Jarcho
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA; (J.B.W.); (C.R.J.); (M.Q.); (D.V.S.)
| | - James B. Wyngaarden
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA; (J.B.W.); (C.R.J.); (M.Q.); (D.V.S.)
| | - Camille R. Johnston
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA; (J.B.W.); (C.R.J.); (M.Q.); (D.V.S.)
| | - Megan Quarmley
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA; (J.B.W.); (C.R.J.); (M.Q.); (D.V.S.)
| | - David V. Smith
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA; (J.B.W.); (C.R.J.); (M.Q.); (D.V.S.)
| | - Clifford M. Cassidy
- University of Ottawa Institute of Mental Health Research, Affiliated with The Royal, Ottawa, ON K1Z 8N3, Canada;
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Bağci B, Düsmez S, Zorlu N, Bahtiyar G, Isikli S, Bayrakci A, Heinz A, Schad DJ, Sebold M. Computational analysis of probabilistic reversal learning deficits in male subjects with alcohol use disorder. Front Psychiatry 2022; 13:960238. [PMID: 36339830 PMCID: PMC9626515 DOI: 10.3389/fpsyt.2022.960238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/27/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Alcohol use disorder is characterized by perseverative alcohol use despite negative consequences. This hallmark feature of addiction potentially relates to impairments in behavioral flexibility, which can be measured by probabilistic reversal learning (PRL) paradigms. We here aimed to examine the cognitive mechanisms underlying impaired PRL task performance in patients with alcohol use disorder (AUDP) using computational models of reinforcement learning. METHODS Twenty-eight early abstinent AUDP and 27 healthy controls (HC) performed an extensive PRL paradigm. We compared conventional behavioral variables of choices (perseveration; correct responses) between groups. Moreover, we fitted Bayesian computational models to the task data to compare differences in latent cognitive variables including reward and punishment learning and choice consistency between groups. RESULTS AUDP and HC did not significantly differ with regard to direct perseveration rates after reversals. However, AUDP made overall less correct responses and specifically showed decreased win-stay behavior compared to HC. Interestingly, AUDP showed premature switching after no or little negative feedback but elevated proneness to stay when accumulation of negative feedback would make switching a more optimal option. Computational modeling revealed that AUDP compared to HC showed enhanced learning from punishment, a tendency to learn less from positive feedback and lower choice consistency. CONCLUSION Our data do not support the assumption that AUDP are characterized by increased perseveration behavior. Instead our findings provide evidence that enhanced negative reinforcement and decreased non-drug-related reward learning as well as diminished choice consistency underlie dysfunctional choice behavior in AUDP.
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Affiliation(s)
- Başak Bağci
- Department of Psychiatry, Katip Celebi University Ataturk Education and Research Hospital, İzmir, Turkey
| | - Selin Düsmez
- Department of Psychiatry, Midyat State Hospital, Mardin, Turkey
| | - Nabi Zorlu
- Department of Psychiatry, Katip Celebi University Ataturk Education and Research Hospital, İzmir, Turkey
| | - Gökhan Bahtiyar
- Department of Psychiatry, Bingöl State Hospital, Bingöl, Turkey
| | - Serhan Isikli
- Department of Psychiatry, Katip Celebi University Ataturk Education and Research Hospital, İzmir, Turkey
| | - Adem Bayrakci
- Department of Psychiatry, Katip Celebi University Ataturk Education and Research Hospital, İzmir, Turkey
| | - Andreas Heinz
- Department of Psychiatry and Neurosciences, Charité Campus Mitte (CCM), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Daniel J Schad
- Department of Psychology, Health and Medical University, Potsdam, Germany
| | - Miriam Sebold
- Department of Psychiatry and Neurosciences, Charité Campus Mitte (CCM), Charité-Universitätsmedizin Berlin, Berlin, Germany
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The Effects of Alcohol and Cannabis Co-Use on Neurocognitive Function, Brain Structure, and Brain Function. Curr Behav Neurosci Rep 2021; 8:134-149. [PMID: 36908333 PMCID: PMC9997650 DOI: 10.1007/s40473-021-00243-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Purpose of review Given increases in the rates of alcohol and cannabis co-use among adolescents and young adults, this review aims to summarize literature on the effects of alcohol and cannabis co-use on neurocognitive functioning, brain structure, and brain function. Recent findings The limited existing studies examining concurrent, recent, and lifetime alcohol and cannabis co-use suggest effects on the brain are likely multifaceted. The majority of studies report that co-use is associated with negative outcomes such as impaired cognitive function and significant alterations in key structural and functional regions of the brain, while others report null effects of co-use compared to non-substance using control and single-substance use groups. Summary Current studies lack a general consensus on methodology, definitions of concurrent and simultaneous use, and neuroimaging approaches, which makes it challenging to draw strong conclusions about the effects of co-use. More studies are needed to explore the effects of co-use in the context of simultaneous alcohol and cannabis use.
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Blair RJR, Bashford-Largo J, Zhang R, Mathur A, Schwartz A, Elowsky J, Tyler P, Hammond CJ, Filbey FM, Dobbertin M, Bajaj S, Blair KS. Alcohol and Cannabis Use Disorder Symptom Severity, Conduct Disorder, and Callous-Unemotional Traits and Impairment in Expression Recognition. Front Psychiatry 2021; 12:714189. [PMID: 34616316 PMCID: PMC8488132 DOI: 10.3389/fpsyt.2021.714189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Alcohol and cannabis are commonly used by adolescents in the United States. Both alcohol use disorder (AUD) and cannabis use disorder (CUD) have been associated with reduced emotion expression recognition ability. However, this work has primarily occurred in adults and has not considered neuro-cognitive risk factors associated with conduct problems that commonly co-occur with, and precede, substance use. Yet, conduct problems are also associated with reduced emotion expression recognition ability. The current study investigated the extent of negative association between AUD and CUD symptom severity and expression recognition ability over and above any association of expression recognition ability with conduct problems [conduct disorder (CD) diagnostic status]. Methods: In this study, 152 youths aged 12.5-18 years (56 female; 60 diagnosed with CD) completed a rapid presentation morphed intensity facial expression task to investigate the association between relative severity of AUD/CUD and expression recognition ability. Results: Cannabis use disorder identification test (CUDIT) scores were negatively associated with recognition accuracy for higher intensity (particularly sad and fearful) expressions while CD diagnostic status was independently negatively associated with recognition of sad expressions. Alcohol use disorder identification test (AUDIT) scores were not significantly associated with expression recognition ability. Conclusions: These data indicate that relative severity of CUD and CD diagnostic status are statistically independently associated with reduced expression recognition ability. On the basis of these data, we speculate that increased cannabis use during adolescence may exacerbate a neuro-cognitive risk factor for the emergence of aggression and antisocial behavior.
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Affiliation(s)
- Robert James R. Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Johannah Bashford-Largo
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Ru Zhang
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Avantika Mathur
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Amanda Schwartz
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Jaimie Elowsky
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Patrick Tyler
- Child and Family Translational Research Center, Boys Town National Research Hospital, Boys Town, NE, United States
| | | | - Francesca M. Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, United States
| | - Matthew Dobbertin
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Sahil Bajaj
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Karina S. Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, United States
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Blair RJR, Bajaj S, Sherer N, Bashford-Largo J, Zhang R, Aloi J, Hammond C, Lukoff J, Schwartz A, Elowsky J, Tyler P, Filbey FM, Dobbertin M, Blair KS. Alcohol Use Disorder and Cannabis Use Disorder Symptomatology in Adolescents and Aggression: Associations With Recruitment of Neural Regions Implicated in Retaliation. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 6:536-544. [PMID: 33712378 DOI: 10.1016/j.bpsc.2020.11.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 11/18/2020] [Accepted: 11/22/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Alcohol and cannabis are commonly used by adolescents in the United States. Both alcohol use disorder (AUD) and cannabis use disorder (CUD) have been associated with an increased risk of aggression. One form of aggression seen during retaliation is reactive aggression to social provocation. This study investigated the association between AUD and CUD symptom severity and recruitment of neural regions implicated in retaliation. METHODS In this study, 102 youths aged 13-18 years (67 male; 84 in residential care) completed self-report measures of aggression-related constructs and participated in a retaliation task during functional magnetic resonance imaging to investigate the association between relative severity of AUD/CUD and atypical recruitment of regions implicated in retaliation. RESULTS AUD Identification Test scores were positively associated with irritability and reactive aggression scores. CUD Identification Test scores were positively associated with callous-unemotional traits and both proactive and reactive aggression scores. In functional magnetic resonance imaging analyses, only AUD Identification Test (not CUD Identification Test) scores were associated with an exaggerated recruitment of regions implicated in retaliation (dorsomedial frontal, anterior insula cortices, caudate, and, to a lesser extent, periaqueductal gray). CONCLUSIONS These data suggest that relative severity of AUD is associated with a disinhibited, exaggerated retaliation response that relates to an increased risk for reactive aggression. Similar findings were not related to severity of CUD.
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Affiliation(s)
- R James R Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska.
| | - Sahil Bajaj
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Noah Sherer
- Department of Biological Sciences, Fordham University, New York City, New York
| | - Johannah Bashford-Largo
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Ru Zhang
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Joseph Aloi
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana
| | - Chris Hammond
- Department of Psychiatry, Johns Hopkins University, Baltimore, Maryland
| | - Jennie Lukoff
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Amanda Schwartz
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Jaimie Elowsky
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Patrick Tyler
- Child and Family Translational Research Center, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas
| | - Matthew Dobbertin
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
| | - Karina S Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, Nebraska
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Assari S, Akhlaghipour G, Boyce S, Bazargan M, Caldwell CH. African American Children's Diminished Returns of Subjective Family Socioeconomic Status on Fun Seeking. CHILDREN (BASEL, SWITZERLAND) 2020; 7:E75. [PMID: 32660094 PMCID: PMC7401867 DOI: 10.3390/children7070075] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/28/2020] [Accepted: 07/07/2020] [Indexed: 02/08/2023]
Abstract
Background: Reward sensitivity (fun-seeking) is a risk factor for a wide range of high-risk behaviors. While high socioeconomic status (SES) is known to reduce reward sensitivity and associated high-risk behaviors, less is known about the differential effects of SES on reward sensitivity. It is plausible to expect weaker protective effects of family SES on reward sensitivity in racial minorities, a pattern called Minorities' Diminished Returns (MDRs). Aim: We compared Caucasian and African American (AA) children for the effects of subjective family SES on children's fun-seeking. Methods: This was a cross-sectional analysis of 7061 children from the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was subjective family SES. The main outcome was children's fun-seeking measured by the behavioral approach system (BAS) and behavioral avoidance system (BIS). Age, gender, marital status, and household size were the covariates. Results: In the overall sample, high subjective family SES was associated with lower levels of fun-seeking. We also found a statistically significant interaction between race and subjective family SES on children's fun-seeking in the overall sample, suggesting that high subjective family SES is associated with a weaker effect on reducing fun-seeking among AA than Caucasian children. In race-stratified models, high subjective family SES was protective against fun-seeking of Caucasian but not AA children. Conclusion: Subjective family SES reduces the fun-seeking for Caucasian but not AA children.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
| | - Golnoush Akhlaghipour
- Department of Neurology, University of California Los Angeles, Los Angeles, CA 90095, USA;
| | - Shanika Boyce
- Department of Pediatrics, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
| | - Cleopatra H. Caldwell
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA;
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA
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Assari S, Boyce S, Akhlaghipour G, Bazargan M, Caldwell CH. Reward Responsiveness in the Adolescent Brain Cognitive Development (ABCD) Study: African Americans' Diminished Returns of Parental Education. Brain Sci 2020; 10:E391. [PMID: 32575523 PMCID: PMC7349244 DOI: 10.3390/brainsci10060391] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 02/08/2023] Open
Abstract
(1) Background: Reward responsiveness (RR) is a risk factor for high-risk behaviors such as aggressive behaviors and early sexual initiation, which are all reported to be higher in African American and low socioeconomic status adolescents. At the same time, parental education is one of the main drivers of reward responsiveness among adolescents. It is still unknown if some of this racial and economic gap is attributed to weaker effects of parental education for African Americans, a pattern also called minorities' diminished returns (MDRs). (2) Aim: We compared non-Hispanic White and African American adolescents for the effects of parent education on adolescents RR, a psychological and cognitive construct that is closely associated with high-risk behaviors such as the use of drugs, alcohol, and tobacco. (3) Methods: This was a cross-sectional analysis that included 7072 adolescents from the adolescent brain cognitive development (ABCD) study. The independent variable was parent education. The main outcome as adolescents' RR measured by the behavioral inhibition system (BIS) and behavioral activation system (BAS) measure. (4) Results: In the overall sample, high parent education was associated with lower levels of RR. In the overall sample, we found a statistically significant interaction between race and parent education on adolescents' RR. The observed statistical interaction term suggested that high parent education is associated with a weaker effect on RR for African American than non-Hispanic White adolescents. In race-stratified models, high parent education was only associated with lower RR for non-Hispanic White but not African American adolescents. (5) Conclusion: Parent education reduces RR for non-Hispanic White but not African American adolescents. To minimize the racial gap in brain development and risk-taking behaviors, we need to address societal barriers that diminish the returns of parent education and resources in African American families. We need public and social policies that target structural and societal barriers, such as the unequal distribution of opportunities and resources. To meet such an aim, we need to reduce the negative effects of social stratification, segregation, racism, and discrimination in the daily lives of African American parents and families. Through an approach like this, African American families and parents can effectively mobilize their resources and utilize their human capital to secure the best possible tangible outcomes for their adolescents.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
| | - Shanika Boyce
- Department of Pediatrics, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
| | - Golnoush Akhlaghipour
- Department of Neurology, University of California Los Angeles, Los Angeles, CA 90095, USA;
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA;
- Department of Family Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Cleopatra H. Caldwell
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA;
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA
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Assari S. Age-Related Decline in Children's Reward Sensitivity: Blacks' Diminished Returns. RESEARCH IN HEALTH SCIENCE 2020; 5:112-128. [PMID: 33274304 DOI: 10.22158/rhs.v5n3p112] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND It is important to study the correlates of reward sensitivity since it predicts high-risk behaviors. While ageing reduces children's reward sensitivity and its associated risk taking, there is more to find out about racial differences in regard to the effect of age on reward sensitivity. Minorities' Diminished Returns (MDRs) suggest that resources and assets show weaker effects on Black children than White children. AIM We compared White children to Black children as for the effects of age on reward sensitivity. METHODS This cross-sectional study included 10533 American children who participated in the baseline of the Adolescent Brain Cognitive Development (ABCD) study. The independent variable was age, while the dependent variable was reward sensitivity as captured by the behavioral approach/behavioral avoidance system (BAS-BIS). Gender, parental education, marital status, parental education, and household income were the covariates. RESULTS Higher age was associated with less reward sensitivity. A significant interaction was found between race and age when it comes to children's reward sensitivity. It suggested that age is associated with a smaller gain in terms of reduced reward sensitivity in Black children than White children. CONCLUSION Age is more likely to reduce reward sensitivity in White children than Black children. This finding is in line with MDRs, and may be due to social racism, segregation, stratification, and discrimination.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.,Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
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