Behavioral Impulsivity and Risk-Taking Trajectories Across Early Adolescence in Youths With and Without Family Histories of Alcohol and Other Drug Use Disorders

Assessing Children's Autonomic Nervous System Activity During Structured Tasks: A Feasibility and Reliability Study in Ghana

The significance of physiological regulation in relation to behavioral and emotional regulation is well documented, but primarily in economically advantaged contexts. Few studies have been conducted in low- and middle-income countries. We investigated the feasibility and reliability of measuring autonomic nervous system (ANS) activity and behavior during challenge tasks in 30 children aged 8-10 years in Ghana during two visits, 1 week apart. Completeness of ANS data ranged from 80% to 100% across all tasks. There was low-to-moderate test-retest reliability of video mood induction (VMI) emotion ratings and balloon analog risk task (BART) pumps (r = 0.34-0.52). VMI elicited higher targeted emotion ratings in Visit 2 than Visit 1. Respiratory sinus arrhythmia (RSA) was higher, and pre-ejection period (PEP) was longer at Visit 2 than Visit 1 for baseline and both tasks. RSA was higher at baseline than during the VMI anger scene at Visit 1, whereas PEP was shorter at baseline than during all VMI emotion scenes at Visit 2. RSA was higher at baseline than during BART at both visits. In conclusion, ANS data collection within evocative and arousing challenge tasks was feasible in Ghana, and the tasks were generally reliable and effective in eliciting target emotions and risk-taking behavior in this sample.

Ecological validity of common behavioral decision making tasks: evidence across two samples

BACKGROUND

Clinicians and scholars routinely use behavioral decision tasks to assess real-world decision making capabilities. However, many common behavioral decision making tasks lack data on the extent to which they predict real-world risky behaviors. Across two pre-registered studies, and two timepoints, we assessed decision making abilities using common behavioral tasks and predicted participants' real-world risky decision making from task performance.

METHOD

In Study 1, 918 Mechanical Turk (MTurk) workers completed three decision making tasks in addition to assessments of real-world risk behavior: preventive health behaviors, COVID-19 vaccination status, and virtual social distancing task performance. In Study 2, 221 college student participants completed the Study 1 tasks plus additional assessments of decision making and real world risk and protective behaviors.

RESULTS

Across both studies, the selected behavioral decision tasks rarely predicted real world behavior and, when they did, the relationship was weak at best.

CONCLUSIONS

These data suggest that these behavioral decision making tasks may not be good predictors of real world risky behavior at present, with some evidence that the specificity of the behavior being assessed matters (i.e. the closer the task was to the specific behavior being predicted), calling for additional ecological validity research, with a greater variety of tasks in the future.

Associations Between Family History of Alcohol and/or Substance Use Problems and Frontal Cortical Development From 9 to 13 Years of Age: A Longitudinal Analysis of the ABCD Study

Background

Previous investigations that have examined associations between family history (FH) of alcohol/substance use and adolescent brain development have been primarily cross-sectional. Here, leveraging a large population-based sample of youths, we characterized frontal cortical trajectories among 9- to 13-year-olds with (FH+) versus without (FH-) an FH and examined sex as a potential moderator.

Methods

We used data from 9710 participants in the Adolescent Brain Cognitive Development (ABCD) Study (release 4.0). FH+ was defined as having ≥1 biological parents and/or ≥2 biological grandparents with a history of alcohol/substance use problems (n = 2433). Our primary outcome was frontal cortical structural measures obtained at baseline (ages 9-11) and year 2 follow-up (ages 11-13). We used linear mixed-effects models to examine the extent to which FH status qualified frontal cortical development over the age span studied. Finally, we ran additional interactions with sex to test whether observed associations between FH and cortical development differed significantly between sexes.

Results

For FH+ (vs. FH-) youths, we observed increased cortical thinning from 9 to 13 years across the frontal cortex as a whole. When we probed for sex differences, we observed significant declines in frontal cortical thickness among boys but not girls from ages 9 to 13 years. No associations were observed between FH and frontal cortical surface area or volume.

Conclusions

Having a FH+ is associated with more rapid thinning of the frontal cortex across ages 9 to 13, with this effect driven primarily by male participants. Future studies will need to test whether the observed pattern of accelerated thinning predicts future substance use outcomes.

Patterns of executive functions and theory of mind in adults with a family history of alcohol use disorder: Combined group and single-case analyses

BACKGROUND

Impairments in executive function and social cognition are highly prevalent in individuals with an alcohol use disorder (AUD). Some studies show that similar difficulties are displayed by individuals with a positive family history of AUD (FH+) compared with individuals with a negative family history (FH-). Yet, no studies have jointly investigated cognitive and affective theory of mind at the behavioral level. Moreover, some studies show preserved executive and socioemotional functioning in FH+ participants. One possible explanation for these divergent results is that FH+ individuals are cognitively heterogeneous. In this study, we examined the frequency and co-occurrence of difficulties in executive function and social cognition among FH+ individuals at the individual level.

METHODS

Sixty FH+ and 60 FH- participants matched on age, sex, and education level were included. They completed tasks assessing executive functions (Stroop, Trail Making Test) and affective and cognitive theory of mind (Movie for the Assessment of Social Cognition). They also completed self-report questionnaires measuring impulsivity, alexithymia, and empathy. Single-case analyses assessed the proportion of FH+ participants with difficulties in executive function and/or theory of mind.

RESULTS

FH+ individuals exhibited difficulties in response inhibition and made more errors during theory of mind processing, indicating an absence of mental state representation, compared with FH- individuals. In the FH+ sample, 53.33% had executive function and/or theory of mind difficulties. Those with lower theory of mind scores reported higher alexithymia and lower empathy on self-report measures.

CONCLUSIONS

FH+ individuals display heterogeneous executive function and theory of mind abilities. Given that they mostly occur independently of one another, executive function and theory of mind difficulties may be distinct vulnerability markers in AUD.

Prenatal alcohol exposure and attention-deficit/hyperactivity disorder independently predict greater substance use in young adulthood

BACKGROUND

The degree to which prenatal alcohol exposure (PAE) may influence alcohol and drug use in adulthood is difficult to determine. That is because PAE is highly correlated with environmental factors, including low socioeconomic status and exposure to parental drinking, and with behavioral problems, such as, attention-deficit/hyperactivity disorder (ADHD), which are correlated with alcohol use and abuse.

METHODS

Participants were 121 young adults from our Detroit Longitudinal Cohort study. Mothers were recruited during pregnancy and interviewed about their alcohol consumption using a timeline follow-back procedure. At 19 years, their offspring were interviewed regarding current and past use of alcohol, cigarettes, and other illicit drugs.

RESULTS

PAE was associated with greater alcohol, cannabis, and cigarette use. PAE, assessed using overall alcohol intake during pregnancy and alcohol dose per occasion, was associated with larger quantities of alcohol per occasion and greater alcohol tolerance in early adulthood. These effects persisted after control for demographic background, sex, age and education of participant, home environment, other prenatal drug exposure, and postnatal alcohol and drug use by the primary caregiver. Whereas ADHD predicted average alcohol consumed/month during young adulthood, PAE predicted alcohol dose/drinking occasion, and the effect on dose/occasion was not mediated by ADHD.

CONCLUSIONS

The effects of PAE on alcohol and cannabis use in young adulthood are not attributable to being reared in an environment that is socioeconomically disadvantaged or in one in which there is extensive maternal drinking. Furthermore, PAE was related to enhanced alcohol tolerance in young adults, a risk factor for alcohol use disorder later in life. Although ADHD was associated with greater alcohol consumption in early adulthood, it did not mediate the effect of PAE on offspring's alcohol use.

Sooner is Better: Longitudinal Relations Between Delay Discounting, and Depression and Anxiety Symptoms among Vietnamese Adolescents

Delay discounting refers to the decline in the present value of an outcome as a function of the delay to its receipt. Research on delay discounting initially focused on substance abuse, generally finding that greater delay discounting is associated with increased risk for and severity of substance abuse. More recently, delay discounting has been linked theoretically and empirically to affective psychopathology, potentially suggesting novel intervention targets for mental health problems such as depression and anxiety. Longitudinal research consequently is critical to determine direction of causality and rule out possible third variable explanations. Only a small number of longitudinal studies have been conducted in this area, however. Furthermore, socio-economic and socio-cultural factors may influence delay discounting and its effects, but thus far the literature is relatively limited in this regard. The present study focused on adolescence, a key time-period for development of delay discounting and emotional problems. Longitudinal relations between delay discounting, and depression and anxiety symptoms were assessed among 414 adolescents in Vietnam, a lower-middle-income Southeast Asian nation with significant cultural divergence from Western countries. In contrast to most cross-sectional studies that have found positive or non-significant correlations, in the present study delay discounting at Time 1 had a negative beta with anxiety and depression symptoms at Time 1, with preference for immediate but smaller rewards (higher discounting) at Time 1 associated with lower anxiety and depression symptoms at Time 2. These results suggest that under certain circumstances, steeper delay discounting may be adaptive and supportive of emotional mental health.

A Model Guided Approach to Evoke Homogeneous Behavior During Temporal Reward and Loss Discounting

Background

The tendency to devaluate future options as a function of time, known as delay discounting, is associated with various factors such as psychiatric illness and personality. Under identical experimental conditions, individuals may therefore strongly differ in the degree to which they discount future options. In delay discounting tasks, this inter-individual variability inevitably results in an unequal number of discounted trials per subject, generating difficulties in linking delay discounting to psychophysiological and neural correlates. Many studies have therefore focused on assessing delay discounting adaptively. Here, we extend these approaches by developing an adaptive paradigm which aims at inducing more comparable and homogeneous discounting frequencies across participants on a dimensional scale.

Method

The proposed approach probabilistically links a (common) discounting function to behavior to obtain a probabilistic model, and then exploits the model to obtain a formal condition which defines how to construe experimental trials so as to induce any desired discounting probability. We first infer subject-level models on behavior on a non-adaptive delay discounting task and then use these models to generate adaptive trials designed to evoke graded relative discounting frequencies of 0.3, 0.5, and 0.7 in each participant. We further compare and evaluate common models in the field through out-of-sample prediction error estimates, to iteratively improve the trial-generating model and paradigm.

Results

The developed paradigm successfully increases discounting behavior during both reward and loss discounting. Moreover, it evokes graded relative choice frequencies in line with model-based expectations (i.e., 0.3, 0.5, and 0.7) suggesting that we can successfully homogenize behavior. Our model comparison analyses indicate that hyperboloid models are superior in predicting unseen discounting behavior to more conventional hyperbolic and exponential models. We report out-of-sample error estimates as well as commonalities and differences between reward and loss discounting, demonstrating for instance lower discounting rates, as well as differences in delay perception in loss discounting.

Conclusion

The present work proposes a model-based framework to evoke graded responses linked to cognitive function at a single subject level. Such a framework may be used in the future to measure cognitive functions on a dimensional rather than dichotomous scale.

Addictive use of digital devices in young children: Associations with delay discounting, self-control and academic performance

The use of smartphones, tablets and laptops/PCs has become ingrained in adults’ and increasingly in children’s lives, which has sparked a debate about the risk of addiction to digital devices. Previous research has linked specific use of digital devices (e.g. online gaming, smartphone screen time) with impulsive behavior in the context of intertemporal choice among adolescents and adults. However, not much is known about children’s addictive behavior towards digital devices and its relationship to personality factors and academic performance. This study investigated the associations between addictive use of digital devices, self-reported usage duration, delay discounting, self-control and academic success in children aged 10 to 13. Addictive use of digital devices was positively related to delay discounting, but self-control confounded the relationship between the two variables. Furthermore, self-control and self-reported usage duration but not the degree of addictive use predicted the most recent grade average. These findings indicate that children’s problematic behavior towards digital devices compares to other maladaptive behaviors (e.g. substance abuse, pathological gambling) in terms of impulsive choice and point towards the key role self-control seems to play in lowering a potential risk of digital addiction.

Differential effects of quinine adulteration of alcohol on seeking and drinking

Alcohol dependence is characterized by compulsive alcohol use. Alcohol-paired stimuli can drive compulsive alcohol use, induce craving, and lead to relapse. Alcohol dependence is highly heritable, and individuals with a family history are at elevated risk to develop an alcohol use disorder. Understanding the association between genetic vulnerability to alcohol dependence and neural alterations that promote an addiction phenotype are critical to the prevention and treatment of alcohol dependence. Here we use selectively bred alcohol-preferring P rats and their progenitor strain, Wistar rats, to investigate the relationship between genetic liability and alcohol-seeking and drinking behaviors in a discriminative stimuli paradigm. To further investigate strain differences in motivated responding, alcohol was adulterated with quinine, and intake and responding were assessed. While both strains learned to discriminate between stimuli that predicted alcohol availability, P rats learned faster and consumed more alcohol. Quinine adulteration reduced ethanol intake in both strains with no effect on ethanol-seeking measures. These data suggest genetic vulnerability to alcohol dependence is associated with increased motivated behaviors and highlight the utility of P rats in teasing apart the neural mechanisms associated with this phenotype. Additionally, these data suggest a dissociation between the neural systems that engage ethanol drinking versus compulsive ethanol seeking.

On Imbalance of Impulse Control and Sensation Seeking and Adolescent Risk: An Intra-individual Developmental Test of the Dual Systems and Maturational Imbalance Models

Heterogeneity in development of imbalance between impulse control and sensation seeking has not been studied until now. The present study scrutinized this heterogeneity and the link between imbalance and adolescent risk. Seven-wave data of 7,558 youth (50.71% males; age range from 12/13 until 24/25) were used. Three developmental trajectories were identified. The first trajectory, “sensation seeking to balanced sensation seeking”, included participants with a higher level of sensation seeking than impulse control across all ages. The second trajectory, “moderate dominant control”, included participants showing moderate and increasing impulse control relative to sensation seeking across all ages. The third trajectory, “strong late dominant control”, included participants showing the highest level of impulse control which was about as strong as sensation seeking from early to middle adolescence and became substantially stronger from late adolescence to early adulthood. Although the systematic increase of impulse control in all subgroups is in line with both models, neither of these combined trajectories of control and sensation seeking was predicted by the Dual Systems Model or the Maturational Imbalance Model. Consistent with both models the “sensation seeking to balanced sensation seeking” trajectory showed the highest level of substance use. It can be concluded that, even though both theories adequately predict the link between imbalance and risk, neither the Dual Systems Model nor the Maturational Imbalance Model correctly predict the heterogeneity in development of imbalance between impulse control and sensation seeking.

A Systematic Review of the Balloon Analogue Risk Task (BART) in Alcohol Research

Risk-taking propensity has been crucial to the investigation of alcohol use and consequences. One measure, the balloon analogue risk task (BART), has been used consistently over the past two decades. However, it is unclear how this measure is related to alcohol outcomes. This paper systematically reviews the literature on the BART and alcohol outcomes. First, direct associations between the BART and alcohol use are reviewed including correlations, group comparisons, the BART's prediction of alcohol outcomes and BART performance after consuming alcohol. Then, potential moderators that explain when and for whom the BART is related to alcohol outcomes are reviewed. Finally, potential mechanisms that explain how the BART and alcohol outcomes are related are reviewed. This review reveals patterns in the BART suggesting risk-taking propensity may be related to changes in alcohol use over time; however, there is little evidence to suggest BART scores increase after consuming alcohol. Yet, additional research suggests adjusted average pump scores may be too simplistic for the amount of information the BART captures and understanding individual's patterns of responses on the BART is important for investigating its relation to alcohol outcomes. Finally, this review opens up several future directions for research to understand how risk-taking propensity is related to alcohol outcomes.

Impulsivity traits and neurocognitive mechanisms conferring vulnerability to substance use disorders

Impulsivity - the tendency to act without sufficient consideration of potential consequences in pursuit of short-term rewards - is a vulnerability marker for substance use disorders (SUD). Since impulsivity is a multifaceted construct, which encompasses trait-related characteristics and neurocognitive mechanisms, it is important to ascertain which of these aspects are significant contributors to SUD susceptibility. In this review, we discuss how different trait facets, cognitive processes and neuroimaging indices underpinning impulsivity contribute to the vulnerability to SUD. We reviewed studies that applied three different approaches that can shed light on the role of impulsivity as a precursor of substance use related problems (versus a consequence of drug effects): (1) longitudinal studies, (2) endophenotype studies including non-affected relatives of people with SUD, and (3) clinical reference groups-based comparisons, i.e., between substance use and behavioural addictive disorders. We found that, across different methodologies, the traits of non-planning impulsivity and affect-based impulsivity and the cognitive processes involved in reward-related valuation are consistent predictors of SUD vulnerability. These aspects are associated with the structure and function of the medial orbitofrontal-striatal system and hyperexcitability of dopamine receptors in this network. The field still needs more theory-driven, comprehensive studies that simultaneously assess the different aspects of impulsivity in relation to harmonised SUD-related outcomes. Furthermore, future studies should investigate the impact of impulsivity-related vulnerabilities on novel patterns of substance use such as new tobacco and cannabinoid products, and the moderating impact of changes in social norms and lifestyles on the link between impulsivity and SUD. This article is part of the special issue on 'Vulnerabilities to Substance Abuse'.

Behavioral processes and risk for problem substance use in adolescents

This narrative review examines associations of delay discounting, response inhibition, sensation-seeking, and urgency with adolescent problem substance use. Each of these processes is linked to adult substance use disorders, is associated with conditions linked to increased risk for adolescent problem substance use, and predicts problem substance use. Notably, all processes are linked to early life adversity (ELA) exposure and most appear to help explain links between ELA exposure and problem substance use. These findings are consistent with a growing body of literature indicating ELA interferes with the development of neural circuits crucial to cognitive functioning and emotion regulation. Further, developmental trajectories of these processes generally align with maturational imbalance hypotheses of adolescent risk. Ongoing and pending large longitudinal studies may be essential for better understanding how ELA and other influences shapes these processes and the role of these processes in risk for problem substance use in adolescence and beyond. Finally it is possible that risk-related processes may be useful metrics in the context of implementing and evaluating strategies to prevent problem substance use in adolescence.

Altitude and latitude variations in trait-impulsivity, depression, anxiety, suicidal risk, and negative alcohol-related consequences in Argentinean adolescents

The aims of this research were threefold: 1) to analyze mental health state both general (GMHS, i.e., self-perceived health and psychological distress) and specific (SMHS; i.e., depression, trait-anxiety, negative alcohol-related consequences, and suicidal risk), and impulsivity-related traits (i.e., negative urgency, positive urgency, [lack of] perseverance, [lack of] premeditation, and sensation seeking) in a sample of Argentinean adolescent college students, in function of sex (women, men) and three different altitude-latitude regions (high-north, middle-center, low-south), for identifying common and specific features; 2) to analyze relationships between impulsivity-related traits and indicators of GMHS and SMHS, in the entire sample and in each altitude-latitude region, for understanding the importance of impulsivity-related traits in these forms of mental disorders; and 3) to analyze bivariate relationships between depression, trait-anxiety, negative alcohol-related consequences, and suicidal risk, in the entire sample and considering the three altitude-latitude regions, for testing two-disorder comorbidities. Scores on impulsivity-related traits differed by sex and by altitude-latitude region. GMHS and SMHS differed by sex but not by altitude-latitude region. Several relationships were found between impulsivity-related traits, GMHS, and SMHS as well as between indicators of SMHS. Some of these relationships were dependent on altitude-latitude regions, and implications of these findings were discussed.

The disengaging brain: Dynamic transitions from cognitive engagement and alcoholism risk

Human functional brain connectivity is usually measured either at "rest" or during cognitive tasks, ignoring life's moments of mental transition. We propose a different approach to understanding brain network transitions. We applied a novel independent component analysis of functional connectivity during motor inhibition (stop signal task) and during the continuous transition to an immediately ensuing rest. A functional network reconfiguration process emerged that: (i) was most prominent in those without familial alcoholism risk, (ii) encompassed brain areas engaged by the task, yet (iii) appeared only transiently after task cessation. The pattern was not present in a pre-task rest scan or in the remaining minutes of post-task rest. Finally, this transient network reconfiguration related to a key behavioral trait of addiction risk: reward delay discounting. These novel findings illustrate how dynamic brain functional reconfiguration during normally unstudied periods of cognitive transition might reflect addiction vulnerability, and potentially other forms of brain dysfunction.

Association of PPM1G methylation with risk-taking in alcohol use disorder

Alcohol use disorder (AUD) is a chronic and relapsing disease with a substantial genetic influence. Given the recent discovery of the association of PPM1G methylation with alcohol use disorder (AUD) from a genome-wide methylation study, we sought to verify and extend the previous work of AUD-related impulsivity in a Korean population with AUD. A total of 244 men with AUD were assessed for psychological characteristics and behavioral impulsivity using stop signal task (response inhibition) and Balloon Analog Risk Task (risk-taking). Leukocyte DNA methylation at PPM1G was quantified using pyrosequencing. The effects of PPM1G methylation on severity of problematic drinking measured by Alcohol Use Disorder Identification Test (AUDIT) and multidimensional impulsivity were tested using linear regression analyses. Hypermethylation of PPM1G was significantly associated with risk-taking propensity among men with AUD. No significant association of PPM1G methylation was found to be associated with AUDIT scores and response inhibition. Our findings indicate that altered methylation of PPM1G may influence the impulsive choice of risk-taking in AUD. Further research is required in order to determine the role of PPM1G in the pathophysiology of AUD and multidimensional impulsivity.

Impulsivity and Impulsivity-Related Endophenotypes in Suicidal Patients with Substance Use Disorders: an Exploratory Study

Suicidal behavior (SB) is a major problem in patients with substance use disorders (SUDs). However, little is known about specific SB risk factors in this population, and pathogenetic hypotheses are difficult to disentangle. This study investigated some SB and SUD-related endophenotypes, such as impulsivity, aggression, trait anger, and risk-taking behaviors (RTBs), in forty-eight patients with SUDs in relation to lifetime history of suicide attempts (SAs). Disorders related to alcohol, cannabis, cocaine, opiates, and hallucinogenic drugs were included. Lifetime SAs was significantly associated with both higher impulsivity and higher aggression, but not with trait anger. A higher number of RTBs were associated with lifetime SAs and higher impulsivity, but not with aggression and trait anger. Assessing these endophenotypes could refine clinical SB risk evaluation in SUDs patients by detecting higher-risk subgroups. An important limitation of this study is exiguity of its sample size. Its primary contribution is inclusion of all SUD types.

Changes in delay discounting, substance use, and weight status across adolescence

OBJECTIVE

Higher rates of delay discounting have been consistently linked to maladaptive health behaviors, including substance use and overeating, among adults. Despite adolescence representing a critical period for the escalation of these risky health behaviors, little is known about the developmental course of delay discounting or how this construct relates to important health outcomes in youth. The current study examined change in delay discounting over time using a latent growth curve approach and the relation between growth in this construct and changes in substance use and body-mass index over a 6-year period.

METHOD

Participants included 247 adolescents (44% female) with a mean age of 13 at the initial assessment.

RESULTS

Findings suggest that, on average, rates of delay discounting are stable across adolescence; however, there are significant individual differences around this trajectory. Moreover, youth who demonstrate significant increases in delay discounting over time are also more likely to experience more rapid escalations of both substance use and Body Mass Index across adolescence.

CONCLUSIONS

Results indicate that delay discounting is an important trans-disease process among adolescents. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Effects of Substance Misuse and Family History of Substance Use Disorder on Delay Discounting in Adolescents and Young Adults with Attention-Deficit/Hyperactivity Disorder

BACKGROUND

Attention-deficit/hyperactivity disorder (ADHD) and substance use disorder (SUD) often co-occur. Both disorders are characterized by impulsive choice. However, little is known about the effects of substance misuse (SM) and family history of SUD (FH) on impulsive choice in ADHD-SUD comorbidity. Impulsive choice is also linked to callous-unemotional (CU) traits, which are suggested to play a role in ADHD-SUD comorbidity. Our aim was to examine the effects of (1) FH and (2) SM on impulsive choice, while exploring the role of CU traits.

METHODS

Impulsive choice was assessed with the delay discounting (DD) task. We compared task performance across (1) ADHD patients and controls with or without FH of SUD (ADHD FH+: n = 86; ADHD FH-: n = 63; control FH+: n = 49; control FH-: n = 72; mean age of the whole sample [n = 270]: 16.39, SD: 3.43) and (2) family history-matched ADHD groups with and without SM and controls (ADHD + SM: n = 62; ADHD-only: n = 62; controls: n = 62; mean age of the whole sample [n = 186]: 18.01, SD: 2.71). Effects of CU traits were explored by adding this as a covariate in all analyses.

RESULTS

(1) There was no main effect of FH on DD. (2) We found increased DD in ADHD + SM compared to ADHD-only and no difference between ADHD-only and controls. Finally, increased DD was associated with increased callous traits only in ADHD FH+ and control FH+.

CONCLUSIONS

In adolescents and young adults with ADHD, high impulsive choice might only be present in those with comorbid SM and in an FH+ subgroup with high callous traits. This suggests that impulsive choice in ADHD might result from (1) effects of SM and (2) a combined effect of SUD vulnerability and high callousness. Future studies should investigate efficacy of early interventions, targeting CU traits.

The Predictive Value of Impulsivity and Risk-Taking Measures for Substance Use in Substance Dependent Offenders

Impulsivity and risk-taking are known to have an important impact on problematic substance use and criminal behavior. This study examined the predictive value of baseline self-report and behavioral impulsivity and risk-taking measures [Delay Discounting Task (DDT), Balloon Analogue Risk Task (BART) and Behavioral Inhibition, Behavioral Activation Scale (BIS/BAS)] in 12-months follow-up substance use outcomes (e.g., use of alcohol, cannabis and other substances) and criminal recidivism (yes/no). Participants were 213 male offenders with a substance use disorder (SUD) under probation supervision. Bivariate regression analyses showed that BIS and BAS levels were associated (respectively) with the use of alcohol and cannabis. Multiple regression analysis showed that BIS was negatively associated with alcohol use at follow-up, whereas cannabis use at baseline and BAS predicted cannabis use at follow-up. At a trend level, interactions between delay discounting and risk-taking, and interactions between baseline cannabis use and BAS and BART predicted cannabis use at follow-up. Other substance use at follow-up was solely predicted by baseline other substance use. Overall, the findings provide marginal support for the predictive utility of impulsivity and risk-taking in accounting for variability in substance use among offenders with a SUD. This may be partly explained by the fact that only a limited number of psychological factors was assessed in this study. The studied population consists of a severe group, in which relapse into substance use or criminal behavior likely is related to complex, interacting biopsychosocial factors, of which impulsivity measures play a relatively small part.

Borderline Personality Disorder: Associations Between Dimensional Personality Profiles and Self-Destructive Behaviors

Ongoing research is shifting towards a dimensional understanding of borderline personality disorder (BPD). Aim of this study was to identify personality profiles in BPD that are predictive of self-destructive behaviors. Personality traits were assessed (n = 130) according to the five-factor model of personality (i.e., Neuroticism, Extraversion, Openness to Experience, Agreeableness, Conscientiousness) and an additional factor called Risk Preference. Self-destructive behavior parameters such as non-suicidal self-injury (NSSI) and other borderline typical dyscontrolled behaviors (e.g., drug abuse) were assessed by self-report measures. Canonical correlation analyses demonstrated that Neuroticism, Extraversion, and Conscientiousness are predictors of NSSI. Further, Neuroticism, Agreeableness, and Risk Preference were associated with dyscontrolled behaviors. Our results add further support on personality-relevant self-destructive behaviors in BPD. A combined diagnostic assessment could offer clinically meaningful insights about the causes of self-destruction in BPD to expand current therapeutic repertoires.

Early life adversity and increased delay discounting: Findings from the Family Health Patterns project

Increased discounting (devaluing) of delayed rewards is associated with nearly all types of substance use disorders (SUDs) and is also present in individuals with family histories of SUDs. Early life adversity (ELA) likely contributes to these findings as it is common in both individuals with SUDs and their children and is linked to increased delay discounting and other neurocognitive impairments in human and animal studies. Here we examined data from 1192 healthy young adults (average age 23.6 years old) with (SUDs+) and without (SUDs-) histories of SUDs and with (FH+) and without (FH-) family histories of SUDs. A 2-way ANOVA was conducted to examine the effects of SUDs (SUDs-, SUDs+) and FH (FH-, FH+) on delay discounting followed by an examination of the effects of adding ELA to the model. First, we replicated findings that SUDs+ and FH+ participants had increased rates of delay discounting. After taking ELA into account, the effect of SUDs and FH on delay discounting were both reduced but still significant. The association of ELA and delay discounting was similar in magnitude among both SUDs+ and SUDs- participants and FH+ and FH- participants; those with higher levels of ELA had increased delay discounting. Collectively, these findings indicate that increased ELA is closely associated with the increased delay discounting seen in SUDs+ and FH+ individuals and suggests ELA may be contributing to the increased delay discounting seen in these populations. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

P3 Component as a Potential Endophenotype for Control Inhibition in Offspring of Alcoholics

Aims

To assess inhibitory processes and the ongoing event-related potential (ERP) activity of offspring of alcoholics (OA) during a Go/No-Go task, with the purpose of characterizing possible psychophysiological endophenotypes for alcohol-dependent vulnerability.

Short summary

EEG recordings and ERP measurements of young adults with positive and negative family history of alcoholism where obtained while they performed a Go/No-Go task to assess inhibitory processes. Offspring of alcoholics showed a different ERP pattern compared to the control group and exerted greater effort than the control group.

Methods

ERP measurements were obtained by electroencephalogram (EEG) recordings of 65 participants divided into two groups: one group of 30 subjects with positive family history of alcoholism and a control group of 35 subjects with negative family history of alcoholism. They performed a Go/No-Go task, where each individual was required to classify visual stimuli by colour (Go) and inhibit their response to a No-Go signal.

Results

OA have higher P3 amplitudes during the Go condition in all of the regions analysed and higher No-Go P3 amplitudes than control subjects in the frontal region. Unlike controls, OA have no differences between the P3 amplitudes across conditions.

Conclusions

The absence of differences between the P3 Go and No-Go observed in the OA group can be interpreted as a possible alteration related with inhibition, in a way that they may need to recruit similar resources for inhibitory and classificational processes for both conditions. Therefore, the P3 component may be considered as a useful endophenotype and a vulnerability marker to develop addictive behaviour.

Trait Impulsivity in Alcohol-naïve Offspring at High Risk for Alcoholism

BACKGROUND

Impulsivity is considered to be a vulnerability marker for substance use disorders, including alcoholism, in offspring with familial alcoholism. However, it is not adequately explored whether different age groups offspring at high risk for alcoholism differ in their impulsivity. The present study examined trait impulsivity in offspring at high risk for alcoholism, and further examined impulsivity by categorizing these offspring into different age groups. The study also examined the association between impulsivity and age, and the association of executive functions with age and education.

MATERIALS AND METHODS

Sample consisted of alcohol-naïve offspring at high (n = 34) and low (n = 34) risk for alcoholism. Participants were matched on age (±1 year), education (±1 year), and gender. The measures included were: Mini-international neuropsychiatric interview, family interview for genetic studies, sociodemographic data sheet, Annett's handedness questionnaire, Barratt's Impulsiveness Scale-version 11, and tests assessing executive functions.

RESULTS

Offspring at high risk for alcoholism demonstrated significantly high impulsivity. Furthermore, offspring at high risk were categorized into three subgroups with age. Results showed no significant difference between the subgroups with respect to impulsivity. Correlation analysis revealed no significant association between impulsivity and age. However, executive functions (concept formation, working memory, and safe decision-making) showed significant positive association, while perseveration and risky decision-making showed a negative association with age and education in both the groups.

CONCLUSION

The present study demonstrates high impulsivity trait in offspring at high risk for alcoholism. The high impulsivity could pose a risk for addiction and may require preventive intervention.

Trajectories of impulsivity by sex predict substance use and heavy drinking

Although impulsivity and sensation seeking have been consistently associated with substance use, few studies have analyzed the relationship between changes in these variables and substance use in early adolescents. The aim of this study was to identify trajectories of impulsivity and sensation seeking and explore their relationship with substance use and heavy drinking. A total of 1342 non-user adolescents (53.6% males; mean age = 12.98, SD = 0.50) annually completed the Barratt Impulsiveness Scale, the Zuckerman's Impulsive Sensation Seeking scale and a delay discounting task, over a total period of three years. Past alcohol, tobacco and cannabis use, drunkenness episodes (DE) and problem drinking were also assessed. Impulsivity trajectories were explored using latent class mixed modelling. To study their predictive power binary logistic regressions were used. Two trajectories of impulsivity were found in males and five were found in females. Males with an increasing impulsivity trajectory were more likely to report tobacco [odds ratio (OR) = 1.84] and cannabis (OR = 3.01) use, DE (OR = 2.44) and problem drinking (OR = 3.12). The early increasing trajectory in females predicted tobacco use (OR = 3.71), cannabis use (OR = 5.87) and DE (OR = 3.64). Lack of premeditation and delay discounting were the most relevant facets in high-risk trajectories. Selective intervention and more intense and tailored treatment might help these adolescents to reduce early increases in impulsivity and prevent escalation of substance use.

Psychosocial and neural indicators of resilience among youth with a family history of substance use disorder

BACKGROUND

Little is known regarding the combined influence of psychosocial and neural protective mechanisms against substance use. The present study examined the extent to which neuroimaging measures of disinhibition predicted resilience against binge drinking and marijuana use among youth with a family history of substance use disorder (SUD; FH+), accounting for psychosocial measures of behavioral control.

METHODS

Participants were 57 FH+ youth from the Michigan Longitudinal Study categorized into resilient and high-risk groups based on patterns of weekly binge drinking and monthly marijuana use during early adulthood. Psychosocial measures of behavioral control (reactive control and externalizing behavior during early and late adolescence) and neural measures of disinhibition (Go/No-Go task and Monetary Incentive Delay Task (MIDT) measured through functional magnetic resonance imaging (fMRI)) were entered sequentially in hierarchical logistic regression models to predict resilient versus high-risk groups.

RESULTS

Greater activation in the right dorsolateral prefrontal cortex (DLPFC) during correctly inhibited trials on the Go/No-Go task was a significant predictor of resilience (OR = 2.46, p < 0.05), over and above greater reactive control in early adolescence (OR = 4.96, p < 0.05) and lower externalizing behavior in late adolescence (OR = 0.64, p < 0.05). Neural activation in the ventral striatum associated with reward anticipation during the MIDT was not a significant predictor of resilience.

CONCLUSIONS

Brain function in the right DLPFC associated with inhibitory control may be a neural indicator of resilience against elevated substance use among FH+ youth, even after accounting for psychosocial measures of behavioral control.

A test of the psychometric characteristics of the BIS-Brief among three groups of youth

The Barratt Impulsiveness Scale (BIS-11) is the most widely administered trait impulsiveness questionnaire. Recently a shorter, unidimensional version of the instrument was developed for adults (BIS-Brief). While psychometric characteristics of the BIS-Brief support its use among adults, it also may be more appropriate for youth samples than the complete BIS-11 because it less burdensome and omits items about activities not usually encountered by children and adolescents. This article describes a test of psychometric characteristics of the BIS-Brief among youth. To measure a sufficiently wide range of scores, analyses were conducted based on secondary data analysis of data sets pooled from 3 distinct youth cohorts aged 10-17: healthy controls (Control; n = 356); those who had a family history of substance use disorder (FH+; n = 302); and psychiatric inpatients (Patients; n = 322). Model fit for the BIS-Brief was good but varied somewhat depending on the respondent cohort. There was a strong correlation between test and re-test BIS-Brief both within a single day and at 6 months, and also a strong correlation between BIS-Brief and BIS-11 scores. Concurrent validity was supported by correlation with questionnaire measures, which tended to be more robustly associated with BIS-Brief than behavioral measures. Both BIS-Brief and BIS-11 forms were similarly associated with other convergent measures. In conclusion, the BIS-Brief is a shorter version of the BIS-11 that reduces participant burden and with psychometric properties that support its use among youth populations. (PsycINFO Database Record

Defining the phenotype of young adults with family histories of alcohol and other substance use disorders: Studies from the family health patterns project

Individuals with a family history of alcohol and other drug use disorders (FH+) are at increased risk for developing substance use disorders themselves relative to those with no such histories (FH-). Here we sought to identify key characteristics associated with FH+ status and alcohol and other drug use disorder status in a large cohort of FH+ and FH- young adults. We conducted principal component analyses on demographic, temperament, and cognitive measures differentiating 506 FH+ and 528 FH- young adults. Three principal components were identified, and these component scores were then used to predict the odds of being FH+ and the odds of having an alcohol or other drug use disorder. Component 1 consisted of measures indexing internalizing traits, with higher component scores indicating greater depressive, anxious, and emotional instability tendencies. Component 2 consisted of measures of externalizing traits as well as exposure to early life adversity (ELA), with higher scores indicating less impulse control, more antisocial behavior, and greater ELA exposure. Component 3 consisted of estimated intelligence, delay discounting, and demographic characteristics, with higher scores indicating lower estimated intelligence, greater discounting of delayed rewards, less education, and lower childhood socioeconomic status. For each 1-point increase in the Component 1, 2, and 3 scores, the odds of being classified FH+ increased by 2%, 8%, and 4%, respectively. Similar findings were observed when individuals with alcohol or other drug use disorders were removed from the analyses. Finally, greater Component 2 scores were also associated with increased odds of having an alcohol or other drug use disorder. Collectively, these findings provide a more comprehensive understanding of the FH+ phenotype in young adults and help form a basis for further studies on biological mechanisms underlying risk for substance use disorders. The present findings also provide further support for a prominent role of ELA in promoting risk for problem alcohol and other drug use.

Cortical Thickness in Adolescents with a Family History of Alcohol Use Disorder

BACKGROUND

Individuals with a family history (FH+) of alcohol use disorder (AUD) have a higher risk for developing an AUD than those with no family history (FH-) of AUD. In addition, FH+ individuals tend to perform worse on neuropsychological measures and show heightened impulsivity, which may be due to underlying differences in brain structure such as cortical thickness. The primary aim of this study was to investigate differences in cortical thickness in FH+ compared to FH- adolescents. Secondary aims were to (i) investigate differences in executive functioning and impulsivity, and (ii) examine associations between brain structure and behavior.

METHODS

Brain scans of 95 FH- and 93 FH+ subjects aged 13 to 18 were obtained using magnetic resonance imaging. FH+ subjects were required to have at least 1 biological parent with a history of an AUD. FH+ and FH- individuals had limited or no past alcohol use, thereby minimizing potential effects of alcohol. Subjects were evaluated on impulsivity and executive functioning tasks. Thicknesses of cortical lobes and subregions were analyzed using FreeSurfer. Regions showing group differences were examined for group-by-age interactions and correlations with neuropsychological and personality measures.

RESULTS

FH+ adolescents had thinner cortices in frontal and parietal lobes, notably in the medial orbitofrontal, lateral orbitofrontal, and superior parietal cortices. The difference in cortical thickness between family history groups was strongest among the youngest subjects. FH+ subjects were also more impulsive and had poorer performance on a spatial memory task.

CONCLUSIONS

These findings demonstrate frontal and parietal structural differences in FH+ adolescents that might underlie cognitive and behavioral characteristics associated with AUD risk.

Differences in decision-making as a function of drug of choice

Poor decision-making is a central feature of all substance use disorders (SUD), but substances vary in the legal and health consequences associated with their use. For example, while the negative health consequences associated with cigarette smoking are often years away, the consequences of heroin abuse can be fatal in mere hours. It remains unclear if users of these substances show decision-making patterns that differ with the relative riskiness of their drug of choice. To address this question, we reviewed studies that compared decision-making of individuals using different substances. We focused on studies assessing two of the most commonly investigated decision-making processes-delay discounting and risk taking-and specifically focused on decision-making that involved selection between options for hypothetical monetary rewards. For delay discounting, we reviewed studies that assessed decisions regarding delayed or immediate monetary rewards, and for risk-taking we reviewed studies using the Iowa Gambling Task. Studies directly comparing different SUD groups were limited in number and tended to compare alcohol or cocaine users to other substance users. Overall, these studies do not support the hypothesis that decision-making differed by drug of choice. Major limitations in the literature include failing to account for comorbid substance use and a lack of prospective longitudinal studies. Due to these limitations, conclusions should be considered provisional. Nonetheless, current findings suggest that these two facets of decision-making are similar across drugs of abuse.

Do adolescent risk behaviors mediate health and school bullying? Testing the stress process and general strain frameworks

Adolescent bullying is a significant public health issue in the United States. The health consequences of bullying may vary, however, according to the social position and characteristics of victims and bullies within the bullying subculture. For example, research suggests that bully involved youth are more likely to engage in risky health behaviors, including social withdrawal, tobacco, and alcohol use. Yet, the extent to which health outcomes are shaped by involvements in bullying or the risk behaviors associated with bullying remains unclear. In this study we assess the extent to which risk behaviors mediate the links between health outcomes of bully-involved youth using data from the Health Behavior of School Aged Children 2005-2006 Study (N = 8066). School-level fixed-effects regression models assessed whether risk behaviors mediate relationships between bullying statuses and somatic and depressive symptoms. Results show that mediational risk behavior pathways vary across outcomes for youth situated differently in the bullying subculture, with substantially more mediation for bullies than victims. This study advances the current bullying and health research by accounting for risk behavior pathways linking bullying and health.

Binge drinking and family history of alcoholism are associated with an altered developmental trajectory of impulsive choice across adolescence

AIMS

To test whether binge drinking, the density of familial alcoholism (FHD) and their interaction are associated with an altered developmental trajectory of impulsive choice across adolescence, and whether more life-time drinks are associated with a greater change in impulsive choice across age.

DESIGN

Alcohol-naive adolescents, with varying degrees of FHD, were recruited as part of an ongoing longitudinal study on adolescent development, and were grouped based on whether they remained non-drinkers (n = 83) or initiated binge drinking (n = 33) during follow-up. During all visits, adolescents completed a monetary delay discounting task to measure impulsive choice. The effects of binge-drinking status, FHD and their interaction on impulsive choice across adolescence were tested.

SETTING

Developmental Brain Imaging Laboratory, Oregon Health & Science University, Portland, Oregon, USA.

PARTICIPANTS

A total of 116 healthy male and female adolescents (ages 10-17 years at baseline) completed two to four visits between July 2008 and May 2016.

MEASUREMENTS

Discounting rates were obtained based on adolescents' preference for immediate or delayed rewards. FHD was based on parent-reported prevalence of alcohol use disorder in the participant's first- and second-degree relatives. Binge-drinking status was determined based on the number of recent binge-drinking episodes.

FINDINGS

There was a significant interaction effect of binge-drinking status and FHD on impulsive choice across age (b = 1.090, P < 0.05, β = 0.298). In adolescents who remained alcohol-naive, greater FHD was associated with a steeper decrease in discounting rates across adolescence (b = -0.633, P < 0.05, β = -0.173); however, this effect was not present in binge-drinkers. Furthermore, total life-time drinks predicted escalated impulsive choice (b = 0.002, P < 0.05, β = 0.295) in binge-drinking adolescents.

CONCLUSIONS

A greater degree of familial alcoholism is associated with a steeper decline in impulsive choice across adolescence, but only in those who remain alcohol-naive. Meanwhile, more life-time drinks during adolescence is associated with increases in impulsive choice across age.

Rapid transition from drinking to alcohol dependence among adolescent and young-adult newly incident drinkers in the United States, 2002-2013

BACKGROUND

To study male-female and age differences in estimates of rapid transition from first full drink to alcohol dependence among youthful newly incident drinkers in the United States (US).

METHOD

The study population included 12-to-25-year-old non-institutionalized US civilian residents, sampled for US National Surveys on Drug Use and Health 2002-2013, with assessments via confidential computer assisted self-interviews. Newly incident drinkers are those who had their first full drink soon before the assessment (n=32,562 12-to-25-year- olds). Alcohol dependence (AD) criteria are from DSM-IV.

RESULTS

For 12-to-25-year-old females, the peak risk for making a rapid transition from first full drink to alcohol dependence is seen during adolescence, followed by declining estimates (meta-analysis summary=3% at 12-17 years of age, 95% CI=2%, 3%). Among males, corresponding estimates fluctuate around 2%, with no appreciable differences across age strata. Among 12-to-17-year-old newly incident drinkers, there is a female excess in the rapid transition to alcohol dependence; a male excess is observed among young adult newly incident drinkers. Evaluated cohort-wise, using an epidemiological mutoscope view, individual cohorts show a congruent pattern, with age at first drink held constant.

CONCLUSIONS

Studying multiple replication samples of young newly incident drinkers, we discovered a clear female excess in the risk of a rapid transition from first full drink to alcohol dependence among adolescents, with age patterns differing across males and females.

Assessment and Treatment of Adolescent Substance Use Disorders: Alcohol Use Disorders

Alcohol drinking in childhood and adolescence is a serious public health concern. Adolescence is a vulnerable period for risk-taking tendencies. Understanding the influences of problematic alcohol use is important for evolving interventions. Alcohol use in early years foreshadows a lifetime risk for psychiatric and substance use disorders. Early screening and assessment can alter tragic sequelae. We discuss clinical aspects such as confidentiality, differential levels of care, and criteria for best fitting treatments. Given the prevalence of drinking and its impact on psychiatric and substance use disorders, the need for further study and prevention are emphasized.

Alcohol-Preferring P Rats Exhibit Elevated Motor Impulsivity Concomitant with Operant Responding and Self-Administration of Alcohol

BACKGROUND

Increased levels of impulsivity are associated with increased illicit drug use and alcoholism. Previous research in our laboratory has shown that increased levels of delay discounting (a decision-making form of impulsivity) are related to appetitive processes governing alcohol self-administration as opposed to purely consummatory processes. Specifically, the high-seeking/high-drinking alcohol-preferring P rats showed increased delay discounting compared to nonselected Long Evans rats (LE) whereas the high-drinking/moderate-seeking HAD2 rats did not. The P rats also displayed a perseverative pattern of behavior such that during operant alcohol self-administration they exhibited greater resistance to extinction.

METHODS

One explanation for the previous findings is that P rats have a deficit in response inhibition. This study followed up on this possibility by utilizing a countermanding paradigm (stop signal reaction time [SSRT] task) followed by operant self-administration of alcohol across increasing fixed ratio requirements (FR; 1, 2, 5, 10, and 15 responses). In separate animals, 24-hour access 2-bottle choice (10% EtOH vs. water) drinking was assessed.

RESULTS

In the SSRT task, P rats exhibited an increased SSRT compared to both LE and HAD2 rats indicating a decrease in behavioral inhibition in the P rats. Also, P rats showed increased operant self-administration across all FRs and the greatest increase in responding with increasing FR requirements. Conversely, the HAD2 and LE had shorter SSRTs and lower levels of operant alcohol self-administration. However, for 2-bottle choice drinking HAD2s and P rats consumed more EtOH and had a greater preference for EtOH compared to LE.

CONCLUSIONS

These data extend previous findings showing the P rats to have increased delay discounting (decision-making impulsivity) and suggest that P rats also have a lack of behavioral inhibition (motor impulsivity). This supports the notion that P rats are a highly impulsive as well as "high-seeking" model of alcoholism, and that the HAD2s' elevated levels of alcohol consumption are not mediated via appetitive processes or impulsivity.