Neural Predictors of Initiating Alcohol Use During Adolescence
Abstract
Objective:
Method:
Results:
Conclusions:
Method
Participants
Variable | Continuous Nonusers (N=67) | Moderate to Heavy Alcohol Initiators (N=70) | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Mean | SD | % | Mean | SD | % | t or χ2 | df | p | Cohen’s d | |
Demographic and family variables | ||||||||||
Sex (female) | 60 | 29 | 13.48 | 1, N=137 | <0.001 | 0.661 | ||||
Follow-up age (range=16–19)b | 18.20 | 0.66 | 18.20 | 0.57 | 0.07 | 135 | 0.943 | 0.000 | ||
Race (Caucasian) | 58 | 77 | 5.63 | 1, N=137 | 0.018 | 0.414 | ||||
Baseline Hollingshead Index of Social Position score (socioeconomic status) | 24.03 | 16.75 | 21.11 | 11.50 | 1.19 | 135 | 0.235 | 0.203 | ||
Family history density of alcohol or drug use disorder | 0.17 | 0.28 | 0.18 | 0.31 | 0.14 | 135 | 0.887 | 0.034 | ||
Baseline Pubertal Development Scale score (girls only; N=60) | 15.05 | 3.15 | 14.95 | 3.15 | 0.12 | 58 | 0.908 | 0.032 | ||
Baseline Pubertal Development Scale score (boys only; N=77) | 10.81 | 3.33 | 11.20 | 3.37 | 0.48 | 75 | 0.632 | 0.116 | ||
Baseline grade in school | 6.76 | 0.74 | 7.00 | 0.87 | 1.73 | 135 | 0.086 | 0.297 | ||
Birth order | 1.52 | 0.79 | 1.64 | 0.76 | 0.91 | 135 | 0.364 | 0.155 | ||
Baseline % living with both parents | 79 | 81 | 0.12 | 1, N=137 | 0.732 | 0.059 | ||||
Baseline % youth with biological parents married to each other | 78 | 77 | 0.00 | 1, N=137 | 0.948 | 0.000 | ||||
Baseline youth behavior, mood, and cognition | ||||||||||
Initiated dating by age 14 (%) | 22 | 61 | 21.37 | 1, N=137 | <0.001 | 0.860 | ||||
Involved in extracurricular activities (%) | 82 | 89 | 1.15 | 1, N=137 | 0.283 | 0.184 | ||||
Hours of video games played per week | 3.10 | 4.95c | 2.47 | 4.04c | 0.72 | 106 | 0.472 | 0.139 | ||
Grade point average (4.0 scale) | 3.65 | 0.45 | 3.47 | 0.55 | 2.14 | 135 | 0.034 | 0.358 | ||
CBCL externalizing disorder t score | 41.09 | 7.12d | 40.42 | 7.64d | 0.52 | 128 | 0.606 | 0.091 | ||
CBCL internalizing t score | 44.48 | 8.80d | 42.11 | 7.65d | 1.65 | 128 | 0.102 | 0.287 | ||
CBCL withdrawn t score | 52.00 | 3.79d | 51.42 | 2.69d | 1.00 | 128 | 0.319 | 0.176 | ||
CBCL somatic complaints t score | 52.45 | 4.13d | 51.79 | 3.15d | 1.04 | 128 | 0.302 | 0.180 | ||
CBCL anxious/depressed t score | 51.61 | 3.60d | 51.11 | 2.60d | 0.92 | 128 | 0.361 | 0.159 | ||
CBCL social problems t score | 51.33 | 3.62d | 50.55 | 1.64d | 1.60 | 128 | 0.113 | 0.278 | ||
CBCL thought problems t score | 51.98 | 3.90d | 51.03 | 2.31d | 1.70 | 128 | 0.091 | 0.296 | ||
CBCL attention problems t score | 51.05 | 2.16d | 51.20 | 2.81d | 0.34 | 128 | 0.734 | 0.060 | ||
CBCL delinquent behavior t score | 50.59 | 1.84d | 50.98 | 2.53d | 1.01 | 128 | 0.317 | 0.176 | ||
CBCL aggressive behavior t score | 50.75 | 2.06d | 50.68 | 2.11d | 0.19 | 128 | 0.852 | 0.034 | ||
CBCL total problem t score | 39.83 | 9.75d | 37.83 | 8.83d | 1.22 | 128 | 0.223 | 0.215 | ||
Conduct Disorder Questionnaire total score | 0.45 | 1.08 | 1.17 | 1.88 | 2.75 | 135 | 0.007 | 0.470 | ||
Beck Depression Inventory–II total score | 1.39 | 2.75e | 1.25 | 2.81e | 0.30 | 132 | 0.765 | 0.050 | ||
State-Trait Anxiety Inventory total score | 26.22 | 6.66f | 26.68 | 6.48f | 0.40 | 130 | 0.690 | 0.070 | ||
AEQ total score | 79.14 | 32.23 | 92.45 | 29.75 | 2.51 | 135 | 0.013 | 0.429 | ||
AEQ global positive score | 37.81 | 8.37 | 40.83 | 9.53 | 1.97 | 135 | 0.051 | 0.336 | ||
AEQ social behavior change score | 36.92 | 7.41 | 41.23 | 7.94 | 3.28 | 135 | 0.001 | 0.561 | ||
AEQ improved performance score | 16.55 | 4.57 | 16.96 | 4.98 | 0.50 | 135 | 0.621 | 0.086 | ||
AEQ sexual enhancement score | 20.15 | 5.06 | 21.00 | 4.07 | 1.09 | 135 | 0.279 | 0.185 | ||
AEQ impaired performance score | 98.41 | 10.08 | 96.39 | 10.28 | 1.16 | 135 | 0.247 | 0.198 | ||
AEQ increased arousal score | 24.24 | 5.44 | 24.96 | 4.78 | 0.82 | 135 | 0.414 | 0.141 | ||
AEQ relaxation score | 41.88 | 9.83 | 43.87 | 7.90 | 1.31 | 135 | 0.193 | 0.293 | ||
Baseline substance use | ||||||||||
CDDR baseline lifetime smoking days | 0.03 | 0.17 | 0.11 | 0.65 | 1.03 | 135 | 0.305 | 0.168 | ||
CDDR baseline lifetime drinking days | 0.00 | 0.00 | 0.31 | 1.50 | 1.72 | 135 | 0.089 | 0.292 | ||
CDDR baseline lifetime marijuana use days | 0.00 | 0.00 | 0.09 | 0.44 | 1.59 | 135 | 0.115 | 0.289 | ||
Total number of repetitions excluded during functional magnetic resonance imaging | 4.46 | 6.77 | 7.03 | 8.82 | 1.90 | 134 | 0.060 | 0.327 | ||
Follow-up substance use | ||||||||||
Age at first use of alcohol | 16.54 | 1.27g | 15.46 | 1.60 | 3.09 | 94 | 0.003 | 0.748 | ||
Lifetime alcohol use occasions | 1.52 | 2.87g | 69.01 | 110.58 | 4.99 | 135 | 0.000 | 0.863 | ||
Peak drinks on an occasion in past year | 0.46 | 0.96g | 9.30 | 4.60 | 15.41 | 135 | 0.000 | 2.66 | ||
Lifetime marijuana use occasions | 0.06 | 0.38h | 108.61 | 256.94 | 3.46 | 135 | 0.001 | 0.597 | ||
Reporting >30 lifetime marijuana use occasions (%) | 0 | 29 | ||||||||
Lifetime other drug use | 0.00 | 0.00 | 7.04 | 38.05 | 1.52 | 135 | 0.132 | 0.261 |
Measures
Substance use measures.
Demographic information.
Socioeconomic status.
Family background.
Pubertal development.
Psychopathology and mood.
Alcohol Expectancy Questionnaire–Adolescent version.
Neurocognition.
Continuous Nonusers (N=67) | Moderate to Heavy Alcohol Initiators (N=70) | ||||||||
---|---|---|---|---|---|---|---|---|---|
Variable | Domain Assessed | Mean | SD | Mean | SD | t | df | p | Cohen’s d |
Digit vigilance total time to complete (sec) | Sustained attention | 225.06 | 52.80a | 219.59 | 41.46a | 0.67 | 132 | 0.504 | 0.115 |
Wechsler Abbreviated Scale of Intelligence (WASI) block design raw score | Spatial perception, visual abstract processing, problem solving | 47.27 | 13.81a | 42.86 | 13.13a | 1.89 | 132 | 0.060 | 0.327 |
WASI matrix reasoning raw score | Nonverbal abstract problem solving, inductive reasoning | 27.80 | 3.62b | 26.41 | 3.34b | 2.31 | 131 | 0.023 | 0.399 |
WASI vocabulary raw score | Word knowledge, verbal concept formation | 53.02 | 7.09a | 51.96 | 7.06a | 0.87 | 132 | 0.389 | 0.150 |
WASI similarities raw score | Abstract verbal reasoning | 35.17 | 4.24a | 34.31 | 5.07a | 1.06 | 132 | 0.292 | 0.184 |
Delis-Kaplan Executive Function System (D-KEFS) trails number-letter switching time to complete (sec) | Flexibility of thinking on a visual-motor task | 70.60 | 19.45 | 77.46 | 28.75 | 1.63 | 135 | 0.106 | 0.279 |
D-KEFS towers total achievement score (raw) | Spatial planning, rule learning | 17.04 | 2.68 | 17.24 | 2.73 | 0.43 | 135 | 0.669 | 0.074 |
D-KEFS color word interference inhibition time to complete (sec) | Inhibitory functioning | 57.39 | 14.25 | 59.60 | 13.12 | 0.95 | 135 | 0.346 | 0.161 |
D-KEFS color word interference inhibition/switching time to complete (sec) | Inhibition/cognitive flexibility | 65.81 | 15.81 | 63.91 | 14.39 | 0.73 | 135 | 0.465 | 0.126 |
Rey-Osterrieth Complex Figure (ROCF) copy accuracy score | Visuospatial functioning; organization | 29.35 | 3.02a | 28.63 | 3.01a | 1.39 | 132 | 0.168 | 0.239 |
ROCF delay accuracy score | Spatial memory | 18.09 | 4.12c | 17.77 | 4.26c | 0.43 | 130 | 0.665 | 0.076 |
Wechsler Intelligence Scale for Children, 3rd edition (WISC-III), digits forward raw score | Attention | 9.91 | 1.84a | 10.17 | 1.94a | 0.81 | 132 | 0.421 | 0.138 |
WISC-III digits backward raw score | Short-term memory, attention | 6.44 | 1.74a | 6.19 | 2.05a | 0.76 | 132 | 0.447 | 0.131 |
WISC-III arithmetic raw score | Computational skills, auditory memory, attention, problem solving | 22.23 | 3.36a | 22.46 | 3.34a | 0.39 | 132 | 0.701 | 0.069 |
WISC-III coding raw score | Visual motor speed, visual memory, sustained effort and attention | 61.20 | 10.88a | 59.37 | 10.75a | 0.98 | 132 | 0.329 | 0.169 |
WISC-III mazes raw score | Planning, perceptual organization, visual-motor coordination and speed, nonverbal reasoning | 23.48 | 3.71a | 22.77 | 3.20a | 1.19 | 132 | 0.235 | 0.205 |
Wechsler Adult Intelligence Scale (WAIS-IV) letter-number sequence raw score | Attention, auditory short-term memory, sequencing ability | 10.69 | 1.94d | 10.09 | 1.88d | 1.65 | 108 | 0.103 | 0.314 |
Hooper Visual Organization Test total raw score | Visuospatial functioning and spatial integration | 25.32 | 2.26d | 24.94 | 2.40d | 0.86 | 108 | 0.392 | 0.163 |
California Verbal Learning Test (CVLT) list A total 1 to 5 raw score | Verbal learning and memory | 55.91 | 8.01a | 54.51 | 6.29a | 1.12 | 132 | 0.263 | 0.194 |
CVLT list A trial 1 raw score | Verbal learning and memory | 7.72 | 1.93a | 7.37 | 1.64a | 1.13 | 132 | 0.262 | 0.195 |
CVLT list A trial 5 raw score | Verbal learning and memory | 12.92 | 1.68a | 12.74 | 1.57a | 0.64 | 132 | 0.525 | 0.111 |
CVLT short delay free raw score | Verbal learning and memory | 11.87 | 2.07a | 11.74 | 2.29a | 0.33 | 132 | 0.743 | 0.060 |
CVLT short delay cued raw score | Verbal learning and memory | 12.15 | 1.94e | 12.19 | 1.70e | 0.12 | 129 | 0.907 | 0.022 |
CVLT long delay free raw score | Verbal learning and memory | 12.11 | 1.91f | 12.30 | 1.79f | 0.60 | 130 | 0.550 | 0.103 |
CVLT long delay cued raw score | Verbal learning and memory | 12.52 | 1.80f | 12.54 | 1.75f | 0.04 | 130 | 0.968 | 0.011 |
Wide Range Achievement Test–3 Reading raw score | Premorbid functioning and intellectual capacity | 45.44 | 4.14a | 44.67 | 4.04a | 1.08 | 132 | 0.280 | 0.188 |
Follow-up procedures.
Procedures
Image acquisition.
Visual working memory task.
Data Analysis
Structural image processing.
Variable | Model 1 | Model 2 | Model 3 |
---|---|---|---|
Demographic and family variables | |||
1. Sex | X | X | X |
2. Baseline age | |||
3. Follow-up age | X | X | X |
4. Race | |||
5. Hollingshead Index of Social Position score (socioeconomic status) | X | X | X |
6. Family history density of alcohol or drug use disorder | |||
7. Pubertal Development Scale score | X | ||
8. Grade in school | |||
9. Birth order | |||
10. Living with both parents | |||
11. Parents’ marital status | |||
Youth behavior, mood, and cognition | |||
12. Dating status | X | X | X |
13. Child involvement in extracurricular activities | |||
14. Hours of video games per week | |||
15. Grade point average | X | ||
16. CBCL externalizing t score | |||
17. CBCL internalizing t score | |||
18. CBCL withdrawn t score | |||
19. CBCL somatic complaints t score | |||
20. CBCL anxious/depressed t score | |||
21. CBCL social problems t score | |||
22. CBCL thought problems t score | |||
23. CBCL attention problems t score | |||
24. CBCL delinquent behavior t score | |||
25. CBCL aggressive behavior t score | |||
26. CBCL total problem t score | X | ||
27. Conduct Disorders Questionnaire total score | X | X | X |
28. Beck Depression Inventory-II total score | |||
29. State-Trait Anxiety Inventory total score | |||
30. AEQ total score | X | X | X |
31. AEQ global positive score | X | X | X |
32. AEQ social behavior change score | X | X | X |
33. AEQ improved performance score | |||
34. AEQ sexual enhancement score | |||
35. AEQ impaired performance score | |||
36. AEQ increased arousal score | |||
37. AEQ relaxation total score | |||
38. CDDR baseline lifetime smoking days (<5 for all participants) | |||
39. CDDR baseline lifetime drinking days (<10) | |||
40. CDDR baseline lifetime marijuana use days (<3) | |||
41. Repetitions excluded from functional magnetic resonance imaging (fMRI) series due to motion | X | ||
Neuropsychological testing variables | |||
1. Digit vigilance total time to complete (sec) | X | X | |
2. WASI block design raw score | X | X | |
3. WASI matrix reasoning raw score | X | X | |
4. WASI vocabulary raw score | X | ||
5. WASI similarities raw score | |||
6. D-KEFS trails condition 4 (number-letter switching) time to complete (sec) | X | ||
7. D-KEFS towers total achievement raw score | |||
8. D-KEFS color word interference inhibition time to complete (sec) | |||
9. D-KEFS color word interference inhibition/switching time to complete (sec) | |||
10. ROCF copy accuracy score | |||
11. ROCF delay accuracy score | |||
12. WISC-III digits forward raw score | |||
13. WISC-III digits backward raw score | |||
14. WISC-III arithmetic raw score | |||
15. WISC-III coding raw score | |||
16. WISC-III mazes raw score | |||
17. WAIS-IV letter-number sequence raw score | |||
18. Hooper Visual Organization Test total raw score | |||
19. CVLT list A total 1 to 5 raw score | |||
20. CVLT list A trial 1 raw score | |||
21. CVLT list A trial 5 raw score | |||
22. CVLT short delay free raw score | |||
23. CVLT short delay cued raw score | |||
24. CVLT long delay free raw score | |||
25. CVLT long delay cued raw score | |||
26. WRAT–3 reading raw score | |||
Cortical thickness and BOLD regionsb | |||
1. Banks of superior temporal sulcus | L-CT | ||
2. Caudal anterior cingulate | R-BOLD | ||
3. Caudal middle frontal | |||
4. Cuneus | |||
5. Entorhinal | |||
6. Fusiform | |||
7. Inferior parietal | |||
8. Inferior temporal | |||
9. Isthmus cingulate | |||
10. Lateral occipital | L-CT | ||
11. Lateral orbitofrontal | |||
12. Lingual | L-CT | ||
13. Medial orbitofrontal | |||
14. Middle temporal | R-CT, L-BOLD | ||
15. Parahippocampal | |||
16. Paracentral | |||
17. Pars opercularis | |||
18. Pars orbitalis | R-CT | ||
19. Pars triangularis | |||
20. Pericalcarine | |||
21. Postcentral | |||
22. Posterior cingulate | R-BOLD | ||
23. Precentral | |||
24. Precuneus | R-CT, L-BOLD, R-BOLD | ||
25. Rostral anterior cingulate | L-CT | ||
26. Rostral middle frontal | R-CT | ||
27. Superior frontal | R-CT | ||
28. Superior parietal | L-CT, R-CT | ||
29. Superior temporal | R-BOLD | ||
30. Supramarginal | L-CT | ||
31. Frontal pole | R-CT, R-BOLD | ||
32. Temporal pole | R-CT | ||
33. Transverse temporal | L-CT | ||
34. Insula |
Functional image processing.
Volumetric and functional image alignment.
Statistical Analysis
Results
Demographic Model
Demographic and Neuropsychological Performance Model
Demographic, Neuropsychological Performance, and Neuroimaging Model
Further Investigation of Model 3
Measure | Continuous Nonusers (N=67) | Moderate to Heavy Alcohol Initiators (N=70) | p | Variable Importance | Cohen’s d | ||||
---|---|---|---|---|---|---|---|---|---|
Mean | SD | % | Mean | SD | % | ||||
1. L supramarginal cortical thickness | 2.96 | 0.14 | 2.89 | 0.13 | 0.002 | 10.01 | 0.518 | ||
2. Sex (female)b | 60 | 29 | >0.001 | 9.99 | 0.661 | ||||
3. R posterior cingulate BOLD | –0.63 | 3.90 | –2.19 | 3.60 | 0.016 | 8.84 | 0.416 | ||
4. R superior temporal BOLD | –1.17 | 3.60 | –1.89 | 2.83 | 0.194 | 8.45 | 0.222 | ||
5. Dating at baselineb | 22 | 61 | >0.001 | 8.08 | 0.860 | ||||
6. Socioeconomic status | 24.03 | 16.75 | 21.11 | 11.50 | 0.235 | 7.44 | 0.203 | ||
7. L transverse temporal cortical thickness | 2.78 | 0.21 | 2.68 | 0.21 | 0.006 | 7.37 | 0.476 | ||
8. R pars orbitalis cortical thickness | 3.02 | 0.22 | 2.92 | 0.19 | 0.005 | 7.28 | 0.487 | ||
9. WASI matrix reasoning raw score | 27.80 | 3.62 | 26.41 | 3.34 | 0.023 | 7.11 | 0.399 | ||
10. WASI block design raw score | 47.27 | 13.81 | 42.86 | 13.13 | 0.060 | 6.43 | 0.327 | ||
11. R rostral middle frontal cortical thickness | 2.53 | 0.10 | 2.49 | 0.11 | 0.058 | 6.06 | 0.381 | ||
12. L middle temporal BOLD | –1.11 | 2.56 | –1.62 | 2.47 | 0.238 | 5.83 | 0.203 | ||
13. R superior parietal cortical thickness | 2.60 | 0.12 | 2.55 | 0.10 | 0.016 | 5.76 | 0.453 | ||
14. L lingual cortical thickness | 2.26 | 0.16 | 2.28 | 0.13 | 0.367 | 5.62 | 0.137 | ||
15. R precuneus cortical thickness | 2.82 | 0.11 | 2.78 | 0.11 | 0.049 | 5.42 | 0.364 | ||
16. R caudal anterior cingulate BOLD | 2.40 | 4.90 | 0.43 | 4.66 | 0.017 | 5.24 | 0.412 | ||
17. AEQ social behavior change total scoreb | 36.92 | 7.41 | 41.23 | 7.94 | 0.001 | 5.23 | 0.561 | ||
18. R temporal pole cortical thickness | 3.88 | 0.30 | 3.76 | 0.37 | 0.041 | 5.18 | 0.356 | ||
19. R precuneus BOLD | –1.46 | 5.64 | –3.06 | 4.90 | 0.078 | 4.81 | 0.303 | ||
20. Repetitions excluded from functional magnetic resonance imaging series due to motion | 4.46 | 6.77 | 7.03 | 8.82 | 0.060 | 4.44 | 0.327 | ||
21. L lateral occipital cortical thickness | 2.45 | 0.16 | 2.46 | 0.14 | 0.774 | 4.41 | 0.067 | ||
22. Conduct Disorder Questionnaire total score | 0.45 | 1.08 | 1.17 | 1.88 | 0.007 | 4.04 | 0.470 | ||
23. R frontal pole BOLD | 2.02 | 4.74 | 0.50 | 7.54 | 0.161 | 3.91 | 0.241 | ||
24. R frontal pole cortical thickness | 3.10 | 0.28 | 2.99 | 0.33 | 0.038 | 3.80 | 0.360 | ||
25. L rostral anterior cingulate cortical thickness | 3.20 | 0.30 | 3.12 | 0.26 | 0.107 | 3.71 | 0.285 | ||
26. AEQ total score | 79.14 | 32.23 | 92.45 | 29.75 | 0.013 | 2.88 | 0.429 | ||
27. R middle temporal cortical thickness | 3.26 | 0.14 | 3.22 | 0.18 | 0.192 | 2.85 | 0.248 | ||
28. L banks superior temporal sulcus cortical thickness | 2.85 | 0.19 | 2.80 | 0.16 | 0.104 | 2.67 | 0.285 | ||
29. L precuneus BOLD | –2.03 | 5.85 | –3.46 | 5.17 | 0.130 | 2.63 | 0.260 | ||
30. L superior parietal cortical thickness | 2.60 | 0.12 | 2.5 | 0.11 | 0.015 | 2.55 | 0.869 | ||
31. AEQ global positive total score | 37.81 | 8.37 | 40.83 | 9.53 | 0.051 | 2.42 | 0.336 | ||
32. Digit vigilance completion time (seconds) | 225.06 | 52.80 | 219.59 | 41.46 | 0.504 | 2.36 | 0.115 | ||
33. Right superior frontal cortical thickness | 3.05 | 0.15 | 3.01 | 0.13 | 0.076 | 2.19 | 0.285 | ||
34. Follow-up age | 18.20 | 0.66 | 18.20 | 0.57 | 0.943 | 1.22 | 0.000 |
Discussion
Acknowledgments
Supplementary Material
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