Abstract
During adolescence, problems reflecting cognitive, behavioral and affective dysregulation, such as inattention and emotional dyscontrol, have been observed to be associated with substance use disorder (SUD) risks and outcomes. Prior studies have typically been with small samples, and have typically not included comprehensive measurement of executive dysfunction domains. The relationships of executive dysfunction in daily life with performance based testing of cognitive skills and structural brain characteristics, thought to be the basis for executive functioning, have not been definitively determined. The aims of this study were to determine the relationships between executive dysfunction in daily life, measured by the Behavior Rating Inventory of Executive Function (BRIEF), cognitive skills and structural brain characteristics, and SUD risks, including a global SUD risk indicator, sleep quality, and risky alcohol and cannabis use. In addition to bivariate relationships, multivariate models were tested. The subjects (n = 817; ages 12 through 21) were participants in the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study. The results indicated that executive dysfunction was significantly related to SUD risks, poor sleep quality, risky alcohol use and cannabis use, and was not significantly related to cognitive skills or structural brain characteristics. In multivariate models, the relationship between poor sleep quality and risky substance use was mediated by executive dysfunction. While these cross-sectional relationships need to be further examined in longitudinal analyses, the results suggest that poor sleep quality and executive dysfunction may be viable preventive intervention targets to reduce adolescent substance use.
Highlights
Executive functioning is a broad construct comprised of behavioral competencies and cognitive skills, including attention, inhibition, mental flexibility, working memory, self-monitoring, planning, and emotional control (Chan et al, 2008)
While Behavior Rating Inventory of Executive Function (BRIEF) scores were noted to be, on average, somewhat lower than might be expected from the scale construction samples, subsequent studies have noted that normative samples have mean calculated t-scores similar to the NCANDA sample (Roth et al, 2015)
Previous studies have indicated that characteristics related to executive functioning are associated with substance use disorder (SUD) risk indicators, including externalizing characteristics (Familiar et al, 2015; Long et al, 2015), internalizing characteristics (Clark et al, 1997), family SUD history (Tapert and Brown, 2000), and the early adolescent onset of alcohol use (Tarter et al, 2003)
Summary
Executive functioning is a broad construct comprised of behavioral competencies and cognitive skills, including attention, inhibition, mental flexibility, working memory, self-monitoring, planning, and emotional control (Chan et al, 2008). Pertinent indicators include dysregulation in cognitive (e.g., attention deficits), behavioral (e.g., impulsivity), and affective (e.g., affective lability) domains (Clark and Winters, 2002; Vanyukov et al, 2009; Clark et al, 2012) Most studies on these relationships have not explicitly and comprehensively measured executive dysfunction dimensions, leaving remaining questions on the extent to which SUD risks and outcomes may relate to specific dimensions or global executive dysfunction indicators
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