Relation between cognitive distortions and neurobehavior disinhibition on the development of substance use during adolescence and substance use disorder by young adulthood: a prospective study

Abstract

Objective: Previous research has demonstrated that neurobehavior disinhibition increases the risk for a diagnosis of substance use disorder (SUD). This investigation tested the hypothesis that a deficiency in the capacity to appraise the effects of alcohol and drugs and interpret social interactions mediates the relation between neurobehavior disinhibition in childhood and SUD by early adulthood. Methods: Boys with fathers having lifetime SUD ( N = 88) and no SUD or other psychiatric disorder ( N = 127) were prospectively tracked from ages 10–12 to 19 years. Neurobehavior disinhibition was evaluated at baseline followed by assessments of cognitive distortions and substance use involvement in early and mid-adolescence. SUD outcome was evaluated up to age 19 years. Results: Cognitive distortions (age 12–14 years) mediated the association between neurobehavior disinhibition (age 10–12 years) and marijuana use (age 16 years) which, in turn, predicted SUD by age 19 years. Cognitive distortions in early adolescence did not directly predict SUD by young adulthood. Conclusions: Inaccurate social cognition, significantly predicted by childhood neurobehavior disinhibition, biases development toward marijuana use prodromal to SUD. These results indicate that cognitive processes, in conjunction with psychological self-regulation, comprise important components of the individual liability to SUD.