Risk For Substance Use Problems Research Articles

A study of the prevalence of Risk factors of NonCommunicable diseases amongst medical students in Rama Medical College, Kanpur

•Noncommunicable diseases (NCDs) are slowly progressive. They are of long duration and responsible for more than 50% of the global burden of disease, including heart disease, stroke, cancer, diabetes, and chronic lung disease. • few studies to date have examined the prevalence of tobacco and alcohol use among UGs and PGs. Out of the available studies, tobacco and alcohol use prevalence was 9.0% in UGs and 7.1% in PGs; however, they may be at a higher risk of substance use problems due to higher stress levels. • Few studies on NCDs and their risk factors have been conducted among medical students in Kanpur, so we have planned this study in this area. AIM: To study the prevalence of risk factors for noncommunicable diseases among medical students at Rama Medical College, Kanpur.

Tobacco-Cannabis Co-use and Risk of Substance Use Problems Among Black and Hispanic Adolescent and Young Adult Females in New York City

Tobacco-Cannabis Co-use and Risk of Substance Use Problems Among Black and Hispanic Adolescent and Young Adult Females in New York City

The Association of Frequency of Worry About Financial Debt With Substance Use Among Adults in Ontario, Canada

Background Financial debt and associated stress might increase the risk of substance use problems or exacerbate existing ones. Little evidence is available about the degree of debt stress and its association with substance use. The objective of this study was to examine the associations of the frequency of worry about debt with heavy episodic drinking (HED), daily smoking, e-cigarette use, and cannabis use in the past 30 days. Methods Data were utilized from the 2020/2022 Monitor study, a repeated cross-sectional survey of adults 18 years and older in Ontario, Canada. The surveys employed a web-based panel survey of 6038 adults and collected data on debt-related stress, HED, tobacco smoking, e-cigarettes, and cannabis use in the past 30 days. Odds ratios (OR) were estimated from logistic regression models accounting for sociodemographic factors. Results Overall, 18.4% of respondents reported that they were worried about their debt most or all of the time. Accounting for household income, educational status, employment status, and other factors, the results revealed that there was a dose-response relationship between the frequency of worry about debt and substance use including daily smoking, e-cigarette use, and cannabis use in the past 30 days compared to those who were not worried at all about their debt. Sex differences were also found in the association between worry about debt and e-cigarette use. Conclusions The frequency of worry about debt might have an important role in substance use, which suggests that financial well-being is vital in substance use prevention and harm reduction.

Adaptation of a trauma-informed intervention to prevent opioid use among youth in the legal system

IntroductionYouth in the legal system are at high risk for opioid and other substance use problems and exhibit high rates of trauma exposure. Trauma-focused therapeutic approaches to prevent substance use show promise, but few evidence-based interventions are designed with justice-involved youth in mind. Consequently, implementing trauma-informed, evidence-based interventions within juvenile justice systems is challenging. The current paper describes the systematic adaptation of Trust-Based Relational Intervention (TBRI) as a family-centered substance use prevention program for youth transitioning from secure residential facilities. MethodsThe study utilized the ADAPT-ITT methodological framework to adapt TBRI Caregiver Training, an evidence-based, trauma-informed intervention designed to help caregivers support children and youth with histories of trauma. Phases of adaptation included (1) Assessment, (2) Decision, (3) Prototype Development, and (4) Testing and Integration. The adaptation process explored contextual factors (e.g., systems, facilities, and staff) and the needs of the new target population (i.e., youth in the legal system and their caregivers). Adaptations were made to both content (e.g., terminology and activities) and structure (e.g., session duration and delivery setting) with input from participants from the target population, key stakeholders, and content experts. ResultsThe systematic adaptation of the intervention model resulted in a two-phase, four-component intervention package that can be implemented in juvenile justice settings as part of youth reentry services. The primary intervention, delivered while youth are in residential facilities, includes the TBRI Caregiver Curriculum, TBRI Youth & Young Adult Curriculum, and TBRI Nurture Groups. The secondary intervention, delivered after youth transition home, includes the TBRI Family Coaching Curriculum. ConclusionsUtilizing a systematic methodological framework to guide adaptation has implications for developing accessible, culturally relevant, and contextually appropriate interventions. Accounting for contextual factors and population needs can improve the fit of evidence-based interventions for youth in the legal system, facilitating uptake and ultimately improving outcomes for youth at risk for substance use problems. Trial registrationClinicalTrials.gov Identifier: NCT04678960.

Offspring hospitalization for substance use and changes in parental mental health in Finland

Abstract Background Prior research indicates that parental psychiatric disorders increase their offspring's risk of substance use problems. Though the association is likely bidirectional, the effects of an adult child's substance use on parental mental health remain understudied. We examined parents’ psychotropic medication use trajectories by parental sex and educational attainment following a child's alcohol- or narcotics-attributable hospitalization. Methods We identified Finnish residents, born 1979-1988, with a first hospitalization for substance use during emerging adulthood (ages 18-29, n = 12,851). Their biological mothers (n = 12,283) and/or fathers (n = 10,765) were followed for the two years before and after the hospitalization. Psychotropic medication use was measured in three-month periods centered around the time of child's hospitalization, and the probability of psychotropic medication use at each time point was assessed using generalized estimating equations logit models. Results Among mothers, the predicted prevalence of psychotropic medication use increased during the year before, peaked during the 0-3 months after hospitalization, and remained at a similarly elevated level until the end of follow-up. The prevalence among fathers increased gradually and linearly across follow-up, with minimal changes evident either directly before or after the hospitalization. Parents’ educational attainment did not modify these trajectories. Conclusions Our results highlight the importance of considering linked lives when quantifying substance use-attributable harms and underscore the need for future research examining the intergenerational spillover effects of substance use in both directions, particularly in mother-child dyads. Key messages • Adult children’s substance use has a detrimental impact on maternal mental health, irrespective of the mother’s socioeconomic position. • The study highlights the importance of considering the intergenerational spillover effects when quantifying the burden of substance use-attributable harms.

Offspring hospitalization for substance use and changes in parental mental health: A Finnish register-based study.

Prior research indicates that parental psychiatric disorders increase their offspring's risk of substance use problems. Though the association is likely bidirectional, the effects of an adult child's substance use on parental mental health remain understudied. We examined parents' psychotropic medication use trajectories by parental sex and educational attainment before and after a child's alcohol- or narcotics-attributable hospitalization. We identified Finnish residents, born 1979-1988, with a first hospitalization for substance use during emerging adulthood (ages 18-29, n=12,851). Their biological mothers (n=12,283) and/or fathers (n=10,765) were followed for the two years before and after the hospitalization. Psychotropic medication use was measured in three-month periods centered around the time of child's hospitalization, and the probability of psychotropic medication use at each time point was assessed using generalized estimating equations logit models. Among mothers, the prevalence of psychotropic medication use increased during the year before, peaked during the 0-3 months after hospitalization, and remained at a similarly elevated level until the end of follow-up. The prevalence among fathers increased gradually and linearly across follow-up, with minimal changes evident either directly before or after the hospitalization. Parents' educational attainment did not modify these trajectories. Our results highlight the importance of considering linked lives when quantifying substance use-attributable harms and underscore the need for future research examining the intergenerational spillover effects of substance use in both directions, particularly in mother-child dyads.

The age-varying effects of adolescent stress on impulsivity and sensation seeking.

Adolescence is defined in part by heightened exposure and sensitivity to stressors. In a longitudinal cohort of youth at risk for substance use problems, we examined the age-varying relationship between stress exposure and traits that are central to the dual systems model. The positive associations between stress exposure, impulsivity, sensation seeking varied as function of age. Specifically, the influence of stress exposure on impulsivity strengthened during early adolescence and remained stable into early adulthood, while the influence of stress exposure on sensation seeking strengthened from early- to mid-adolescence and weakened thereafter. These findings suggest that the maturational imbalance between the capacity to regulate impulsive tendencies and sensation seeking may be exaggerated for youth who are exposed to a high number of stressors.

Prevalence of Substance Use Among Asian Sexual Minority Individuals in the United States, 2015-2020

ABSTRACT Asian sexual minorities (SMs) are an under-researched population. SMs are at higher risk for substance use problems than heterosexuals, but little research exists specifically on Asians who are SM. This study compared the prevalence of substance use among Asian SMs and among adults by race/ethnicity and sexual identity in the US. Data were analyzed from participants in the 2015–2020 National Survey on Drug Use and Health, a nationally representative cross-sectional survey of non-institutionalized adults. Controlling for demographic characteristics, logistic regression models were used to estimate odds of substance use 1) among Asian adults by sexual identity (N = 11,079) and 2) all adults by race/ethnicity and sexual minority status (N = 223,971). Among Asians, compared to heterosexuals, identifying as gay/lesbian was associated with higher odds of past-month use of marijuana. Bisexual Asians were at higher odds of engaging in past-year prescription opioid misuse and having past-year alcohol use disorder (AUD). Compared to White heterosexuals, Asian SMs were at lower odds for past-month binge drinking and cocaine use, but not for past-month marijuana use and past-year AUD, marijuana use disorder, and prescription opioid misuse. More research is needed to understand these disparities and address sexual identity’s role in substance use among Asians.

Implementation of group cognitive processing therapy in correction centers: Anticipated determinants from formative evaluation.

Nearly all people in prison have experienced trauma, and many meet the criteria for posttraumatic stress disorder (PTSD). Untreated PTSD increases the risk of substance use problems after release, contributing to a well-documented cycle of trauma, addiction, and incarceration. However, evidence-based, trauma-focused therapy for PTSD is rarely offered in prisons, and there is little research that can guide implementation efforts. In preparation for an effectiveness-implementation hybrid II pilot trial examining group-delivered cognitive processing therapy (CPT) in prisons, we conducted a formative evaluation using interviews structured according to the consolidated framework for implementation research (i.e., CFIR). Participants were correction center leadership, treatment staff, health care staff, and security staff (n = 22) and incarcerated persons (n = 14; 57.1% female). We found that CPT was highly compatible with residents' needs and the centers' available resources, culture, existing programs, and current workflow. CPT was also acceptable to all stakeholders. Potential barriers were the lower relative priority for CPT compared with programs that are reinforced at the system level, limited staff time to deliver CPT, limited staff knowledge about PTSD, and center features that could distract from CPT groups and/or training or be countertherapeutic. Taken together, CPT is a promising trauma-focused therapy for corrections, but these findings underscore the importance of identifying and matching potential barriers to effective implementation strategies a priori and work in the policy arena to promote sustainability.

Long-Term Outcomes for Young People With Substance Use Problems in Outpatient Treatment: Gender-Specific Patterns.

This study presents the results of a longitudinal research project focusing on long-term outcomes among young people after initiation of outpatient treatment for substance use problems (SUP) in Sweden. Young people are defined with the age group 13–25 years. A clinical sample of 451 young people (29% girls, median age 17 years) completed a structured interview at baseline and was followed using official records one, two, and 3 years after initiation of treatment. Gender-specific patterns at intake were described and bivariate associations and logistic regressions were calculated to analyse the links between risk factors at treatment start and indications of substance use problems 3 years later. Significantly more boys than girls displayed indications of continued SUP at 3-year follow-up. More specifically, 49% of the boys vs. 35% of the girls were identified through records as still having problems with substance use. Predictive risk factors also displayed gender-specific patterns. Primary drug use frequency and age at intake predicted indications of SUP among boys but not among girls. Placement in foster care/residential homes, depression, and early drug debut had significant predictive value regarding indications of SUP among females but not among males. Girls also displayed a greater psychosocial burden at treatment start, but a more favorable treatment outcome at follow-up. Youths with a heavy risk load at treatment start (i.e., over six risk factors) did not display a greater risk of SUP at 3-year follow-up, although our results suggest that this subgroup has indications of continued problems with mental health. Consequently, future studies should further explore gender-specific treatment pathways for young people with substance use problems. Since women and girls seem to have different risk factors, co-occurring psychiatric problems and more experiences of trauma compared to men, they might need multidimensional and more comprehensive treatment interventions that run over a longer period of time.

Alcohol- and Drug-Related Mortality Among Adults Within and Outside the U.S.–Mexico Border Region

Although researchers and policy makers have often considered the U.S.-Mexico border region to be at high risk for substance use problems, epidemiological studies of this region have been hard to interpret because of their modest geographic coverage, reliance on self-report, and mixed results. The current study addresses limitations of existing studies and extends the knowledge base by comparing alcohol- and drug-related mortality in counties on versus off the border across all four U.S. border states. Data were from the 2008-2017 Centers for Disease Control and Prevention WONDER Multiple Causes of Death data set, American Community Survey, and Rural Urban Continuum Codes, including all four border states. Spatial lag models tested differences across on- and off-border counties in total alcohol- and drug-related mortality ("total mortality"), alcohol-related mortality, and drug-related mortality. In multivariate models, mortality rates were significantly higher in off- versus on-border counties for all three outcomes (ps < .05). Rates for total mortality, alcohol-related mortality, and drug-related mortality were 28%, 82%, and 30% higher, respectively, off versus on the border. Border effects were similar, excluding California; robust over time; and stronger for Latinx versus White decedents. Results suggest a revised understanding of the border, revealing that residents of interior counties of border states are at highest risk of severe substance use consequences. Results are consistent with other research finding that border counties were protected against drug overdose deaths, particularly for Latinx residents.

Circadian preference is associated with multiple domains of trait and state level impulsivity

ABSTRACT Impulsivity is a multidimensional construct with well-documented risk for substance use problems at both the trait- and state levels. A circadian preference towards eveningness has been linked to trait-level, global impulsivity, but whether this association holds true across multiple dimensions of impulsivity and whether actual sleep timing shows parallel associations with impulsivity remain unclear. Here, we extend existing literature by investigating whether eveningness is associated with multiple facets of both trait- and state-level impulsivity. We also examined these associations utilizing daily measures of sleep timing and duration and explored whether they differed by sex and/or race. All participants were moderate-to-heavy social drinkers aged 21–35. Primary analyses included 78 participants (100% White male participants: Sample 1) with circadian preference data (Composite Scale of Morningness: CSM) and sleep timing (midsleep) and duration assessed via daily self-report over 10 days. Five facets of impulsivity were assessed via the UPPS-P, both at baseline (full scale; trait-level) and up to 6 times per day over 10 days (reduced scale; state-level). Linear regression and mixed-effects models were used to examine between- and within-person associations of impulsivity with measures of circadian preference, timing, and duration, accounting for covariates. Exploratory analyses combined Sample 1 with an additional more diverse sample (Sample 2), resulting in a total of 182 participants (29.1% self-identified as Black, 29.7% as female) with daily self-report sleep timing and duration only (no circadian preference). Primary between-person models found that eveningness was associated with multiple facets of impulsivity, at trait (lack of perseverance) and state levels (negative and positive urgency, lack of perseverance, and lack of premeditation), while average midsleep and duration were generally unrelated to impulsivity. Primary within-person models largely paralleled the between-person findings. Exploratory analyses in the larger combined Samples 1 and 2 (without circadian preference) found that later midsleep timing was associated with greater mean state-level impulsivity across multiple facets, associations that may differ by race and sex. In a sample of White male participants, circadian preference for eveningness was strongly associated with multiple facets of impulsivity, at both trait- and state-levels, which may contribute to risk for substance use. Preliminary findings suggest sex and race differences in sleep-impulsivity associations, but future research with objective sleep/circadian measures in larger, more diverse samples will be important to clarify implications for sleep-focused prevention and/or treatment of substance use.

Polygenic Risk for Aggression Predicts Adult Substance Use Disorder Diagnoses via Substance Use Offending in Emerging Adulthood and is Moderated by a Family-Centered Intervention.

A substance use offense reflects an encounter with law enforcement and the court system in response to breaking the law which may increase risk for substance use problems later in life. Individuals may also be at risk for substance use offending and substance use problems based on genetic predisposition. We examined a mediation model in which polygenic risk for aggression predicted adult substance use disorder diagnoses (SUD) via substance use offending in emerging adulthood. In addition, we explored for potential attenuation of genetic influences on these outcomes by a family-based intervention, the Family Check-Up (FCU). Secondary data analyses based upon the Project Alliance 1 sample was conducted among those with genetic data (n = 631; 322 from control and 309 from FCU intervention). The sample was ethnically diverse (30% African American, 44% European American, 6% Latinx, 4% Asian American, 3% Native American, and 13% Other). Greater polygenic risk for aggression was found to increase risk for substance use violations (age 19-23), which in turn was associated with greater likelihood of being diagnosed with SUD at age 27. A gene-by-intervention effect was found in which individuals in the control group had greater risk for SUD with increasing polygenic risk for aggression. Some convergence in results was found when replicating analyses in African American and European American subgroups. Results imply that genetic predisposition may increase risk for problematic substance use later in life via antisocial behavior, such as substance use offending, and that this can be attenuated by a family-centered intervention.

Sexual excitation and sex-linked substance use predict overall cannabis use in mostly heterosexual and bisexual women

ABSTRACT Background: Bisexual and mostly heterosexual women report higher substance use than exclusively heterosexual or lesbian women. In sexual minority men, sex-linked substance use (SLSU) can increase risk for substance use problems; equivalent research in women is lacking. Objectives: To test if sexual excitation and inhibition mediate the association between sexual minority status and women’s SLSU. Methods: We surveyed a convenience sample of 595 undergraduate women who identified as exclusively heterosexual (n = 499), mostly heterosexual (n = 59), or bisexual (n = 37). Participants reported on their last month use of alcohol, cannabis, and other drugs (e.g., cocaine) in sexual and non-sexual contexts, and symptoms of alcohol and non-alcohol drug use disorders (e.g., withdrawal symptoms). Drug use symptoms were collapsed across non-alcohol substances. We used structural equation modeling to test serial mediations of women’s SLSU and overall drug and alcohol use. Results: Bisexual and mostly heterosexual women reported higher cannabis use (η2 = 0.030) and drug use disorder symptoms (η2 = 0.050) than heterosexual women. Mostly heterosexual women’s SLSU was a stronger predictor of alcohol use (η2 = 0.019) and binge drinking frequency (η2 = 0.015) than for other orientation groups. Bisexual and mostly heterosexual women’s higher sexual excitation predicted their higher SLSU, which in turn predicted higher cannabis use frequency and drug use disorder symptoms. However, sexual inhibition failed to mediate either SLSU or overall substance use. Conclusion: These findings point to SLSU as a mechanism by which sexual minority women may experience disparities in substance use related harms.

083 Circadian Preference is Associated with Impulsivity at Both the Trait and State Level

Abstract Introduction Impulsivity is a multifaceted construct with well-documented risk for substance use problems. A circadian preference towards eveningness has been linked to trait, global impulsivity. Here we extend existing literature by investigating whether eveningness is associated with multiple facets of impulsivity at both trait- and state-level impulsivity. We also examined these associations utilizing daily measures of sleep timing and duration. Methods The primary sample included 78 moderate-to-heavy social drinkers (aged 21–35, 100% White men) with circadian preference data (Composite Scale of Morningness: CSM). Five facets of impulsivity were assessed via the UPPS-P, both at baseline (full scale) and up to 6 times per day over 10 days (reduced scale). Daily sleep timing (midsleep) and duration were assessed via self-report over 10 days. Multilevel models were used to examine between- and within-person associations, accounting for covariates and correcting for multiple comparisons. Results Between-person models found that eveningness was associated with multiple facets of impulsivity, at trait (lack of perseverance) and state levels (negative urgency, positive urgency, lack of perseverance, and lack of premeditation). However, average midsleep and duration were generally unrelated to impulsivity when accounting for circadian preference. Within-person models in the primary sample largely paralleled the between-person findings. In a larger, more diverse sample (29.1% self-identified as Black, 29.7% female) without CSM data, later midsleep timing was associated with greater mean state-level impulsivity across multiple facets. These effects largely appear to be driven by White women. Conclusion A circadian preference for eveningness is strongly associated with multiple facets of impulsivity, at both trait- and state-levels, potentially increasing risk for substance use. This association does not appear to be driven by actual daily sleep timing and/or duration. Future research with objective measures of sleep in larger, more diverse samples will be important to clarify implications for sleep-focused prevention and/or treatment of substance use. Support (if any) Supported by grants from NIH (R01AA026249; K01 AA021135), as well as a Foundation Grant from ABMRF/The Foundation for Alcohol Research.

Examining the Prospective Associations Between Mindfulness Facets and Substance Use in Emerging Adulthood.

Emerging adulthood (i.e. ages 18-25) is a developmental phase associated with frequent alcohol and cannabis use, placing this population at risk for substance use problems. Depression and anxiety (i.e. emotional psychopathology) are also prevalent during this phase, and some emerging adults use substances to cope with these negative emotions. Mindfulness-a multifaceted construct-involves being present in a nonjudgmental and nonreactive way. Certain mindfulness facets are particularly relevant in buffering against substance use. A recent longitudinal study [Single A, Bilevicius E, Johnson EA. etal. (2019) Specific facets of trait mindfulness reduce risk for alcohol and drug use among first-year undergraduate students. Mindfulness 10:1269-1279] showed that specific mindfulness facets (i.e. acting with awareness, nonjudging of inner experience and nonreactivity to inner experience) predicted decreased alcohol and drug use in undergraduates. These pathways were explained by low levels of emotional psychopathology. This study expanded this recent work by using a three time-point longitudinal design and by including measures of both alcohol and cannabis use and related problems. Using MTurk, participants (N=299) completed online measures of trait mindfulness, depression, anxiety, alcohol and cannabis use and related problems at three time-points, each 2weeks apart. Structural equation modeling was used to test the hypotheses. The acting with awareness and nonjudging of inner experience facets predicted fewer alcohol problems, but not alcohol use, and this effect was mediated by low levels of emotional psychopathology. These results were not supported for cannabis use and problems. This study demonstrates that there may be differences in the pathways from trait mindfulness to alcohol and cannabis use during emerging adulthood.

Cannabis Concentrate Use in Adolescents.

Cannabis concentrates, which are cannabis plant extracts that contain high concentrations of Δ-9-tetrahydrocannbinol (THC), have become increasingly popular among adults in the United States. However, no studies have reported on the prevalence or correlates of cannabis concentrate use in adolescents, who, as a group, are thought to be particularly vulnerable to the harms of THC. Participants are a racially and ethnically diverse group of 47 142 8th-, 10th-, and 12th-grade students recruited from 245 schools across Arizona in 2018. Participants reported on their lifetime and past-month marijuana and cannabis concentrate use, other substance use, and risk and protective factors for substance use problems spanning multiple life domains (ie, individual, peer, family, school, and community). Thirty-three percent of all 8th-, 10th-, and 12th-graders reported lifetime cannabis use, and 24% reported lifetime concentrate use. Seventy-two percent of all lifetime cannabis users had used concentrates. Relative to adolescent cannabis users who had not used concentrates, adolescent concentrate users were more likely to use other substances and to experience more risk factors, and fewer protective factors, for substance use problems across numerous life domains. Most adolescent cannabis users have used concentrates. Based on their risk and protective factor profile, adolescent concentrate users are at higher risk for substance use problems than adolescent cannabis users who do not use concentrates. Findings raise concerns about high-risk adolescents' exposure to high-THC cannabis.

Adolescent childbirth, miscarriage, and abortion: associations with changes in alcohol, marijuana, and cigarette use.

Adolescent girls who become pregnant demonstrate greater risk for substance use than same-aged peers. However, it remains unclear how risk relates to normative changes in adolescence. Few studies have examined adolescent substance use changes before, during, and after pregnancy and considered how pregnancy outcomes (childbirth, miscarriage, abortion) differentially influence substance use changes. The present study examined associations between different adolescent pregnancy outcomes and within-person changes in substance use from prepregnancy to postpregnancy. Participants included 2,450 girls (52% Black) oversampled from low-income urban neighborhoods in Pittsburgh, PA. Participants self-reported pregnancy outcomes and substance use frequency (alcohol, cigarette, marijuana) annually from ages 11-20. Fixed effects regressions focused on first births, first miscarriages, and first abortions occurring from ages 12-19 to test the associations between pregnancy outcomes and within-individual changes in substance use from prepregnancy to postpregnancy. By design, models controlled for all potential time-stable confounds,and models included age and subsequent pregnancies as time-varying covariates. Consistent with prior studies, girls who became pregnant (20%) reported greater early risk for substance use problems than never-pregnant adolescents, including earlier age of onset and more regular marijuana and cigarette use. Childbirth predicted a 26%-51% within-individual reduction in alcohol, marijuana, and cigarette use that remained significantly lower than prepregnancy levels after childbirth. Alcohol and marijuana use decreased (32%-47%) after miscarriage. Abortion was not associated with long-term changes in substance use; however, marijuana and cigarette use gradually increased (44%-46%) in the years leading up to the year of and after abortion, respectively, before returning to prepregnancy levels. Findings highlight important differences in adolescent substance use patterns based on pregnancy outcome. For pregnant adolescents with heightened pre-existing risk for substance use, pregnancy may be a window of opportunity for substance use screening and behavioral intervention.

Frontostriatal Resting State Functional Connectivity in Resilient and Non-Resilient Adolescents with a Family History of Alcohol Use Disorder.

Objectives: Youth with parental substance use disorder (family-history positive [FH+]) are at an elevated risk for substance use problems, but not all FH+ youth experience this outcome. Frontostriatal brain networks involved in inhibitory control and reward responsivity underlie risk-taking behaviors, but the role of these networks in substance use heterogeneity among FH+ youth has not been examined. The present study examined resting state functional connectivity (RSFC) in frontostriatal networks in FH+ youth with and without risky substance use. Methods: Participants were 36 FH+ adolescents (mean age 14.96 years at the scan date; 36% female) from a longitudinal, community-based functional magnetic resonance imaging study enriched for parental alcohol use disorder. Groups were based on the absence (resilient) or presence (high-risk) of at least one occasion of any substance use by age 14 and also use of at least two different types of substances by the most recent substance use assessment (mean age 16.89 years). Bilateral masks of the dorsolateral prefrontal cortex (DLPFC) and the nucleus accumbens were used for seed-based RSFC due to the importance of these regions in executive control and salience networks, respectively. Results: Compared with FH+/high-risk youth, FH+/resilient youth displayed greater connectivity between the left DLPFC seed and the left posterior cingulate cortex. No other brain regions showed significantly different RSFC between resilient and high-risk groups. Conclusion: FH+/resilient youth showed stronger synchrony between brain regions associated with cognitive control, particularly those associated with flexible adaptation of thoughts and behaviors. Although preliminary, the results of this study set the stage for a continued focus on risk-group heterogeneity to better identify neural markers of resilience against substance use problems in vulnerable populations.

Indirect Associations of Anxiety Sensitivity with Tobacco, Alcohol, and Other Drug Use Problems Through Emotional Disorder Symptoms in Adolescents

Theoretically, anxiety sensitivity—fear of anxiety symptoms—enhances perception of and emotional reactivity to autonomic arousal and mental distress, thereby increasing negative affect and motivation to use substances for negative reinforcement. Because no prior study of adolescents has tested if anxiety sensitivity is indirectly associated with substance use problems through symptoms of emotional disorders (i.e., disorders involving high levels of negative affect), the current cross-sectional study examined this theoretical pathway. Participants included ninth-grade students from 10 different high schools in the Los Angeles metropolitan area (N = 3005; 54.3% female). Self-report measures of anxiety sensitivity, emotional disorder symptoms, tobacco dependence, and alcohol and other drug problems were administered. Controlling for sex, race/ethnicity, parental education, school, and impulsiveness, we tested the associations of anxiety sensitivity with tobacco, alcohol, and other drug use problems as well as the indirect effects of anxiety sensitivity on each domain of substance use problems through emotional disorder symptoms. Anxiety sensitivity was associated with more severe tobacco dependence and greater alcohol problems and other drug problems, and anxiety sensitivity further was indirectly associated with all three domains of substance use problems through emotional disorder symptoms. Current findings suggest that adolescents high in anxiety sensitivity tend to experience emotional disorder symptoms, which may increase risk for substance use problems. Interventions that target anxiety sensitivity and enhance negative-affect coping skills may assist in preventing and reducing adolescent substance use problems.