Event-related potentials in alcoholic fathers and their sons

ERPs were recorded during a simple color discrimination and a more difficult visual continuous performance task (CPT) from three father-son (n = 15) pair groups: recovering alcoholics with a family history of alcoholism and their sons (A+), nonalcoholics with a family history of alcoholism and their sons (NA+), and nonalcoholics with no family history of alcoholism and their sons (NA-). The sons, aged 8 to 12, had not begun drinking or using other drugs. Groups were matched on age, education and socioeconomic status. There were two principal findings. Compared to nonalcoholic groups, both A+ sons and fathers exhibited increased latency and decreased amplitude of P3 for the difficult task, but not for the easy task. This result helps to explain previous inconsistencies in the literature, and strengthens the suggestion that one indication of a vulnerability to develop alcoholism is an abnormal P3, when elicited by an appropriate task. Additionally, A+ fathers had more negative amplitudes for a late slow wave in both tasks, suggesting electrophysiological consequences of long-term alcohol abuse.     

EEG, visually evoked and event related potentials in young abstinent alcoholics

EEG, visually evoked potentials (VEP), and event related potentials (P300) were recorded from 60 males aged 25-40 (20 abstinent alcoholics, 20 social drinkers, and 20 lifetime nondrinkers). Alcoholics were at least 1 month abstinent, medication free, and neuropsychologically normal. Residual effects of alcohol abuse were not detected in EEG power and cortical coupling analyses, or VEP amplitude, latency, and amplitude/intensity slope measures. Only P300 measures, recorded while subjects were actively engaged in a visual oddball task (20% targets), differentiated alcoholics from nonalcoholics. Alcoholics had reduced N2-P3 amplitude and delayed N2 latencies compared to social drinkers and nondrinkers. Because P300 abnormalities have been reported for individuals with positive family history for alcoholism, it is not clear whether these results reflect familial influence or residual effects of alcohol abuse. Issues relating to age, health and medication status of abstinent alcoholics, and use of social drinkers as comparison groups in studies of brain dysfunction in "recovering" alcoholics are also discussed.     

Neuroelectric processes in individuals at risk for alcoholism

The literature dealing with electrophysiologic research in alcoholics and individuals at risk for alcoholism is reviewed. Event-related potential (ERP) differences between family history positive (FHP) and family history negative (FHN) males have been reported both prior to the ingestion of alcohol and following alcohol challenge doses. At present, the most robust of these electrophysiological findings is the lower P3 amplitude of the ERP, which has now been replicated in several laboratories. This perhaps provides a phenotypic marker, distinguishing those at risk for alcoholism.     

Event-related potential responses to alcohol-related stimuli in African-American young adults: relation to family history of alcoholism and drug usage

AIMS: To use event-related potentials (ERPs) to investigate the response to alcohol-related stimuli in African-American young adults. METHODS: ERPs to an object recognition task, that included pictures of objects, food and alcohol-related and non-alcohol-related drinks as stimuli, were obtained in 81 African-American young adult men and women (18-25 years old) without a personal history of alcohol dependence. Information on: psychiatric diagnoses, personal drinking and drug use history, and familial history of alcoholism was also obtained. RESULTS: Family history was found to be associated with lowered P3 components and higher N1 components in response to the non-alcohol-related drinks. Additionally, an exploratory analyses revealed that lower amplitude N1 components were generated in response to alcohol-related stimuli in regular marijuana users compared with non-regular users. No associations of N1 or P3 amplitudes with conduct disorder symptoms or current drinking status were found in this population. CONCLUSIONS: These studies demonstrated that family history is significantly and selectively associated with lower P3 amplitudes in this group of young adult men and women of African-American heritage. Additionally, current usage of marijuana and alcohol do not modify P3 amplitudes. However, regular marijuana use may diminish N1 response to alcohol-related stimuli, whereas, family history of alcoholism may augment N1 responses. Taken together these studies further suggest that ERPs can provide specific information on alcoholism risk as well as use of other misused drugs.     

Risk factors for injury during adolescence

Injuries kill more American adolescents than all other diseases combined. It is unclear, however, if adolescents are able or willing to provide the information necessary to characterize their risk for injury. Our objective was to determine if adolescents hospitalized for severe injury are more likely than those hospitalized for acute illness to describe risk factors for injury such as: previous injury, family dysfunction, recent stress, or substance use. All patients completed the Offer Self-Image Questionnaire, the Life-Events Scale for Adolescents, the Adolescent Alcohol-Involvement Scale, and the NIDA Adolescent Drug Use Survey. There were no differences between injured and ill adolescents in demographics, impulse control, emotional tone, perceived family function, alcohol scores, or use of cigarettes, marijuana, or other illicit drugs. The groups differed significantly in sex, previous serious injury, previous hospitalization for injury, injury after alcohol or drug use, and life-event scores. The most common life stresses reported were parental or sibling hospitalization, death of a grandparent, school failure or suspension, getting a summer job, and breaking up with a girl/boy friend. Two variables comprised a stepwise logistic regression model designed to differentiate injured from ill adolescents: male sex and life-event score. We conclude that adolescent boys with recent stressful events may be at high risk for unintentional injury.     

Do alcohol expectancies and peer delinquency/substance use mediate the relationship between impulsivity and drinking behaviour in adolescence?

AIMS: To investigate (1). whether aggressive and delinquent behaviour problems predict subsequent adolescent drinking behaviour; and (2). to what extent this association is mediated by alcohol expectancies and/or peer delinquency/substance use. METHODS: 147 adolescents (approximately 15 years old) were interviewed with regard to their drinking behaviour. In addition, several self-rating questionnaires were given to gather information regarding the peers of these children. RESULTS: As proposed by the Acquired Preparedness Model (APM), we found that behavioural problems were related to quantity and frequency of alcohol consumed, and that this relationship was mediated by alcohol expectancies. Regarding peer relations, we found positive correlations between drinking behaviour and peer delinquency/substance use, aggression/delinquency and alcohol expectancies. Furthermore, the association between behavioural problems and drinking decreased dramatically if peer delinquency/substance use was accounted for. A hierarchical regression analysis revealed that both alcohol expectancies and peer delinquency/substance use predicted alcohol consumption of adolescents at the 1-year follow-up above and beyond the effects of age, sex, family history of alcoholism and aggression/delinquency of respondents. CONCLUSIONS: Alcohol expectancies and peer delinquency/substance use are both crucial to the amount and frequency of adolescent alcohol use. They should be considered in designing prevention and intervention strategies in this age group.     

Addressing the critical health problem of adolescent substance use through health care, research, and public policy

The use of addictive substances-tobacco, alcohol, and other drugs-during adolescence interferes with brain development and increases the risk of serious health and mental health conditions, including addiction. Yet, adolescents live in a culture in which family, social, community, and media influences regularly bombard them with pro-substance use messages, creating an environment in which substance use is considered an expected behavior, rather than a considerable health risk. To prevent the significant harm that falls to teens and young adults because of substance use, The National Center on Addiction and Substance Abuse at Columbia University (CASA Columbia) undertook a study to explore how adolescent brain development relates to the risk of substance use and addiction; the cultural influences that create an environment in which substance use is considered normative behavior; individual factors that make some teens more disposed to substance use and addiction; and evidence-based prevention and treatment strategies for addressing this problem. The recently published report Adolescent Substance Use: America's #1 Public Health Problem concludes that risky substance use is a major public health problem that can be ameliorated through evidence-based public health measures, including education about the disease and its risk factors, screenings, and clinical interventions, and that addiction can be treated and managed effectively within routine health care practice and specialty care.     

Differential associations of sex and D2 dopamine receptor (DRD2) genotype with negative affect and other substance abuse risk markers in children of alcoholics

Children of alcoholics have increased risk for substance abuse problems. Self-medication of negative affect may be one developmental path to future substance abuse. Because the 146 young (adolescent) children of alcoholics in the current sample had not used enough abused substances to study substance use directly, the relation of substance abuse risk markers to negative affect was assessed. Because the D₂ dopamine receptor (DRD2) A₁ allele has been associated with alcoholism and other substance use disorders, negative affect, measured by the Beck Depression Inventory (BDI), was determined in four groups of children: boys and girls with the A₁⁺ allele (A₁A₁ and A₁A₂ genotypes) and with the A₁⁻ allele (A₂A₂ genotype). The other risk markers were stress, low amplitude of the P300 evoked potential, poor visuospatial functioning, novelty seeking (NS), and harm avoidance (HA). Stress was correlated with BDI scores in all groups. In contrast, low P300 was associated with BDI scores only in boys with the A₁⁺ allele (P = .04), NS was associated with BDI scores only in girls with the A₁⁺ allele (P = .02), and HA was associated with BDI scores only in boys with the A₁⁻ allele (P = .01). In addition, boys with the A₁⁺ allele had lower BDI (P = .05) and HA (P = .005) scores than the respective scores for boys with the A₁⁻ allele. Girls with the A₁⁻ allele had lower HA scores compared with scores for boys with the A₁⁻ allele (P = .02). Girls with the A₁⁺ allele had lower visuospatial functioning than that of boys with the A₁⁺ allele (P<.001). Results indicate that both sex and DRD2 genotype modify associations between negative affect and other substance abuse risk markers.     

Perceived risks and benefits of alcohol,cigarette, and drug use among urban low-income African-American early adolescents.

Perceptions about drugs and the social environment may be important influences on cigarette, alcohol and drug use, yet little is known regarding the perspective of early adolescent boys and girls, especially among minority urban youths. Among 351 African-American low-income urban youth, 9 through 15 years of age, completing a community-based computerized questionnaire, 25% acknowledged alcohol, cigarette, and/or illicit drug use in the past 6 months; 19% expected to use one of those substances in the next 6 months. Family exposure to drugs increased the likelihood that youths expected to use drugs by factors of 4.5 (boys) and 2.5 (girls). Other factors (feelings about drugs, community drug use, long-term expectations) distinguished users from nonusers or had different associations with use in boys and girls. Gender-specific perceptions about drugs may have the potential to be modified in drug and substance use prevention programs.     

Adolescent substance use and family problems

This study aimed to evaluate the association between substance use (alcohol, tobacco, and illicit drugs) and family problems among 965 adolescents from 50 public schools in two cities in S?o Paulo State, Brazil, in 2007. The Drug Use Screening Inventory (DUSI) was used for data collection. Use of alcohol, tobacco, and illicit drugs was associated with a negative assessment of the family relationship, lack of monitoring/support, and psychoactive substance use by family members (p < 0.05). Adolescents that reported having used alcohol, tobacco, and illicit drugs had more family problems than those who did not consume any substance (p < 0.001). Adolescents that used alcohol and tobacco (p = 0.028) and illicit drugs (p < 0.001) reported having more family problems than those who used only alcohol. The results highlight the importance of awareness of alcohol and tobacco use by adolescents, since such use was associated with significant family impairments, similar to illicit drug use.     

Clinical predictors of response to naltrexone in alcoholic patients: who benefits most from treatment with naltrexone?

AIMS: To determine the clinically ascertained variables that are related to satisfactory response to naltrexone (NTX) treatment of alcohol dependence after detoxification. METHODS: The use of intake and outcome variables were measured in a randomized 3-month open-controlled trial comparing the effects of naltrexone plus psychotherapy treatment versus psychotherapy treatment alone on the maintenance of abstinence in the final 28 days (n = 336, all male). RESULTS: Predictors of a positive response to NTX treatment were family history of alcoholism (P = 0.010), early age at onset of drinking problems (P = 0.014) and comorbid use of other drugs of abuse (P < 0.001). Among the subjects not treated with NTX, the greater the number of predictor variables, the lower the final 28 days abstinence rates (P = 0.00003), but this was not the case in patients treated with NTX (P = 0.844). CONCLUSIONS: Patients with these features, suggesting biological vulnerability overall have poorer outcomes, but this can be reduced with NTX treatment. The type of alcoholism should be considered before deciding on the pharmacological strategy.     

Risk and Protective Factors for Adolescent Substance Use: Findings from a Study in Selected Central American Countries

PurposeTo identify the prevalence of substance use and problems with use, and risk and protective factors at different levels of the adolescent’s ecology associated with substance use among adolescents in selected Central American countries.MethodsResults of a survey of 17,215 students from Panama, Costa Rica, and Guatemala conducted in 2000–2001 served as the basis for the analyses. Lifetime use of alcohol, tobacco, marijuana, and five other drugs (inhalants, tranquilizers, cocaine, crack, and ecstasy), and problems with drugs and alcohol were the outcome variables. Risk factors included dysregulation, family problems with drugs/alcohol, negative family interactions, school disengagement, peer deviance, and exposure to community violence. Protective factors included a personal belief in God, positive family interactions, parent religiosity, and positive student-teacher interaction. Both hierarchical linear regression and logistic regression analyses were used to model main and interaction effects of risk and protective factors.ResultsThere was a linear association between number of risk and protective factors and substance use, however, risk factors were more strongly associated with substance use than were protective factors. There were significant risk-by-protective-factor interactions for alcohol and marijuana use, and for problems with drugs and alcohol. Risk interacted most consistently with a personal belief in God, but also with parent religiosity and with student-teacher communication.ConclusionsIt is important to consider risk and protective factors at different levels of an adolescent’s ecology. Prevention and intervention efforts should focus on interactions adolescents have in different microsystems (e.g., with parents, teachers, and peers).     

Violence and its relationship to substance use in adolescent pregnancy.

We surveyed 342 pregnant adolescents 17 years old and younger for a history of physical or sexual assault and substance use to investigate whether victims of childhood violence are at increased risk of smoking and using alcohol or drugs. A total of 95% of new patients who attended the university's teen pregnancy clinic between May 8, 1989, and December 8, 1990, were interviewed. Substance use was reported seven times more often in those with a history of combined physical and sexual assault, five times more frequently by those who had been sexually assaulted, and three times more often in those who had been physically assaulted than adolescents without a history of assault. Violence was associated with substance use in all ethnic groups although this relationship was modified by ethnicity. Among Hispanics, an association was observed between physical assault and tobacco use. Sexual and combined physical and sexual assault were strongly associated with use of alcohol among blacks. All categories of violence were associated with drug use among all ethnic groups. When use of each substance was analyzed by the adolescent's relationship to the perpetrator, drug use was most strongly associated with assault by a mate, whereas tobacco or alcohol use was more often associated with assault by a member of the victim's family of origin.     

Adolescent alcohol and drug abuse and health

Purpose: To examine the relationship of adolescent alcohol and drug use over a 5-year period to cumulative health problems in late adolescence and young adulthood.

Methods: We prospectively examined self-reported health problems in a sample of adolescents, some of whom received treatment for substance use disorders and had consistently poor substance use outcomes (n = 38), some of whom received treatment for substance use disorders and had positive substance use outcomes (n = 30), and a low alcohol and drug use community comparison group (n = 48). Data regarding health-related problems of these adolescents (mean, 15.9 years; 83% Caucasian; 56.5% female) were collected at 2, 4, and 6 years following initial assessments.

Results: Alcohol and/or drug involvement severe enough to warrant treatment during adolescence was associated with more cumulative health problems and severe health problems for girls and more cumulative health problems for boys. Protracted and continuous abuse of alcohol and drugs was associated with more cumulative and severe health problems for girls and more severe health problems for boys.

Conclusions: These results suggest that significant health problems and concerns are related to both brief and protracted alcohol and drug abuse during adolescence. Health problems will likely become even more evident as early-onset, chronic substance abusers continue to age.     

Getting Boozy in Books: Substance Use in Adolescent Literature

Media effects research provides evidence for a link between adolescent exposure to media portrayals of substance use and usage. Exposure to media content that glamorizes and normalizes substance use carries potential public health risks. Though substance use has been examined in other media, such as film, television, and magazines, no research to date examines usage portrayals in adolescent novels. Given that adolescents do read, and given the potential impact of content on adolescent attitudes and behavior, this study provides a detailed analysis of the frequency and nature of substance use in the understudied area of novels. Substance use was examined in 40 best-selling adolescent novels on the New York Times Best Sellers list (time span June–July 2008). Substance use varied widely. Of the various types of substances, alcohol portrayals were most common. Almost all substance use was portrayed as having no consequences. Alcohol use was portrayed in similar frequencies in books aimed at younger, middle, and older adolescents, though illegal drug use was more likely to be found in books aimed at older ages. Our results suggest that the manner in which substance use is generally portrayed may encourage use among adolescents. Researchers, parents, and adolescents are encouraged to examine books as one potentially overlooked area of influence.     

Psychoactive substance use disorder in youth suicide

Fifty-eight consecutive suicides committed between 1984 and 1987 by adolescents and young adults (age 15-29 years) from an urban community were the subject of retrospective investigations through interviews with survivors and analyses of registers and medical records. Psychoactive substance use disorder in accordance with DSM-III-R was present in 47% of the youth suicides investigated, predominantly as alcohol dependence. Substance use disorder often coexisted with a borderline personality disorder or schizophrenia. Secondary depression was a frequent final factor. Dependence had developed in all females and most males. The median duration of substance use was 9 years. Substance use preceded suicidal behaviour by two years. Exposure to parental substance misuse during childhood, early parental divorce and parasuicide in the family were more frequent among subjects with substance use disorder than among other subjects. The social situation was often characterized by unemployment and legal problems. Previous inpatient care was more common than among other subjects.     

Getting boozy in books: substance use in adolescent literature

Media effects research provides evidence for a link between adolescent exposure to media portrayals of substance use and usage. Exposure to media content that glamorizes and normalizes substance use carries potential public health risks. Though substance use has been examined in other media, such as film, television, and magazines, no research to date examines usage portrayals in adolescent novels. Given that adolescents do read, and given the potential impact of content on adolescent attitudes and behavior, this study provides a detailed analysis of the frequency and nature of substance use in the understudied area of novels. Substance use was examined in 40 best-selling adolescent novels on the New York Times Best Sellers list (time span June-July 2008). Substance use varied widely. Of the various types of substances, alcohol portrayals were most common. Almost all substance use was portrayed as having no consequences. Alcohol use was portrayed in similar frequencies in books aimed at younger, middle, and older adolescents, though illegal drug use was more likely to be found in books aimed at older ages. Our results suggest that the manner in which substance use is generally portrayed may encourage use among adolescents. Researchers, parents, and adolescents are encouraged to examine books as one potentially overlooked area of influence.