Neural processes of inhibitory control in American Indian peoples are associated with reduced mental health problems

Abstract

American Indians (AI) experience disproportionately high prevalence of suicide and substance use disorders (SUD). However, accounting for risk burden (e.g., historical trauma, discrimination) the likelihood of mental health disorders or SUD is similar or decreased compared to the broader population. Such findings have spurred psychological research examining protective factors, but no studies have investigated potential neural mechanisms. Inhibitory control is one potential neurobehavioral construct with demonstrated protective effects but has not been examined in neuroimaging studies with AI populations specifically. We examined incidence of suicidal thoughts and behaviors (STB) and SUD among AI (n=76) and propensity matched (sex, age, income, IQ proxy, and trauma exposure) non-Hispanic White (NHW) participants (n=76). Among the AI sample, functional magnetic resonance imaging data recorded during the stop-signal task (SST) was examined in relation to STB and SUDs. AIs relative to NHW subjects displayed lower incidence of STB. AIs with no reported STBs showed greater activity in executive control regions during the SST compared to AI who endorsed STB. AI without SUD demonstrated lower activity relative to those individual reporting SUD. Results are consistent with a growing body of literature demonstrating the high level of risk burden driving disparate prevalence of mental health concerns in AI. Furthermore, differential activation during inhibitory control processing in AI individuals without STB may represent a neural mechanism of protective effects against mental health problems in AI. Future research is needed to elucidate sociocultural factors contributing protection against mental health outcomes in AIs and further delineate neural mechanisms with respect to specific concerns (e.g., SUD vs. STB).

Striatal hypoactivation during monetary loss anticipation in individuals with substance use disorders in a heterogenous urban American Indian sample

“…AIs also experience greater prevalence of early substance use onset and mental health comorbidities ( Beals et al, 2005 ; Swaim and Stanley, 2018 ; Walls et al, 2021; Whitbeck et al, 2014 ). These disproportionate mental health risks in AI populations are rooted in higher rates of exposure to historical trauma and loss, discrimination, and stereotyping (Brave Heart, 1998; Brown-Rice, 2013; Cromer et al, 2018; Dickerson et al, 2021 ; Kading et al, 2015 ; Les Whitbeck et al, 2004; Skewes & Blume, 2019; White et al, 2022a ). Given these enhanced risk factors, it is important to carry out research examining within AIs (versus just conducting Hispanic/Non-Hispanic White comparisons) to avoid misrepresentation and promulgation of prejudicial attitudes or policies that harm AI communities ( Beals et al, 2009 ; Jordan et al, 2021 ; White et al, 2022a ; 2022b).…”

“…These disproportionate mental health risks in AI populations are rooted in higher rates of exposure to historical trauma and loss, discrimination, and stereotyping (Brave Heart, 1998; Brown-Rice, 2013; Cromer et al, 2018; Dickerson et al, 2021 ; Kading et al, 2015 ; Les Whitbeck et al, 2004; Skewes & Blume, 2019; White et al, 2022a ). Given these enhanced risk factors, it is important to carry out research examining within AIs (versus just conducting Hispanic/Non-Hispanic White comparisons) to avoid misrepresentation and promulgation of prejudicial attitudes or policies that harm AI communities ( Beals et al, 2009 ; Jordan et al, 2021 ; White et al, 2022a ; 2022b). This is a critical step in mitigating such risks and identifying SUD correlates to characterize SUD symptom development, maintenance, and recovery within AI communities ( Castillo-Carniglia et al, 2019 ; Warfield et al, 2021 ).…”

“…SUD literature often lacks sampling diversity of affected populations, making it difficult to obtain precise information and interpretation of neural activation within clinical samples ( Harnett, 2020 ). This study sought to contribute to the understanding of striatal functioning in SUD specifically within AIs under/misrepresented within literature despite facing disproportionate risks (e.g., historical trauma, loss, inadequate access to health treatment) associated with SUD ( Dickerson et al, 2021 ; Whitbeck et al, 2014 ; White et al, 2022a ; 2022b). It is not only important to increase AI representation within research ( Blue Bird Jernigan et al, 2015 ; Walters et al, 2019 ), but also to mitigate conclusions from research results that may not apply to underrepresented populations (e.g., AIs; Jones, 2000 ).…”