Working memory ability and early drug use progression as predictors of adolescent substance use disorders

Abstract

Aims To test a neurobehavioral model of adolescent substance use disorder (SUD) resulting from an imbalance between a hyperactive reward motivation system and a hypoactive executive control system. Specifically, we tested (1) if early weakness in working memory (WM) and associated imbalance indicators of acting-without-thinking (AWT) and delay discounting (DD) predict SUD in late adolescence, and (2) if early drug use progression mediates this relation. Design Five waves of longitudinal data collected annually from 2005–2010, with a final follow-up in 2012. Setting & Participants Sample of 387 community adolescents (baseline ages 11–13) recruited from the Philadelphia, Pennsylvania, USA area. Measurements WM was assessed at baseline using 4 different computerized tasks. AWT and DD were assessed at baseline using self-reports. Early drug use patterns were modeled using annual self-reports of recent drug use across the first four waves. Final outcome of SUD was assessed at last wave using self-reports matched to the DSM-5 criteria for three commonly used substances: alcohol, marijuana, and tobacco. Findings Weakness in WM at baseline, associated with neurobehavioral imbalance indicators of AWT, B (SE) = −0.06(0.02), p<0.01, and DD, B (SE) = −7.30(1.93), p<0.01, was a significant predictor of SUD at final follow-up. WM predicted SUD both independent of early drug use, B (SE) = −0.36(0.12), p<0.01, and as mediated by early drug use progression, B (SE) = −0.06(0.02), p<0.01. Conclusions Adolescents with weak working memory have less control over impulsive urges, placing them at risk for later substance use disorder with some of the effects mediated by early drug use progression.

Disentangling longitudinal relations between youth cannabis use, peer cannabis use, and conduct problems: developmental cascading links to cannabis use disorder

“…At T4, participants were between ages 18–21 [ M age = 18.78 (0.72)]. The sample was diverse regarding race–ethnicity; 56% non‐Hispanic white, 26% non‐Hispanic black, 9% Hispanic and 9% in other categories . Most participants came from low–middle SES families, and the mean Hollingshead Two‐Factor Index of Social Status was 47.0 ± 15.8, reversed‐scored; higher scores indicate higher SES .…”

Evidence accumulation and associated error-related brain activity as computationally-informed prospective predictors of substance use in emerging adulthood

“…For instance, poor behavioral performance and abnormalities in neural responses during working memory tasks have been associated with increased substance use risk in adolescence [10][11][12][13] .…”

Working memory predicts methamphetamine hair concentration over the course of treatment: moderating effect of impulsivity and implications for dual‐systems model

“…Impulsivity refers to a preference for short-term rewards and engaging in behaviour without adequate foresight (Stevens et al 2014). This reward-driven behaviour is characterized by impulsive choice (the preference for smaller immediate rewards over larger, delayed rewards), which is analogous to the decisions made regarding drug use (Khurana et al 2017). The top-down system of cognitive control is underpinned by working memory, the ability to temporarily store, access and manipulate a limited amount of information and to manage incoming stimuli (Baddeley 2012).…”

“…Deficits are reflected in diminished cognitive control in substance-dependent individuals (Brooks 2016). Here, working memory fails to exert control over distracting, arousing stimuli (Okon-Singer et al 2015), such as impulsive urges to use substances (Khurana et al 2017). Therefore, high levels of reward-driven behaviour to use substances, combined with deficiencies in the ability to inhibit these impulses can 'hardwire' drug use and potentially explain the high levels of relapse among individuals with substance use disorders.…”