A precision functional atlas of personalized network topography and probabilities.

Although the general location of functional neural networks is similar across individuals, there is vast person-to-person topographic variability. To capture this, we implemented precision brain mapping functional magnetic resonance imaging methods to establish an open-source, method-flexible set of precision functional network atlases-the Masonic Institute for the Developing Brain (MIDB) Precision Brain Atlas. This atlas is an evolving resource comprising 53,273 individual-specific network maps, from more than 9,900 individuals, across ages and cohorts, including the Adolescent Brain Cognitive Development study, the Developmental Human Connectome Project and others. We also generated probabilistic network maps across multiple ages and integration zones (using a new overlapping mapping technique, Overlapping MultiNetwork Imaging). Using regions of high network invariance improved the reproducibility of executive function statistical maps in brain-wide associations compared to group average-based parcellations. Finally, we provide a potential use case for probabilistic maps for targeted neuromodulation. The atlas is expandable to alternative datasets with an online interface encouraging the scientific community to explore and contribute to understanding the human brain function more precisely.

Disposable E-Cigarette Use and Subsequent Use Patterns in Adolescents and Young Adults.

BACKGROUND AND OBJECTIVES: Disposable electronic cigarettes (e-cigarettes) are widely used by adolescents and young adults (AYAs). Whether using disposable devices is associated with future e-cigarette use patterns is unknown but important for informing e-cigarette regulation. METHODS: Prospective longitudinal study combining data from adolescent (14-17 years) and young adult (21-24 years) cohorts from Southern California surveyed at baseline and approximately 8-month follow-up during 2021 to 2022. The analyses included AYAs who used e-cigarettes in the past 30 days at baseline and had exposure and outcome data (N = 403; adolescent n = 124, young adult n = 279). RESULTS: In the pooled sample of AYAs who used e-cigarettes at baseline (57.2% cis-gender female, 56.2% Hispanic), 278 (69.0%) reported past 30-day disposable e-cigarette use, and 125 (31.0%) used only nondisposable e-cigarettes. Baseline use of disposable (versus only nondisposable) devices was associated with higher odds of continued e-cigarette use (adjusted odds ratio = 1.92; 95% confidence interval = 1.09-3.42) and a greater number of times used e-cigarettes per day at follow-up (adjusted incidence rate ratio = 1.29; 95% confidence interval = 1.02-1.63). In supplemental analyses, disposable e-cigarette use was associated with greater odds of no changes (versus reductions) in e-cigarette use frequency and puffs per episode from baseline to follow-up but was not associated with increases in use frequency and intensity. No differences in e-cigarette use outcomes were found between those with poly-device (disposable and nondisposable) versus only disposable device use. CONCLUSIONS: Use of disposable e-cigarette devices among AYAs may be associated with higher risks for persistent e-cigarette use patterns, which should be considered in tobacco product regulation designed to protect AYAs.

Preliminary evaluation of a novel group-based motivational interviewing intervention with adolescents: a feasibility study.

Drinking is closely intertwined with social life among many adolescents, particularly in Europe. Group-based interventions, such as group-based motivational interviewing (group MI), have shown the capacity to prevent and reduce hazardous drinking and related problems among adolescents, but few examinations have been conducted in a European high school setting. This study examines the preliminary outcomes of a pilot group MI intervention among Danish adolescents. High school students (ages 15-18 years) were randomly allocated to two 1-h group MI sessions delivered in a school setting (N = 65) or an assessment only control condition (N = 67). Data were collected in August and November 2020 using online self-administrated questionnaires regarding the acceptability of the intervention and past month alcohol use. The pilot group MI intervention showed high feasibility and acceptability in this setting and with this age group. Group MI adolescents significantly reduced peak drinks per drinking day compared to assessment only adolescents (-2.7 drinks, p < 0.05). Results are discussed in relation to the metrics being evaluated during COVID-19 lockdown, including increased social restrictions at follow-up compared to baseline. Group MI shows promise for reducing hazardous alcohol use among Danish adolescents. In addition, the findings indicate the importance of building on and extending this work in future larger, better-powered randomized controlled trials.

Cumulative Effects of Resting-State Connectivity Across All Brain Networks Significantly Correlate with Attention-Deficit Hyperactivity Disorder Symptoms.

Identification of replicable neuroimaging correlates of attention-deficit hyperactivity disorder (ADHD) has been hindered by small sample sizes, small effects, and heterogeneity of methods. Given evidence that ADHD is associated with alterations in widely distributed brain networks and the small effects of individual brain features, a whole-brain perspective focusing on cumulative effects is warranted. The use of large, multisite samples is crucial for improving reproducibility and clinical utility of brain-wide MRI association studies. To address this, a polyneuro risk score (PNRS) representing cumulative, brain-wide, ADHD-associated resting-state functional connectivity was constructed and validated using data from the Adolescent Brain Cognitive Development (ABCD, N = 5,543, 51.5% female) study, and was further tested in the independent Oregon-ADHD-1000 case-control cohort (N = 553, 37.4% female). The ADHD PNRS was significantly associated with ADHD symptoms in both cohorts after accounting for relevant covariates (p < 0.001). The most predictive PNRS involved all brain networks, though the strongest effects were concentrated among the default mode and cingulo-opercular networks. In the longitudinal Oregon-ADHD-1000, non-ADHD youth had significantly lower PNRS (Cohen's d = -0.318, robust p = 5.5 × 10-4) than those with persistent ADHD (age 7-19). The PNRS, however, did not mediate polygenic risk for ADHD. Brain-wide connectivity was robustly associated with ADHD symptoms in two independent cohorts, providing further evidence of widespread dysconnectivity in ADHD. Evaluation in enriched samples demonstrates the promise of the PNRS approach for improving reproducibility in neuroimaging studies and unraveling the complex relationships between brain connectivity and behavioral disorders.

Prediction Rules Identify Which Young Adults Have Higher Rates of Heavy Episodic Drinking After Exposure to 12-Week Text Message Interventions.

BACKGROUND: An alcohol text message intervention recently demonstrated effects in reducing heavy episodic drinking (HED) days at the three month follow-up in young adults with a history of hazardous drinking. An important next step in understanding intervention effects involves identifying baseline participant characteristics that predict who will benefit from intervention exposure to support clinical decision-making and guide further intervention development. To identify baseline characteristics that predict HED, this exploratory study used a prediction rule ensemble (PRE). Compared to more complex decision-tree methods (e.g., random forest), PREs have comparable performance, while generating simpler rules that can directly identify subgroups that do or do not respond to intervention. METHODS: This secondary analysis examined data from 916 young adults who reported HED (68.5% female, mean age = 22.1, SD = 2.1), were enrolled in an alcohol text message randomized clinical trial and who completed baseline assessment and the three month follow-up. A PRE with ten fold cross-validation, which included 21 baseline variables representing sociodemographic characteristics (e.g., sex, age, race, ethnicity, college enrollment), alcohol consumption (frequency of alcohol consumption, quantity consumed on a typical drinking day, frequency of HED), impulsivity subscales (i.e., negative urgency, positive urgency, lack of premeditation, lack of perseverance, sensation seeking), readiness to change, perceived peer drinking and HED-related consequences, and intervention status were used to predict HED at the three month follow-up. RESULTS: The PRE identified 12 rules that predicted HED at three months (R2 = 0.23) using 7 baseline features. Only two cases (0.2%) were not classified by the 12 rules. The most important features for predicting three month HED included baseline alcohol consumption, negative urgency score, and perceived peer drinking. CONCLUSIONS: The rules provide interpretable decision-making tools that predict who has higher alcohol consumption following exposure to alcohol text message interventions using baseline participant characteristics (prior to intervention), which highlight the importance of interventions related to negative urgency and peer alcohol use.

Validity of an online, self-administered Timeline Followback for alcohol use with adolescents.

Objective: The Timeline Followback (TLFB) is a widely used and well-validated interview-based tool for assessing patterns of recent health risk behavior. There is some evidence of the validity of the TLFB as a self-administered online tool for assessing alcohol use, but further research is needed to establish its validity in younger populations and populations outside the United States. Further, it is unknown how self-administered online TLFB formats compare to more timesaving and commonly used single-item alcohol questions. The primary aim of the current study was to validate a new online, self-administered TLFB for alcohol use against the TLFB interview in a sample of European (Danish) adolescents aged 16-18 years (N = 30). Methods: Participants completed a TLFB telephone interview, a self-administered online version of the TLFB, and single-item alcohol questions. Assessments were administered using a within-subject, counter-balanced design. Estimates of number of drinking days, binge-drinking days, maximum drinks consumed on one occasion, total drinks, and drinks per drinking day were compared across metrics. Results: All correlations between the drinking outcomes assessed via the TLFB interview and the TLFB online were positive, and statistically significant (rss = 0.86-0.94, p < 0.01). Wilcoxon signed-rank tests showed no significant differences between the TLFB interview and the TLFB online on drinking days, binge drinking days, max drinks, and total drinks. Participants reported drinking significantly more drinks per drinking day on the TLFB online (M = 4.66) compared to on the TLFB interview (M = 4.12; p = 0.009). Conclusion: Overall, the results support the validity of the online, self-administered TLFB in a sample of European (Danish) adolescents.

Leveraging the adolescent brain cognitive development study to advance and promote adolescent health: Introduction to the special issue.

The empirical reports in this special issue of Health Psychology showcase the work of a diverse array of accomplished early-stage investigators who are members of the Adolescent Brain Cognitive Development (ABCD) study consortium and who are drawn from the community of female and underrepresented scientists. Their studies focus primarily on youth assessed during preadolescence and early adolescence, and they are based on the ABCD data that were available to the scientific community at the time this special issue was being prepared (e.g., baseline, Years 1 and 2 assessments). They address a variety of questions about adolescent health behavior, such as the effects of screen time and caffeine on sleep; individual lifestyle, neighborhood, and environmental factors associated with physical health conditions and brain development; and the antecedents and consequences of prenatal and adolescent substance exposure. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Adolescent: provider connectedness and STI risk reduction following a brief alcohol intervention: findings from a randomized controlled trial.

Objective: Given the frequent co-occurrence between alcohol use and sexual behavior among adolescents, alcohol interventions may play a role in helping prevent sexually transmitted infections (STIs) in this age group. Psychotherapy "common factors" are one potential active ingredient in intervention efficacy. Thus, the purpose of this study was to evaluate the influence of a critical common factor, adolescent: provider connectedness, on STI risk reduction at 3 months post-intervention. Methods: Community-based youth (N = 168) were randomized to two 60-min individual sessions of either motivational interviewing (MI) or brief adolescent mindfulness (BAM). Logistic regressions predicted post-intervention positive STI from adolescent: provider connectedness, intervention condition, and their interaction. Path analytic models tested post-intervention hazardous drinking as a mediator of the association between adolescent: provider connectedness and reduction in STI risk at 3-month follow-up. Results: Stronger adolescent: provider connectedness reduced risk of STI at 3 months post-intervention, with no differences by treatment condition. A mediational relationship between adolescent: provider connectedness and STI risk via hazardous drinking was not observed. Conclusion: Psychotherapeutic common factors, including adolescent: provider connectedness, may be important in mitigating adolescent health risk in behavioral interventions, above and beyond intervention condition and beyond the target behavior of the intervention.

Long-Term RCT outcomes for adolescent alcohol and cannabis use within a predominantly Hispanic sample.

Because adolescents are unlikely to seek, receive, or complete treatment for alcohol and/or cannabis misuse, it is important to enhance the lasting impact of clinical contacts when they do occur. Adolescents (N = 506; 72.5% Hispanic) were randomized to motivational interviewing (MI) versus alcohol and cannabis education (ACE). Latent growth models estimated change over time. Significant reductions in alcohol use were observed, with slightly greater reductions by 12-month follow-up for MI. Both interventions significantly reduced cannabis use, with no treatment group differences. When outcomes were examined comparing Hispanic to non-Hispanic participants, there were no significant differences in intervention efficacy by group. MI's inherently client-centered and culturally adaptive approach may contribute to its equitable degree of behavior change for youth across race/ethnic backgrounds.

Gene-by-Environment Interaction Effects of Social Adversity on Externalizing Behavior in ABCD Youth.

This study tested whether multiple domains of social adversity, including neighborhood opportunity/deprivation and life stress, moderate genetic (A), common environmental (C), and unique environmental (E) influences on externalizing behaviors in 760 same-sex twin pairs (332 monozygotic; 428 dizygotic) ages 10-11 from the ABCD Study. Proportion of C influences on externalizing behavior increased at higher neighborhood adversity (lower overall opportunity). A decreased and C and E increased at lower levels of educational opportunity. A increased at lower health-environment and social-economic opportunity levels. For life stress, A decreased and E increased with number of experienced events. Results for educational opportunity and stressful life experiences suggest a bioecological gene-environment interaction pattern such that environmental influences predominate at higher levels of adversity, whereas limited access to healthcare, housing, and employment stability may potentiate genetic liability for externalizing behavior via a diathesis-stress mechanism. More detailed operationalization of social adversity in gene-environment interaction studies is needed.

Twin study of caffeine use, ADHD, and disrupted sleep in ABCD youth.

OBJECTIVE: Evidence suggests that caffeine use disproportionately impacts sleep functioning among youth with attention-deficit/hyperactivity disorder (ADHD). The present study aimed to examine the association of caffeine use with disrupted sleep, and to test moderating effects of ADHD, by leveraging differences within twin pairs to explore potential quasi-causal (i.e., within-pair) effects. METHOD: N = 765 complete same-sex twin pairs (mean age at baseline = 10.14 [SD = .5]; 49% girls; 73% white) from the ABCD study reported caffeine use and frequency of disrupted sleep; parents reported youth ADHD symptoms. Cotwin control analyses predicted disrupted sleep from caffeine use, ADHD, and their interaction at ages 10 and 12. RESULTS: Neither quasi-causal within-pair effects of caffeine use on disrupted sleep, nor a moderating role of ADHD were identified. Posthoc biometric models indicated that genetic and environmental influences on these phenotypes may change over time, such that genetic influences on disrupted sleep began to emerge more robustly around early adolescence. Additionally, caffeine use and disrupted sleep, but not ADHD, displayed overlapping genetic influences (12-13% of total phenotypic variance) at age 10. CONCLUSIONS: In a sample of preadolescent twin pairs from the ABCD Study, we did not observe evidence that caffeine use was quasi-causally associated with disrupted sleep at this early developmental stage. However, caffeine use and disrupted sleep emerged with shared etiologic influences. In sum, this study sets the stage for examining these dynamic patterns in future examinations of this critical and timely ABCD study sample, as genetic and environmental influences on behavior are known to change throughout development. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Impulsivity typologies and simultaneous alcohol and cannabis use.

Simultaneous use of alcohol and cannabis or marijuana ("SAM") use is prevalent among young adults and associated with adverse outcomes. Impulsivity is a key construct associated with alcohol and other substance use in this age group, but scant work has considered the role of individual facets of impulsivity on SAM use. The present study compared latent profiles defined by facets of impulsivity (negative urgency, lack of perseverance, lack of premeditation, sensation seeking, and positive urgency) and examined whether profiles were associated with recent SAM use relative to alcohol without cannabis use. Participants were 542 young adults (53% female) recruited through Qualtrics Panels who reported past-year alcohol use and blackout drinking behavior. Participants completed online questionnaires regarding their past-year substance use behavior and typical impulsivity. Regression analysis examining the five impulsivity facets revealed that only sensation seeking predicted the likelihood of recent SAM use relative to alcohol without cannabis use. Using latent profile analysis, four profiles were identified: "low impulsivity," "high sensation seeking/urgency impulsivity," "moderate impulsivity," and "high lack of premeditation/perseverance impulsivity." Individuals in the high sensation seeking/urgency group were more likely to engage in SAM use. Impulsivity may be an important individual difference factor associated with SAM use. Young adults who engage in SAM use may be particularly vulnerable for impulsivity related to sensation seeking and urgency, which may further heighten their risk for hazardous use and related outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Examining the influence of adolescent:provider alliance on youth hazardous drinking: Findings from a randomized controlled trial.

PURPOSE: Behavioral interventions to reduce hazardous drinking are only moderately successful in promoting sustained behavior change and post-intervention effect sizes among adolescents remain modest. This study aimed to explore a relevant therapeutic active ingredient, adolescent:provider alliance, as a moderator of short-term (3 month) adolescent intervention outcomes within the course of a larger parent randomized control trial (RCT). METHODS: Participants were community-based youth engaged in hazardous drinking (N = 168) who were randomized to 2 sessions of either motivational interviewing (MI) or mindfulness (brief adolescent mindfulness; BAM). Youth reported pre-intervention hazardous drinking at baseline and rated therapeutic alliance (a metric of adolescent:provider "connectedness" that helps facilitate working relationships during interventions) immediately post-intervention; they reported hazardous drinking again at 3 months post-intervention. Negative binomial regressions predicted post-intervention hazardous drinking score from adolescent:provider alliance, intervention condition, and their interaction. RESULTS: Mean hazardous drinking was reduced by 34-40 % across both intervention conditions, with no significant between-condition differences. Stronger adolescent:provider alliance was associated with lower hazardous drinking scores at 3 months, but this effect was attenuated after controlling for baseline hazardous drinking. Contrary to predictions, adolescent:provider alliance did not appear to moderate the effect of intervention condition in this sample of young people engaged in hazardous drinking. CONCLUSIONS: Consistent with prior literature, baseline hazardous drinking was a robust predictor of treatment outcomes. At the same time, these results suggest that future work may benefit from continuing to examine and disaggregate the nature of adolescent:provider alliance across the spectrum of empirically supported brief interventions for adolescent hazardous drinking. CLINICAL TRIALS REGISTRATION NUMBER: ClinicalTrials.gov identifier: NCT03367858. Data Sharing Statement: Requests for deidentified individual participant data can be made to the first author.

Hazardous drinking and alcohol use disorders.

Alcohol is one of the most widely consumed psychoactive drugs globally. Hazardous drinking, defined by quantity and frequency of consumption, is associated with acute and chronic morbidity. Alcohol use disorders (AUDs) are psychiatric syndromes characterized by impaired control over drinking and other symptoms. Contemporary aetiological perspectives on AUDs apply a biopsychosocial framework that emphasizes the interplay of genetics, neurobiology, psychology, and an individual's social and societal context. There is strong evidence that AUDs are genetically influenced, but with a complex polygenic architecture. Likewise, there is robust evidence for environmental influences, such as adverse childhood exposures and maladaptive developmental trajectories. Well-established biological and psychological determinants of AUDs include neuroadaptive changes following persistent use, differences in brain structure and function, and motivational determinants including overvaluation of alcohol reinforcement, acute effects of environmental triggers and stress, elevations in multiple facets of impulsivity, and lack of alternative reinforcers. Social factors include bidirectional roles of social networks and sociocultural influences, such as public health control strategies and social determinants of health. An array of evidence-based approaches for reducing alcohol harms are available, including screening, pharmacotherapies, psychological interventions and policy strategies, but are substantially underused. Priorities for the field include translating advances in basic biobehavioural research into novel clinical applications and, in turn, promoting widespread implementation of evidence-based clinical approaches in practice and health-care systems.

Detection of vaping, cannabis use, and hazardous prescription opioid use among adolescents.

There has been a global surge in adolescents' use of electronic nicotine delivery systems (vaping), cannabis (vaped and edible), and prescription opioids, collectively termed ECPO. The nature of ECPO use can make it difficult to detect due to few obvious immediate physical and behavioural signs, as well as subtle long-term effects that allow adolescents to transition from initial exploration into hazardous ECPO use without easy detection by care providers. Here, we address the nature of the presentation of ECPO use in adolescents (roughly age 13-18 years), including challenges in detecting use and related complications, which affect screening, prevention, and intervention. We begin by reviewing empirical data on these difficult to detect effects in adolescents, including acute effects at cellular and neural levels and long-term neurocognitive and developmental changes that precede outwardly detectable physical signs. We then provide concrete approaches for providers to screen for ECPO use in adolescents even in the absence of overt physical and behavioural symptoms. Finally, we conclude with direct practice recommendations for prevention and intervention.

Correlates of HIV Testing across the lifespan - adolescence through later adulthood - among sexual minority men in the US who are not on PrEP.

Regular HIV testing is an essential component of the HIV prevention and care cascade. Sexual minority males (SMM) account for most new HIV infections in the US and testing rates among SMM vary substantially across the lifespan. Research has largely overlooked the developmental context of HIV testing. The current study compared correlates of HIV testing among adolescents (aged 13-17; n = 1,641), emerging adults (aged 18-29; n = 50,483), early adults (aged 30-39; n = 25,830), middle adults (aged 40-64; n = 25,326), and late adults (65 and older; n = 1,452) who were recruited online. Overall, HIV testing rates were lowest among adolescent SMM. Having condomless anal sex in the past 3-months was a consistentpredictor of HIV testing across all age cohorts.The association between relationship status and frequency of HIV testing varied across ages. Being in a non-monogamous relationship (versus single) was associated with more frequent HIV testing among adolescent and emerging adult SMM , while being in a monogamous relationship (versus single) was associated with lower odds of HIV testing among early, middle, and late adults.

Intersection between social inequality and emotion regulation on emerging adult cannabis use.

Emerging adulthood (EA; ages 18-25) is characterized by socioemotional and neurodevelopmental challenges. Cannabis is a widely used substance among EAs, and hazardous use may increase risk for sustained use patterns and related health consequences. Research shows differential increases in hazardous use by objective as well as subjective measures of social inequality, with more concerning trajectories for youth with greater experiences of social inequality. Learning how to flexibly monitor and modify emotions in proactive ways (i.e., emotion regulation) is a central developmental task navigated during the EA window. Challenges to and with emotion regulation processes can contribute to the emergence of mental health symptoms during EA, including hazardous cannabis use. In this perspective, we highlight emotion dysregulation and social inequality as two critical factors that interact to either buffer against or exacerbate cannabis use during the EA period, noting critical gaps in the literature that merit additional research. We recommend novel methods and longitudinal designs to help clarify how dynamic cognition-emotion interplay predicts trajectories of negative emotional experiences and cannabis use in EA.

Evaluating Providers' Prescription Opioid Instructions to Pediatric Patients.

Receiving an opioid prescription during childhood increases the risk of hazardous prescription opioid (PO) use during emerging adulthood. Instruction on how to safely use POs plays an essential role in pediatric patients' capacity to utilize as well as to discontinue POs appropriately. This study aimed to evaluate pediatric PO label instructions provided to a large sample of pediatric outpatients. Data were extracted from the electronic healthcare records system identifying pediatric patients who received a PO between 2016 and 2019 from pediatric outpatient medical clinics were affiliated with a northwestern United States medical center and children's hospital. Pediatric patients (n = 12,613) between 0−17 years old who received a PO during outpatient care were included. Patients with chronic health conditions (e.g., cancer) or who received their PO from an inpatient medical setting were excluded. Patient demographics, medication instructions, associated diagnoses, and other prescription information (e.g., name of medication, dose, and quantity dispensed) were examined using automated text classification. Many label instructions did not include any indication/reason for use (20.8%). Virtually none of the POs (>99%) included instructions for how to reduce/wean off POs, contact information for questions about the POs, and/or instructions around how to dispose of the POs. Efforts are needed to ensure that pediatric PO instructions contain essential elements to improve comprehension of when and how to use POs for pediatric patients.

Time for a paradigm shift: The adolescent brain in addiction treatment.

OBJECTIVE: One route to improve adolescent addiction treatment outcomes is to use translational approaches to help identify developmental neuroscience mechanisms that undergird active treatment ingredients and advance adolescent behavior change. METHODS: This sample included 163 adolescents (ages 15-19) randomized to motivational interviewing (MI) vs. brief adolescent mindfulness (BAM). Youth completed an fMRI paradigm assessing adolescent brain response to therapist language (complex reflection vs. mindful; complex reflection vs. confront; mindful vs. confront) at pre- (prior to the completion of the full intervention) and post-treatment (at 3-month follow-up) and behavioral measures at 3, 6 and 12 months. RESULTS: Youth in both treatment groups showed significant problem drinking reductions at 3 and 6 months, but MI youth demonstrated significantly better treatment outcomes than BAM youth at 12 months. We observed several significant treatment group differences (MI > BAM) in neural response to therapist language, including at pre-treatment when examining complex reflection vs. mindful, and complex reflection vs. confront (e.g., superior temporal gyrus, lingual gyrus); and at post-treatment when examining mindful vs. confront (e.g., supplementary motor area; middle frontal gyrus). When collapsed across treatment groups (MI + BAM), we observed significant differences by time, with youth showing a pattern of brain change in response to complex reflection vs. mindful, and complex reflection vs. confront (e.g., precuneus; postcentral gyrus). There was no evidence of a significant group × time interaction. However, brain change in response to therapist language (complex reflection vs. confront) in regions such as middle frontal gyrus, was associated with reductions in problem drinking at 12 months. Yet, few treatment group differences were observed. CONCLUSIONS: These data underscore the need to better understand therapist language and it's impact on the developing brain, in order to inform and aggregate the most impactful elements of addiction treatment for future treatment development for adolescents.

Measuring retention within the adolescent brain cognitive development (ABCD)SM study.

The Adolescent Brain Cognitive Development (ABCD)SM study aims to retain a demographically diverse sample of youth and one parent across 21 sites throughout its 10-year protocol while minimizing selective (systematic) attrition. To evaluate the effectiveness of these efforts, the ABCD Retention Workgroup (RW) has employed a data-driven approach to examine, track, and intervene via three key metrics: (1) which youth completed visits late; (2) which youth missed visits; and (3) which youth withdrew from the study. The RW actively examines demographic (race, education level, family income) and site factors (visit satisfaction, distance from site, and enrollment in ancillary studies) to strategize efforts that will minimize disengagement and loss of participating youth and parents. Data showed that the most robust primary correlates of late visits were distance from study site, race, and parental education level. Race, lower parental education level, parental employment status, and lower family income were associated with higher odds of missed visits, while being enrolled in one of the ancillary studies was associated with lower odds of missed visits. Additionally, parents who were primary Spanish speakers withdrew at slightly higher rates. These findings provide insight into future targets for proactive retention efforts by the ABCD RW.