Sexual Identity and its Association with Trajectories of Depressive Symptoms and Emotion Regulation Difficulties from Early to Middle Adolescence.

Few studies have examined how changes in sexual identity impact trajectories of depressive symptoms and emotion regulation difficulties. The current study addresses this gap in the literature by examining these associations over a three-year period in a community sample of adolescents (N = 177; Mage = 12.56; SD = 0.60; nmale = 95). Multilevel modeling revealed that youth who consistently held sexual minority identities from early to middle adolescence-but not youth with inconsistent sexual identity-demonstrated increases in depressive symptoms and emotion regulation difficulties relative to their heterosexual peers. Findings suggest that treatments that bolster emotion regulation abilities and address depressive symptoms may be of particular benefit to youth with consistent sexual minority identities from early to middle adolescence.

High-Frequency Heart Rate Variability and Emotion-Driven Impulse Control Difficulties During Adolescence: Examining Experienced and Expressed Negative Emotion as Moderators.

Emotion-driven impulse control difficulties are associated with negative psychological outcomes. Extant research suggests that high frequency heart rate variability (HF-HRV) may be indicative of emotion-driven impulse control difficulties and potentially moderated by negative emotion. In the current study, 248 eleven- to 14-year-olds and their parent engaged in a negatively emotionally arousing conflict task at Time 1. Adolescents' HF-HRV and negative emotional expression and experience were assessed before, during, and/or after the task. Adolescents reported on their levels of emotion-driven impulse control difficulties at Time 1 and one year later. Results revealed that higher levels of HF-HRV reactivity (i.e., higher HF-HRV augmentation) predicted higher levels of emotion-driven impulse control difficulties one year later among adolescents who experienced higher negative emotion. These findings suggest that negative emotional context should be considered when examining HF-HRV reactivity as a risk factor for emotion-driven impulse control difficulties and associated outcomes.

Does Alcohol Initiation in Early-To-Middle Adolescence Predict Changes in Reward Motivation? Evidence of Sex Differences.

BACKGROUND: Reward motivation has been cross-sectionally correlated with adolescent alcohol use, but the temporal nature of this relationship remains unclear. This project sought to determine whether adolescent alcohol initiation longitudinally predicted changes in reward motivation and behavioral inhibition from early to middle adolescence, and explored the role of adolescent sex in this prediction. METHODS: A total of 180 11- to 14-year-olds were recruited and then followed for 3 years to age 14 to 17. Participants self-reported their alcohol use at all time points. We selected participants who were alcohol-naïve at Baseline (early adolescence) and then grouped them based on whether or not they reported alcohol initiation by Year 3 (Y3: middle adolescence). Adolescents completed self-report and experimental (delay discounting) measures of reward motivation and self-report measures of behavioral inhibition at Baseline and Y3. RESULTS: Adolescents' alcohol initiation significantly predicted higher Y3 self-reported reward motivation on one measure. Additionally, a significant sex × alcohol initiation interaction was found predicting Y3 task-based reward motivation (delay discounting), with boys' alcohol initiation predicting increased bias toward immediate reward at Y3. There was also a sex × alcohol initiation interaction predicting behavioral inhibition, with girls' alcohol initiation predicting higher behavioral inhibition at Y3. CONCLUSIONS: Results suggest that alcohol initiation among adolescents might precede changes in reward motivation, and the effects of alcohol on reward and behavioral inhibition may differ by adolescent sex.

Difficulties in Emotion Regulation Predict Depressive Symptom Trajectory from Early to Middle Adolescence.

Major depressive disorder begins to increase in early adolescence and is associated with significant impairment (e.g., suicidality). Difficulties in emotion regulation (ER) have been associated with depressive symptoms; however, little research has examined this relation over time beginning in early adolescence. Starting when they were 11-14 years old, 246 adolescents (nboys = 126; nwhite = 158) completed self-report questionnaires on their ER at Time 1 and depressive symptoms every year for 2 years. Results revealed that overall difficulties in ER (and limited access to ER strategies) at Time 1 predicted depressive symptoms both cross-sectionally and longitudinally. Gender moderated this relation cross-sectionally, such that higher overall ER difficulties at Time 1 was more strongly associated with higher depressive symptoms for girls than for boys. These findings suggest that depression prevention efforts should promote adaptive ER in early adolescence, particularly for girls, in order to prevent the increases in depressive symptoms seen into middle adolescence.

Negative Urgency Linked to Craving and Substance Use Among Adults on Buprenorphine or Methadone.

Despite the effectiveness of medication-assisted treatment (MAT), adults receiving MAT experience opioid cravings and engage in non-opioid illicit substance use that increases the risk of relapse and overdose. The current study examines whether negative urgency, defined as the tendency to act impulsively in response to intense negative emotion, is a risk factor for opioid cravings and non-opioid illicit substance use. Fifty-eight adults (predominately White cis-gender females) receiving MAT (with buprenorphine or methadone) were recruited from online substance use forums and asked to complete self-report questionnaires on negative urgency (UPPS-P Impulsive Behavior Scale), past 3-month opioid cravings (ASSIST-Alcohol, Smoking, and Substance Involvement Screening Test), and non-opioid illicit substance use (e.g., amphetamines, cocaine, benzodiazepines). Results revealed that negative urgency was associated with past 3-month opioid cravings, as well as past month illicit stimulant use (not benzodiazepine use). These results may indicate that individuals high in negative urgency would benefit from receiving extra intervention during MAT.

Sex differences in emotion- and reward-related neural responses predicting increases in substance use in adolescence.

Adolescent substance use is a significant public health problem and there is a need for effective substance use preventions. To develop effective preventions, it is important to identify neurobiological risk factors that predict increases in substance use in adolescence and to understand potential sex differences in risk mechanisms. The present study used functional magnetic resonance imaging and hierarchical linear modeling to examine negative emotion- and reward-related neural responses in early adolescence predicting growth in substance use to middle adolescence in 81 youth, by sex. Adolescent neural responses to negative emotional stimuli and monetary reward receipt were assessed at age 12-14. Adolescents reported on substance use at age 12-14 and at 6 month, and 1, 2, and 3 year follow-ups. Adolescent neural responses did not predict initiation of substance use (yes/no), but, among users, neural responses predicted growth in substance use frequency. For girls, heightened right amygdala responses to negative emotional stimuli in early adolescence predicted growth in substance use frequency through middle adolescence. For boys, blunted left nucleus accumbens and bilateral ventromedial prefrontal cortex responses to monetary reward predicted growth in substance use frequency. Findings suggest different emotion and reward-related predictors of the development of substance use for adolescent girls versus boys.

Affect-Related Brain Activity and Adolescent Substance Use: A Systematic Review.

Purpose of review: This review aims to summarize the research on brain activity during affective processing (i.e., reward, negative emotional stimuli, loss) and adolescent substance use (SU). Recent findings: Most research revealed links between altered neural activity in midcingulo-insular, frontoparietal and other network regions and adolescent SU. Increased recruitment of midcingulo-insular regions-particularly the striatum-to positive affective stimuli (e.g., monetary reward) was most often associated with initiation and low-level use of substances, whereas decreased recruitment of these regions was most often associated with SUD and higher risk SU. In regards to negative affective stimuli, most research demonstrated increased recruitment of midcingulo-insular network regions. There is also evidence that these associations may be sex-specific. Summary: Future research should employ longitudinal designs that assess affect-related brain activity prior to and following SU initiation and escalation. Moreover, examining sex as as moderating variable may help clarify if affective neural risk factors are sex-specific.

Behavioral inhibition and approach tendencies are associated with striatal activation to loss: Implications for adolescent substance use.

Behavioral inhibition/avoidance and approach systems (BIS/BAS), which facilitate avoidance of aversive stimuli and approach of enticing stimuli, are thought to underlie engagement in substance use (SU). However, little is known about the neural correlates of these systems, particularly in adolescence. The current study examined associations between BIS/BAS tendencies and neural response to reward and loss and then examined whether there was an indirect effect of BIS/BAS on later SU initiation through these neural responses. 79 12-14 year olds underwent fMRI at baseline during a card guessing task. Adolescents reported on their BIS/BAS at baseline and on their SU at baseline and through a 3-year follow-up period. Results showed that higher BIS was associated with lower striatal activation and higher BAS with higher striatal activation to monetary loss. BIS and BAS were not associated with neural activation to monetary reward. There was no support that BIS or BAS predicted SU initiation through striatal activation to monetary loss. Overall, these results may suggest that adolescents with the tendency to avoid aversive stimuli assign less salience and adolescents with the tendency to approach enticing stimuli assign more salience to monetary loss.

Exploring county-level spatio-temporal patterns in opioid overdose related emergency department visits.

Opioid overdoses within the United States continue to rise and have been negatively impacting the social and economic status of the country. In order to effectively allocate resources and identify policy solutions to reduce the number of overdoses, it is important to understand the geographical differences in opioid overdose rates and their causes. In this study, we utilized data on emergency department opioid overdose (EDOOD) visits to explore the county-level spatio-temporal distribution of opioid overdose rates within the state of Virginia and their association with aggregate socio-ecological factors. The analyses were performed using a combination of techniques including Moran's I and multilevel modeling. Using data from 2016-2021, we found that Virginia counties had notable differences in their EDOOD visit rates with significant neighborhood-level associations: many counties in the southwestern region were consistently identified as the hotspots (areas with a higher concentration of EDOOD visits) whereas many counties in the northern region were consistently identified as the coldspots (areas with a lower concentration of EDOOD visits). In most Virginia counties, EDOOD visit rates declined from 2017 to 2018. In more recent years (since 2019), the visit rates showed an increasing trend. The multilevel modeling revealed that the change in clinical care factors (i.e., access to care and quality of care) and socio-economic factors (i.e., levels of education, employment, income, family and social support, and community safety) were significantly associated with the change in the EDOOD visit rates. The findings from this study have the potential to assist policymakers in proper resource planning thereby improving health outcomes.

Neural activation to loss and reward among alcohol naive adolescents who later initiate alcohol use.

Adolescent alcohol use is associated with adverse psychosocial outcomes, including an increased risk of alcohol use disorder in adulthood. It is therefore important to identify risk factors of alcohol initiation in adolescence. Research to date has shown that altered neural activation to reward is associated with alcohol use in adolescence; however, few studies have focused on neural activation to loss and alcohol use. The current study examined neural activation to loss and reward among 64 alcohol naive 12-14 year olds that did (n = 20) and did not initiate alcohol use by a three year follow-up period. Results showed that compared to adolescents that did not initiate alcohol use, adolescents that did initiate alcohol use by the three year follow-up period had increased activation to loss in the left striatum (i.e., putamen), right precuneus, and the brainstem/pons when they were alcohol naive at baseline. By contrast, alcohol initiation was not associated with neural activation to winning a reward. These results suggest that increased activation in brain regions implicated in salience, error detection/self-referential processing, and sensorimotor function, especially to negative outcomes, may represent an initial vulnerability factor for alcohol use in adolescence.

Striatal bases of temporal discounting in early adolescents.

Steeper rates of temporal discounting-the degree to which smaller-sooner (SS) rewards are preferred over larger-later (LL) ones-have been associated with impulsive and ill-advised behaviors in adolescence. Yet, the underlying neural systems remain poorly understood. Here we used a well-established temporal discounting paradigm and functional MRI (fMRI) to examine engagement of the striatum-including the caudate, putamen, and ventral striatum (VS)-in early adolescence (13-15 years; N = 27). Analyses provided evidence of enhanced activity in the caudate and VS during impulsive choice. Exploratory analyses revealed that trait impulsivity was associated with heightened putamen activity during impulsive choices. A more nuanced pattern was evident in the cortex, with the dorsolateral prefrontal cortex mirroring the putamen and posterior parietal cortex showing the reverse association. Taken together, these observations provide an important first glimpse at the distributed neural systems underlying economic choice and trait-like individual differences in impulsivity in the early years of adolescence, setting the stage for prospective-longitudinal and intervention research.

Maternal Emotional and Physiological Reactivity: Implications for Parenting and the Parenting-Adolescent Relationship.

OBJECTIVE: Parent physiology and emotion may play an important role in parenting and parent-child relationship quality, yet little research has examined these associations in parents of adolescents. This study employed a naturalistic laboratory-based approach to observe maternal reactivity (mothers' cardiovascular and negative emotional responses) during a parent-adolescent interaction task (PAIT) and associations with parenting behavior and parent-adolescent relationship quality. We also examined possible indirect effect of maternal reactivity on parent-adolescent relationship quality through parenting variables. METHODS: Mothers (n = 196) of 12-14 year olds completed the PAIT, a 10-minute laboratory task in which mothers and adolescents discussed a family conflict topic. Mother-rated negative emotional experience, mother heart rate (HR), and systolic and diastolic blood pressure (BP) responses to PAIT were collected. Additionally, observed maladaptive and positive parenting during PAIT and reported parent-adolescent relationship quality were collected. RESULTS: We found that mothers' heightened negative emotional experience in PAIT was associated with heightened observed and reported maladaptive parenting and lower parent-adolescent relationship quality (p<.001). Additionally, blunted HR reactivity was related to higher positive parenting in PAIT (p<.05). Lastly, we found an indirect effect of HR on parent-adolescent relationship through positive parenting and an indirect effect of maternal negative emotional experience on parent-adolescent relationship quality through maladaptive and positive parenting. In sum, high emotional reactivity and blunted HR predicted poorer parenting, and directly and indirectly affected parent-adolescent relationship quality. CONCLUSIONS: Parent reactivity may be important to consider in interventions.

Maternal stress and adolescent brain structure and function.

INTRODUCTION: Adolescence is a time of heightened sensitivity in biological stress systems and the emergence of stress-related psychopathology. Thus, understanding environmental factors in adolescence that might be associated with adolescents'' stress systems is important. Maternal stress levels may be involved. However, the relationship between maternal stress and the adolescent brain is unknown. METHOD: The present study examined the association between mothers' self-reported stress levels and mothers' cortisol stress reactivity and their early adolescents' brain structure and functional activation to stressful negative emotional images. Participants included 66 mothers and their 12- to 14-year old adolescents. Mother's perceived stress and salivary cortisol reactivity to a stressful task were collected. Then, adolescents' brain structure and function were assessed in a magnetic resonance imaging session. RESULTS: Functional whole-brain analyses revealed that mothers' higher reported perceived stress, but not cortisol reactivity, predicted adolescents' higher responses in the medial prefrontal cortex (mPFC) to stressful negative emotional stimuli. There were no statistically significant associations for structural analyses. CONCLUSIONS: Given the finding of maternal stress reactivity related to adolescent mPFC function-an integral structure related to stress responses-parent stress may play a role in the development of neural stress systems in adolescence, with potential implications for development of psychopathology.

Trait impulsivity during early adolescence predicts steepness of alcohol use escalation across adolescence.

BACKGROUND AND AIMS: Alcohol use during adolescence is a significant public health concern with serious implications. Both early initiation and rate of escalation of alcohol use during adolescence forecast long-term alcohol-related difficulties and alcohol use disorders (AUDs), underscoring the need to understand psychological factors that contribute to these risk behaviors. One factor that contributes to alcohol use during adolescence is trait impulsivity. The purpose of the present prospective study was to examine associations between trait impulsivity and changes in alcohol use from early adolescence through late adolescence. METHODS: Two hundred forty-six participants (45% female; M age = 13.06; 52.5% Caucasian ethnicity) were drawn from a larger study. Levels of impulsivity and alcohol use were measured at every assessment using self-report questionnaires. Data were analyzed using a latent growth modeling approach (LGM) and fit was examined across four indices. RESULTS: Consistent with previous studies, our findings indicate that trait impulsivity decreased and alcohol use increased during adolescence, and initial levels of impulsivity were associated with concurrent levels of alcohol use. Further, level of trait impulsivity during early adolescence predicted the rate of escalation of alcohol use during adolescence. CONCLUSIONS: In the present research, trait impulsivity assessed during early adolescence predicted the steepness of alcohol use escalation during adolescence, a variable with significant prognostic value for long-term AUDs and behavioral problems. This research underscores the importance of understanding trait impulsivity during early adolescence, and suggests that early trait impulsivity may have predictive value with respect to later alcohol abuse and behavioral problems.

Stress reactivity and the developmental psychopathology of adolescent substance use.

Adolescence represents a period of risk for initiation of substance use and the development of substance use disorders (SUDs). In addition, during adolescence, there is rapid development of stress reactivity systems. This paper describes a conceptual model of the role of stress reactivity in the development of substance use in adolescence. It is proposed that some children develop maladaptive patterns of emotional, physiological, and neural reactivity to stressful situations that are either too high or too low and that their patterns of reactivity interact with increased stressful life events during adolescence to lead to potential for substance use and SUDs. In one pathway, youth develop a heightened reactivity to stress, which leads to high negative emotion and using substances to cope. In a second pathway, youth develop a blunted reactivity to stress, which leads to chronic under-arousal and using substances to increase sensation/arousal. We propose that girls may be more likely to take the high-reactivity pathway to substance use and boys may be more likely to take the low-reactivity pathway. We review existing studies of stress reactivity in adolescents, which support our theory that altered stress reactivity is correlated with and, in some cases, predictive of adolescent substance use, with some studies finding high stress reactivity and some finding low stress reactivity to be correlated with increased substance use and SUD risk. Some studies find that the blunted reactivity pathway to substance use occurs particularly for youth from high-risk contexts. Further, some evidence supports the proposed sex differences in stress reactivity pathways. We discuss future directions and implications of these findings for developing and refining developmentally-sensitive stress reactivity-focused SUD prevention programs.