Working memory ability and early drug use progression as predictors of adolescent substance use disorders.
Working memory ability and early drug use progression as predictors of adolescent substance use disorders.
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DOI：
10.1111/add.13792
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发表时间：
2017-07
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影响因子：
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通讯作者：
Hurt H
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文献类型：
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作者：
Khurana A;Romer D;Betancourt LM;Hurt H
探讨青少年物质使用障碍（SUD）的神经行为模型，该模型是由过度活跃的奖励动机系统和低活性的执行控制系统之间的失衡引起的。具体来说，我们测试了（1）工作记忆（WM）的早期弱点以及相关的不经思考的行动（AWT）和延迟折扣（DD）的不平衡指标是否预测青春期后期的SUD，以及（2）早期药物使用进展是否介导了这种关系。从2005年至2010年，每年收集五波纵向数据，2012年进行最后一次跟踪。从美国宾夕法尼亚州费城地区招募的387名社区青少年（基线年龄11-13岁）样本。WM在基线时使用4种不同的计算机任务进行评估。使用自我报告在基线时评估AWT和DD。早期的药物使用模式是使用前四波最近药物使用的年度自我报告来建模的。SUD的最终结果在最后一波使用与DSM-5标准相匹配的自我报告进行评估，其中三种常用物质为酒精、大麻和烟草。基线时WM的减弱，与AWT的神经行为失衡指标相关，B（SE）=-0.06（0.02），p<0.01，DD，B（SE）=-7.30（1.93），p<0.01，是最终随访时SUD的重要预测因子。WM预测SUD，均独立于早期药物使用，B（SE）=-0.36（0.12），p<0.01，并且由早期药物使用进展介导，B（SE）=-0.06（0.02），p<0.01。工作记忆力弱的青少年对冲动的控制能力较差，使他们有可能在以后患上物质使用障碍，其中一些影响是由早期药物使用进展介导的。
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. Five waves of longitudinal data collected annually from 2005–2010, with a final follow-up in 2012. Sample of 387 community adolescents (baseline ages 11–13) recruited from the Philadelphia, Pennsylvania, USA area. 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. 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. 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.