fMRI and treatment response with binge drinking adolescents

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Project Summary While the field of translational research is gaining increased attention, few teams have successfully integrated brain+behavioral approaches to examine the developing adolescent brain in the context of addiction treatment. PI Feldstein Ewing has been at the forefront of this work, highlighting that in contrast to adults who show reduced reward response in mesocorticolimbic regions during addiction treatment, adolescents' addiction behavior change revolves around enhanced default mode network response [DMN; precuneus, posterior cingulate gyrus (PCC), and middle frontal gyrus (MFG)]. Our foundational studies underscore in this age group, greater DMN response during critical elements of treatment (client language; therapist language) corresponds with greater behavior change (less problem drinking). Our foundational studies have also critically advanced neurodevelopmental addiction theory, illuminating 4 neuro-biobehavioral drivers of adolescent addiction treatment response, including innovative behavioral treatment approaches that planfully integrate a neurodevelopmental perspective and engage: (a) prosocial (vs. problem-based) approaches, (b) adolescents' drastically developing cognitive skills, (c) adolescents' developmentally-specific drive for autonomy, and (d) parents into programming. Following our team's established track record in adolescent intervention development, we aim to use the opportunity of this competitive continuation to maximize our formative translational (brain+behavioral) developmental neuroscience data and theory to inform the creation of a novel behavioral treatment for adolescent addiction (JUNO: Jumpstart Understanding of Neurodevelopmental Opportunity). This competitive continuation directly responds to NOT-AA-19-010's 2019 Notice Interest: of Special "development and dissemination of behavioral treatments for alcohol use disorder.” Here,we propose to merge quantitative neurodevelopmental data from the 1st 4 years of this project with qualitative data from adolescent focus groups (Aim 1), to create a tailored for drinking neurodevelopmentally-responsive behavioral treatment youth (JUNO). We will then evaluate initial impact of this novel behavioral treatment on adolescent problem and proposed neurodevelopmental mechanisms (Aim 2).