Effects of Stereotype Threat on Impulsivity and Its Relation to Alcohol Use in African Americans: An fMRI Study

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Summary African Americans experience higher rates of alcohol-related sequalae (e.g., cirrhosis, mortality) relative to their European American counterparts. It is thus critical from a public health perspective that we gain a deep understanding of the unique factors contributing to alcohol use behaviors in African American individuals. To this end, many studies have focused on understanding how social and environmental factors (social determinants) contribute to increased alcohol use among African Americans. Yet, the mechanisms through which these social determinants affect alcohol use behaviors are poorly understood, resulting in an absence of vital information needed to enhance alcohol use disorders (AUD) prevention and intervention strategies. We have recently shown that exposure to a common stressor, stereotype threat, is associated with increases in impulsivity – a key mediating mechanism of AUD risk. Stereotype threat (ST) is a behavioral phenomenon that arises when cues in the environment evoke negative stereotypes associated with an individual’s group, triggering cognitive processes that adversely impact behavior. An enduring stereotype of African American communities is that they experience high levels of alcohol/substance use. We have shown that exposure to these negative race-related stereotypes elevates impulsivity. Further, our data reveal that this increase in impulsivity correlates with alcohol use among African Americans. These findings reveal ST-induced impulsivity as a novel correlate of AUD-risk behaviors. In line with NIAAA’s goal to develop a more thorough understanding of the mechanisms contributing to AUD risk, we propose to investigate the neural mechanisms associated with ST-induced impulsivity. We will further assess whether these neural mechanisms are associated with alcohol use behaviors among African American adults. Participants will include 280 African American adults who regularly consume alcohol. While undergoing functional MRI, all will complete a measure of impulsivity administered both before and after an ST exposure manipulation. This manipulation will utilize a 2x2x2 between-subjects design to systematically manipulate exposure to a verbal ST prime, race-related stimuli, and AUD-related stimuli in order to assess the effects of these exposures, independently and combined, on neural systems involved in impulsive decision-making. Alcohol use behaviors will be assessed outside of the scanner. We predict that ST exposure will lead to shifts within affect-related and cognitive control-related brain regions. To increase clinical impact, we will assess the relation of ST-induced shifts in impulsivity and brain response to alcohol use behaviors. Results from the proposed study will enrich our understanding of how sociocultural, behavioral, and neural factors combine to influence AUD risk behaviors. In addition, our results will provide greater insights into the neural systems implicated in AUD-risk – systems that could serve as targets for novel strategies that enhance resilience.