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Diminished alternative reinforcement as a mechanism linking conduct problems and substance use in adolescence: a longitudinal examination.

ABSTRACT: AIMS:To determine whether diminished alternative reinforcement (i.e. engagement and enjoyment from substance-free activities) mediated the longitudinal association of conduct problems with substance use in early-mid-adolescence. DESIGN:Structural equation modeling tested whether the association between wave 1 (baseline) conduct problems and wave 3 (24-month follow-up) substance use outcomes was mediated by diminished alternative reinforcement at wave 2 (12-month follow-up). Additional analyses tested whether sex and socio-economic status moderated this association. SETTING:Ten high schools in Los Angeles, CA, USA, 2013-15. PARTICIPANTS:Students (n = 3396, 53.5% female, mean [standard deviation (SD)] age at wave 1 baseline = 14.1 (0.42) years). MEASUREMENTS:Self-reported conduct problems (11-item questionnaire), alternative reinforcement (44-item questionnaire) and use of alcohol, marijuana and combustible cigarettes during the past 6 months (yes/no) and the past 30 days (nine-level ordinal response based on days used in past 30 days). RESULTS:Significant associations of wave 1 conduct problems with wave 3 marijuana use during the past 6 months (? = 0.25) and past 30 days (? = 0.26) were mediated by wave 2 diminished alternative reinforcement (?indirect effect : 6 months = 0.013, 30 days = 0.017, Ps < 0.001). Associations of conduct problems with alcohol or combustible cigarette use were not mediated by alternative reinforcement. All associations did not differ by sex and socio-economic status. CONCLUSIONS:Diminished alternative reinforcement may be a modifiable mechanism linking early adolescent conduct problems and subsequent marijuana use that could be targeted in prevention programs to offset the adverse health and social sequelae associated with comorbid conduct problems and marijuana use in early-mid adolescence.

SUBMITTER: Khoddam R

PROVIDER: S-EPMC5938106 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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Diminished alternative reinforcement as a mechanism linking conduct problems and substance use in adolescence: a longitudinal examination.

Khoddam Rubin R Cho Junhan J Jackson Nicholas J NJ Leventhal Adam M AM

Addiction (Abingdon, England) 20180207 6

<h4>Aims</h4>To determine whether diminished alternative reinforcement (i.e. engagement and enjoyment from substance-free activities) mediated the longitudinal association of conduct problems with substance use in early-mid-adolescence.<h4>Design</h4>Structural equation modeling tested whether the association between wave 1 (baseline) conduct problems and wave 3 (24-month follow-up) substance use outcomes was mediated by diminished alternative reinforcement at wave 2 (12-month follow-up). Additi ...[more]

PMID: 29333677

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Project description:ObjectiveStructural neuroimaging studies have demonstrated lower regional gray matter volume in adolescents with severe substance and conduct problems. These research studies, including ours, have generally focused on male-only or mixed-sex samples of adolescents with conduct and/or substance problems. Here we compare gray matter volume between female adolescents with severe substance and conduct problems and female healthy controls of similar ages.HypothesesFemale adolescents with severe substance and conduct problems will show significantly less gray matter volume in frontal regions critical to inhibition (i.e. dorsolateral prefrontal cortex and ventrolateral prefrontal cortex), conflict processing (i.e., anterior cingulate), valuation of expected outcomes (i.e., medial orbitofrontal cortex) and the dopamine reward system (i.e. striatum).MethodsWe conducted whole-brain voxel-based morphometric comparison of structural MR images of 22 patients (14-18 years) with severe substance and conduct problems and 21 controls of similar age using statistical parametric mapping (SPM) and voxel-based morphometric (VBM8) toolbox. We tested group differences in regional gray matter volume with analyses of covariance, adjusting for age and IQ at p<0.05, corrected for multiple comparisons at whole-brain cluster-level threshold.ResultsFemale adolescents with severe substance and conduct problems compared to controls showed significantly less gray matter volume in right dorsolateral prefrontal cortex, left ventrolateral prefrontal cortex, medial orbitofrontal cortex, anterior cingulate, bilateral somatosensory cortex, left supramarginal gyrus, and bilateral angular gyrus. Considering the entire brain, patients had 9.5% less overall gray matter volume compared to controls.ConclusionsFemale adolescents with severe substance and conduct problems in comparison to similarly aged female healthy controls showed substantially lower gray matter volume in brain regions involved in inhibition, conflict processing, valuation of outcomes, decision-making, reward, risk-taking, and rule-breaking antisocial behavior.

Dataset Information

Diminished alternative reinforcement as a mechanism linking conduct problems and substance use in adolescence: a longitudinal examination.

Publications

Diminished alternative reinforcement as a mechanism linking conduct problems and substance use in adolescence: a longitudinal examination.

Similar Datasets

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