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New Model Helps Identify Teens At-Risk for Alcohol Use


Underage drinking is a major public health problem in the United States and new research has developed a means of identifying teens who are at-risk of heavy alcohol use.

Teen alcohol use has substantial consequences, including poor school performance, drunk driving and risky sexual behavior; and teen alcohol use accounts for some 5,000 deaths each year.


Researchers from several universities, led by Lindsay M. Squeglia, Ph.D., with the Medical University of South Carolina in Charleston wanted to develop a model to predict which adolescents would initiate moderate to heavy alcohol use by age 18. The ability to identify at-risk youth could contribute significantly to prevention and intervention efforts.

Researchers used a combination of information sources to predict alcohol use by age 18, including demographic, neurocognitive and neuroimaging data. Participants in the study were healthy 12 to 14-year-olds with little or no experience with alcohol and drugs. Ninety-seven percent of participants had never used alcohol and 98 percent had never used marijuana.

Participants were interviewed for demographic information and underwent neuropsychological testing to evaluate cognitive function. Two types of neuroimaging were used to assess brain structure—structural and functional magnetic resonance imaging (sMRI and fMRI). Substance use was measured through an interviewer-administered questionnaire and confirmed with breath alcohol testing and urine screens. Additional input was also collected from parents and/or other family members or friends.

By age 18, 51 percent of the participants had initiated moderate to heavy alcohol use. The combined data model was 74 percent accurate in predicting the outcomes.

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The study identified 34 factors associated with alcohol use by age 18, including being male, early dating, higher socioeconomic status, worse executive functioning, poorer performance on two subtests of the intelligence assessment (Wechsler Abbreviated Scale of Intelligence) and several specific brain structures. The addition of neuroimaging and neuropsychological information significantly improved prediction of future alcohol use behaviors compared to demographic data alone.

The authors conclude that “understanding neurocognitive factors that predate substance use initiation is crucial to specifying the consequences of substance use on brain development, as well as identifying at-risk youths and potential targets of preventive efforts.”

The researchers have published information from the study that will allow others to replicate the findings in the hope that a validated model can be used to predict adolescent alcohol use.

The research was published in AJP in Advance in August 2016. It was supported by the National Institute of Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse.




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