Squeglia Lindsay M, Jacobus Joanna, Nguyen-Louie Tam T, Tapert Susan F
Department of Psychiatry, University of California San Diego.
Joint Doctoral Program in Clinical Psychology, San Diego State University.
Neuropsychology. 2014 Sep;28(5):782-790. doi: 10.1037/neu0000083. Epub 2014 Apr 21.
Adolescent substance use has been associated with poorer neuropsychological functioning, but it is unclear if deficits predate or follow the onset of use. The goal of this prospective study was to understand how neuropsychological functioning during early adolescence could predict substance use by late adolescence.
At baseline, participants were 175 substance-use-naïve healthy 12- to 14-year-olds (41% female) recruited from local schools. Participants completed extensive interviews and neuropsychological tests. Each year, participants' substance use was assessed. By late adolescence (ages 17 to 18), 105 participants transitioned into substance use and 75 remained substance-naïve. Hierarchical linear regressions examined how baseline cognitive performance predicted subsequent substance use, controlling for common substance use risk factors (i.e., family history, externalizing behaviors, gender, pubertal development, and age).
Poorer baseline performance on tests of cognitive inhibition-interference predicted higher follow-up peak drinks on an occasion (β = -.15; p < .001), more days of drinking (β = -.15; p < .001), and more marijuana use days (β = -.17; p < .001) by ages 17 to 18, above and beyond covariates. Performances on short-term memory, sustained attention, verbal learning and memory, visuospatial functioning, and spatial planning did not predict subsequent substance involvement (ps > .05).
Compromised inhibitory functioning during early adolescence prior to the onset of substance use was related to more frequent and intense alcohol and marijuana use by late adolescence. Inhibition performance could help identify teens at risk for initiating heavy substance use during adolescence, and potentially could be modified to improve outcome.
青少年物质使用与较差的神经心理功能有关，但尚不清楚这些缺陷是在使用开始之前还是之后出现。这项前瞻性研究的目的是了解青春期早期的神经心理功能如何预测青春期后期的物质使用情况。
在基线时，参与者为从当地学校招募的175名未使用过物质的健康12至14岁青少年（41%为女性）。参与者完成了广泛的访谈和神经心理测试。每年对参与者的物质使用情况进行评估。到青春期后期（17至18岁），105名参与者开始使用物质，75名仍未使用物质。分层线性回归分析了基线认知表现如何预测随后的物质使用情况，同时控制常见的物质使用风险因素（即家族史、外化行为、性别、青春期发育和年龄）。
在认知抑制-干扰测试中基线表现较差，预示着到17至18岁时，随访时单次饮酒的峰值更高（β = -.15；p <.001）、饮酒天数更多（β = -.15；p <.001）以及大麻使用天数更多（β = -.17；p <.001），在考虑协变量之后仍是如此。短期记忆、持续注意力、言语学习和记忆、视觉空间功能以及空间规划方面的表现并不能预测随后是否会使用物质（p >.05）。
在物质使用开始之前的青春期早期，抑制功能受损与青春期后期更频繁、更大量地使用酒精和大麻有关。抑制功能表现有助于识别在青春期有开始大量使用物质风险的青少年，并且有可能通过干预来改善结果。
