Neural Response to Risky Decision Making in Youth at High Risk for Substance Use Disorders and HIV

药物使用障碍和艾滋病毒高危青少年对危险决策的神经反应

• 批准号: 9925192
• 负责人: Leslie A. Hulvershorn
• 金额: $ 64.24万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-01 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9925192
• 关键词: 12 year old; 14 year old; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adolescence; Adolescent; Adolescent Behavior; Adult Children; Alcohol or Other Drugs use; Back; Behavior; Behavior assessment; Behavioral; Behavioral Mechanisms; Brain; Cause of Death; Cessation of life; Child Rearing; Childhood; Cognition; Cognitive; Corpus striatum structure; Cues; Data; Decision Making; Development; Disease; Drug Experimentation; Drug usage; Experimental Designs; Failure; Family; Family history of; Feedback; Foundations; Future; Genetic; HIV; Heritability; Image; Impairment; Impulsivity; Intervention; Interview; Lead; Learning; Light; Link; Longitudinal Studies; Modeling; Motivation; Motor; Neurophysiology - biologic function; Outcome; Parents; Participant; Pattern; Pharmaceutical Preparations; Phase; Phenotype; Prefrontal Cortex; Prevention; Prevention strategy; Process; Psychological Factors; Psychopathology; Recording of previous events; Research; Rewards; Risk; Risk Behaviors; Risk Factors; Sampling; Sex Behavior; Short-Term Memory; Substance Use Disorder; Substance abuse problem; Symptoms; System; Time; Training; Translating; Treatment Side Effects; United States; Work; Youth; addiction; alcohol behavior; behavior measurement; behavioral phenotyping; brain abnormalities; cognitive process; cost; design; discounting; disorder risk; drug of abuse; externalizing behavior; follow-up; high risk; high risk population; high risk sexual behavior; improved; innovation; longitudinal design; neuroimaging; neuromechanism; non-drug; novel; predictive test; psychologic; public health relevance; relating to nervous system; response; sex; sexual risk behavior; therapy development; trait; treatment strategy

 DESCRIPTION (provided by applicant): Substance use disorders (SUDs) cost the United States $110 billion each year, while HIV/AIDS approaches $36 billion. Despite extensive prevention and treatment efforts, drug-related deaths remain near historic highs; AIDS is still a leading cause of death among 15-to 24-year olds. Given the inadequate response rates to current prevention and treatment strategies for both SUDs and HIV, improvements are needed to reduce their onset. Future interventions which specifically target cognitive and neural mechanisms known to impact the onset of drug use and risky sexual (leading to HIV acquisition) practices in adolescence would allow for prevention in early, more malleable phases of development. While adolescent behavior provides some clues about motivation for early drug use/sexual behavior, improved understanding of adolescent brain mechanisms underlying the behavior may shed additional light. One process thought to lead to early and problematic drug use/sexual behavior is impairment in risky decision-making. We have shown ventromedial prefrontal activation abnormalities in high-risk youth during risky-decision making, prior to drug experimentation. Specifically, these abnormalities are present when high-risk 10-14-year-olds learn about the negative outcomes of their risky decisions. We speculate that failure of the brain to effectively process, and therefore learn from, a negative outcome may lead adolescents to continue to take drug/sexual behavior risks. Existing imaging-risk studies have defined risk according to a family history of SUD, early substance use, the presence of impulsive/risky behaviors and a combination of these models. Important questions remain: (1) Do brain abnormalities pertaining to risky decision-making in drug-naïve adolescents actually predict later risky drug/sexual experimentation? (2) Is there something unique about brain functioning in youth with behavioral manifestations of addiction/sexual behavior risk, depending on whether or not they have parents with SUDs? (3) What are the underlying cognitive processes that lead to abnormal brain response to negative outcomes of risky decisions in high-risk youth? To address these questions we propose to study 2 high-risk groups of non-drug using 11-12- year-olds (those with behavioral risk factors +/- family histories of SUDs) and healthy comparison participants. Brain function of these groups will be assessed cross-sectionally using experimental decision making tasks, along with behavioral assessments of impulse control. Then, youth will then be invited back for interviews about their drug, alcohol and sexual behavior practices over several years. Outcomes of the project will allow for a better understanding of the brain mechanisms that underlie risky-decision making in youth at high risk for SUDs and HIV and the capacity for brain function to predict later drug and high risk sexual behaviors. Ultimately, this information can be translated to novel interventions targeting high-risk youth.

 描述（由申请人提供）：美国每年因药物使用障碍 (SUD) 花费 1,100 亿美元，而艾滋病毒/艾滋病则接近 360 亿美元，尽管开展了广泛的预防和治疗工作，但与药物相关的死亡人数仍然接近历史最高水平；鉴于目前针对 SUD 和 HIV 的预防和治疗策略的响应率不足，未来需要采取专门针对认知的干预措施来减少其发病率。已知影响青春期吸毒和危险性行为（导致艾滋病毒感染）行为的神经机制将有助于在早期、更具可塑性的发展阶段进行预防，而青少年行为提供了一些关于早期吸毒/性行为动机的线索。行为，提高对行为背后的青少年大脑机制的了解可能会进一步阐明导致早期和有问题的吸毒/性行为的一个过程，即高风险青少年的腹内侧前额叶激活异常。期间具体而言，当 10-14 岁的高风险儿童了解其风险决策的负面结果时，就会出现这些异常，因此我们推测大脑无法有效处理这些决策。从中吸取教训，负面结果可能会导致青少年继续承担毒品/性行为风险，现有的影像学风险研究根据 SUD 家族史、早期药物使用、冲动/危险行为的存在以及以下因素的组合来定义风险。这些模型。重要的问题仍然存在：（1）未接触过药物的青少年中与风险决策相关的大脑异常是否真的能预测以后的情况？ 危险的药物/性实验？（2）具有成瘾/性行为风险行为表现的青少年的大脑功能是否存在独特之处，取决于他们的父母是否患有 SUD？（3）导致其的潜在认知过程是什么？为了解决这些问题，我们建议研究 2 个不吸毒的 11-12 岁高危人群（具有行为风险因素的人 +/-）家族史SUD）和健康比较参与者的大脑功能将通过实验行为决策任务以及冲动控制评估进行横断面评估，然后，青少年将被邀请回来接受有关他们的药物、酒精和性行为的采访。该项目的成果将有助于更好地了解 SUD 和 HIV 高危青少年做出危险决策的大脑机制，以及预测以后吸毒和高风险性行为的大脑功能的能力。最终，这些信息可以转化为针对高危青少年的新颖干预措施。