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Front Behav Neurosci. 2017 Nov 13;11:223. doi: 10.3389/fnbeh.2017.00223. eCollection 2017.

Adolescent Executive Dysfunction in Daily Life: Relationships to Risks, Brain Structure and Substance Use.

Author information

1
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States.
2
Department of Psychology and Psychiatry, University of California, San Diego, La Jolla, CA, United States.
3
Center for Health Sciences, SRI International, Menlo Park, CA, United States.
4
Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Palo Alto, CA, United States.
5
Department of Psychiatry, Duke University, Durham, NC, United States.
6
Department of Psychology, University of North Carolina Wilmington, Wilmington, NC, United States.
7
Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States.

Abstract

During adolescence, problems reflecting cognitive, behavioral and affective dysregulation, such as inattention and emotional dyscontrol, have been observed to be associated with substance use disorder (SUD) risks and outcomes. Prior studies have typically been with small samples, and have typically not included comprehensive measurement of executive dysfunction domains. The relationships of executive dysfunction in daily life with performance based testing of cognitive skills and structural brain characteristics, thought to be the basis for executive functioning, have not been definitively determined. The aims of this study were to determine the relationships between executive dysfunction in daily life, measured by the Behavior Rating Inventory of Executive Function (BRIEF), cognitive skills and structural brain characteristics, and SUD risks, including a global SUD risk indicator, sleep quality, and risky alcohol and cannabis use. In addition to bivariate relationships, multivariate models were tested. The subjects (n = 817; ages 12 through 21) were participants in the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study. The results indicated that executive dysfunction was significantly related to SUD risks, poor sleep quality, risky alcohol use and cannabis use, and was not significantly related to cognitive skills or structural brain characteristics. In multivariate models, the relationship between poor sleep quality and risky substance use was mediated by executive dysfunction. While these cross-sectional relationships need to be further examined in longitudinal analyses, the results suggest that poor sleep quality and executive dysfunction may be viable preventive intervention targets to reduce adolescent substance use.

KEYWORDS:

adolescents; alcohol; executive functioning; neurocognitive testing; neuroimaging

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