Objective

The present longitudinal study examines how age of alcohol initiation and regular use (weekly drinking for ≥6 months) relates to adolescent physiological development, social behaviors, psychological functioning, and substance use patterns. Method: Data are drawn from a prospective sample of 295 youth (42% female) who completed a 15-year longitudinal study. The current investigation uses data collected at 4 timepoints from ages 12-19. Results: Latent growth modeling revealed earlier age of alcohol initiation is associated with (1) a more advanced stage of pubertal development, more self-reported dating experience, and greater externalizing behaviors at ages 12-13 (study entry); (2) a slower rate of change in pubertal development; and (3) greater rate of increase in externalizing and internalizing symptoms from ages 12 to 19. These relationships were not moderated by gender. Conclusion: Early alcohol initiation appears to be associated with early onset pubertal development and dating behaviors. Over time, early alcohol use behaviors may delay pubertal development while exacerbating psychological risk behaviors (i.e. externalizing and internalizing behaviors). These findings suggest the importance of delaying alcohol initiation and may be beneficial for improving existing adolescent substance use prevention efforts.

Aims: Adolescents with substance use disorders (SUD) exhibit hyposensitivity to pleasant internally generated (interoceptive) stimuli and hypersensitivity to external rewarding stimuli. It is unclear whether similar patterns exist for aversive interoceptive stimuli. We compared activation in the insular cortex and other brain regions during the anticipation and experience of aversive stimuli between adolescents with SUD and those without. Design: Cross-sectional experimental study with two groups. Participants: Adolescents (ages 15-17years) with an alcohol or marijuana SUD (n=18) and healthy comparison subjects (CON, n=15).Participants were recruited by distributing flyers at local high schools. Setting: Keck Imaging Center, University of California San Diego, CA, USA. Measurements: Behavioral and neural responses to a continuous performance task with inspiratory breathing load recorded during an fMRI session. Questionnaires assessed life-time drug use, anxiety, sensation-seeking, impulsivity, affect and bodily awareness. Visual analog scales assessed drug craving and breathing load responses. Findings: Across subjects, experience of breathing load elicited greater bilateral anterior and posterior insula (AI and PI, respectively) activation than anticipation (F(1,31)=4.16, P<0.05). SUD exhibited greater left AI and bilateral PI activation during breathing load than anticipation, comparedwithCON (F(1,31)=4.16, P<0.05). In contrast, CON showed greater activation during anticipation than breathing load in left PI, comparedwithSUD (F(1,31)=4.16, P<0.05). Conclusions: Adolescents with alcohol and marijuana substance use disorders may be hypersensitive to aversive interoceptive stimuli.