title: Characterization of South African adolescents with alcohol use disorders but without psychiatric or polysubstance comorbidity.
abstract: BACKGROUND
  Individuals who begin drinking during early adolescence and exhibit externalizing pathology and disinhibitory/dysregulatory tendencies are more vulnerable to developing alcohol use disorders (AUDs) in adulthood. Previous research has focused on in-treatment populations with substantial comorbid psychopathology and polysubstance use. Here, we characterize a unique sample of treatment-naïve adolescents without such comorbidity to help identify vulnerable youth who may benefit from early intervention.
  
  
  METHODS
  We compared externalizing propensity, disinhibitory characteristics, and school performance in adolescents with AUDs (but without comorbid psychopathology or other substance use; n = 70) to those of demographically matched controls (n = 70). Within the AUD group, we compared measures of substance use and the disinhibitory syndrome between boys and girls with differing severity of externalizing propensity.
  
  
  RESULTS
  Adolescents with AUDs demonstrated more externalizing propensity and disinhibitory personality traits (impulsivity, novelty seeking, and excitement seeking), poorer self-monitoring and response inhibition, more bullying and sexual risk-taking behavior, poorer first-language performance, and greater use of alcohol, cannabis, and nicotine (p < 0.05). Within the AUD group, participants with higher externalizing propensity began drinking earlier, more frequently, and for a longer duration than those with lower externalizing symptoms (p < 0.05). Disinhibitory features (personality, cognition, and behavior) were, however, not stronger in those with higher externalizing propensity.
  
  
  CONCLUSIONS
  We suggest that the constructs of externalizing propensity and disinhibitory syndrome are useful in characterizing treatment-naïve adolescents with AUDs but without comorbid psychopathology or polysubstance use. These results support the importance of these constructs in understanding adolescent AUDs, even when the frank externalizing diagnoses of childhood (oppositional defiant disorder and conduct disorder) are excluded.
authors.affiliation: Department of Psychiatry, Stellenbosch University, Tygerberg, South Africa.
authors.forename: Helen L
authors.initials: HL
authors.lastname: Ferrett
authors.forename: Natalie L
authors.initials: NL
authors.lastname: Cuzen
authors.forename: Kevin G F
authors.initials: KG
authors.lastname: Thomas
authors.forename: Paul D
authors.initials: PD
authors.lastname: Carey
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
authors.forename: Peter R
authors.initials: PR
authors.lastname: Finn
authors.forename: Susan F
authors.initials: SF
authors.lastname: Tapert
authors.forename: George
authors.initials: G
authors.lastname: Fein
mesh_terms: D000293:Adolescent; D000367:Age Factors; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000523:psychology*; D000437:Alcoholism / Q000175:diagnosis / Q000523:psychology; D002648:Child; D015897:Comorbidity; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008570:Memory, Short-Term; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D010551:Personality; D011569:Psychiatric Status Rating Scales; D012309:Risk-Taking; D012727:Sex Characteristics; D013019:South Africa; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology