title: Neural Predictors of Initiating Alcohol Use During Adolescence.
abstract: OBJECTIVE
  Underage drinking is widely recognized as a leading public health and social problem for adolescents in the United States. Being able to identify at-risk adolescents before they initiate heavy alcohol use could have important clinical and public health implications; however, few investigations have explored individual-level precursors of adolescent substance use. This prospective investigation used machine learning with demographic, neurocognitive, and neuroimaging data in substance-naive adolescents to identify predictors of alcohol use initiation by age 18.
  
  
  METHODS
  Participants (N=137) were healthy substance-naive adolescents (ages 12-14) who underwent neuropsychological testing and structural and functional magnetic resonance imaging (sMRI and fMRI), and then were followed annually. By age 18, 70 youths (51%) initiated moderate to heavy alcohol use, and 67 remained nonusers. Random forest classification models identified the most important predictors of alcohol use from a large set of demographic, neuropsychological, sMRI, and fMRI variables.
  
  
  RESULTS
  Random forest models identified 34 predictors contributing to alcohol use by age 18, including several demographic and behavioral factors (being male, higher socioeconomic status, early dating, more externalizing behaviors, positive alcohol expectancies), worse executive functioning, and thinner cortices and less brain activation in diffusely distributed regions of the brain.
  
  
  CONCLUSIONS
  Incorporating a mix of demographic, behavioral, neuropsychological, and neuroimaging data may be the best strategy for identifying youths at risk for initiating alcohol use during adolescence. The identified risk factors will be useful for alcohol prevention efforts and in research to address brain mechanisms that may contribute to early drinking.
authors.affiliation: From the Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston; the Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif.; the Department of Psychiatry, University of California, San Diego, La Jolla; the VA San Diego Healthcare System, San Diego; the San Diego State University and University of California, San Diego, Joint Doctoral Program in Clinical Psychology, San Diego; and the Laureate Institute for Brain Research, Tulsa, Okla.
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Squeglia
authors.affiliation: From the Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston; the Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif.; the Department of Psychiatry, University of California, San Diego, La Jolla; the VA San Diego Healthcare System, San Diego; the San Diego State University and University of California, San Diego, Joint Doctoral Program in Clinical Psychology, San Diego; and the Laureate Institute for Brain Research, Tulsa, Okla.
authors.forename: Tali M
authors.initials: TM
authors.lastname: Ball
authors.affiliation: From the Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston; the Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif.; the Department of Psychiatry, University of California, San Diego, La Jolla; the VA San Diego Healthcare System, San Diego; the San Diego State University and University of California, San Diego, Joint Doctoral Program in Clinical Psychology, San Diego; and the Laureate Institute for Brain Research, Tulsa, Okla.
authors.forename: Joanna
authors.initials: J
authors.lastname: Jacobus
authors.affiliation: From the Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston; the Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif.; the Department of Psychiatry, University of California, San Diego, La Jolla; the VA San Diego Healthcare System, San Diego; the San Diego State University and University of California, San Diego, Joint Doctoral Program in Clinical Psychology, San Diego; and the Laureate Institute for Brain Research, Tulsa, Okla.
authors.forename: Ty
authors.initials: T
authors.lastname: Brumback
authors.affiliation: From the Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston; the Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif.; the Department of Psychiatry, University of California, San Diego, La Jolla; the VA San Diego Healthcare System, San Diego; the San Diego State University and University of California, San Diego, Joint Doctoral Program in Clinical Psychology, San Diego; and the Laureate Institute for Brain Research, Tulsa, Okla.
authors.forename: Benjamin S
authors.initials: BS
authors.lastname: McKenna
authors.affiliation: From the Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston; the Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif.; the Department of Psychiatry, University of California, San Diego, La Jolla; the VA San Diego Healthcare System, San Diego; the San Diego State University and University of California, San Diego, Joint Doctoral Program in Clinical Psychology, San Diego; and the Laureate Institute for Brain Research, Tulsa, Okla.
authors.forename: Tam T
authors.initials: TT
authors.lastname: Nguyen-Louie
authors.affiliation: From the Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston; the Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif.; the Department of Psychiatry, University of California, San Diego, La Jolla; the VA San Diego Healthcare System, San Diego; the San Diego State University and University of California, San Diego, Joint Doctoral Program in Clinical Psychology, San Diego; and the Laureate Institute for Brain Research, Tulsa, Okla.
authors.forename: Scott F
authors.initials: SF
authors.lastname: Sorg
authors.affiliation: From the Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston; the Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif.; the Department of Psychiatry, University of California, San Diego, La Jolla; the VA San Diego Healthcare System, San Diego; the San Diego State University and University of California, San Diego, Joint Doctoral Program in Clinical Psychology, San Diego; and the Laureate Institute for Brain Research, Tulsa, Okla.
authors.forename: Martin P
authors.initials: MP
authors.lastname: Paulus
authors.affiliation: From the Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston; the Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif.; the Department of Psychiatry, University of California, San Diego, La Jolla; the VA San Diego Healthcare System, San Diego; the San Diego State University and University of California, San Diego, Joint Doctoral Program in Clinical Psychology, San Diego; and the Laureate Institute for Brain Research, Tulsa, Okla.
authors.forename: Susan F
authors.initials: SF
authors.lastname: Tapert
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000437:Alcoholism / Q000503:physiopathology* / Q000523:psychology*; D001921:Brain / Q000503:physiopathology; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000503:physiopathology; D003469:Culture; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007389:Internal-External Control; D000069550:Machine Learning; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D000066608:Underage Drinking / Q000523:psychology*; D014481:United States
keywords: Adolescents; Alcohol Abuse; Cognitive Neuroscience; Underage Drinking