The effects of exposure to violence on risk for substance abuse: neural mechanisms and community level moderators

Project SummaryIt is well known that stressful events, such as those occurring as a result of COVID-19 prevention efforts, are apotent trigger for the initiation and escalation of illicit substance use. However, it is not well known how stresstriggers increased substance use, which could help improve understanding, prevention, and treatment ofsubstance use disorders. Therefore, our ongoing longitudinal study of adolescents was designed to test thehypothesis that stress during development recalibrates the neural processes underlying threat and rewardreactivity as well as working memory capacity, which leads to increased risk for the initiation and escalation ofsubstance use. Because COVID-19 related social distancing is a profound stressor, measuring it's effectsprovides an opportunity to better understand these hypothesized pathways by which stress increasessubstance use. Therefore, we propose to recontact adolescents (n=309) and caregivers (n=246) in ourongoing longitudinal study to assess changes in stress, cognitive function, and substance use due to theCOVID-19 pandemic at two time points. At both time points, youths will also complete a working memorycapacity task and delay discounting assessment and have their locations tracked with GPS for a week whilethey receive 35 ecological momentary assessment (EMA) prompts to assess their momentary stress, socialinteractions, substance use, and feelings at particular locations as was done in prior waves. In Aim 1, we focuson 3 particular categories of stress to understand their relative contribution to increased substance use: (1)Social distancing experiences: the GPS and questionnaire assessments of activity patterns provide aquantitative, state-of-the-art measure of the magnitude of change in individual mobility elicited by COVID-19social distancing; (2) Economic hardship: Because our sample is socioeconomically diverse (37.4% haveannual household incomes under $30,000), we will have the opportunity to clarify the effects of increasedeconomic challenges on substance use; (3) Social isolation and conflict: The questionnaire and EMA data onfrequency of interpersonal interaction and conflict provide the opportunity to determine if these are also triggersof increased substance use. In Aim 2, potential cognitive mediators of these effects will be assessed using themeasurement of working memory capacity and delay discounting. These youths have already completed aneuroimaging session that assessed neural structure (anatomy and connectivity), resting state activity, andactivity during tasks probing working memory capacity (Emotional N-Back), reward reactivity (viewing imagesof marijuana, e-cigs, and alcohol), reward anticipation (Monetary Incentive Delay), and threat reactivity(emotional faces). Because these same procedures will be repeated as soon as research activity can resumeafter COVID-19 restrictions are lifted, Aim 3 will be to determine how COVID-19 related stress moderateschanges in neural structure and function as well as the degree to which these neural changes predict changesin substance use.