Stephanie L. Sitnick

An altered neural response to reward may contribute to alcohol problems among late adolescents with an evening chronotype

Evening chronotypes not only differ from morning-types in their sleep and circadian timing, but they are prone to problematic outcomes involving reward function, including affective disturbance, sensation seeking, and substance involvement. We explored the neural mechanisms underlying these chronotype differences by comparing the neural response to reward in morning- and evening-types. Using a monetary reward fMRI paradigm, we compared the neural response to reward in 13 morning-types and 21 evening-types (all 20 y/o males). Region-of-interest (ROI) analyses focused on the medial prefrontal cortex (mPFC) and ventral striatum (VS), comparing the chronotype groups in these ROIs during anticipation and outcome conditions, and adjusting for time of scan. Chronotype groups were also compared on measures of sensation-seeking, substance involvement, and sleep quality. Evening-types reported significantly greater levels of alcohol dependence and worse sleep quality. Furthermore, evening-types showed an altered neural response to reward relative to morning-types, specifically, reduced mPFC reactivity during reward anticipation and increased VS reactivity during win outcome. In turn, less activation in the mPFC region in response to reward was associated with greater alcohol consumption, while increased activation in the VS in response to reward was associated with more symptoms of alcohol dependence. Increased reward-related problems among evening-types may be accompanied by altered neural responses to reward.

Life stress in adolescence predicts early adult reward-related brain function and alcohol dependence

Stressful life events increase vulnerability to problematic alcohol use, and they may do this by disrupting reward-related neural circuitry. This is particularly relevant for adolescents because alcohol use rises sharply after mid-adolescence and alcohol abuse peaks at age 20. Adolescents also report more stressors compared with children, and neural reward circuitry may be especially vulnerable to stressors during adolescence because of prefrontal cortex remodeling. Using a large sample of male participants in a longitudinal functional magnetic resonance imaging study (N = 157), we evaluated whether cumulative stressful life events between the ages of 15 and 18 were associated with reward-related brain function and problematic alcohol use at age 20 years. Higher cumulative stressful life events during adolescence were associated with decreased response in the medial prefrontal cortex (mPFC) during monetary reward anticipation and following the receipt of monetary rewards. Stress-related decreases in mPFC response during reward anticipation and following rewarding outcomes were associated with the severity of alcohol dependence. Furthermore, mPFC response mediated the association between stressful life events and later symptoms of alcohol dependence. These data are consistent with neurobiological models of addiction that propose that stressors during adolescence increase risk for problematic alcohol use by disrupting reward circuit function.

Parenting and the Family Check-Up: Changes in Observed Parent-Child Interaction Following Early Childhood Intervention

Coercion theory posits a cyclical relationship between harsh and coercive parent–child interactions and problem behavior beginning in early childhood. As coercive interactions have been theorized and found to facilitate the development and growth of early conduct problems, early interventions often target parenting to prevent or reduce early disruptive problem behavior. This study utilizes direct observations of parent–child interactions from the Early Steps Multisite study (N = 731; 369 boys) to examine the effect of the Family Check-Up, a family-centered intervention program, on measures of parent–child positive engagement and coercion from age 2 through 5, as well as on childhood problem behavior at age 5. Results indicate that high levels of parent–child positive engagement were associated with less parent–child coercion the following year, but dyadic coercion was unrelated to future levels of positive engagement. In addition, families assigned to the Family Check-Up showed increased levels of positive engagement at ages 3 and 5, and the association between positive engagement at age 3 and child problem behavior at age 5 was mediated by reductions in parent–child coercion at age 4. These findings provide longitudinal confirmation that increasing positive engagement in parent–child interaction can reduce the likelihood of coercive family dynamics in early childhood and growth in problem behavior.

The long-term effectiveness of the Family Check-Up on school-age conduct problems: moderation by neighborhood deprivation

Several studies suggest that neighborhood deprivation is a unique risk factor in child and adolescent development of problem behavior. We sought to examine whether previously established intervention effects of the Family Check-Up (FCU) on child conduct problems at age 7.5 would persist through age 9.5, and whether neighborhood deprivation would moderate these effects. In addition, we examined whether improvements in parent-child interaction during early childhood associated with the FCU would be related to later reductions in child aggression among families living in the highest risk neighborhoods. Using a multisite cohort of at-risk children identified on the basis of family, child, and socioeconomic risk and randomly assigned to the FCU, intervention effects were found to be moderated by neighborhood deprivation, such that they were only directly present for those living at moderate versus extreme levels of neighborhood deprivation. In addition, improvements in child aggression were evident for children living in extreme neighborhood deprivation when parents improved the quality of their parent-child interaction during the toddler period (i.e., moderated mediation). Implications of the findings are discussed in relation to the possibilities and possible limitations in prevention of early problem behavior for those children living in extreme and moderate levels of poverty.

Reducing Risk for Substance Use by Economically Disadvantaged Young Men: Positive Family Environments and Pathways to Educational Attainment.

Using prospective, longitudinal data spanning 10 years (age = 10-20) from a study of 295 economically disadvantaged males, the current investigation evaluated a developmental model that links early family environment and later educational aspirations, extracurricular activities, and educational attainment to substance use in early adulthood. The results indicate that a positive family environment during adolescence (low family conflict, high family warmth, and effective child management) predicted educational involvements during adolescence that promoted educational attainment during early adulthood. Finally, higher levels of educational attainment were associated with less substance use in early adulthood, even after controlling for adolescent substance use. These findings suggest that positive parenting promotes educational achievements that increase resilience to substance use for economically disadvantaged males.

The hazards of bad sleep—Sleep duration and quality as predictors of adolescent alcohol and cannabis use

BACKGROUND Although an association between adolescent sleep and substance use is supported by the literature, few studies have characterized the longitudinal relationship between early adolescent sleep and subsequent substance use. The current study examined the prospective association between the duration and quality of sleep at age 11 and alcohol and cannabis use throughout adolescence. METHODS The present study, drawn from a cohort of 310 boys taking part in a longitudinal study in Western Pennsylvania, includes 186 boys whose mothers completed the Child Sleep Questionnaire; sleep duration and quality at age 11 were calculated based on these reports. At ages 20 and 22, participants were interviewed regarding lifetime alcohol and cannabis use. Cox proportional hazard analysis was used to determine the association between sleep and substance use. RESULTS After accounting for race, socioeconomic status, neighborhood danger, active distraction, internalizing problems, and externalizing problems, both the duration and quality of sleep at age 11 were associated with multiple earlier substance use outcomes. Specifically, less sleep was associated with earlier use, intoxication, and repeated use of both alcohol and cannabis. Lower sleep quality was associated with earlier alcohol use, intoxication, and repeated use. Additionally, lower sleep quality was associated with earlier cannabis intoxication and repeated use, but not first use. CONCLUSIONS Both sleep duration and sleep quality in early adolescence may have implications for the development of alcohol and cannabis use throughout adolescence. Further studies to understand the mechanisms linking sleep and substance use are warranted.

Eveningness among late adolescent males predicts neural reactivity to reward and alcohol dependence 2 years later

HighlightsEveningness, a preference for later sleep timing, is linked to altered reward function.Eveningness is also linked to substance use.We examined eveningness and reward‐related brain function longitudinally.Eveningness at age 20 predicated reward‐related brain function at age 22.Eveningness had an indirect effect on alcohol dependence via reward response. Abstract Eveningness, a preference for later sleep–wake timing, is linked to altered reward function, which may explain a consistent association with substance abuse. Notably, the extant literature rests largely on cross‐sectional data, yet both eveningness and reward function show developmental changes. We examined whether circadian preference during late adolescence predicted the neural response to reward 2 years later. A sample of 93 males reported circadian preference and completed a monetary reward fMRI paradigm at ages 20 and 22. Primary analyses examined longitudinal paths from circadian preference to medial prefrontal cortex (mPFC) and ventral striatal (VS) reward responses. We also explored whether reward responses mediated longitudinal associations between circadian preference and alcohol dependence, frequency of alcohol use, and/or frequency of cannabis use. Age 20 eveningness was positively associated with age 22 mPFC and VS responses to win, but not associated with age 22 reactivity to reward anticipation. Age 20 eveningness was indirectly related to age 22 alcohol dependence via age 22 mPFC response to win. Our findings provide novel evidence that altered reward‐related brain function could underlie associations between eveningness and alcohol use problems. Eveningness may be an under‐recognized but modifiable risk factor for reward‐related problems such as mood and substance use disorders.

Mothers’ Physical Illness in One- and Two-Parent Families

Parental physical illness has been associated with a variety of negative child outcomes but the mechanisms explaining this relationship are not fully understood. Additionally, few studies have explored what role, if any, marital status may play in this relationship. This study used prospective longitudinal survey data from 382 two-parent and 182 single-parent families in the Iowa Youth and Families and Single Parents Project to explore the relationship between maternal illness and parenting with depressed affect as a potential mediator. Multiple group structural equation modeling was used to investigate whether the relationships between these indicators were the same for single and married mothers. Analyses revealed associations between mothers’ illness and parenting for both single and married mothers, but mothers’ depressed affect played a meditational role for single mothers, which was not evident with married mothers. Both the empirical and clinical implications of these findings are discussed.

Transactional effects among maternal depression, neighborhood deprivation, and child conduct problems from early childhood through adolescence: A tale of two low-income samples.

The current study sought to advance our understanding of transactional processes among maternal depression, neighborhood deprivation, and child conduct problems (CP) using two samples of low-income families assessed repeatedly from early childhood to early adolescence. After accounting for initial levels of negative parenting, independent and reciprocal effects between maternal depressive symptoms and child CP were evident across both samples, beginning in early childhood and continuing through middle childhood and adolescence. In addition, neighborhood effects were consistently found in both samples after children reached age 5, with earlier neighborhood effects on child CP and maternal depression found in the one exclusively urban sample of families with male children. The results confirm prior research on the independent contribution of maternal depression and child CP to the maintenance of both problem behaviors. The findings also have implications for designing preventative and clinical interventions to address child CP for families living in high-risk neighborhoods.

My child at mealtime: A visually enhanced self-assessment of feeding styles for low-income parents of preschoolers.

The importance of caregiver feeding styles on childrens dietary outcomes is well documented. However, the instruments used to assess feeding style are limited by high literacy demands, making selfassessment with low-income audiences challenging. The purpose of the current study is to report on the development of My Child at Mealtime (MCMT), a self-assessment tool with reduced literacy demands, designed to measure feeding styles with parents of preschool-aged children. Cognitive interviews were conducted with 44 Head Start parents of 2-5 year old children to develop question wording and identify appropriate visuals. The resulting tool was administered to 119 ethnically diverse, low-income parents of 2-5 year old children. Factor analysis resulted in a two-factor structure that reflects responsiveness and demandingness in a manner consistent with existing assessment tools. Results indicate the final visually enhanced MCMT self-assessment tool provides a measure of parenting style consistent with existing measures, while reducing the literacy demand.