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Biomedical subjects

Ralph E Tarter

Publications and source records attributed to Ralph E Tarter.

At least 19 recordsLinked to original sources

Application of item response theory to quantify substance use disorder severity.

OBJECTIVE: The present investigation had two main goals: (1) Determine whether binary substance use disorder (SUD) diagnoses are indicators of a unidimensional trait indexing severity of disorder; and, (2) demonstrate the predictive, concurrent and construct validity of the SUD severity scale. METHODS: Boys and their biological parents were administered structured diagnostic interviews to diagnose SUD. Item response theory (IRT) was applied to determine whether the diagnoses are indicators of a unidimensional trait. The score on this scale was correlated with substance use behavior, violence, treatment history, risky sex, and social adjustment. RESULTS: SUD diagnoses are indicators of a unidimensional latent trait. Maternal and paternal SUD severity predicted son's SUD severity at age 19. The score on the SUD severity scale correlated with drug use frequency, number of different drugs used in lifetime, treatment seeking, illegal behavior, social maladjustment, and risky sex. CONCLUSION: SUD can be quantified on an interval scale indexing severity of disorder. The advantages of measuring SUD severity as a continuous trait are discussed.

Adult↗

Predictors of marijuana use in adolescents before and after licit drug use: examination of the gateway hypothesis.

OBJECTIVE: The authors investigated whether the transition from licit drug use to marijuana use is determined by particular risk factors, as specified by the gateway hypothesis. They also evaluated the accuracy of the "gateway sequence" (illicit drug use following licit drugs) for predicting a diagnosis of substance use disorder. METHOD: Boys who consumed licit drugs only (N=99), boys who consumed licit drugs and then transitioned to marijuana use (gateway sequence) (N=97), and boys who used marijuana before using licit substances (alternative sequence) (N=28) were prospectively studied from ages 10-12 years through 22 years to determine whether specific factors were associated with each drug use pattern. The groups were compared on 35 variables measuring psychological, family, peer, school, and neighborhood characteristics. In addition, the utility of the gateway and alternative sequences in predicting substance use disorder was compared to assess their clinical informativeness. RESULTS: Twenty-eight (22.4%) of the participants who used marijuana did not exhibit the gateway sequence, thereby demonstrating that this pattern is not invariant in drug-using youths. Among youths who did exhibit the gateway pattern, only delinquency was more strongly related to marijuana use than licit drug use. Specific risk factors associated with transition from licit to illicit drugs were not revealed. The alternative sequence had the same accuracy for predicting substance use disorder as the gateway sequence. CONCLUSIONS: Proneness to deviancy and drug availability in the neighborhood promote marijuana use. These findings support the common liability model of substance use behavior and substance use disorder.

Adolescent↗

Impaired oculomotor response inhibition in children of alcoholics: The role of attention deficit hyperactivity disorder.

OBJECTIVE: The aim of the project was to determine whether children at high risk for alcohol use disorder (AUD) are impaired at performing oculomotor response inhibition tasks sensitive to detecting prefrontal cortex dysfunction. METHODS: Three antisaccade tasks were administered to 67 10-12-year-old children having fathers with AUD and 12 children whose fathers had no psychiatric disorder. RESULTS: Children of AUD+ fathers performed similar to children of AUD- fathers on measures of response latency and gain to target. Peak velocity discriminated the two groups on only one task. Children of AUD+ fathers exhibited a higher rate of prosaccade errors on the most difficult antisaccade task. Within the AUD+ group of men, offspring who qualified for attention deficit hyperactivity disorder (ADHD; N = 13) exhibited more response suppression errors than children without ADHD on two of three tasks. No differences were observed between children without ADHD whose fathers either qualified for AUD+ or had no psychiatric disorder. CONCLUSION: Inhibiting a response to a prepotent stimulus in children of AUD+ fathers is circumscribed to ADHD youths. These findings suggest that frontal-striatal mechanisms may underlie the risk for AUD among ADHD children.

Alcoholism↗

Individual differences in childhood neurobehavior disinhibition predict decision to desist substance use during adolescence and substance use disorder in young adulthood: a prospective study.

Genetic, physiological and psychological investigations have demonstrated that deficient inhibitory regulation amplifies the risk for substance use disorder (SUD). This study extends this line of research by determining the association between childhood neurobehavior disinhibition and decision to desist substance use following prevention intervention during adolescence. The sample consisted of 302 boys who were evaluated at ages 10-12, 12-14, 16, and 19. Results indicated that childhood neurobehavior disinhibition negatively covaried with decision to desist substance use during adolescence. These two variables predicted acceleration of drug consumption frequency during adolescence and DSM-IV diagnosis of SUD by age 19. Decision to desist drug use did not mediate the association between neurobehavior disinhibition and substance use/SUD. The findings indicate that substance abuse prevention would be potentiated by ameliorating childhood neurobehavior disinhibition.

Adolescent↗

Childhood risk categories for adolescent substance involvement: a general liability typology.

Childhood risks for adolescent substance involvement include parental substance use disorders (SUDs), psychological dysregulation and early tobacco and alcohol experimentation. This study was designed to identify childhood risk categories predicting accelerated adolescent substance involvement across drug types and stages. The index subjects were 560 children recruited from high risk (n = 266) or low risk (n = 294) families based on fathers' SUDs. Assessments were conducted at approximately ages 11 (baseline), 13, 16, and 19 years. Childhood predictors included parent SUDs, early tobacco or alcohol use (i.e., substance use), and neurobehavior disinhibition (ND) as determined by indicators of cognitive, affective and behavioral disinhibition. A cluster analysis defined five risk categories based on baseline characteristics as follows: (1) High (n = 31; 100% had both parents with SUDs, 100% had early substance use, and the mean ND score = 58.9); (2) Intermediate-High (n = 76; 45% had one parent with SUD, 100% early substance use and ND = 51.9); (3) Intermediate (n = 76; 100% both parents with SUDs, 0% early substance use and ND = 51.4); (4) Intermediate-Low (n = 161; 100% with one SUD parent; 0% early substance use and ND = 49.9) and; (5) Low (n = 216; no parental SUD, no early substance use and ND = 47.5). Compared with all other groups, children in the High risk group had significantly accelerated substance involvement across all substance types and stages. The ordering of risk categories from low to high was also consistent for all substance involvement outcomes. The findings indicate that these five risk categories constitute general liability classes for adolescent substance involvement, and may identify homogeneous groups of children requiring distinct preventive interventions.

Adolescent↗

Direct and mediated associations between P300 amplitude in childhood and substance use disorders outcome in young adulthood.

BACKGROUND: Attenuated amplitude of the P300 wave has been frequently documented in youths at high risk for substance use disorders (SUDs). This investigation had two aims: 1) determine whether P300 amplitude in late childhood is a predictor of SUD outcome by age 19; and 2) evaluate whether neurobehavior disinhibition (ND) mediates this association. METHODS: Boys (aged 10-12) were recruited through proband biological fathers with either a lifetime DSM-III-R diagnosis of SUD (N = 67) or no adult psychiatric disorder (N = 94). P300 amplitude was recorded during an auditory oddball task. Neurobehavior disinhibition was evaluated using tests of executive cognitive function, behavior under control, and emotion dysregulation. The relationship is assessed using multiple and logistic regressions. RESULTS: Substance use disorder by age 19 was significantly predicted by P300 amplitude (odds ratio [OR] = .958; 95% confidence interval [CI] = .918-.999; Wald chi (2) = 3.992; df = 1; p = .045) and ND score (OR = 1.060; 95% CI = 1.023-1.098; Wald chi (2) = 10.267; df = 1; p = .0014) measured at age 10 to 12. P300 amplitude also significantly correlated with ND severity (beta = -.217; t = -2.412; df = 6,160; p = .017). Low P300 amplitudes were observed in children who succumbed to SUD by age 19. CONCLUSIONS: These results indicate that ND mediates the association between attenuated P300 amplitude in childhood and SUD at age 19; however, P300 amplitude is not a specific childhood marker of SUD.

Acoustic Stimulation↗

Association among parental substance use disorder, p300 amplitude, and neurobehavioral disinhibition in preteen boys at high risk for substance use disorder.

The P300 amplitude of the event-related potential as a mediator of the association between parental substance use disorder (SUD) and child's neurobehavioral disinhibition was assessed. The P300 amplitude was recorded using an oddball task in sons of fathers having either lifetime SUD (n = 105) or no psychiatric disorder (n = 160). Neurobehavioral disinhibition was assessed using measures of affect regulation, behavior control, and executive cognitive function. Parental SUD and child's P300 amplitude accounted for, respectively, 16.6% and 16.8% of neurobehavioral disinhibition variance. Controlling for parental and child psychopathology, an association between parental SUD and child's P300 amplitude was not observed. It was concluded that the P300 amplitude does not mediate the association between parental SUD and child's neurobehavioral disinhibition.

Adult↗

Relation between cognitive distortions and neurobehavior disinhibition on the development of substance use during adolescence and substance use disorder by young adulthood: a prospective study.

OBJECTIVE: Previous research has demonstrated that neurobehavior disinhibition increases the risk for a diagnosis of substance use disorder (SUD). This investigation tested the hypothesis that a deficiency in the capacity to appraise the effects of alcohol and drugs and interpret social interactions mediates the relation between neurobehavior disinhibition in childhood and SUD by early adulthood. METHODS: Boys with fathers having lifetime SUD (N=88) and no SUD or other psychiatric disorder (N=127) were prospectively tracked from ages 10-12 to 19 years. Neurobehavior disinhibition was evaluated at baseline followed by assessments of cognitive distortions and substance use involvement in early and mid-adolescence. SUD outcome was evaluated up to age 19 years. RESULTS: Cognitive distortions (age 12-14 years) mediated the association between neurobehavior disinhibition (age 10-12 years) and marijuana use (age 16 years) which, in turn, predicted SUD by age 19 years. Cognitive distortions in early adolescence did not directly predict SUD by young adulthood. CONCLUSIONS: Inaccurate social cognition, significantly predicted by childhood neurobehavior disinhibition, biases development toward marijuana use prodromal to SUD. These results indicate that cognitive processes, in conjunction with psychological self-regulation, comprise important components of the individual liability to SUD.

Adolescent↗

Characteristics of men with substance use disorder consequent to illicit drug use: comparison of a random sample and volunteers.

OBJECTIVE: Men qualifying for substance use disorder (SUD) consequent to consumption of an illicit drug were compared according to recruitment method. It was hypothesized that volunteers would be more self-disclosing and exhibit more severe disturbances compared to randomly recruited subjects. METHODS: Personal, demographic, family, social, substance use, psychiatric, and SUD characteristics of volunteers (N = 146) were compared to randomly recruited (N = 102) subjects. RESULTS: Volunteers had lower socioceconomic status, were more likely to be African American, and had lower IQ than randomly recruited subjects. Volunteers also evidenced greater social and family maladjustment and more frequently had received treatment for substance abuse. In addition, lower social desirability response bias was observed in the volunteers. SUD was not more severe in the volunteers; however, they reported a higher lifetime rate of opiate, diet, depressant, and analgesic drug use. CONCLUSIONS: Volunteers and randomly recruited subjects qualifying for SUD consequent to illicit drug use are similar in SUD severity but differ in terms of severity of psychosocial disturbance and history of drug involvement. The factors discriminating volunteers and randomly recruited subjects are well known to impact on outcome, hence they need to be considered in research design, especially when selecting a sampling strategy in treatment research.

Adult↗

Haplotypes of the monoamine oxidase genes and the risk for substance use disorders.

Monoamine oxidase A (MAOA) locus is an attractive candidate for exploring genetic contribution to the variation in the risk for substance use disorders (SUD) because of its important role in the metabolism of neurotransmitters, including dopamine and serotonin. Prior findings have suggested an association of the MAOA gene with the risk for early onset SUD. To extend this research, we genotyped four MAOA markers (two VNTR polymorphisms and two SNPs) and built a cladogram reflecting the evolutionary history of MAOA haplotypes [Nguyen et al., under review]. The cladogram served as the framework for nested ANOVA and logit analyses of association between MAOA and indices of liability to SUD (diagnosis, age of onset, and a dimensional index of substance use related problems) in a sample of adult males of European ancestry. Whereas no association was found for the categorical diagnosis, a significant relationship was detected between the dimensional liability indices and MAOA haplotypes. Overall, our results, albeit not definitive, are consistent with the hypothesis that variants in MAOA account for a small portion of the variance of SUD risk, possibly mediated by liability to early onset behavioral problems.

Adult↗

Neurobehavior disinhibition in childhood predisposes boys to substance use disorder by young adulthood: direct and mediated etiologic pathways.

OBJECTIVE: The development of substance use disorder (SUD) was prospectively investigated in 66 boys having fathers with SUD and 104 boys having fathers with no adult Axis I or II psychiatric disorder. Evaluations were conducted to determine the context in which neurobehavior disinhibition in relation to parental SUD, parental neglect of the child and child's social maladjustment culminated in a DSM-III-R diagnosis of SUD. METHODS: A neurobehavior disinhibition latent trait was derived using indicators of behavior undercontrol, affect dysregulation and executive cognitive functioning in the boys when they were 10-12 and again at 16 years of age. These latter characteristics have been frequently observed in individuals who have a prefrontal cortex disturbance. The data were analyzed to determine whether the score on the neurobehavior disinhibition construct mediates the association between father's and mother's SUD and son's SUD. RESULTS: SUD in the mother and father predicted neurobehavior disinhibition in the son. The neurobehavior disinhibition score in the sons predicted SUD between ages 10-12 and 19. Neurobehavior disinhibition, in conjunction with social maladjustment and drug use frequency, mediated the association between paternal and maternal SUD and son's SUD. Neurobehavior disinhibition was unrelated to neglect of the child by either the father or mother; however, paternal but not maternal neglect at age 10-12 predicted SUD at age 19. CONCLUSIONS: The association of neurobehavior disinhibition in childhood and SUD by young adulthood suggests that a prefrontal cortex dysfunction contributes to SUD liability. The results extend previous findings demonstrating that neurobehavior disinhibition is an important component of the liability to SUD.

Adjustment Disorders↗

Liability to substance use disorders: 1. Common mechanisms and manifestations.

Variation in the risk for and severity of substance use disorders (SUD) in the population is caused by multiple organismic (genetic, biochemical, psychological) and environmental factors. Whereas drug- or drug-class-specific liability mechanisms exist, a substantial proportion of variance in the risk is shared between specific liabilities, reflecting mechanisms that determine common liability to SUD. Data from epidemiologic, clinical, psychological, physiological, biochemical, and family and genetic studies reviewed in this paper indicate the existence of mechanisms and characteristics shared in common by liabilities to SUD related to different drugs. These mechanisms can be conceptualized as common liability to SUD, a latent trait accounting for a substantial portion of variation in SUD risk and severity and determined by all factors influencing the probability of SUD development. An accompanying paper describes an approach to the quantitative estimation of this trait.

Brain Chemistry↗

Liability to substance use disorders: 2. A measurement approach.

Liabilities to complex disorders, discussed in the accompanying paper, present difficulties in measurement related to the arbitrariness of diagnostic threshold definitions and problems with discrimination between trait values, especially within the 'normal' individuals. The inability to quantitatively estimate the risk for a disorder, such as substance use disorders (SUD), is an obstacle for studying etiological (e.g. genetic) mechanisms and developing efficient prevention and treatment measures. Based on the concept of common liability to SUD, this paper delineates an application of the longitudinal family/high-risk design and item response theory to the development of a continuous index of liability. The method has been tested in both simulation study and empirical data. The approach described affords the opportunity to quantitatively estimate the risk for SUD at an early age and before any drug exposure. This method is also applicable to measuring liabilities to other complex disorders, especially those with relatively late onset.

Algorithms↗

Neurobehavioral disinhibition in childhood predicts early age at onset of substance use disorder.

OBJECTIVE: This longitudinal study had three aims: 1) determine the extent to which boys at high average risk and low average risk for substance use disorder differ on a construct of neurobehavioral disinhibition, 2) evaluate the capacity of neurobehavioral disinhibition to predict substance use frequency at age 16, and 3) demonstrate the utility of neurobehavioral disinhibition in predicting substance use disorder. METHOD: The authors derived an index of neurobehavioral disinhibition from measures of affect, behavior, and cognition. The neurobehavioral disinhibition score was used to discriminate youth at high and low average risk for substance use disorder and to predict substance use frequency after 4-6 years and substance use disorder after 7-9 years. RESULTS: The neurobehavioral disorder score significantly discriminated boys at high average risk from those at low average risk at ages 10-12. Neurobehavioral disinhibition at age 16, in conjunction with substance use frequency and risk status group, predicted substance use disorder at age 19 with 85% accuracy and accounted for 50% of the variance in Drug Use Screening Inventory overall problem density score. Neurobehavioral disinhibition was a stronger predictor of substance use disorder (odds ratio=6.83) than substance consumption frequency (odds ratio=3.19). CONCLUSIONS: Cross-sectional and longitudinal analyses indicated that neurobehavioral disinhibition is a component of the liability to early age at onset of substance use disorder.

Adolescent↗

Origins and consequences of child neglect in substance abuse families.

The empirical literature pertaining to the prevalence, origins, and consequences of neglectful parenting as it relates to substance abuse is critically reviewed. Available evidence indicates that children who experience parental neglect, with or without parental alcohol or drug abuse, are at high risk for substance use disorder (SUD). The effects of parental substance abuse on substance abuse outcome of their children appear to be partly mediated by their neglectful parenting. The discussion concludes with presentation of a developmental multifactorial model in which neglect, in conjunction with other individual and environmental factors, can be integratively investigated to quantify the child's overall liability across successive stages of development as well as to map the trajectory toward good and poor outcomes.

Adult↗

Reactive aggression in boys with disruptive behavior disorders: behavior, physiology, and affect.

This study examined responses to peer provocation in boys ages 9-13 years who met symptomatic criteria for ADHD-only, ODD/CD-only, comorbid ADHD/ODD/CD, or no diagnosis. Boys participated in a reaction-time game that included standardized verbal and behavioral provocation. Their behavioral, physiological, and affective responses to this task were measured. Results showed that groups did not differ following high levels of provocation because all boys behaved aggressively. However, following low provocation boys with comorbid ADHD/ODD/CD had higher levels of behavioral aggression, had greater heart rate acceleration, and were rated as angrier than all other boys. In addition, boys with comorbid ADHD/ODD/CD held a grudge longer than other children. Results suggest that boys with comorbid ADHD/ODD/CD are especially reactive to provocation from their peers.

Adolescent↗

Predictor variables by developmental stages: a center for substance abuse prevention multisite study.

Five articles present the results obtained in a multisite study funded by the Center for Substance Abuse Prevention (CSAP). The overarching goal of this effort was to determine the efficacy of reducing severity of factors during childhood that are known to magnify the risk for substance abuse (SA) in adolescence. The factors targeted for preventive intervention were Behavior Self-Regulation, Parental Involvement, School Bonding, and Social Competence. Conceptualizing SA within a developmental framework, the findings indicate that prevention directed at youth between 3-14 years of age has a significant positive impact on attenuating intermediary factors predisposing to SA. In this introduction, both the theoretical framework and rationale guiding this cooperative agreement and the key findings are described.

Achievement↗