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Aims This study aimed to systematically review the literature on neuroanatomical predictors of future problematic drinking in adolescents. Methods Using PRISMA guidelines, a systematic review was conducted to evaluate neuroanatomical predictors of problematic drinking in adolescents. Embase, MEDLINE, and PsycINFO databases were searched from inception to January 6th, 2023. Studies were included if they were original, had a prospective design, had a sample size of at least 12, had a follow-up period of at least one year, had at least one structural neuroimaging scan before 18 with no prior alcohol use, and had alcohol use as the primary outcome. Studies were excluded if: had animals only; and were not in English. Risk of bias was conducted using the CASP tool. Results Out of 1,412 studies identified, 19 studies met the criteria, consisting of eleven gray matter (n = 4,040), five white matter (n = 319), and three assessing both (n = 3,608). Neuroanatomical predictors of future problematic drinking in adolescents were reported to be distributed across various brain regions such as the orbitofrontal cortex and paralimbic regions. However, the findings were largely heterogeneous. Conclusions This is the first systematic review to map out the existing literature on neuroanatomical predictors of problematic drinking in adolescents. Future research should focus on the aforementioned regions to determine their role in predicting future problematic drinking with more certainty.

The externalizing psychopathological dimension is associated with alterations in adolescents’ functional brain connectivity. The current study aims to identify the functional correlates of the unique variability in conduct problems within the context of the broad externalizing dimension. The broad externalizing dimension and unique variability in conduct problems were estimated using a bifactor model. Resting-state data were available for a sample of 125 adolescents. Based on multiresolution parcellation of functional brain networks atlas, major resting-state functional brain networks and the connectivity correlates of unique conduct problems and the broad externalizing dimension were established. The broad externalizing dimension was related to connectivity alterations in the ventral attention/salience network, while unique variability in conduct problems dimension was related to connectivity alterations in the cerebellum crusi as well as the mesolimbic network. The current study is a first step toward the identification of functional resting-state network correlates of broad and specific variability in the externalizing dimension.

Objectives: Exposure to adverse childhood experiences (ACEs) is associated with increased risk of criminal justice involvement and repeated victimization among homeless individuals. This study aimed to (1) examine whether the relationship between cumulative ACE score and odds of experiencing criminal justice involvement and victimization remains significant over time after receiving the Housing First (HF) intervention and (2) investigate the moderating effect of cumulative ACE score on the effectiveness of the HF intervention on the likelihood of experiencing these outcomes among homeless individuals with mental illnesses. Methods: We used longitudinal data over the 2-year follow-up period from the At Home/ Chez Soi demonstration project that provided HF versus treatment as usual (TAU) to homeless adults with mental illness in five Canadian cities (N = 1,888). Results: In all 4 follow-up time points, the relationship between cumulative ACE score and both outcomes remained significant, regardless of study arm (HF vs. TAU) and other confounding factors. However, cumulative ACE score did not moderate intervention effects on odds of experiencing either outcome, suggesting that the effectiveness of HF versus TAU, with regard to the odds of being victimized or criminal justice involvement, did not differ by cumulative ACE scores over the course of study. Conclusions: Findings suggest that providing services for homeless individuals with mental illness should be trauma informed and include specialized treatment strategies targeting the experience of ACEs and trauma to improve their treatment outcomes. An intensive approach is required to directly address the problem of criminal justice involvement and victimization in these individuals.

Perceived stress plays an important role in the development and course of psychiatric disorders and early dropout from treatment. This study examined the effect of different types of childhood malt...

Summary Background Adverse childhood experiences (ACEs) are strong risk factors for homelessness and poor health and functioning. We aimed to evaluate the lifetime prevalence of ACEs and their associations with health-related and functioning-related outcomes among homeless adults. Methods In this systematic review and meta-analysis, we searched from database inception to Nov 11, 2020, for original and peer-reviewed studies in English that documented lifetime prevalence of ACEs or associations between ACEs and health-related or functioning-related outcomes. We selected studies if they included a definable group of homeless adults and measured at least four ACE categories. We calculated pooled estimates of lifetime prevalence of one or more ACEs and four or more ACEs with random-effects models. We used the leave-one-out method in sensitivity analyses and studied meta-regressions to explore potential moderators of ACE prevalence. We also did a narrative summary of associations between ACEs and health-related and functioning-related outcomes, as there were too few studies on each outcome for quantitative meta-analysis. This study is registered with PROSPERO, CRD42020218741. Findings We identified 2129 studies through systematic search, of which 29 studies (16 942 individuals) were included in the systematic review, 20 studies (10 034 individuals) were included in the meta-analysis for one or more ACEs, and 15 studies (5693 individuals) were included in the meta-analysis for four or more ACEs. Studies included samples of adults experiencing homelessness in the USA, Canada, and the UK; participants in the included studies were predominantly male (65·2%) and mean ages ranged between 18·3 and 58·1 years, but many studies did not report race, ethnicity, and sexual and gender minority data. Lifetime prevalence of one or more ACEs among homeless adults was 89·8% (95% CI 83·7–93·7) and the lifetime prevalence of four or more ACEs was 53·9% (45·9–61·7). Considerable heterogeneity was identified in both meta-analyses (I2>95%). Of the potential moderators analysed, the ACE measurement tool significantly moderated the estimated lifetime prevalence of one or more ACEs and four or more ACEs, and age also significantly moderated the estimated lifetime prevalence of four or more ACEs. In the narrative synthesis, ACEs were consistently positively associated with high suicidality (two studies), suicide attempt (three studies), major depressive disorder (two studies), substance misuse (two studies), and adult victimisation (two studies). Interpretation The lifetime prevalence of ACEs is substantially higher among homeless adults than among the general population, and ACE exposure might be associated with prevalence of mental illness, substance misuse, and victimisation. Policy efforts and evidence-based interventions are urgently needed to prevent ACEs and address associated poor outcomes among this population. Funding Rhodes Trust and Canadian Institutes of Health Research.

Exposure to childhood maltreatment and trauma has a strong relationship with onset and development of substance use disorders. The purpose of this chapter is to review important models and mechanisms that explain pathways from childhood trauma to substance misuse and dependence. This chapter integrates findings from several cross-sectional and longitudinal studies conducted in this area with a focus on three main categories of explanatory mechanisms and models: (1) neurocognitive mechanisms; (2) negative reinforcement and self-medication mechanisms; and (3) psychosocial development mechanisms. Each section describes the dominant models and explanatory mediators that link childhood trauma to substance use disorders. In the final section, the clinical implications and directions for future studies are presented.

Homeless individuals are at higher risk of criminal justice involvement (CJI) and victimization compared to their housed counterparts. Exposure to childhood maltreatment (CM; e.g., abuse, neglect) is one of the most significant predictors of CJI and victimization among homeless populations. The aim of this systematic review was to synthesize current knowledge regarding the relationship between CM and CJI and victimization among homeless individuals. Guided by the preferred reporting items for systematic reviews and meta-analyses (PRISMA) methods, a systematic search was performed using PsycINFO, MEDLINE, Embase, Web of Science, and the Cumulative Index to Nursing and Allied Health Literature for published studies investigating the relationship between CM and CJI and victimization among homeless samples. We identified 20 studies that met the inclusion criteria. Findings showed that across the majority of studies, CM, and in particular childhood physical (CPA) and sexual (CSA) abuse, is associated with increased risk of both CJI and victimization, regardless of various important factors (e.g., sociodemographic characteristics, psychiatric disorders, substance use). These findings support the need for prevention and treatment for "families at risk" (i.e., for intimate partner violence, child abuse and neglect) and also document the need for trauma-informed approaches within services for homeless individuals. Future research should focus on prospective designs that examine victimization and CJI in the same samples.

Several school-based prevention programmes have been developed and used to prevent, delay, or reduce substance misuse, and related problems among community samples of adolescents. However, findings indicate that many of these interventions are associated with null, small, or mixed effects in reducing adolescent substance misuse, in particular for those mostly at risk of transitioning to substance use disorders. These findings highlight the need to shift the focus of substance use prevention efforts toward intervention strategies which directly target high-risk adolescents. The Preventure programme was designed to target four personality risk factors for substance misuse: hopelessness, anxiety sensitivity, impulsivity, and sensation seeking. This article reviews findings from the previous trials of personality-targeted interventions (i.e., Preventure programme) with adolescents and discuss the promises and benefits of these interventions for targeting community samples of high-risk adolescents at school level for reducing substance misuse and related mental health problems. Findings indicated that this programme has been successful in reducing the rates of alcohol and illicit drug use and substance-related harms by ~50% in high-risk adolescents with the effects last for up to 3 years. These interventions were also associated with a 25% reduction in likelihood of transitioning to mental health problems, such as anxiety, depression, suicidal ideation, and conduct problems. The programme is particularly beneficial for youth with more significant risk profiles, such as youth reporting clinically significant levels of externalizing problems, and victimized adolescents. A key strength of the Preventure programme is that it is embedded in the community and provides substance use intervention at school level to the general samples of high-risk adolescents who might not otherwise have access to those programmes.

Exposure to childhood maltreatment (CM) is associated with increased risk for developing substance use disorders (SUDs). CM exerts negative effects on cognitive abilities including intellectual performance, memory, attention, and executive function. Parallel cognitive impairments have been observed in SUDs. Hence, limited studies have examined the mediating effect of cognitive impairments in the relationship between CM and SUDs. In addition, most studies used concurrent self-report assessments in adult populations. Longitudinal studies that investigated the long-term consequences of CM on psychopathology, including SUDs, throughout childhood, adolescence, and adulthood are rare. Thus, the underlying developmental pathways between CM and SUDs are not clearly understood. In this article, we review the evidence that cognitive impairments mediate, at least in part, the relationship between CM and development of SUDs and propose a model that explains how CM increases the risk for SUDs through the development of a cognitive framework of vulnerability.

Higher rate of Delay Discounting (DD) is associated with increased risk for the initiation and development of substance use disorders in adolescents.This study aimed to provide a preliminary assessment of the validity of a brief self-report measure of DD by examining discounting rates across 3 periods of increasing delay and subsequently examining the extent to which overall DD scores are associated with having initiated tobacco, alcohol and cannabis use.Data were collected in the 2012 fall cycle of the British Columbia Adolescent Substance Use Survey. The sample consisted of 1,143 adolescents (61% female) in grades 10 and 11. A brief self-report measure of DD was developed to assess the tendency of adolescents to discount a delayed monetary reward of $100 over a period of 1-year, 1-month, and 1-week. The area under the curve was calculated for each participant's DD responses and coded into quartiles.The amount of discounting increased as reward delay increased from 1-week to 1-month to 1-year. Compared to participants in the lowest DD quartile, being in the second, third, or fourth quartile was associated with significantly greater odds of having initiated tobacco use, binge drinking, and cannabis use after controlling for sex, age, maternal education, and ethnicity.These results provide preliminary support for the validity of the brief measure of DD presented in this study and support the emerging body of evidence suggesting that DD is an important indicator of increased risk for the initiation of substance use among adolescents.

Background A range of school-based prevention programs has been developed and used to prevent, delay, or reduce alcohol use among adolescents. Most of these programs have been evaluated at the community-level impact. However, the effect of contextual risk factors has rarely been considered in the evaluation of these programs. The aim of this study was to investigate the potential moderating effects of 2 important contextual risk factors (i.e., socioeconomic status [SES] and peer victimization) on the effectiveness of the school-based personality-targeted interventions (Preventure program) in reducing adolescent alcohol use over a 2-year period using a cluster-randomized trial. Methods High-risk adolescents were identified using personality scores on the Substance Use Risk Profile Scale and randomized to intervention and control groups. Two 90-minute cognitive behavioral therapy-based group sessions targeted 1 of 4 personality risk profiles: Anxiety Sensitivity, Hopelessness, Impulsivity, or Sensation Seeking. Multilevel linear modeling of alcohol use, binge drinking, and drinking-related harm was conducted to assess the moderating effect of baseline peer victimization and SES. Results Results indicated that the Preventure program was equally beneficial to all adolescents, regardless of SES and victimization history, in terms of their alcohol outcomes and related harm. Receiving the intervention was additionally beneficial for adolescents reporting peer victimization regarding their alcohol-related harm compared to nonvictimized youth (β = -0.29, SE = 0.11, p = 0.014). Conclusions Findings suggest that the content of personality-targeted interventions is beneficial for all high-risk youth regardless of their SES or experience of peer victimization. The current study suggests that using targeted approaches, such as targeting underlying personality risk factors, may be the most appropriate substance use prevention strategy for high-risk youth, as it is beneficial for all high-risk youth regardless of their contextual risk factors.

Adolescence is a transitional period of development characterized by critical changes in physical, neural, cognitive, affective, and social functions. Studies investigating the underlying mechanisms of substance use at levels of self-report, brain response, and behavioral data are generally consistent with suggestions from dual-process model that differential growth rates of frontally mediated control and striato-frontal reward processing are related to a heightened risk of substance use during adolescence. However, social theories highlight the important role of social context and environment in which adolescents grow up and suggest that growing up in an unfavorable environment and in particular exposure to adverse childhood experiences play a huge role in how this vulnerability is translated into actual risk. In this review, we provide a summary of recent theories that examine a number of key individual and social and environmental risk factors underlying risk for early initiation and escalation of substance misuse. We also present a model that expands the dual-process model to incorporate the role of negative self-concept and negative affect associated with growing up in an unfavorable environment and their interactions with cognitive control and inhibition to further explain vulnerability to early initiation and development of substance misuse in adolescents.

Relationship between poor inhibitory control and adolescent interpersonal difficulties is well-documented. However, the way in which an emotionally neutral cognitive process (i.e., response inhibition) can lead to interpersonal difficulties is less clear. The current study is based on multimodal longitudinal data from 3,826 adolescents followed over a 4-year period. The main aim of this study was to examine an ecophenotype conceptualization of the association between response inhibition and bullying perpetration through increasing vulnerability of peer victimization and a negative attributional style toward self and others. To test for potential mediations, we first tested the independent effects of the main predictor (response inhibition) and proposed mediators (victimization, hostile automatic thoughts, and self esteem). Multilevel models highlighted independent effects of response inhibition, hostility-related automatic thoughts, and self-esteem in susceptibility to peer victimization and bullying perpetration, both in terms of general liability and fluctuations at each time point over the 4-year period (i.e., between and within person effects). Moreover, results from multivariate multilevel path model were in line with the ecophenotype conceptualization. Indirect effects indicated that general liability of peer victimization mediated the effect of poor response inhibition on bullying perpetration. Likewise, general liability and concurrent fluctuations in hostility-related automatic thoughts and self-esteem mediated the effect of peer victimization on bullying perpetration. The current study highlights the need for a comprehensive understanding of bullying perpetration which is only possible through consideration of individual characteristics along with environmental factors. This framework has the potential to inform targeted intervention strategies aimed at reducing peer-to-peer violence. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Numerous studies have identified differences in the identification of emotional displays between psychopaths and non-psychopaths; however, results have been equivocal regarding the nature of these differences. The present study investigated an alternative approach to examining the association between psychopathy and emotion processing by examining attentional bias to emotional faces; we used a modified dot-probe task to measure attentional bias toward emotional faces in comparison with neutral faces, among a sample of male jail inmates assessed using the Psychopathy Checklist–Revised (PCL-R). Results indicated a positive association between psychopathy and attention toward happy versus neutral faces, and that this association was attributable to Factor 1 of the psychopathy construct.

Exposure to adverse childhood experiences (ACEs) is highly prevalent among homeless individuals and is associated with negative consequences during homelessness. This study examined the effect of ACEs on the risk of criminal justice involvement and victimization among homeless individuals with mental illness.The study used baseline data from a demonstration project (At Home/Chez Soi) that provided Housing First and recovery-oriented services to homeless adults with mental illness. The sample was recruited from five Canadian cities and included participants who provided valid responses on an ACEs questionnaire (N=1,888).Fifty percent reported more than four types of ACE, 19% reported three or four types, 19% reported one or two, and 12% reported none. Rates of criminal justice involvement and victimization were significantly higher among those with a history of ACEs. For victimization, the association was significant for all ten types of ACE, and for justice involvement, it was significant for seven types. Logistic regression models indicated that the effect of cumulative childhood adversity on the two outcomes was significant regardless of sociodemographic factors, duration of homelessness, and psychiatric diagnosis, with one exception: the relationship between cumulative childhood adversity and criminal justice involvement did not remain significant when the analysis controlled for a diagnosis of posttraumatic stress disorder and substance dependence.Findings support the need for early interventions for at-risk youths and trauma-informed practice and violence prevention policies that specifically target homeless populations.

We examined the hypothesis that exposure to childhood maltreatment increases the vulnerability to Adult Victimization (AV) in a homeless population ( N = 500). We also investigated the effects of specific types (emotional, physical, and sexual) and cumulative experience of childhood maltreatment on AV, and whether gender moderates these relationships. All three groups with AV experience (emotional, physical, and sexual) indicated higher exposure to childhood abuse and cumulative maltreatment, and those who were sexually victimized as an adult showed higher exposure to childhood neglect. In addition, exposure to childhood maltreatment had type-specific and cumulative effects on AV. Exposure to all types of childhood abuse maintained a strong direct association with AV, regardless of demographic characteristics, including age, ethnicity, marital status, education level, and housing situation. In addition, exposure to physical neglect showed a significant relationship with Adult Sexual Victimization. Cumulative experience of childhood maltreatment was consistently associated with cumulative risk of experiencing AV. Gender had no significant effect on these relationships. Findings suggest that intervention programs in homeless population should consider the history of childhood maltreatment and its characteristics to increase the effectiveness of intervention strategies for AV in this population.