A Family History Of Alcoholism May Make Adolescent Brains Respond Differently
Main Category: Alcohol / Addiction / Illegal DrugsAlso Included In: Pediatrics / Children's Health; Psychology / Psychiatry
Article Date: 18 Jan 2012 - 0:00 PST
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Researchers know that adolescents with a family history of alcoholism (FHP) are at risk for developing alcohol use disorders. Some studies have shown that, compared to their peers, FHP adolescents have deficits in behavioral inhibition. A study of the neural substrates of risk-taking in both FHP adolescents and their peers with a negative family history of alcoholism (FHN) has shown that FHP youth demonstrated atypical brain activity while completing the same task as the FHN youth.
Results will be published in the April 2012 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.
"We know that a familial history of alcoholism is a significant risk factor for future alcohol abuse," said Bonnie J. Nagel, assistant professor of psychiatry and behavioral neuroscience at Oregon Health & Science University as well as corresponding author for the study. "We were interested in determining whether adolescents at heightened risk for alcohol use made more risky decisions during a laboratory task compared to their lower-risk peers. Additionally, we wanted to examine whether differences in brain responses when making risky decisions were present in these two groups. We wanted to investigate pre-morbid neural risk factors during decision making in FHP youth, as opposed to differences in brain response due to heavy alcohol use itself."
"This is the first study to examine the neural substrates of risk-taking in FHP adolescents who are substance naïve," added Megan Herting, a PhD candidate in behavioral neuroscience at Oregon Health & Science University. "A previous study looked at young adults who were drinkers, therefore, it is hard to say if the differences found were purely a pre-existing neural risk factor for alcohol use. Alcohol use may also differentially impact the brains of those with and without a family history of alcoholism. Thus, the current study is a very novel and important piece of work showing that the brain is doing something different during risky decision making in substance-naïve FHP adolescents."
Study authors recruited 31 youth - 18 FHP (12 males, 6 females) and 13 FHN (8 males, 5 females) - between 13 and 15 years of age from the local community. All of the youth had little to no alcohol involvement prior to their participation in the study. Functional magnetic resonance imaging (fMRI) was used to examine brain responses of the youth during a Wheel of Fortune (WOF) decision-making task, which presented risky versus safe probabilities of winning different amounts of money.
"While our study found that FHP adolescents did not perform significantly differently on the WOF task compared to the FHN adolescents," said Nagel, "we found two areas of the brain that responded differently. These areas were in the prefrontal cortex and cerebellum, both of which are important for higher-order day-to-day functioning, such as decision-making. In these brain regions, FHP adolescents showed weaker brain responses during risky decision-making compared to their FHN peers. We believe that weaker activation of these brain areas, known to be important for optimal decision-making, may confer vulnerability towards risky decisions with regards to future alcohol use in adolescents already at risk for alcoholism."
Herting noted that higher-order or executive functioning is also important for things like attention, working memory, and inhibition. "Therefore, differences in brain activity may impact the ability of FHP individuals to make good decisions in many contexts, and in particular may facilitate poor decision-making in regards to alcohol use," she said. "Taken together with other studies on FHP youth, these results suggest that atypical brain structure and function exist prior to any substance use, and may contribute to an increased vulnerability for alcoholism in these individuals."
Both Nagel and Herting believe these findings can help to develop better prevention programs based on familial risk factors. "These findings may suggest a neurobiological marker that helps to explain how family history of alcoholism confers risk," said Nagel. "Furthermore, our research may aid clinicians who work with high-risk youth to develop effective prevention strategies for these adolescents to promote healthy decision-making."
However, they both added, having a familial history of alcoholism is just one of many different factors involved in future alcohol abuse. "While having a family history of alcoholism may put one at greater risk for alcohol abuse, personality and behavioral risk factors are also important to consider," said Nagel. "The combination of genetic and environmental factors is very different for everyone, so some individuals may be at higher risk than others, and certainly there are genetic and environmental factors that can also protect against alcohol abuse. Future research will need to determine the relative influence of these traits on alcohol abuse risk to be able to design specific prevention strategies for different high-risk populations."
Visit our alcohol / addiction / illegal drugs section for the latest news on this subject.
Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. The first co-author of the ACER paper, "Risky Decision-Making: An fMRI Study of Youth at High Risk for Alcoholism," was Anita Cservenka in the Department of Behavioral Neuroscience at Oregon Health & Science University. The study was funded by the National Institute on Alcohol Abuse and Alcoholism, the Portland Alcohol Research Center, and the National Institute of Neurological Disorders and Stroke. This release is supported by the Addiction Technology Transfer Center Network at http://www.ATTCnetwork.org.
Alcoholism: Clinical & Experimental Research
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Addiction causation and prevention
posted by Dan Umanoff, M.D. on 20 Jan 2012 at 6:58 amRe: A Family History Of Alcoholism May Make Adolescent Brains Respond Differently.
Here are the implications of this finding:
"Both Nagel and Herting believe these findings can help to develop better prevention programs based on familial risk factors. "These findings may suggest a neurobiological marker that helps to explain how family history of alcoholism confers risk," said Nagel. "Furthermore, our research may aid clinicians who work with high-risk youth to develop effective prevention strategies for these adolescents to promote healthy decision-making." "
Despite their findings they still don't have a paradigm for treatment, prevention, and public policies because they don't have a brain mechanism for the causation of addictions derived from this deficit. Just because there are frontal lobe deficiencies, this can't explain how addiction happens out of these deficits. There needs to be a physiological reason for the use and addiction to the addictor. Bad decision-making may well help but it makes no connection to how addiction is derived from it. It's a big leap from bad decision-making to addiction. The physiology is just not there. Compare their vague and circumstantial ideas about the premorbid brain changes to my complete paradigm based on the specific premorbid unique and specific genetic alterations of each individual's Hypoism. Genetic low dopamine activity causes the hypoic to unconsciously search out dopamine raising drugs and activities as well as addiction to them. My book, Hypoic's Handbook, goes through this process in detail. There is bad decision-making as well as the required dopamine activity deficiency, the critical physiological requirement for addiction.
They didn't look at the differences in Dopamine receptor levels and other dopamine activity levels in substance naive kids (which I predict when finally studied will show low levels in kids who go on to become all kinds of addicts), a critical mistake, but nonetheless they are showing evidence for an important concept, the existence of premorbid differences in kids' brains who later go on to get addicted, and that prevention of addiction can be started then by dealing with decision-making difficulties in these kids before any addiction has time to begin. This is exactly what I've been writing about since 1992, twenty years ago, and have put into effect with Hypoic's Not Anonymous recovery methodology. This deals with the thinking, feelings, and behavior caused by the genetic changes in the decision-making apparatus also called the instinct regulating apparatus (including any alterations of the frontal lobes) of the brain which cause this disease. I call the genetic-based premorbid disease these kids have Hypoism, hypo for low reward activity via low dopamine receptors and levels in the nucleus accumbans and elsewhere in the brain. I call this prevention program Hypoic's Not Anonymous where all hypoics (addicts and especially not yet addicts) come for recovery from the underlying disease, Hypoism, not just from a single addiction and hitting bottom as the 12 step groups require. Hopefully this is before they get addicted, thus prevention. That's the whole point of the Hypoism paradigm. We deal with all addictions with this recovery program, not just a single one, because hypoics are susceptible to all addictions. But the addiction is not the disease. Hypoism is the disease which all addicts have. Thus the recovery is from Hypoism, not just the individual addictor. We deal with the effects of the entire disease on the individual depending on how the disease works on the individual. The individual gets specific recovery from the specific genetic alterations unique to him alone as manifest by his feelings, thinking, and actions, rather than one size fits all for each specific addiction requiring a different program for each addiction, an absurdity. We stress acceptance of how one feels rather than changing how one feels, exactly how we got addicted to begin with. Thus we avoid mood altering drugs and addictive behaviors of any kind, especially addictive drugs/medications, from the get-go. All this, the complete recovery/prevention methodology, is discussed in my book, Hypoic's Handbook (1996). We need to stop wasting time and begin using my already defined paradigm which is ready to be used for prevention, treatment, and the basis of necessary public policy changes.
"Love is an action not a feeling.
Integrity is an action not a thought.
Anything less is too little." ---
Dan OF. Umanoff, M.D.
Author of Hypoic's Handbook - The Hypoism Paradigm of Addiction.
President and founder of The National Association for the Advancement and Advocacy of Addicts, Inc. (N4A), a not-for-profit 501 (c) (3) organization of addicts for addicts offering free educational and legal services to discriminated against and abused addicts of all varieties, "substances" and "behavioral," and their families.
http://www.nvo.com/hypoism/thenationalassociationfortheadvancementandadvocacyofaddicts/
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