Alcohol craving: the role of stress from early life to adulthood

Abstracts / Comprehensive Psychiatry 54 (2013) e15–e40 training influences cortical thickness development, thickness was regressed against an “Age × Years of Playing” interaction term. Age, gender, total brain volume, and scanner were controlled for in analyses. Subject ID was entered as a random effect to account for within-person dependence. False discovery rate correction was applied to the entire cortical surface (q ≤ 0.05). Results: There was no association between cortical thickness and years of playing a musical instrument. The “Age × Years of Playing” interaction term was associated with thickness in a number of regions including right premotor and primary motor cortices, left primary and supplementary motor cortices, bilateral parietal cortices, as well as bilateral orbitofrontal cortices. Follow-up analysis revealed that musical training was associated with an increased rate of thinning in these regions. Results were largely unchanged when IQ and handedness were included as covariates. Conclusions: These findings suggest that, among youths and young adults, playing a musical instrument influences cerebral cortical development. Specifically, playing a musical instrument was associated with more rapid cortical thickness development within areas implicated in motor planning and coordination, visuospatial ability, and, interestingly, emotion regulation. However, given the quasi-experimental nature of this study, we cannot rule out the influence of potentially confounding variables. http://dx.doi.org/10.1016/j.comppsych.2013.07.029

Alcohol craving: the role of stress from early life to adulthood J.H. Kim, S.S. Martins, J. Santaella, D.S. Hasin Department of Epidemiology, Columbia University Background: This study examines the relationship between past-year stressful life experiences (SLEs) and past-year craving for alcohol, including whether experience of childhood maltreatment (CM) modifies this relationship. Method: This is a secondary analysis of past-year drinkers in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Wave 2, years 2004–2006 (n = 22,152). From fourteen items measuring SLEs, an ordinal variable was created grouping individuals as experiencing no, one, two, or at least three events. Craving was assessed by the item, “In the past-year, have you ever wanted a drink so badly that you couldn't think of anything else?” CM was coded as dichotomous, indicating positive/negative experience of physical abuse/neglect, emotional abuse/neglect, or sexual abuse. Multivariable logistic regression was used to obtain adjusted odds ratios (AOR) for all past-year alcohol craving among past-year drinkers at each level of our ordinal SLE variable, after adjusting for psychiatric vulnerability and other control variables. Interaction terms were included between SLE and CM. All interaction effects were assessed on the additive scale, using interaction contrasts (IC). Results: After adjusting for potential confounders, SLE frequency remained significantly associated with alcohol craving, although the absence of prior CM appeared to reduce this risk. Among those without a history of CM, SLE significantly increased the risk for craving only if two events (AOR: 3.85; CI: 1.45–10.25) or at least three events (AOR: 4.90; CI: 1.92–12.50) were experienced. In contrast, among those with a history of CM, SLE significantly increased the risk for craving if one event (AOR: 3.57; CI: 1.25–10.17), two events (AOR: 6.25; CI: 15.98), or at least three events (AOR = 10.33; CI: 4.13–25.83) were experienced. After adjusting for controls, experiencing at least three events compared to having no events increased the risk for alcohol craving by 1.7% (p b .001) among those with a history of CM, and this was significantly greater than the same risk for those without such a history (ARD: 0.8%, p b .001; CI: 1.0%, p = 0.032). Conclusion: Stressful life events in adulthood exhibited a dose-response relationship with alcohol craving, with greater past-year stress exposures associated with an increasing risk for alcohol craving among past-year drinkers. Adult drinkers who were maltreated in childhood were more likely

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to experience alcohol craving associated with proximal stressors compared to adult drinkers who did not experience any type of childhood maltreatment. Particularly for at-risk drinkers, increased awareness of stress responsiveness and stress-related craving may help curb disorder progression. Funding source: NIH grant: T32DA031099-01A1 (P.I. Hasin). http://dx.doi.org/10.1016/j.comppsych.2013.07.030

High depressive symptoms during adolescence increases the effect of stressful life events on depression in a population-based sample of young adults G.E. Kraus, J. O'Loughlin, I. Karp, E. Dugas, E. O'Loughlin, N.C. Low Montreal, QC, Canada Introduction: Findings from clinical samples demonstrate that stressful life events precipitate depressive episodes in the early course of major depression. However, it is not known if there is an association between stressful life events and depressive symptoms in young adults from population-based settings. Although stressful life events are ubiquitous, only 10–20% of young adults develop depression. Therefore, stressful life events likely precipitate depressive episodes in those with other risk factors, such as the presence of anxiety disorders or depressive symptoms during childhood. Objective: (1) To test if past-year stressful life events predict current depressive symptoms in a population-based cohort of young adults; (2) To test for effect modification by previous anxiety disorder diagnosis and level of depressive symptoms during adolescence. Method: Data were drawn from the Nicotine Dependence in Teens (NDIT) Study, a prospective school-based cohort from Montreal. The analytic sample includes 823 adolescents who completed 22 self-report questionnaires between the ages of 12 and 24 years. Data from the 21st questionnaire cycle were analyzed for this study. The exposure included 17 possible pastyear stressful life events (e.g., break-up of a relationship, losing a job, death of a family member) drawn from the List of Threatening Events. The outcome was depressive symptoms in the past 2 weeks, assessed by the Major Depression Inventory (MDI). We tested for effect modification by previous anxiety disorder diagnosis and depressive symptoms in early adolescence. Results: Results indicated that a higher number of recent stressful life events in the past year predicted higher current depressive symptoms. Depressive symptoms in early adolescence modified the association between stressful life events and current depressive symptoms. More specifically, in the presence of high depressive symptoms during early adolescence, the association between stressful life events and current depressive symptoms during young adulthood was greater. Previous anxiety disorder diagnosis did not modify the association between stressful life events and current depression. Conclusions: These findings highlight the importance of treatment and prevention programs for youth that address how to manage stressful life events by fostering effective coping skills. Teachers, parents, and healthcare professionals should remain vigilant in recognizing stressful life events as a significant source of stress in adolescents and young adults and for the potential development of depression. http://dx.doi.org/10.1016/j.comppsych.2013.07.031

The association of early parent support for child autonomy with changes in bullying among children with and without ADHD and ODD E. Kruszewski, K. Rajendran, J.M. Halperin Flushing, NY Background: Bullying is more prevalent among children with attentiondeficit/hyperactivity disorder (ADHD) and/or oppositional-defiant disorder (ODD) than among children without these disorders. Children of authoritative parents who support the child's autonomy have a lower risk for bullying. However, it is not clear whether parent support for child