Alcohol cue reactivity in the brain: Age-related differences in the role of social processes in addiction in male drinkers

Abstract

Social attunement (SA)-the tendency to harmonize behavior with the social environment-has been proposed to drive the escalation of alcohol use in adolescence, while reducing use in adulthood. Little is known about how heightened social sensitivity in adolescence may interact with neural alcohol cue reactivity-a marker of alcohol use disorder-and its relationship to alcohol use severity over time. The aims of this study were to test whether (1) adolescents and adults differ in social alcohol cue reactivity in the nucleus accumbens, anterior cingulate cortex, and right medial prefrontal cortex (mPFC), and (2) age moderates the relationship between social alcohol cue reactivity and social attunement, measures of drinking at baseline, and changes in drinking over time. A sample of male adolescents (16-18 years) and adults (29-35 years) completed an fMRI social alcohol cue-exposure task at baseline and an online follow-up two to three years later. No main effects of age or drinking measures were observed in social alcohol cue reactivity. However, age significantly moderated associations of social alcohol cue reactivity in the mPFC and additional regions from exploratory whole-brain analyses with SA, with a positive association in adolescents and negative association in adults. Significant age interactions emerged only for SA in predicting drinking over time. Adolescents with higher SA scores escalated drinking, while adults with higher SA scores reduced drinking. These findings warrant further research on SA as a risk and protective factor and suggest that social processes influence cue reactivity differentially in male adolescents and adults.

Keywords: adolescence; cue reactivity; fMRI; social processes.

Figure 1.

Schematic overview of Social Alcohol Cue Exposure (SACE) paradigm.

Figure 2.

Results of whole brain exploratory analyses of the moderating role of age in social alcohol cue reactivity and its association drinking measures and social attunement (Z threshold = 2.3, p <.05). Cluster information in Table 3. Panel a – main effect of group in social alcohol cue reactivity; Panel b – significant interaction between age and recent alcohol use; Panel c –significant interaction between age and task-induced craving; Panel d – significant interaction between age and social attunement tendencies; Panel b-d – Data points represent mean parameter estimate for social alcohol cue reactivity contrast (SB > SS) > (NB > NS) per participant in significant cluster of voxels. Values above zero on the y-axis indicate higher activity to social compared to non-social alcohol cues. Values below zero on the y-axis indicate higher activity to non-social alcohol cues compared to social alcohol cues.

Figure 3.

Significant interaction between age and social attunement tendencies in social alcohol compared to non-social alcohol cue reactivity in the right mPFC in moderated regression analysis. Statistics in Table 6. Data points represent the mean parameter estimates for the social alcohol cue activity contrast (SB > SS) > (NB > NS) in the mPFC for each participant. Values above zero on the y-axis indicate higher activity to social compared to non-social alcohol cues. Values below zero on the y-axis indicate higher activity to non-social alcohol cues compared to social alcohol cues.

Figure 4.

Results of moderated regression analyses examining the association between social attunement tendencies (SAQ) and changes in drinking at the two to three-year follow-up. Statistics in Tables 7–8; Panel a – significant interaction between social attunement tendencies and age on change in recent alcohol use as measured by a timeline follow back (TLFB) questionnaire. Panel b - significant interaction between social attunement tendencies and age on change in number of AUD symptoms.