Browsing by Author "Kwon, Elizabeth"

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    Clinical Perspective: Treatment of adolescent e-cigarette use – limitations of existing nicotine use disorder treatment and future directions for e-cigarette use cessation
    (Elsevier, 2021) Adams, Zachary W.; Kwon, Elizabeth; Aalsma, Matthew C.; Zapolski, Tamika C.B.; Dir, Allyson; Hulvershorn, Leslie A.; Psychiatry, School of Medicine
    Electronic cigarette use ("vaping") has surged in the United States since the mid-2010s. From 2011 to 2018, current e-cigarette use among high school students escalated from 1.5% to 20.8% (∼3.05 million youths),1 countering downward trends in combustible nicotine product use (21.8% in 2011 to 13.9% in 2018).1 Although preventing the initial uptake of vaping is crucial, for the millions of adolescents who have taken up this behavior-many of whom express interest in quitting (eg, 44.5% of current, adolescent non-light e-cigarette users in one US national representative sample)2-it is critically important to help them quit vaping so as to curtail future substance use disorders and other health consequences. Here, we discuss several challenges around adolescent vaping treatment, and highlight research areas in urgent need of attention.
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    Family history of substance use disorder and parental impulsivity are differentially associated with neural responses during risky decision-making
    (Frontiers Media, 2023-06-21) Aloi, Joseph; Kwon, Elizabeth; Hummer, Tom A.; Crum, Kathleen I.; Shah, Nikhil; Pratt, Lauren; Aalsma, Matthew C.; Finn, Peter; Nurnberger, John; Hulvershorn, Leslie A.; Psychiatry, School of Medicine
    Background: Risky decision-making is associated with the development of substance use behaviors during adolescence. Although prior work has investigated risky decision-making in adolescents at familial high risk for developing substance use disorders (SUDs), little research has controlled for the presence of co-morbid externalizing disorders (EDs). Additionally, few studies have investigated the role of parental impulsivity in offspring neurobiology associated with risky decision-making. Methods: One-hundred twenty-five children (28 healthy controls, 47 psychiatric controls with EDs without a familial history of SUD, and 50 high-risk children with co-morbid EDs with a familial history of SUD) participated in the Balloon Analog Risk Task while undergoing functional magnetic resonance imaging. Impulsivity for parents and children was measured using the UPPS-P Impulsive Behavior Scale. Results: We found that individuals in the psychiatric control group showed greater activation, as chances of balloon explosion increased, while making choices, relative to the healthy control and high-risk groups in the rostral anterior cingulate cortex (rACC) and lateral orbitofrontal cortex (lOFC). We also found a positive association between greater activation and parental impulsivity in these regions. However, within rACC, this relationship was moderated by group, such that there was a positive relationship between activation and parental impulsivity in the HC group, but an inverse relationship in the HR group. Conclusions: These findings suggest that there are key differences in the neurobiology underlying risky decision-making in individuals with EDs with and without a familial history of SUD. The current findings build on existing models of neurobiological factors influencing addiction risk by integrating parental factors. This work paves the way for more precise risk models in which to test preventive interventions.
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    Functional connectivity in frontostriatal networks differentiate offspring of parents with substance use disorders from other high-risk youth
    (Elsevier, 2021) Kwon, Elizabeth; Hummer, Tom; Andrews, Katharine D.; Finn, Peter; Aalsma, Matthew; Bailey, Allen; Hanquier, Jocelyne; Wang, Ting; Hulvershorn, Leslie; Psychiatry, School of Medicine
    Background: Family history (FH) of substance use disorders (SUDs) is known to elevate SUD risk in offspring. However, the influence of FH SUDs has been confounded by the effect of externalizing psychopathologies in the addiction risk neuroimaging literature. Thus, the current study aimed to assess the association between parental SUDs and offspring functional connectivity in samples matched for psychopathology and demographics. Methods: Ninety 11-12-year-old participants with externalizing disorders were included in the study (48 FH+, 42 FH-). We conducted independent component analyses (ICA) and seed-based analyses (orbitofrontal cortex; OFC, nucleus accumbens (NAcc), dorsolateral prefrontal cortex) with resting state data. Results: FH+ adolescents showed stronger functional connectivity between the right lateral OFC seed and anterior cingulate cortex compared to FH- adolescents (p < 0.05, corrected). Compared to FH-, FH+ adolescents showed stronger negative functional connectivity between the left lateral OFC seed and right postcentral gyrus and between the left NAcc seed and right middle occipital gyrus (p < 0.05, corrected). Poorer emotion regulation was associated with more negative connectivity between right occipital/left NAcc among FH+ adolescents based on the seed-based analysis. FH- adolescents had stronger negative functional connectivity between ventral attention/salience networks and dorsal attention/visuospatial networks in the ICA. Conclusions: Both analytic methods found group differences in functional connectivity between brain regions associated with executive functioning and regions associated with sensory input (e.g., postcentral gyrus, occipital regions). We speculate that families densely loaded for SUD may confer risk by altered neurocircuitry that is associated with emotion regulation and valuation of external stimuli beyond what would be explained by externalizing psychopathology alone.
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    Impulsivity as a Predictor of Early Dating Initiation in 11–12-Year-Old Youth
    (Springer, 2023) Kwon, Elizabeth; Aalsma, Mathew C.; Zapolski, Tamika C. B.; Monahan, Patrick O.; Hulvershorn, Leslie; Psychology, School of Science
    As early initiation of dating behaviors is associated with risky sexual behaviors (e.g., higher number of sexual partners, sex with strangers), the current study examined determinants of early dating behaviors, focusing on impulsivity. Participants were 11–12-year-old boys (n = 109) and girls (n = 61) recruited from a psychiatric clinic and ads targeted to the general public. Ordered logistic regression models were used to examine the association between each facet of impulsivity (negative urgency, positive urgency, lack of premeditation, lack of perseverance, and sensation seeking) and dating behaviors. Youth with higher sensation seeking and negative urgency was more likely to initiate dating behaviors at early ages compared to those with lower scores on those measures. Further, we found that female gender and higher parental education were associated with lower risk of initiating dating behaviors at early age. Advanced pubertal development was associated with higher risk for early dating. Our findings can inform prevention efforts, identifying sensation seeking and negative urgency as predictors of youths’ early engagement in dating behaviors, which can be a precursor of early sexual debut and risky sexual behaviors.
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    Opioid Use Disorder Stigma, Discrimination, and Policy Attitudes in a National Sample of U.S. Young Adults
    (Elsevier, 2021) Adams, Zachary W.; Taylor, Bruce G.; Flanagan, Elizabeth; Kwon, Elizabeth; Johnson-Kwochka, Annalee V.; Elkington, Katherine S.; Becan, Jennifer E.; Aalsma, Matthew C.; Psychiatry, School of Medicine
    Purpose: A small fraction of people with opioid use disorder (OUD) receives appropriate care. Public opinion about addiction contributes to the availability and accessibility of effective treatment services. Little is known about such attitudes toward OUD among young adults, a population at heightened risk for OUD onset. The current study examined endorsement of social stigma, discrimination, and policy attitudes about OUD and hypothesized correlates of such attitudes (familiarity with OUD, criminal justice involvement, respondent demographic characteristics). Methods: A national sample of 190 young adults (weighted n = 408; 69% female, 42% White, non-Hispanic) aged 19-29 years completed web and telephone surveys covering opioid social stigma, discrimination, policy attitudes, personal experience with opioids, and criminal justice, and participant characteristics (age, sex, race, education, employment, income). Linear regressions were performed to examine associations between respondent characteristics and attitudes. Results: Young adults, on average, endorsed moderate levels of stigma and discrimination toward people with OUD and support for treatment-oriented policies. Stigma was positively associated with discrimination and negatively associated with support for policies favorable to people with OUD. Regression results revealed that more negative attitudes toward OUD were endorsed as a function of older age and less personal experience or familiarity with OUD. Conclusions: Heterogeneity in young adults' attitudes about OUD may be explained, in part, by personal characteristics and familiarity with OUD. Adolescence may be an opportune developmental period to prevent or reduce public stigma related to OUD and MOUD and increase public attitudes in support of expanded access to effective OUD treatments.