The following projects were completed between 2008 and 2013.

Self-Regulation and Substance Abuse

The 6 pilot projects listed here examine the mechanisms involved in self-regulation and how multidisciplinary factors, at multiple levels, interact to predict substance abuse and other risky behaviors that result from regulatory failure.

The Role of ADHD, Genes, and Sex in the Developmental Trajectories of Substance Use and Involvement: A Collaborative Working Group

Investigators: Scott Kollins, Bernard Fuemmeler, Joseph McClernon, Marcy Boynton and Krista Ranby

This pilot, conducted by three members of a Faculty Working Group and two C-StARR postdoctoral associates, aimed at examining the associations between ADHD phenotypic classes and ADHD symptoms and smoking/alcohol use trajectories across childhood and adulthood utilizing several existing prospective, longitudinal samples. Findings and publications are presented in the progress report. This multidisciplinary collaborative effort led to the funding of an R01 grant entitled “Elucidating Links between ADHD and Symptoms and Tobacco/Alcohol Use Trajectories” which examines how ADHD symptoms, measured both at single time points and longitudinally, are related to the patterns of substance use across time.

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Influences on the Neural Processing of Teen Risky Behaviors

nvestigators: Timothy Strauman, Ahmad Hariri, Scott Huettel, and Philip Costanzo

The aims of this project are: (1) to identify the neural and psychological factors associated with the effects of peer influence on risky decision making among adolescents, and (2) to compare adolescents and young adults on the associations among peer influence, regulatory styles and impulsive/risky behavioral choices. Preliminary findings, based on quality control analyses of fMRI data obtained to date, are presented in the progress report. Findings will set the stage for subsequent studies in which interventions targeting self-regulatory processes can be tested in schools and other settings in which adolescents encounter significant risks for early substance use and social challenges to self control.

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Exploring a Bioecological, Longitudinal Model of the Development of Substance Use Problems

Investigators: Jane Costello, Beth Gifford, Bill Copeland, North Carolina Education Research Center (NCERC)

The aim of this pilot is to study the effect of complex interactions among multilevel factors: the individual (personality, genetic vulnerability, regulatory processes, endocrine function etc.), the family (parenting, marital relations), and the community (school, neighborhood) on the initiation and progression of substance use. This investigation employs secondary analyses of data from large scale longitudinal datasets–the Great Smokey Mountain Study and the North Carolina Education Research Center–(NCERC) to track the temporal course of these complex interactions.

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Adult Selective Eating: A Model for the Study of Self-Regulation

Investigator: Nancy Zucker

This project examines how the  study of adults who are selective eaters; i.e. those who consume a limited variety of food and report extreme sensitivity to sensory experiences of taste and smell, may inform the development and maintenance of self-regulatory capacities more generally. Individuals differ in their capacities to sense and decipher internal visceral cues; such variation may be a critical mediator influencing individual capacities for self-regulation. While understanding the phenomena of selective eating has special relevance to eating disorders, similar dynamics of over- or under- controlled behavior are likely to apply to multiple substances and activities. These will be examined in subsequent research. Findings are presented in the progress report.

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Parental Drug Problems and Self-Regulation in Pre-School Children: Analysis of Parent-Child Observations

Investigators: Adrian Angold, Helen Egger, Nissa Towe-Goodman

The aim of this pilot is to examine associations between prenatal and postnatal parental substance abuse and parenting style as each affects the development of self-regulation in pre-school children. The study of the determinants of emotional dysregulation in childhood is critical since emotional dysregulation has been found to be strongly associated with increased risk for early onset of substance abuse in adolescence.

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Cultural Determinants Effects on Self-Regulation of Substance Use/Abuse Among Individuals with Severe Mental Illness

Investigators: Jennifer Nolan and Phil Costanzo

The aim of this pilot is to examine the effects of cultural determinants (specifically spirituality and religion) on self regulation of substance use and abuse among patients with Schizophrenia. The findings from this research, described in the progress report, may inform treatment programs and future clinical trials to test the effectiveness of treatment with a spiritual component for dual diagnoses.

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Peer Influences on the Neural Processing of Risk Behaviors in Adolescence

Investigators: Timothy Strauman, Philip Costanzo, Ahmad Hariri, and Scott Huettel

This report documents our progress on the pilot study over the past year.  The study incorporated three fMRI paradigms (a gambling task to measure the impact of peers on risk-taking, a face perception task to measure affect regulation, and a goal priming task to measure self-regulatory capacity) plus DNA collection to test hypotheses regarding genetic influences on risk-taking.  A behavioral pilot study combining individual difference measures, genotyping, and a signal-detection reward sensitivity task yielded strong evidence of significant interactions between individual differences in self-regulation and COMT genotype on how well participants learned to respond preferentially to high-reward versus low-reward stimuli on the signal detection task. The pilot data were entirely consistent with our initial hypotheses. Thus, the aims of this larger pilot study were: (1) to identify the neural and psychological factors associated with peer influence on risky decision making among adolescents, and (2) to compare the association between those factors and risky decision making outcomes between adolescents and young adults.

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Preventive Interventions

The 3 pilots listed here use randomized trials to test interventions for substance abuse prevention and for supporting parenting of new mothers with substance use disorders.

Effects of Cognitive Control Training Among Adolescent Offenders

Investigators: Anne-Marie Iselin, Ken Dodge, and Ahmad Hariri

This pilot is a randomized controlled trial to test whether cognitive enhancement training can be used as a technique to prevent substance use and disruptive behavior disorders among adolescent offenders. It examines the effect of a cognitive enhancement training task on trained and untrained cognitive as well as social information processing skills of adolescent offenders at two Youth Development Centers in North Carolina.

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A Neuroimaging Study of Genetic, Hormonal, Cognitive, and Social-Cognitive variants in a Subsample of Fast Track Young Adults

Investigators: Anne-Marie Iselin, Justin Carré, Ahmad Hariri, and Ken Dodge

This study is randomized controlled trial that examines a group of young male adults from Durham — a subsample from the Fast Track study—who were randomly assigned to receive the Fast Track intervention and a control group. This study has two goals: 1) to test the hypothesis that random assignment to the Fast Track intervention maps onto alterations in the structure and function of neural circuits that support cognition and emotion and their interactions; these pathways have been linked to antisocial behavioral outcomes including substance abuse; and 2) to improve the understanding of the multiple neural pathways through which gene environment interactions relate to substance use and antisocial behaviors in young adults.

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Promoting Supportive Parenting in New Mothers with Substance Use Problems: A Pilot Randomized Trial

Investigators: Lisa Berlin, Linda Burton, Andrea Hussong and Madeline Carrig

This completed pilot was a randomized controlled trial that examined the feasibility and efficacy of administering a brief home-based parenting (ABC) program to new mothers at risk for problematic parenting due to substance use disorders. The mothers were administered the intervention while living with their infants and toddlers in residential substance abuse treatment facilities in North Carolina. Administering the ABC program was found feasible. Findings and publications are presented in the progress report.

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Science Education Interventions

The 3 pilots in this group use randomized trials to test interventions on science education of students to affect their attitudes and beliefs on substance use.

Evaluation of the Learning through Neuroscience Curriculum: Project LEARN

Investigators: Wilkie Wilson, Desiree Murray, Leslie Babinski, Cindy Kuhn and Tim Strauman

The ultimate goal of this project is to develop an early high school–based educational curriculum that would teach adolescents the role of the brain in multiple daily activities and choices. This curriculum includes units stressing the brain’s roles in supporting physical performance, motivation, learning and overall health. It will also provide a scientific introduction to the understanding of the effects of substance use on the brain’s capacity to engage these everyday processes.  The course will target 9th graders because developmentally they are at the peak of numerous risk behaviors and because a semester of health education, mandatory in North Carolina, is typically taken at this grade level.  The current pilot project is a follow up to a pre-pilot faculty group that convened to identify a theoretical basis for the curriculum. Carol Dweck’s growth mindset theory was used as background to compose 5 curriculum lessons that were administered in a trial in two Wake county schools.  These lessons were subsequently revised and administered in a small randomized controlled trial in a selected public school. Data analysis and future evaluation of the curriculum with regard to feasibility, content, methods and impact on students’ beliefs and attitudes on substance use will inform the expansion of the curriculum from 5 lessons to a full semester course. Preliminary findings are presented in the progress report.

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Genes and Addiction: Using Science to Unravel the Misconceptions of Teens’ Susceptibility to Drug Abuse and Addiction

Investigators: Rochelle D. Schwartz-Bloom

This completed study was a randomized controlled trial to determine if providing enhanced science content in genetics to 8th grade students can improve science knowledge and genetics learning and can help students apply that knowledge to understanding the risks for drug abuse and addiction. Findings are presented in the progress report. The findings will help determine basic knowledge of the level of genetics which will help develop better curricular materials for the 8th grade student population to correct misconceptions and enhance genetics learning. Ultimately, the impact of improved understanding of genetics of addiction on prevention strategies can be determined in a major study.

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Waterpipe Use

Investigators:: Isaac Lipkus

This completed pilot was a randomized controlled trial to test whether a web-based science education approach, part of a health risk communication intervention, modifies perceptions of harm and addiction and motivates cessation. The study compared a control group that received information on prevalence of waterpipe tobacco smoking and how it works with another group that received the same information plus additional messages on the risks of waterpipe smoking. Findings, presented in the progress report, indicated that the provision of risk information increased significantly feelings of worry and beliefs about personal harm and addiction and desires to cease use, compared to the control group that did not receive risk messages.

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Non-Random Evaluative Procedures

Using non-random procedures the 3 projects below aim at assessing an intervention for truancy prevention, a new technology for tattoo removal for youth at risk of substance abuse and effect of treatment services for mental health and substance abuse on educational outcomes for high risk youth.

The Truancy Prevention Project

Investigator: Phil Cook, Ken Dodge & Amy Schulting and Katherine Duch

The main goal of this study was to collaborate with teachers, principals and NC Wise managers to indentify and understand the causes of truancy in elementary schools in Durham and to identify effective ways to intervene with chronically absent students. Specific goals were to: 1) evaluate the feasibility of teachers implementing three components of an intervention protocol; 2) refine classroom-based incentives and targeted intervention strategies based on participant feedback; 3) identify the type of training and on-going support teachers need to successfully implement all components of the intervention; and 4) identify the best way to obtain accurate attendance data from the schools. Truants have been found to be at very high risk for early and continued risky behaviors including substance use and delinquent behavior. It is important to determine whether prevention and intervention models aimed at reducing truancy also affect the timing and magnitude of substance use behaviors in at risk populations. This study will provide initial data to help in this determination.

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Social Costs and Benefits of Tattoo Removal Among Recently Released Inmates and Former Gang Members

Investigators: Philip J. Cook, Dr. Tamera Coyne-Beasley and Jeremy Bray

This project aimed at assessing the safety and efficacy of the whole-light technology for tattoo removal by observing young clients in two clinics that provide tattoo removal procedures for indigent patients using the whole-light technology. This technology has a very low cost, in comparison with laser removal and has the potential to make tattoo removal available to low-income youths. This pilot will lay the groundwork for future research to evaluate the costs, and the medical and social outcomes of tattoo removal on the life course of youths at risk in view of tattoos viewed as a possible impediment to transitioning to a “straight” life, particularly with regard to risky behaviors associated with substance use and delinquency.

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Do Substance Use and Behavioral Health Services Improve Education Outcomes for Youth in the Child and Family Support Team Initiative

Investigators: Beth Gifford, Frank Sloan, Joel Rosch, NCERC

This study examines the effect of substance abuse and mental health services on behavioral and academic outcomes for Medicaid enrolled youth, served by the Child and Family Support Team Initiative (CFST). Education, juvenile justice and social service records for students throughout the state were merged and Medicaid data were coded for substance use services. The education data was put into a normalized database like format so that differences that occur across different datasets can be reconciled prior to data analysis.

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Tools for Genomic Research

The 2 projects in this group provide new measurement tools for genomic research.

Harmozing Data Sets for Genomic Research

Investigators: Jane Costello, Rick Hoyle, Madeline Carrig, Jerry Reiter, Krista Ranby, and Daniel Manrique-Vallier

In the study of gene by environment interaction (G-E) models of disease risk, pooling data from different completed or ongoing studies is viewed as a time- and cost-effective alternative to conducting large new investigations. This project sought to develop and test a new methodology, data harmonization, for pooling data from 3 studies that used different measures to assess the same or similar constructs. The ultimate aim is for this methodology to become an important tool for research across many areas of genomic research. In this study theoretical and empirical studies pertinent to the study of gene-environment interactions in the development of substance use disorders were reviewed and, using harmonized data, theoretical models are being  built that will be tested for their fit to the harmonized data . This advance in measurement and analysis should allow for important advances in our capacity to track the life course determinants of risky behaviors and substance use disorders.

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From Brain to Behavior: Using Neuroscience to Inform Phenotype Assessment: From Impulsivity to Identity

Investigators: Scott Huettel, Rick Hoyle, and Philip Costanzo

The purpose of this pilot project is to understand how functional neuroimaging measures can be used to improve the predictive validity of psychometric measures relevant to addiction. Comprehensive behavioral and fMRI data related to impulsive choice were collected in paradigms focused on two concepts: Impulsivity and Identity.
The overall goal of this study is to provide the first proof-of-concept that the incorporation of neuroscience data in instruments can improve the identification of behavioral phenotypes. Such a proof-of-concept will allow for the development of self report instruments that are referent to neurally connected markers of impulsivity. This step can usher in the possibility of using self-report and behavioral indicators as neural processes, which in turn permits the screening of targeted individuals at probable risk for neural regulatory difficulties. Since performing fMRI on a population-wide sample is not feasible either practically or financially, such an advance in measurement of risk propensity should have an enormous impact on population based epidemiological studies of regulatory risk. Preliminary findings are presented in the progress report.

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Substance Use and Criminality

This project covers the role of SUD in the differentiation of adolescent limited and persistent criminal behavior.

The Role of SUD in Differentiation of Adolescent Limited and Persistent Criminal Behavior

Investigators: Jane Costello, Bill Copeland, Shari Miller-Johnson and North Carolina Education Research Center (NCERC)

The goal of this project is to examine the role of substance use disorder (SUD)in persistent versus adolescence-limited criminality, to clarify mechanisms that link early substance use and persistent use with later violence, and to also test individual, family, and community factors that might moderate these links. The project builds on two NIH-funded studies in North Carolina, the Great Smoky Mountain Study and the Caring for Children in the Community. In both studies identical assessment measures of substance-related outcomes as well as individual, family and community functioning facilitate parallel analyses.

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