Relation between cognitive distortions and neurobehavior disinhibition on the development of substance use during adolescence and substance use disorder by young adulthood: a prospective study

Objective: Previous research has demonstrated that neurobehavior disinhibition increases the risk for a diagnosis of substance use disorder (SUD). This investigation tested the hypothesis that a deficiency in the capacity to appraise the effects of alcohol and drugs and interpret social interactions mediates the relation between neurobehavior disinhibition in childhood and SUD by early adulthood. Methods: Boys with fathers having lifetime SUD (N = 88) and no SUD or other psychiatric disorder (N = 127) were prospectively tracked from ages 10-12 to 19 years. Neurobehavior disinhibition was evaluated at baseline followed by assessments of cognitive distortions and substance use involvement in early and mid-adolescence. SUD outcome was evaluated up to age 19 years. Results: Cognitive distortions (age 12-14 years) mediated the association between neurobehavior disinhibition (age 10-12 years) and marijuana use (age 16 years) which, in turn, predicted SUD by age 19 years. Cognitive distortions in early adolescence did not directly predict SUD by young adulthood. Conclusions: Inaccurate social cognition, significantly predicted by childhood neurobehavior disinhibition, biases development toward marijuana use prodromal to SUD. These results indicate that cognitive processes, in conjunction with psychological self-regulation, comprise important components of the individual liability to SUD. (C) 2004 Elsevier Ireland Ltd. All rights reserved.