Identifying shared and unique mechanisms driving alcohol and eating cognitions and behaviors in early to middle adolescence: Project READY (Research on Eating and Alcohol Development in Youth)

About This Grant

PROJECT SUMMARY ABSTRACT Problematic alcohol use and binge-type eating share common features, frequently co-occur, and are each independently associated with poor health outcomes which are amplified when they co-occur. Shared mechanisms underlying this comorbidity and, alternatively, unique mechanisms that explain vulnerability for one of these behaviors in isolation from the other, are poorly understood. This undermines development of transdiagnostic prevention/early intervention programs, as well as design of and optimal timing for delivery of more targeted, behavior-specific interventions. Adolescence is an ideal time to elucidate shared and unique risk mechanisms underlying maladaptive alcohol use and eating pathology because it is characterized by increasing risk for engaging in risk-taking behaviors, underscored by increasingly complex emotional experiences, growing importance of peer relationships, and non-parallel maturation in brain regions governing self-regulation and reward processing, all of which have etiological relevance in models of both alcohol use and dysregulated eating. Outcome expectancies--cognitive maps about the perceived likelihood of outcomes from a behavior--have been widely studied in relation to later problematic alcohol use or binge-type eating and thus are important developmental precursors to initiation of these behaviors. The acquired preparedness (AP) model postulates that trajectories of alcohol use and binge-type eating are partially driven by dispositional impulsive characteristics that shape positive outcome expectancies over time. There is support for the AP model prospectively for both alcohol use and binge-type eating separately, but studies have focused mostly on college-aged samples (when alcohol use and dysregulated eating have typically already onset); have included relatively short follow-up periods; and have rarely included assessment of both alcohol use and binge-type eating. Further, the AP model has not integrated other important internal factors in conjunction with environmental influences. We therefore propose to evaluate a novel expansion of the AP model, which includes additional shared internal factors of relevance (i.e., emotion regulation, reward sensitivity, and interpersonal processes, in addition to impulsive characteristics) as well as unique environmental influences (e.g., caregiver and peer modeling and norms, presence of alcohol/highly palatable foods in the home) that can buffer or exacerbate how internal factors shape positive expectancies from early to middle adolescence. We will enroll 360 youth (aged 11-14y) who have high genetic and environmental risk for development of problematic alcohol use and binge-type eating, along with at least one parent. Participants will complete self-report, behavioral, and neural assessments of internal and environmental risk processes, alcohol and eating expectancies, and alcohol use and binge-type eating behaviors annually for two years (through ages 13-16y). This study will significantly advance understanding of early risk and protective processes that precede problematic alcohol use and disordered eating, to identify malleable prevention and early intervention targets.