Risk factors associated with curiosity about alcohol use in the ABCD cohort

Highlights

• Curiosity about alcohol use may be an important, early marker for alcohol use risk.

• Factors that shape curiosity are currently unknown.

• Internalizing, externalizing, and impulsivity symptoms predicted curiosity.

• Curiosity is related to low perceived risk of alcohol with peer approval of use.

• Targeting alcohol curiosity predictors may improve early prevention efforts.

Abstract

Curiosity and intent to use alcohol in pre-adolescence is a risk factor for later experimentation and use, yet we know little of how curiosity about use develops. Here, we examine factors that may influence curiosity about alcohol use, as it may be an important predictor of later drinking behavior. Cross-sectional data on youth ages 10–11 from the ongoing Adolescent Brain Cognitive Development℠ (ABCD) Study Year 1 follow-up were used (n = 2,334; NDA 2.0.1). All participants were substance-naïve at time of assessment. Group factor analysis identified latent factors across common indicators of risk for early substance use (i.e., psychopathology and trait characteristics; substance use attitudes/behaviors; neurocognition; family and environment). Logistic mixed-effect models tested associations between latent factors of risk for early substance use and curiosity about alcohol use, controlling for demographics and study site. Two multidimensional factors were significantly inversely and positively associated with greater curiosity about alcohol use, respectively: 1) low internalizing and externalizing symptomatology coupled with low impulsivity, perceived neighborhood safety, negative parental history of alcohol use problems, and fewer adverse life experiences and family conflict; and 2) low perceived risk of alcohol use coupled with lack of peer disapproval of use. When assessing all risk factors in an overall regression, lack of perceived harm from trying alcohol once or twice was associated with greater likelihood of alcohol curiosity. Taken together, perceptions that alcohol use causes little harm and having peers with similar beliefs is related to curiosity about alcohol use among substance-naïve 10–11-year-olds. General mental health and environmental risk factors similarly increase the odds of curiosity for alcohol. Identification of multidimensional risk factors for early alcohol use may point to novel prevention and early intervention targets. Future longitudinal investigations in the ABCD cohort will determine the extent to which these factors and curiosity predict alcohol use among youth.

Introduction

The brain is highly vulnerable to substance exposure during adolescence, leading to potential changes that may influence later life outcomes (Spear, 2013). Despite the known deleterious impact of substance use on neuromaturation, nearly 60% of high school seniors report lifetime alcohol use (Johnston et al., 2020). Concurrently, adolescents’ perception of harm of regular alcohol use is declining (Johnston et al., 2019). Shifting attitudes toward alcohol and other substance use may contribute to a greater willingness to experiment with substance use in youth. Importantly, curiosity and intent to use substances (and, particularly, tobacco) during pre-adolescence is a risk factor for later experimentation and use (Choi, Gilpin, Farkas, & Pierce, 2001; Nodora et al., 2014; Strong et al., 2015); childhood reports of curiosity may increase the likelihood of later substance use initiation two-fold (Pierce, Choi, Gilpin, Farkas, & Merritt, 1996) and significantly increase sensitivity when added to risk profile predictors (Nodora et al., 2014; Strong et al., 2015). However, there has been little investigation of contributors to the development of curiosity, despite the fact that curiosity has been identified as a leading reason why individuals initiate substance use (Guo, Unger, Azen, MacKinnon, & Johnson, 2012; Guo, Unger, Palmer, Chou, & Johnson, 2013) and precedes intention to use (Pierce, Distefan, Kaplan, & Gilpin, 2005). Here we examine factors that may influence curiosity about alcohol use in children 10–11 years of age, as it may be an important predictor of later drinking behavior.

Curiosity has been described as being driven by internal motivation for external stimulation, learning, and receiving information (Giambra, Camp, & Grodsky, 1992; Grossnickle, 2014). Consistent with this, functional neuroimaging data suggest curiosity is broadly related to neural processing (e.g., nucleus accumbens, frontal brain regions) underlying reward-based learning and decision-making abilities (Gruber, Gelman, & Ranganath, 2014; Kang et al., 2009). Notably, satisfaction of curious thoughts (i.e., receiving information) has been shown to increase activity in striatal brain regions (Jepma, Verdonschot, van Steenbergen, Rombouts, & Nieuwenhuis, 2012). As information acts as a reward, it has been suggested that curiosity leads to reward-motivated behaviors (Marvin & Shohamy, 2016). Relatedly, reward processing and decision making are also key factors in risk of substance use onset (Casey et al., 2011; MacKillop et al., 2011). Together, this suggests decision making and reward processing are likely linked to both curiosity and substance use risk.

Thus far, research on substance-related curiosity has focused on 1) tobacco use (Gentzke, Wang, Robinson, Phillips, & King, 2019; Guo et al., 2013; Nodora et al., 2014; Pierce et al., 2005), 2) adolescents (Guo et al., 2013; Pierce et al., 1996), and 3) curiosity as a predictor of future substance use (Guo et al., 2013; Nodora et al., 2014; Pierce et al., 2005), rather than factors that contribute to development of curiosity in childhood. Curiosity about nicotine in early adolescence is a significant predictor of later use in adolescence/young adulthood in numerous studies. For example, Nodora et al. (2014) found inclusion of a tobacco curiosity question substantially increased their ability to identify 10–13-year-olds who would transition to tobacco use by 19 (from 25% to 45%). A study of over 12,000 middle and high school students in China found that curiosity about tobacco use predicted experimentation with tobacco one year later (Guo et al., 2013). Similarly, curiosity has been shown to precede intention to use tobacco in adolescents. A three-year longitudinal study found that among 12–15-year-olds, those who reported any tobacco curiosity at baseline were most likely to later engage in use (Pierce et al., 2005), which suggests curiosity may be one of the earliest markers of risk for later substance initiation. This is important, as curiosity and intent to use substances in pre-adolescence is a risk factor for later experimentation and use (Choi et al., 2001; Nodora et al., 2014; Strong et al., 2015), though a wide range of other risk factors has been noted. More research is needed examining whether development of curiosity about other substances (e.g., alcohol) may be an important marker for even earlier implementation of prevention efforts.

Efforts have been made to identify the most sensitive and specific predictors of who will later initiate substance use in early adolescence, with numerous possible risk factors suggested (see Clark & Winters, 2002). Individual risk factors across several domains have been identified in longitudinal studies examining adolescent cohorts transitioning to alcohol use by later adolescence or young adulthood and include: 1) personality traits (e.g., sensation seeking, impulsivity) (Sargent, Tanski, Stoolmiller, & Hanewinkel, 2010) and psychopathology (e.g., externalizing symptoms; Gorka et al., 2014; Heron et al., 2013); 2) attitudes and peer influences about alcohol use (Donovan & Molina, 2011; Maggs, Staff, Patrick, Wray-Lake, & Schulenberg, 2015); 3) family and environmental influences (e.g., conflict, engagement, alcohol exposure; Donovan & Molina, 2011; Gorka et al., 2014; Hayatbakhsh et al., 2008; Sargent, Wills, Stoolmiller, Gibson, & Gibbons, 2006); and 4) neurocognitive vulnerabilities (e.g., response inhibition, decision making; Audrain-McGovern et al., 2009; MacKillop et al., 2011). More broadly, many of these risk factors also often relate to increased real-world risk taking and impaired decision making, shaping behavioral and clinical outcomes (Isles, Winstanley, & Humby, 2019).

While understanding risk factors for use is important, the current literature is hampered by the use of pre/post data to assess factors of those who have already initiated use. Identification of intermediary time points of higher risk prior to the onset of use may prevent some of the detrimental effects of later substance initiation. As curiosity has already been shown to be a unique and clinically significant predictor of later tobacco use (Nodora et al., 2014), it stands to reason that other substance use, such as alcohol use, may similarly be identified by curiosity. Better knowledge about alcohol curiosity predictors may lead to the development of targeted prevention efforts that can be utilized at the onset of curiosity, rather than the onset of alcohol use. Understanding factors across domains that relate to increased curiosity in pre-adolescent youth prior to substance use initiation may inform early assessment and intervention approaches (Choi et al., 2001; Nodora et al., 2014; Strong et al., 2015). Remarkably, the relationship between identified risk factors for alcohol initiation and alcohol curiosity, a potential antecedent to alcohol use, has not been investigated. Therefore, this investigation was designed to fill a gap in the literature and to broadly investigate factors that influence curiosity about alcohol use in pre-adolescent youth ages 10–11. Using a data-driven process, we include relevant variables across domains, supported by previous studies (Clark & Winters, 2002; Donovan & Molina, 2011; Maggs et al., 2015; Sargent et al., 2010) that may be risk factors for curiosity about alcohol use to create latent factors. We hypothesize that high levels of these empirically derived latent factors will predict increased odds of curiosity about alcohol use.