Project Summary/ Abstract
Heavy drinking is highly prevalent in adolescents and young adults and can lead to dangerous behavioral and
health consequences. Specific mechanisms of risk for escalating drinking in adolescence and young adulthood
are not well understood. The continuous communication between the heart and brain through the ANS is
critical to basic regulatory processes like sleep and circadian rhythms, as well as to responses to stressors and
rewards in one’s environment. In adults with alcohol use disorders, poorer ANS functioning (i.e., lower heart-
rate variability [HRV] and baroreflex sensitivity [BRS]) are associated with greater reported craving and
alcohol-seeking behavior; however, it is unclear how ANS functioning relates to heavy drinking below the
threshold of alcohol use disorders in adolescents. The application seeks to examine autonomic nervous
system (ANS) functioning, as indexed by cardiovascular probes, and its relationship to alcohol use, craving,
and cue-reactivity in an adolescent/young adult sample to elucidate a potential mechanism of risk in heavy
alcohol users. The central premise of the application is that ANS functioning: 1) is critical to one’s ability to self-
regulate emotional response and specifically regulate responses to internal and external cues related to
alcohol use, and 2) is affected acutely and chronically by alcohol use, which cascades to negative effects on
sleep and circadian functioning. Quantifying the relationship between alcohol use and ANS functioning in late
adolescence is an important first step in understanding other potential implications for prevention and
intervention. Accordingly, this project will focus on assessing cardiovascular indices of ANS functioning along
with sleep and circadian functioning, and individuals’ affect and cue-reactivity over one month. To accomplish
these aims, the study will enlist late adolescent Heavy Drinkers (HD, n = 50; ages 18-20) and age- and sex-
matched non-drinking Controls (CON, n = 50) in a 4-week study. Resting-state HRV and BRS will be
measured weekly (5x total), and affect ratings will be gathered daily throughout the 4 weeks, while an alcohol
cue-reactivity task with simultaneous HRV assessment will be gathered twice (first and last week). The primary
aims of the current protocol are to: 1) identify differences in ANS function and cue-reactivity over a month
between HD and CON, and 2) quantify the relations between ANS functioning and craving, sleep, affect,
and substance use. The candidate will use his training in ANS assessment to test whether HD exhibit
differences in ANS functioning, affect, and cue-reactivity related to their alcohol use. Corroborating changes via
multiple modalities (e.g., cardiovascular functioning and self-reported measures) will yield a biopsychosocial
perspective on the potential underlying mechanisms. The candidate’s long-term goals are to identify markers of
risk for substance use in even younger samples and to leverage the malleability of ANS functioning as a
potential target of prevention and intervention efforts.
