Adolescent executive dysfunction in daily life: Relationships to risks, brain structure and substance use

Duncan B. Clark, Tammy Chung, Christopher S. Martin, Brant P. Hasler, Douglas H. Fitzgerald, Beatriz Luna, Sandra A. Brown, Susan F. Tapert, Ty Brumback, Kevin Cummins, Adolf Pfefferbaum, Edith V. Sullivan, Kilian M. Pohl, Ian M. Colrain, Fiona C. Baker, Michael D. De Bellis, Kate B. Nooner, Bonnie J. Nagel

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


During adolescence, problems reflecting cognitive, behavioral and affective dysregulation, such as inattention and emotional dyscontrol, have been observed to be associated with substance use disorder (SUD) risks and outcomes. Prior studies have typically been with small samples, and have typically not included comprehensive measurement of executive dysfunction domains. The relationships of executive dysfunction in daily life with performance based testing of cognitive skills and structural brain characteristics, thought to be the basis for executive functioning, have not been definitively determined. The aims of this study were to determine the relationships between executive dysfunction in daily life, measured by the Behavior Rating Inventory of Executive Function (BRIEF), cognitive skills and structural brain characteristics, and SUD risks, including a global SUD risk indicator, sleep quality, and risky alcohol and cannabis use. In addition to bivariate relationships, multivariate models were tested. The subjects (n = 817; ages 12 through 21) were participants in the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study. The results indicated that executive dysfunction was significantly related to SUD risks, poor sleep quality, risky alcohol use and cannabis use, and was not significantly related to cognitive skills or structural brain characteristics. In multivariate models, the relationship between poor sleep quality and risky substance use was mediated by executive dysfunction. While these cross-sectional relationships need to be further examined in longitudinal analyses, the results suggest that poor sleep quality and executive dysfunction may be viable preventive intervention targets to reduce adolescent substance use.

Original languageEnglish (US)
Article number223
JournalFrontiers in Behavioral Neuroscience
StatePublished - Nov 13 2017


  • Adolescents
  • Alcohol
  • Executive functioning
  • Neurocognitive testing
  • Neuroimaging

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Cognitive Neuroscience
  • Behavioral Neuroscience


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