Retaining Adolescent and Young Adult Participants in Research During a Pandemic: Best Practices From Two Large-Scale Developmental Neuroimaging Studies (NCANDA and ABCD)

The novel coronavirus pandemic that emerged in late 2019 (COVID-19) has created challenges not previously experienced in human research. This paper discusses two large-scale NIH-funded multi-site longitudinal studies of adolescents and young adults – the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) and the Adolescent Brain Cognitive Development (ABCD) Study – and valuable approaches to learn about adaptive processes for conducting developmentally sensitive research with neuroimaging and neurocognitive testing across consortia during a global pandemic. We focus on challenges experienced during the pandemic and modifications that may guide other projects, such as implementing adapted protocols that protect the safety of participants and research staff, and addressing assessment challenges through the use of strategies such as remote and mobile assessments. Given the pandemic’s disproportionate impacts on participants typically underrepresented in research, we describe efforts to retain these individuals. The pandemic provides an opportunity to develop adaptive processes that can facilitate future studies’ ability to mobilize effectively and rapidly

Factors Related to Posttraumatic Stress Disorder in Adolescence Factors Related to Posttraumatic Stress Disorder in Adolescence

Abstract Studies of posttraumatic stress disorder (PTSD) in adolescence published from 2000 to 2011 indicate that adolescents are at greater risk of experiencing trauma than either adults or children, and that the prevalence of PTSD among adolescents is 3-57%. Age, gender, type of trauma, and repeated trauma are discussed as factors related to the increased rates of adolescent PTSD. PTSD in adolescence is also associated with suicide, substance abuse, poor social support, academic problems, and poor physical health. PTSD may disrupt biological maturational processes and contribute to the long-term emotion and behavior regulation problems that are often evident in adolescents with the disorder. Recommendations are presented for practice and research regarding the promotion of targeted prevention and intervention services to maximize adolescents' strengths and minimize vulnerabilities. Public policy implications are discussed. Keywords adolescent, trauma, posttraumatic stress, abuse, development, risk factors, suicidality, substance use Key Points of the Research Review Trauma in Adolescence Four of five adolescents meet DSM criteria for exposure to a serious traumatic event. Of these, 3-57% meet diagnostic criteria for Posttraumatic Stress Disorder (PTSD). Child maltreatment is a common type of trauma for those under 18. There were over 2 million reported cases in the United States in 2008, which likely represents a fraction of the actual incidents of abuse and neglect. PTSD in Adolescence The average rate of adolescent PTSD was nearly 14% among studies conducted in the last decade. Rates of PTSD in adolescence are related to type of trauma. Trauma that is associated with more shame and deviance is associated with higher rates of PTSD (e.g., for sexual abuse 57% have PTSD vs. 10% for natural disasters). Risk Factors for PSTD Rates of traumatic exposure peak in adolescence compared to adulthood, which is associated with correspondingly higher rates of PTSD (adult PTSD 7% vs. adolescent PTSD 13%). Adolescent females are twice as likely to develop PTSD following a significant trauma than males. Repeated trauma, regardless of type, heightens the probability of PTSD symptoms and diagnosis. Adolescents with less social support are more likely to experience trauma and develop PTSD. Serious physical health problems increase risk of PTSD in adolescence. Correlates of PTSD Adolescents with PTSD are significantly more likely to have failed a grade or to have been suspended than those without PTSD. Over 80% of individuals with PTSD have a comorbid substance-use disorder, typically beginning in adolescence. Approximately 6% of adolescents with PTSD have made a suicide attempt versus less than 2% for adolescents with no history of trauma or PTSD. Brain imaging studies relate PTSD and trauma to differences in emotion regulation, dopamine, and norepinephrine activation

Longitudinal Impact of Life Events on Adolescent Binge Drinking in the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA)

Background: Life events experienced during adolescence are associated with risk and resilience to heavy episodic drinking (HED; i.e. binge drinking). The current study builds on prior research using latent class analysis (LCA) to examine heterogeneity in patterns of adolescent life events at baseline to HED over the course of three years (4 timepoints) as part of the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA). Methods: Life event classes were modeled using LCA that characterized NCANDA participants based upon their responses to the Life Events Questionnaire (N = 467, age: M = 14.98, SD = 1.69, 49.7% female). These baseline latent life event classes were then compared to HED at baseline and years 1, 2 and 3 using multinomial logistic regression. Results: At baseline, the LCA characterized four classes of adolescents based on endorsement of life events: negative-relational conflict (n = 65, 13.9%), negative-financial problems (n = 49, 10.5%), low life events (n = 130, 27.8%), and positive life events (n = 223, 47.8%). Life event trajectories differed for the negative life event classes compared to the other two classes, with greater odds of HED in the negative-financial problems class at year 1. Conclusion: The four latent classes derived from the life events of NCANDA youth yielded a characterization of adolescents that could aid in understanding HED over the subsequent three years, suggesting that everyday life events may inform adolescent binge drinking

Posttraumatic Stress Symptoms Predict Transition to Future Adolescent and Young Adult Moderate to Heavy Drinking in the NCANDA Sample.

Purpose of studyApproximately two thirds of youth report experiencing or witnessing a trauma. It is not known whether trauma or the posttraumatic stress symptoms (PTSS) following trauma increases adolescent drinking risk.Recent findingsWe described trauma experienced by the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) longitudinal sample (N=831) participants and examined drinking over 4 years. We hypothesize that more traumatic events and PTSS will predict transition to moderate/heavy drinking.Summary658 no/low drinkers at baseline were followed yearly for 4 years for transition to moderate/heavy drinking using logistic regression models. Youth were grouped by: No Trauma (n=257), Trauma (n= 348), and Trauma with PTSS (n=53). Those with Trauma and PTSS showed escalation to moderate/heavy drinking compared to the No Trauma group in follow-up years 2, 3, and 4. Number of traumatic events did not predict moderate/heavy drinking. Interventions targeting PTSS may prevent transition to moderate/heavy drinking

Impact of Childhood Trauma on Executive Function in Adolescence—Mediating Functional Brain Networks and Prediction of High-Risk Drinking

BackgroundChildhood trauma is known to impart risk for several adverse life outcomes. Yet, its impact during adolescent development is not well understood. We aimed to investigate the relationships among childhood trauma, functional brain connectivity, executive dysfunction (ED), and the development of high-risk drinking in adolescence.MethodsData from the National Consortium on Alcohol and Neurodevelopment in Adolescence (sample size = 392, 55% female) cohort were used. This included resting-state functional magnetic resonance imaging at baseline, childhood trauma and ED self-reports, and detailed interviews on alcohol and substance use collected at baseline and at 4 annual follow-ups. We used longitudinal regression analyses to confirm the relationship between childhood trauma and ED, identified the mediating functional brain network hubs, and used these linkages to predict future high-risk drinking in adolescence.ResultsChildhood trauma severity was significantly related to ED in all years. At baseline, distributed functional connectivity from hub regions in the bilateral dorsal anterior cingulate cortex, right anterior insula, right intraparietal sulcus, and bilateral pre- and postcentral gyri mediated the relationship between childhood trauma and ED. Furthermore, high-risk drinking in follow-up years 1-4 could be predicted with high accuracy from the trauma-affected functional brain networks that mediated ED at baseline, together with age, childhood trauma severity, and extent of ED.DiscussionFunctional brain networks, particularly from hub regions important for cognitive and sensorimotor control, explain the relationship between childhood trauma and ED and are important for predicting future high-risk drinking. These findings are relevant for the prognosis of alcohol use disorders

Retaining Adolescent and Young Adult Participants in Research During a Pandemic: Best Practices From Two Large-Scale Developmental Neuroimaging Studies (NCANDA and ABCD).

The novel coronavirus pandemic that emerged in late 2019 (COVID-19) has created challenges not previously experienced in human research. This paper discusses two large-scale NIH-funded multi-site longitudinal studies of adolescents and young adults - the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) and the Adolescent Brain Cognitive Development (ABCD) Study - and valuable approaches to learn about adaptive processes for conducting developmentally sensitive research with neuroimaging and neurocognitive testing across consortia during a global pandemic. We focus on challenges experienced during the pandemic and modifications that may guide other projects, such as implementing adapted protocols that protect the safety of participants and research staff, and addressing assessment challenges through the use of strategies such as remote and mobile assessments. Given the pandemic's disproportionate impacts on participants typically underrepresented in research, we describe efforts to retain these individuals. The pandemic provides an opportunity to develop adaptive processes that can facilitate future studies' ability to mobilize effectively and rapidly