Psychological changes and cognitive impairments in adolescent heavy drinkers

Abstract

Aims: Adolescence is a developmental period characterized by increased risk-taking behavior, including the initiation of alcohol and other substance use. In this brief review paper we describe psychological and cognitive constructs that are associated with heavy drinking during adolescence. These associations raise the question of causality: is alcohol somehow neurotoxic, or can we identify specific psychological and cognitive variables that serve as risk factors for the escalation of heavy drinking? Methods: This narrative review summarizes results of recent prospective studies that focus on causal relationships between adolescents' alcohol use, and psychological changes and cognitive impairments. Results: Psychological constructs such as elevated impulsivity and poor executive function are risk factors for alcohol involvement in youth. Furthermore heavy drinking during adolescence, particularly in a binge pattern, may exert neurotoxic effects and produce corresponding changes in executive function, perhaps setting the stage for the development of alcohol use disorders later on in life. Conclusion: Although the findings of the discussed studies shed light on the nature of the relationships between alcohol involvement and cognitive deficits, the question of cause and effect remains unanswered. The limitations of existing research and the need for well-powered prospective studies are highlighted. © The Author 2013. Medical Council on Alcohol and Oxford University Press. All rights reserved.