Table 1.
Effect of executive functioning on alcohol use initiation, frequency, and intensity (N=15 studies).
| Authors | Design | N | Age (Years) M (SD) | EF Task(s)/Metric | Alcohol-Related DV | Finding |
|---|---|---|---|---|---|---|
| Updating | (n=6) | |||||
| Noël et al., 2002 [46] | Longitudinal 3 mo. F/U | 20 | 45.5 (7.5) | Alpha Span task | Individuals who ultimately relapsed had done more poorly on alphabetical portion of task | |
| Thush et al., 2008 [40] | Longitudinal 1 mo. F/U | 81 | 16.34 (1.34) | WMC x implicit and explicit positive arousal expectancies | Alcohol use 1 month later | Implicit associations predict alcohol use for those with low WM; explicit associations predict alcohol use for those with high WM |
| Friese et al., 2010 [41] | Cross-sectional | 49 | All males 25.2 (7.22) | Operation Span Task | Average fixation length; total dwell time; NOT 1st fixation length or time to 1st fixation | Implicit associations predict attention allocation for those with low WM capacity; not for those with high WM capacity |
| Pharo et al., 2011 [39] | Cross-sectional | 69 M, 67 F adolescents; 27 M, 30 F adults | Adol: 15.86 (1.06); Adults: 18–22 (19.8, 1.41) | COWAT; Digit Span | Risk-taking composite score (alcohol was on component) | Poorer performance on WM tasks was related to greater risk-taking |
| Houben et al., 2011 [43] | Longitudinal 1 mo. training and 1 mo. F/U | 48 | 44.3 (15.4) | SOPT; Backward Digit Span; Letter Span Task | AUDIT | WM training decreased alcohol use for those with high IAT |
| * Squeglia et al., 2012, Study 2 [36] | Longitudinal 3 year F/U | 40 | 12–16 at baseline assessment | fMRI activation in frontal and parietal areas during a visual WM task | Transition to heavy drinking (defined by [85] and modified for adolescents) | Lower baseline activation predicted transition to heavy drinking |
| Shifting | (n=1) | |||||
| Mullan et al., 2011 [38] | Longitudinal 1 week F/U | 153 | 20.1 (4.2) | Tower of Hanoi; Stroop; IGT; WCST | Binge drinking ≥ in past week | Poorer shifting was associated with increased drinking among those with intentions to drink |
| Inhibition | (n=10) | |||||
| Morgenstern & Bates, 1999 [48] | Longitudinala | 118 | 35.6 (9.1) | Composite score: SILS, TMT–Part B, WCST, FAS, CAT | Treatment outcome | EF did not predict treatment outcome |
| Moriyama et al., 2002 [49] | Longitudinal 18 month F/U | 37 | 51.6 (3.7) | Reaction time, Symbol Digit, Digit Span, Figure Position, TMT, Rule Shift, and other non-EF tasks | Drinking outcome (DSM-III-R alcohol-related problems) | EF did not predict drinking outcome but did predict occupational outcome |
| Noël et al., 2002 [46] | Longitudinal 3 month F/U | 20 | 45.5 (7.5) | Hayling task | Abstainers made fewer errors | |
| Nigg et al., 2006 [12] | Longitudinal 3 year F/U | 498 | 12–14 or 15–17 at baseline | Stop Signal Task No influence of WCST |
Alcohol problems, comorbid alcohol and drug use | Poor stop signal performance predicted alcohol problems, comorbid use |
| Patrick et al., 2008 [42] | Cross-sectional | 72 | All females 21.1 (0.8) | N-back, GNG | Recent alcohol use | Among those with poorer performance on GNG, IGT predicted alcohol use; for those with better N-Back performance, BAS predicted alcohol use |
| Pharo et al., 2011 [39] | Cross-sectional | 69 M, 67 F adolescents; 27 M, 30 F adults | Adol: 15.86 (1.06); Adults: 18–22 yo (19.8, 1.41) | Stroop | Risk-taking composite score (alcohol was one component) | Poorer performance on Stroop task was related to greater risk-taking |
| Mullan et al., 2011 [38] | Longitudinal 1 week F/U | 153 | 20.1 (4.2) | Tower of Hanoi; Stroop; IGT; WCST | Binge drinking ≥ in past week | Poorer inhibition was associated with increased drinking among those with intentions to drink |
| Camchong, Stenger & Fein, 2012 [47] | Longitudinal 6 mo. F/U | 69 | Abstainers: 46.7 (6.8); Relapsers: 46.9 (7.25) | Affective GNG | Relapse to alcohol/drugs | No difference in GNG; relapsers had lower RSS in executive network |
| * Norman et al., 2011 [86] | Longitudinal 5 year F/U | 38 | 12–14 at baseline | GNG in fMRI | Transition to heavy alcohol use | Reduced activation in several brain regions, including frontal regions, predicted transition to heavy drinking |
| Houben et al., 2012 [44] | Longitudinal 1 week F/U | 57 | 20.91 (1.83) | GNG | Alcohol use in past week | Training of “no-go” response decreased alcohol use via change in implicit associations |
| * Wetherill et al., 2013 [37] | Longitudinal 5 year F/U | 60 | 12–14 at baseline; M=~13.3 | GNG in fMRI | Alcohol-induced blackouts | Greater activation in frontal cortices predicted alcohol-induced blackouts |
Note: WM=working memory; COWAT=Controlled Oral Word Association Test; SOPT=self-ordered pointing task; TMT= Trail Making Test; AUDIT=Alcohol Use Disorders Identification Test; fMRI=functional magnetic resonance imaging; IAT=Implicit Associations Task; IGT=Iowa Gambling Task; WCST=Wisconsin Card Sorting Task; GNG=Go/No-Go; BAS=behavioral activation system; SILS=Vocabulary Test from the Shipley Institute of Living Scale; FAS=Phonemic Word Fluency Test; RSS=resting state synchrony; CAT= Booklet Category Test; F/U=follow up;
*
studies that utilize alcohol-naïve adolescents.
a
2.61 ± 13.6 days [87].