Social alcohol cue reactivity in the brain: role of craving and social processes in adolescent and adult alcohol users

Background: Alcohol use disorders (AUDs) typically emerge in adolescence but the majority resolve without treatment. Heightened levels of social attunement –the ability and desire to harmonize with the social environment—has been proposed as one of the mechanisms of this adolescent risk and resilience to AUD. The aim of the current study was to investigate potential age-related differences in the role of social processes, AUD severity, and craving in neural social alcohol cue reactivity (SACR).

Methods: 104 male (51% adult, 49 adolescent) sporadic to heavy drinkers completed a social alcohol cue reactivity task in a 3T MRI scanner in which non-social alcohol, social alcohol, non-social soda, and social soda cues were presented. Whole-brain and region of interest (ROI) analyses for the medial prefrontal cortex, nucleus accumbens, and dorsal anterior cingulate cortex tested the role of age in the relationship between SACR and AUD severity, task-induced craving, social attunement, and social drinking motives.

Results: While there were no age differences in AUD severity, social attunement or task induced craving behaviorally, significant age interactions emerged for social attunement and task-induced craving in the whole brain and ROI analyses. In adolescents, social attunement was positively associated with SACR in the mPFC (p=.002) and superior and middle temporal gyrus (Z=2.3, p<.05), whereas adults showed a negative association. Compared to adults, adolescents with higher craving showed less SACR in the occipital and temporal cortical regions (Z=2.3, p<.05). The opposite was observed in the mPFC; adults with more craving showed less activity compared to adolescents.

Conclusion: Adolescents with stronger social attunement tendencies show higher levels of SACR. Task-induced craving is also differentially associated with SACR in adolescents and adults. This study provides the first evidence that the role of craving and social attunement in an important biomarker of addiction may differ between adolescents and adults.