{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T15:51:54Z","timestamp":1770565914451,"version":"3.49.0"},"posted":{"date-parts":[[2025,7,18]]},"group-title":"Addiction Medicine","reference-count":60,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,7,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Habitual behavior and attentional bias are distinct cognitive processes that both contribute to inflexible behavior and are commonly observed in addiction. While animal studies provide strong evidence for an association between adolescent alcohol use and impairments in behavioral flexibility in adulthood, such a link in human research has not yet been explored. Moreover, since reduced flexible behavior serves as a risk factor for escalating alcohol intake, continued alcohol consumption use in adulthood may further exacerbate any deficits associated with adolescent drinking.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used principal component analysis to create composite scores for adolescent and past year alcohol use, based on self-report measures from a healthy adult sample. Group differences in alcohol use were examined in relation to habitual responding (n=71) and attentional bias (n=44) toward non-drug reward cues, using two behavioral flexibility tasks. We used linear regression analyses to explore associations between past year alcohol use and behavioral flexibility outcomes in adults with histories of light versus heavy adolescent alcohol use.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Heavy adolescent alcohol use was characterized by earlier drinking onset and higher binge-drinking frequency before age 18. Adults with a history of heavy adolescent alcohol use demonstrated significantly greater habitual responding compared to those with lighter use. Among this group, greater past year alcohol use was also associated with increased difficulty disengaging attention from non-drug reward cues.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These results indicate that adolescent and current alcohol use may differentially impact habitual responding and attentional bias towards non-drug reward cues. Notably, this is the first human study to explore both aspects of behavioral inflexibility in relation to different periods of alcohol use within the same adult sample.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2025.07.16.25331591","type":"posted-content","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T17:30:20Z","timestamp":1752859820000},"source":"Crossref","is-referenced-by-count":1,"title":["Linking Adolescent Alcohol Use to Adult Behavioral Flexibility: Habitual Action-Selection and Attentional Bias"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3740-619X","authenticated-orcid":false,"given":"Elena M.","family":"Vidrascu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha","family":"Dove","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madeline M.","family":"Robertson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristin N.","family":"Meyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret A.","family":"Sheridan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donita L.","family":"Robinson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte A.","family":"Boettiger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2025072102200913000_2025.07.16.25331591v1.1","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.copsyc.2020.07.010","article-title":"Relating value-driven attention to psychopathology","volume":"39","year":"2021","journal-title":"Curr Opin Psychol"},{"key":"2025072102200913000_2025.07.16.25331591v1.2","doi-asserted-by":"crossref","first-page":"2122","DOI":"10.1007\/s00426-019-01212-3","article-title":"Measuring attention to reward as an individual trait: the value-driven attention questionnaire (VDAQ)","volume":"84","year":"2020","journal-title":"Psychological Research"},{"key":"2025072102200913000_2025.07.16.25331591v1.3","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0027926"},{"key":"2025072102200913000_2025.07.16.25331591v1.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2014.08.012"},{"key":"2025072102200913000_2025.07.16.25331591v1.5","doi-asserted-by":"publisher","DOI":"10.1037\/amp0000059"},{"key":"2025072102200913000_2025.07.16.25331591v1.6","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.3697-04.2005"},{"key":"2025072102200913000_2025.07.16.25331591v1.7","doi-asserted-by":"crossref","first-page":"104703","DOI":"10.1016\/j.neubiorev.2022.104703","article-title":"Attentional bias in alcohol drinkers: A systematic review of its link with consumption variables","volume":"139","year":"2022","journal-title":"Neurosci Biobehav Rev"},{"key":"2025072102200913000_2025.07.16.25331591v1.8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0160469"},{"key":"2025072102200913000_2025.07.16.25331591v1.9","doi-asserted-by":"publisher","DOI":"10.15288\/jsa.1998.59.427"},{"key":"2025072102200913000_2025.07.16.25331591v1.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2018.04.013"},{"key":"2025072102200913000_2025.07.16.25331591v1.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2019.10.009"},{"key":"2025072102200913000_2025.07.16.25331591v1.12","unstructured":"Conners, K. C. , Erhardt, D. & Sparrow, E. P . 1999. Conners\u2019 adult ADHD rating scales (CAARS), North Tonawanda, Ny, Multi-Health Systems Inc. (MHS)."},{"key":"2025072102200913000_2025.07.16.25331591v1.13","doi-asserted-by":"publisher","DOI":"10.1037\/\/1040-3590.6.2.117"},{"key":"2025072102200913000_2025.07.16.25331591v1.14","doi-asserted-by":"publisher","DOI":"10.1111\/acer.14154"},{"key":"2025072102200913000_2025.07.16.25331591v1.15","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2017.01111"},{"key":"2025072102200913000_2025.07.16.25331591v1.16","doi-asserted-by":"publisher","DOI":"10.1016\/bs.irn.2021.07.004"},{"key":"2025072102200913000_2025.07.16.25331591v1.17","doi-asserted-by":"crossref","unstructured":"Elton, A. , Faulkner, M. L. , Robinson, D. L. & Boettiger, C. A . 2021. Acute depletion of dopamine precursors in the human brain: effects on functional connectivity and alcohol attentional bias. Neuropsychopharmacology.","DOI":"10.1038\/s41386-021-00993-9"},{"key":"2025072102200913000_2025.07.16.25331591v1.18","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.paid.2017.04.024","article-title":"Creature of Habit: A self-report measure of habitual routines and automatic tendencies in everyday life","volume":"116","year":"2017","journal-title":"Pers Individ Dif"},{"key":"2025072102200913000_2025.07.16.25331591v1.19","doi-asserted-by":"publisher","DOI":"10.1167\/14.12.6"},{"key":"2025072102200913000_2025.07.16.25331591v1.20","doi-asserted-by":"publisher","DOI":"10.1007\/s10608-011-9378-7"},{"key":"2025072102200913000_2025.07.16.25331591v1.21","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.5239-14.2015"},{"key":"2025072102200913000_2025.07.16.25331591v1.22","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0402680101"},{"key":"2025072102200913000_2025.07.16.25331591v1.23","doi-asserted-by":"crossref","unstructured":"Gomez, A. A. , Dannenhoffer, C. A. , Elton, A. , S., L., W., B., Ian Shih, Y. , Boettiger, C. A. & Robinson, D. L. 2021. Altered cortico-subcortical network after adolescent alcohol exposure mediates behavioral deficits in flexible decision-making.","DOI":"10.1101\/2021.03.12.435040"},{"key":"2025072102200913000_2025.07.16.25331591v1.24","doi-asserted-by":"publisher","DOI":"10.1016\/S0899-3289(99)80131-X"},{"key":"2025072102200913000_2025.07.16.25331591v1.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"2025072102200913000_2025.07.16.25331591v1.26","doi-asserted-by":"crossref","first-page":"12","DOI":"10.3389\/fpsyg.2018.00012","article-title":"Binge Drinking and the Young Brain: A Mini Review of the Neurobiological Underpinnings of Alcohol-Induced Blackout","volume":"9","year":"2018","journal-title":"Front Psychol"},{"key":"2025072102200913000_2025.07.16.25331591v1.27","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1017\/S1092852913000473","article-title":"Neural correlates of attentional bias in addiction","volume":"19","year":"2014","journal-title":"CNS Spectr"},{"key":"2025072102200913000_2025.07.16.25331591v1.28","doi-asserted-by":"crossref","first-page":"1331960","DOI":"10.3389\/fnhum.2024.1331960","article-title":"Measuring cognitive flexibility: A brief review of neuropsychological, self-report, and neuroscientific approaches","volume":"18","year":"2024","journal-title":"Front Hum Neurosci"},{"key":"2025072102200913000_2025.07.16.25331591v1.29","doi-asserted-by":"publisher","DOI":"10.1111\/adb.12384"},{"key":"2025072102200913000_2025.07.16.25331591v1.30","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(16)00104-8"},{"key":"2025072102200913000_2025.07.16.25331591v1.31","doi-asserted-by":"publisher","DOI":"10.1080\/00223891.2011.627965"},{"key":"2025072102200913000_2025.07.16.25331591v1.32","doi-asserted-by":"crossref","first-page":"811","DOI":"10.15288\/jsad.2016.77.811","article-title":"Predictors of Recall Error in Self-Report of Age at Alcohol Use Onset","volume":"77","year":"2016","journal-title":"J Stud Alcohol Drugs"},{"key":"2025072102200913000_2025.07.16.25331591v1.33","doi-asserted-by":"publisher","DOI":"10.1038\/S41583-020-0289-Z"},{"key":"2025072102200913000_2025.07.16.25331591v1.34","doi-asserted-by":"publisher","DOI":"10.1111\/acer.13354"},{"key":"2025072102200913000_2025.07.16.25331591v1.35","doi-asserted-by":"publisher","DOI":"10.1162\/jocn_a_00953"},{"key":"2025072102200913000_2025.07.16.25331591v1.36","doi-asserted-by":"crossref","first-page":"1354142","DOI":"10.3389\/fnhum.2024.1354142","article-title":"From learned value to sustained bias: how reward conditioning changes attentional priority","volume":"18","year":"2024","journal-title":"Front Hum Neurosci"},{"key":"2025072102200913000_2025.07.16.25331591v1.37","doi-asserted-by":"publisher","DOI":"10.3758\/s13414-020-02130-y"},{"key":"2025072102200913000_2025.07.16.25331591v1.38","doi-asserted-by":"crossref","first-page":"110114","DOI":"10.1016\/j.neuropharm.2024.110114","article-title":"Alcohol, flexible behavior, and the prefrontal cortex: Functional changes underlying impaired cognitive flexibility","volume":"260","year":"2024","journal-title":"Neuropharmacology"},{"key":"2025072102200913000_2025.07.16.25331591v1.39","doi-asserted-by":"publisher","DOI":"10.1002\/1097-4679(199511)51:6&lt;768::AID-JCLP2270510607&gt;3.0.CO;2-1"},{"key":"2025072102200913000_2025.07.16.25331591v1.40","first-page":"231","article-title":"Behavioral Control and Reward Sensitivity in Adolescents\u2019 Risk Taking Behavior: A Longitudinal TRAILS Study","volume":"8","year":"2017","journal-title":"Front Psychol"},{"key":"2025072102200913000_2025.07.16.25331591v1.41","doi-asserted-by":"crossref","first-page":"935043","DOI":"10.3389\/fpsyt.2022.935043","article-title":"Effects of Persistent Binge Drinking on Brain Structure in Emerging Adults: A Longitudinal Study","volume":"13","year":"2022","journal-title":"Front Psychiatry"},{"key":"2025072102200913000_2025.07.16.25331591v1.42","doi-asserted-by":"crossref","first-page":"13775","DOI":"10.1038\/s41598-024-64036-1","article-title":"Adolescent alcohol exposure persistently alters orbitofrontal cortical encoding of Pavlovian conditional stimulus components in female rats","volume":"14","year":"2024","journal-title":"Sci Rep"},{"key":"2025072102200913000_2025.07.16.25331591v1.43","doi-asserted-by":"publisher","DOI":"10.1037\/h0092976"},{"key":"2025072102200913000_2025.07.16.25331591v1.44","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.18-05-01827.1998"},{"key":"2025072102200913000_2025.07.16.25331591v1.45","unstructured":"Samhsa 2023. Key substance use and mental health indicators in the United States: Results from the 2023 National Survey on Drug Use and Health Rockville, MD: Substance Abuse and Mental Health Services Administration."},{"key":"2025072102200913000_2025.07.16.25331591v1.46","first-page":"1418","article-title":"Reporting bias in the association between age at first alcohol use and heavy episodic drinking","volume":"35","year":"2011","journal-title":"Alcohol Clin Exp Res"},{"key":"2025072102200913000_2025.07.16.25331591v1.47","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1993.tb02093.x"},{"key":"2025072102200913000_2025.07.16.25331591v1.48","doi-asserted-by":"publisher","DOI":"10.1016\/S0924-9338(99)80239-9"},{"key":"2025072102200913000_2025.07.16.25331591v1.49","doi-asserted-by":"publisher","DOI":"10.1111\/acer.14289"},{"key":"2025072102200913000_2025.07.16.25331591v1.50","doi-asserted-by":"publisher","DOI":"10.1016\/j.physbeh.2015.01.027"},{"key":"2025072102200913000_2025.07.16.25331591v1.51","first-page":"6","article-title":"Assessment of state and trait anxiety: Conceptual and methodological issues","volume":"2","year":"1985","journal-title":"Southern Psychologist"},{"key":"2025072102200913000_2025.07.16.25331591v1.52","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1007\/s11920-016-0689-y","article-title":"Alcohol and Drug Use and the Developing Brain","volume":"18","year":"2016","journal-title":"Curr Psychiatry Rep"},{"key":"2025072102200913000_2025.07.16.25331591v1.53","doi-asserted-by":"crossref","first-page":"574401","DOI":"10.3389\/fnagi.2020.574401","article-title":"Applying the Inverse Efficiency Score to Visual-Motor Task for Studying Speed-Accuracy Performance While Aging","volume":"12","year":"2020","journal-title":"Front Aging Neurosci"},{"key":"2025072102200913000_2025.07.16.25331591v1.54","doi-asserted-by":"publisher","DOI":"10.1016\/j.tics.2015.06.007"},{"key":"2025072102200913000_2025.07.16.25331591v1.55","first-page":"1040049","article-title":"Adolescent brain maturation and the neuropathological effects of binge drinking: A critical review","volume":"16","year":"2022","journal-title":"Front Neurosci"},{"key":"2025072102200913000_2025.07.16.25331591v1.56","doi-asserted-by":"publisher","DOI":"10.1093\/alcalc\/37.2.187"},{"key":"2025072102200913000_2025.07.16.25331591v1.57","doi-asserted-by":"publisher","DOI":"10.1038\/s41583-021-00428-w"},{"key":"2025072102200913000_2025.07.16.25331591v1.58","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2014.09.004"},{"key":"2025072102200913000_2025.07.16.25331591v1.59","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbr.2019.112292"},{"key":"2025072102200913000_2025.07.16.25331591v1.60","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.23004"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1101\/2025.07.16.25331591","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T20:40:54Z","timestamp":1768509654000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.1101\/2025.07.16.25331591"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,18]]},"references-count":60,"URL":"https:\/\/doi.org\/10.1101\/2025.07.16.25331591","relation":{},"subject":[],"published":{"date-parts":[[2025,7,18]]},"subtype":"preprint"}}