Effects of Stereotype Threat on Impulsivity and Its Relation to Alcohol Use in African Americans: An fMRI Study

Icahn School Of Medicine At Mount Sinai, New York NY

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Abstract

Disparities in alcohol-related sequalae (i.e., cirrhosis, mortality) persist across social groups, with data indicating African Americans experience elevated risk. It is thus critical from a public health perspective that we gain a deep understanding of the unique factors contributing to alcohol use behaviors across all social groups. Many studies have focused on understanding how social and environmental factors contribute to increased alcohol use. Yet, the mechanisms through which these factors affect alcohol use behaviors are poorly understood, resulting in an absence of vital information needed to enhance alcohol use disorders (AUD) prevention and intervention strategies. We have recently shown that exposure to a common stressor, stereotype threat, is associated with increases in impulsivity – a key mediating mechanism of AUD risk. Stereotype threat (ST) is a behavioral phenomenon that arises when cues in the environment evoke negative stereotypes associated with an individual’s group, triggering cognitive processes that adversely impact behavior. An enduring stereotype of African American communities is that they experience high levels of alcohol/substance use. We have shown that exposure to these negative stereotypes elevates impulsivity which correlates with alcohol use among African Americans. These findings reveal ST-induced impulsivity as a novel correlate of AUD-risk behaviors. In line with NIAAA’s goal to develop a more thorough understanding of the mechanisms contributing to AUD risk, we propose to investigate the neural mechanisms associated with ST-induced impulsivity. We will further assess whether these neural mechanisms are associated with alcohol use behaviors among adults. Participants will include 280 adults who regularly consume alcohol. While undergoing functional MRI, all will complete a measure of impulsivity administered both before and after an ST exposure manipulation. This manipulation will utilize a 2x2x2 between-subjects design to systematically manipulate exposure to a verbal ST prime, stereotype-related stimuli, and AUD-related stimuli in order to assess the effects of these exposures, independently and combined, on neural systems involved in impulsive decision-making. Alcohol use behaviors will be assessed outside of the scanner. We predict that ST exposure will lead to shifts within affect-related and cognitive control-related brain regions. To increase clinical impact, we will assess the relation of ST-induced shifts in impulsivity and brain response to alcohol use behaviors. Results from the proposed study will enrich our understanding of how sociocultural, behavioral, and neural factors combine to influence AUD risk behaviors. In addition, our results will provide greater insights into the neural systems implicated in AUD-risk – systems that could serve as targets for novel strategies that enhance resilience.