Psychological dysregulation, white matter disorganization and substance use disorders in adolescence


Duncan B. Clark, University of Pittsburgh, Department of Psychiatry, 3811 O'Hara Street, Oxford Building, Suite 800, Pittsburgh, PA 15213, USA. E-mail:.


Aims  Adolescents with substance use disorders (SUD) have difficulties with cognitive, behavioral and affective regulation. White matter (WM) disorganization has been observed in adolescents with SUD and may be related to psychological dysregulation. This study compared adolescents with SUD and control adolescents to investigate relationships among psychological dysregulation, WM disorganization and SUD symptoms.

Design  Cross-sectional observation.

Setting  Adolescents with SUD were recruited from SUD treatment programs. Controls were recruited from the community.

Participants  The 55 participants were aged 14–19; 35 with SUD and 20 controls without SUD.

Measurements  Psychological dysregulation was characterized by the Behavior Rating Inventory of Executive Function. WM disorganization was measured by diffusion tensor imaging, and fractional anisotropy, radial diffusivity and axial diffusivity were examined within cortical regions of interest.

Findings  Compared to controls, SUD adolescents showed significantly greater psychological dysregulation and prefrontal and parietal WM disorganization. WM disorganization was correlated positively with psychological dysregulation and cannabis-related symptoms. In multivariate mediation models, the results were consistent with both the neurodevelopmental immaturity model, in which WM disorganization leads to psychological dysregulation and cannabis-related symptoms, and with the substance effects model, in which cannabis-related symptoms lead to WM disorganization and psychological dysregulation.

Conclusions  In adolescents, substance use disorder and psychological dysregulation appear to be associated with reduced frontoparietal network white matter maturation.