Childhood injury, psychological resistance and brainimaging evaluation of adolescents with substance use disorderand healthy siblings of adolescents with substance use disorder

Introduction: It's known that in substance use disorder (SUD)the environmental factors are effective as well as the genetic factors.Environmental factors are trauma-like stressors or positive ones like family,school, peer support.The genetic ones can be called the brain structural properties.When the inheritance of structural features of the brain is considered the brain imaging studies with the healthy siblings are quite valuable.The comprasion between adolescents with SUD and their healthy siblings provides the evaluation of the brain structural properties about the predisposition and resistance for SUD.In the litarature the brain imaging studies which are made with the adolescents with SUD are limited while there is none which is made with the healthy siblings. Objective: In our study the 13-19 year old adolescents with SUD diagnosed and their healthy siblings compared in terms of the results of brain imaging, psychological resistance and childhood traumas.At the same time these groups compared in terms of white matter integrity with Diffusion Tensor Imaging (DTG) method. Methodology: The sampling of our research is selected from the 13-19 year old adolescents with SUD diagnosed who have been applied to Ege Univercity Faculty of Medicine Child and Adoslescent Alcohol and Substance Abuse Research and Application center before and their healthy siblings who have no SUD diagnosed and the healthy control group who has no SUD diagnosed.The control group was matched with the healthy siblings by age, gender and smoking habits.The sociodemographic data form was filled up for each case.The psychiatric examinations of all the cases were done by using Affective Disorders and Schizophrenia Interview Schedule for School Age Children - Now and Lifelong Version-Turkish Adaptation.The Adolescent Psychological Endurance Scale (K-SADS-PL) and Childhood Trauma Scale (CTRS) were applied to each case and The Conners Parent Scale-Refurbished Form was applied to the parents to analyze the behavior of the child.The brain structures of the cases are evaluated with Diffusion Tensor Imaging (DTG). Results: 20 SUD diagnosed cases and 20 healthy siblings and 19 control cases have been incuded to our research.The average age is found 17 at the SUD diagnosed group and 15 at the healthy siblings and control group. All cases in our sample were male.There was a significant difference between the groups in terms of psychiatric comorbidity, school attendance and grade retention (p<0,05). The differences between the mean scores of the subscales of the Conners Scale as "Confrontation", "Cognitive problemsCarelessness","Hyperactivity "," ADHD (Attention Deficit and Hyperactivity Disorder) index "," Social problems "," Psychosomatic "," Unrest-impulsivity "," Emotional variability eks, top total "," DSM4 carelessness "," DSM4 Hyperactivity Impulsivity "," DSM4Total " ,was found statistically significant (p<0,05). The score of the "Physical abuse", "Physical neglect", "Emotional abuse" subscales of Childhood Trauma Scale (CTRS) and "Total trauma Score" were found significantly higher at the SUD diagnosed group than the other two groups (p<0,05). The SUD diagnosed group got significantly lower scores at the Psychological endurance scale than the other two groups (p<0,05).According to our research the SUD diagnosed group had lower fractional anisotropy (FA) values in right superior parietal and right superior longitudinal fascicullary regions than the other two groups (p<0,05). In the right middle frontal region, another region with different FA values, the control group had higher FA values than the SUD diagnosed group and siblings group (p=0,01). FA values in right superior frontal region and forceps minor fascicule were higher in siblings group than control group and SUD diagnosed group (p<0,01). Conslusion: According to the results of the study it is observed that the SUD group cases are more likely to emotionally and phsically abused, physcially ignored and exposured the traumas than the siblings and the control groups.It is shown that the SUD group cases have less support from their famiies, schools and peers and they got lower scores on the scales of emphaty, fitting size and determination to strugle which are the sub scales of the psychological resistance.According to the results Diffusion Tensor Imaging (DTG) method, at the SUD groups the right superior parietal cortex,right superior longitudinal fasciculus,right medial frontal cortex,right superior frontal cortex and right forceps minor pathway have lower FA rates. Key Words: Substance Use Disorders; Brain İmaging; Pscyhological Resilience; Childhood Trauma