A Biobehavioral Study On The Effects Of Inhibitory Control On Drinking

restricted_to_institution
Restricted (Penn State Only)
Author:
Cruz, Gabriel
Graduate Program:
Biobehavioral Health
Degree:
Doctor of Philosophy
Document Type:
Dissertation
Date of Defense:
June 03, 2026
Committee Members:
Thomas Gould, Program Head/Chair
Jonathan Hakun, Outside Unit & Field Member
Eric Claus, Co-Chair & Dissertation Advisor
Samuel Baugh, Minor Field Member
Michael Russell, Co-Chair & Dissertation Advisor
Steven Branstetter, Major Field Member
Alexis Santos, Outside Field Member
Keywords:
alcohol drinking
college students
fMRI
ecological momentary assessments
transdermal alcohol concentration.
transdermal alcohol concentration
Abstract:
Heavy alcohol consumption among college students is a significant public health concern with short- and long-term consequences. This substance use behavior is associated with numerous consequences, including acute and long-term neuro-structural and functional deficits, as well as the development of alcohol use disorder (AUD). Young adults are especially at risk because their college years, during which they engage in heavy alcohol consumption, overlap with the final stages of brain development. These neuronal deficits are, in turn, associated with poorer cognitive performance, as well as higher levels of alcohol consumption. Previous theoretical models, like the impaired response inhibition and salience attribution model, have argued that response inhibition is an important cognitive ability that is associated with the development of a substance use disorder, such as AUD. This model proposes that repeated episodes of drug administration and bingeing episodes lead to the development of excessive salience towards the drug and its cues, and a chronic decrease in a person's ability to properly inhibit drug-related behaviors. These changes thus reduce a person’s ability to properly inhibit from engaging in problematic alcohol consumption. Similarly, models such as the Scaffolding Theory of Aging and Cognition propose that external factors that compromise cerebral vasculature, such as alcohol, will affect the brain’s structure and function, cascading into poorer cognitive performance. Previous studies have found an association between alcohol consumption and response inhibition at the neurobiological, cognitive, and behavioral levels; however, the complexity between these multiple levels has not been examined in concert. In this dissertation, I use the previously mentioned theoretical models to examine the relationship between response inhibition and alcohol consumption at multiple levels of analysis. Specifically, the study focuses on integrating functional magnetic resonance imaging (fMRI), ecological momentary assessments (EMA; with a mobile cognitive task), and transdermal alcohol concentration (TAC) sensors. To understand the relationship between response inhibition and alcohol consumption at multiple levels, I conducted a systematic review and two separate analyses using data from a study conducted for this dissertation. The systematic review (Paper 1) examined the current literature on fMRI studies that examined the neuronal activity during the response inhibition task in populations that engage in problematic drinking. The study assessed 169 studies and resulted in 8 papers that were thoroughly synthesized. Studies using a specific response inhibition task, on average, found that the drinking groups showed higher neural activity during inhibition compared to healthy controls, except for heavy drinkers. On average, studies found that regions associated with the inhibition and salience networks were most dysregulated when comparing groups. The cognitive performance scores between the two groups showed no difference in inhibition performance metrics. The second study (Paper 2) examined the construct validity, stability, and reliability of the novel mobile Go/No-Go (GNG) task in a sample of young adults who engage in HED with the goal to validate the use of this task in an EMA context. The study used a confirmatory factor analysis (CFA) model to test for the construct validity of the task, an unconditional multilevel model to examine the stability and the amount of variance attributed at the within and between-person level, and Generalizability Theory to test for the reliability of the task. The test-retest reliability of the laboratory tasks ranged from good to fair, and the CFA models show that the latent IC factor was dominated by the mobile GNG task. The mobile GNG task showed low reliability at the session- and day-levels, and good reliability at the between-person level. The third study (Paper 3) examined the association between daily GNG task performance, measured by the EMA cognitive tasks, and TAC features (drinking dynamics). We then built upon this model a novel Bayesian multivariate multilevel model with a simultaneous Hurdle-lognormal and Gaussian process — The Predictive-Regulatory Model. The findings showed that there was a negative association between the daily response inhibition and whether a person drinks or not, while a person’s neural response in the right inferior parietal lobe moderated the association between the daily response inhibition and how they drank (drinking dynamics), specifically, a higher neural response attenuated the relationship. These three studies highlight the complexity of the inhibition-drinking relationship. Specifically, the findings from the studies indicate that, to understand how response inhibition might influence the problematic alcohol use and lead to the development of AUD, multimodal studies must be employed to examine how each dimension influences this relationship. These results have implications for interventional studies that could target the reduction in alcohol consumption through the training of cognitive abilities or non-invasive neuro-stimulation.