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Abstract
Youth with a family history of alcoholism (FHP) are at elevated risk for alcohol use disorders (AUDs) and may exhibit pre-morbid neural differences in emotion-cognition processing. This study compared FHP and family-history-negative (FHN) adolescents using behavioral emotion tasks, fMRI, and resting-state connectivity prior to heavy alcohol use. While behavioral performance was similar, FHP youth showed reduced activation to positive faces and weaker fronto-striatal engagement during cognitive control. Resting-state analyses revealed altered amygdala connectivity with prefrontal regions, linked to inhibitory control errors. These findings suggest atypical emotion-cognition circuitry in FHP youth may represent a neural risk phenotype for AUD development.