Modelling Incentive Salience in Adolescent Substance Use: The Influence of Substance Cues, Alcohol Expectancies and...

Alcohol urge regulation, drug urge regulation, motivational attitudes and alcohol expectancies have been linked to substance use, but their combined influence on reward sensitivity and behaviour remains underexplored. This is particularly critical during adolescence and young adulthood, a period of heightened susceptibility to alcohol use and risky behaviours. Using data from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA), an accelerated longitudinal design that includes all age groups at each time point, this study examined how these factors interact to shape substance use behaviours, including the onset of regular drinking, binge drinking, drug use and sexual intercourse. Exploratory and confirmatory factor analyses (EFA/CFA) utilized data from Years 7 to 9, comprising 430 participants across all age groups, to identify latent incentive-salience constructs related to urge regulation, motivational attitudes and alcohol expectancies, with a split-sample approach used to validate the factor structure in a mature cohort. Structural equation modelling (SEM) employed longitudinal data from Year 5 predictors and demographic controls to examine outcomes assessed in Year 6, leveraging the developmental focus of this age range. Covariates included age, sex and socio-economic status. EFA/CFA confirmed a robust latent structure, and SEM revealed that alcohol urge regulation significantly predicted past-year binge drinking, while drug urge regulation was negatively associated with total drug use but had no significant effect on alcohol-related behaviours. Alcohol expectancies and demographic factors, such as older age and male sex, were significantly associated with increased substance use, while socio-economic status further influenced these outcomes. Findings highlight the critical role of incentive salience in youth substance use and suggest that prevention strategies should target individual risk factors and demographic influences. Early education and supportive policies may reduce early substance use and its associated harms.