The Adolescent Brain Cognitive Development Study (ABCD Study)

A Significant Study for Understanding the Factors the Affect Brain and Cognitive Development

Knowledge regarding brain and cognitive development and the factors that enhance or deter healthy development have grown over the last 30 years.  However, there remain questions regarding what healthy brain development looks like. In response to these questions, several Institutes across the National Institutes of Health formed a collaboration to support the Adolescent Brain Cognitive Development Study designed to examine the impact that biological, environmental, and particularly behavioral factors such as substance use have on the developing brain and their association with the progression of substance use, mental illness and suicide. (https://nida.nih.gov/research-topics/adolescent-brain/longitudinal-study-adolescent-brain-cognitive-development-abcd-study).

These findings have implications for both prevention and treatment services.

This is the first summary of the findings from the ABCD Study that have implications for prevention practitioners.

Substance Use

“The study of nearly 10,000 adolescents has identified distinct differences in the brain structures of those who used substances before age 15 compared to those who did not. Many of these structural brain differences appeared to exist in childhood before any substance use, suggesting they may play a role in the risk of substance use initiation later in life, in tandem with genetic, environmental, and other neurological factors.

Among the 3,460 adolescents who initiated substances before age 15, most (90.2%) reported trying alcohol, with considerable overlap with nicotine and/or cannabis use; 61.5% and 52.4% of kids initiating nicotine and cannabis, respectively, also reported initiating alcohol. Substance initiation was associated with a variety of brain-wide (global) as well as more regional structural differences primarily involving the cortex, some of which were substance-specific. While these data could someday help inform clinical prevention strategies, the researchers emphasize that brain structure alone cannot predict substance use during adolescence, and that these data should not be used as a diagnostic tool.” (https://nida.nih.gov/research-topics/adolescent-brain/longitudinal-study-adolescent-brain-cognitive-development-abcd-study).

Since the onset of the study, there have been over 1670 publications reporting on results.  Relative to prevention, here are some of the key findings:

·      “This study identified distinct developmental trajectories of sleep disturbance across childhood and early adolescence linked to STB. Specifically, early high sleep disturbances that improved and moderate disturbances that worsened over time were both associated with greater STB severity. Difficulty falling and staying asleep and excessive sleepiness were common in both patterns. These findings highlight the need to identify and address early and/or worsening sleep problems as a potential target for suicide prevention strategies.”

Huber, R.S., Gaillard, M., Sievertsen, S.A., Ma, J., Shao, S., Del Rubin, D.Y., Jones, S.A., Hill, A.R., Bartholomeusz, R., McGlade, E.C., Renshaw, P.F., Yurgelun-Todd, D. & Nagel, B.J. (2025).  Sleep Disturbance Trajectories During Childhood and Early Adolescence Associated With Increased Suicide Risk. Journal of the American Academy of Child & Adolescent Psychiatry, Open. https://doi.org/10.1016/j.jaacop.2025.11.004

·      “Early alcohol use initiation is one of the strongest predictors of alcohol use disorders. Identifying modifiable risk factors for problematic alcohol use can guide prevention initiatives. Globally, approximately 10% of women consume alcohol during pregnancy, however the impact of prenatal alcohol exposure (PAE) on offspring alcohol use patterns has been understudied. The aim of this study was to examine associations between PAE and preadolescent alcohol use behaviors.”

Lees, B., Mewton, L., Stapinski, L.A., Teesson, M. & Squeglia, L.M. (2020).  Association of prenatal alcohol exposure with preadolescent alcohol sipping in the ABCD study. Drug and Alcohol Dependence, 10.1016/j.drugalcdep.2020.108187.

·      “Preadolescents who spend more time using screens, especially digital media, are more likely to fit DSM-5 criteria for internalizing disorders.”

Roberston, L., Twenge, J.M., Joiner, T.E. & Cummins, K. (2022). Associations between screen time and internalizing disorder diagnoses among 9- to 10-year-olds. Journal of Affective Disorders, 311, 530-537. doi: 10.1016/j.jad.2022.05.071.

·      “Heavy prenatal alcohol exposure (PAE) is associated with alterations in behavior, cognitive and brain development. However, the effects of low levels of PAE on brain and behavior remain unclear. The present study aimed to investigate longitudinal changes of brain and behavior in children with low levels of PAE compared to very well-matched controls….

Compared to unexposed controls, children with low levels of PAE had persistent higher CBCL scores (worse behavior) and higher intracranial volumes over time.  Our results provide further evidence of alterations in brain and behavior associated with low levels of PAE across early adolescence, highlighting the importance of prevention and early intervention even with low levels of PAE.”

Long, W. & Lebel, C. (2025). Persistent alterations of brain and behaviour in children with low prenatal alcohol exposure. Biological Psychiatry Global Open Science. 100648, ISSN 2667-1743.  https://doi.org/10.1016/j.bpsgos.2025.100648.

·      “Social media time (Year 2) was significantly associated with cannabis experimentation (Year 4) (B=0.18, 95% CI: 0.13-0.24, p<0.001). At Year 3, positive cannabis expectancies predicted higher likelihood of experimentation one year later, while negative expectancies predicted lower likelihood. Positive cannabis expectancies mediated 19.8% and negative cannabis expectancies mediated 13.6% of the social media-cannabis use association.  Conclusions: Given the association between social media exposure on cannabis use and the mediating role of expectancies for adolescents, future research may explore interventions that limit both social media time and address expectancies to prevent early initiation of cannabis use.”

Nagata, J.M., Caffrey, A., Nguyen, N.D., Nayak, S., Frimpong, I., Helmer, C.K., Ricklefs, C., Al-Shoaibi, A.A., Testa, A., Brindis, C.D., Santos, G-M. & Baker, F.C. (2025). Cannabis expectancies mediate the association between social media use and cannabis experimentation in early adolescents: A prospective cohort study. Drug and Alcohol Dependence, 77, https://doi.org/10.1016/j.drugalcdep.2025.112947.