Cannabis Use and Academic Performance in College Students: The Role of Procrastination.

Objective: The current study investigated procrastination as a potential moderator of the association between cannabis use and college grade point average (GPA). Participants: 220 college students (ages 18 - 24; 71.8% female) in the Northwestern U.S. who were registered for classes in Fall 2021. Methods: Demographic questions, substance use history, the Beck Anxiety Inventory, the Center for Epidemiologic Studies Depression scale, and a Procrastination scale were completed via an online survey. Official term and cumulative GPA records were also collected. Results: A regression model indicated that procrastination moderated the association between lifetime cannabis use and cumulative college GPA, whereas this moderation was not present when examining the relationship between past month cannabis use and term GPA. Conclusion: The current study identifies a putatively modifiable factor that may be related to academic performance for students who use cannabis. These results may help inform future interventions designed to help students using cannabis succeed academically.

Emotion Recognition and Self-Reported Emotion Processing in Alcohol and Cannabis Co-Using Young Adults.

Alcohol and cannabis use are each associated with impairments in emotion recognition accuracy, which may promote interpersonal problems. It is unclear if emotion recognition or self-reported emotion processing differs between young adult alcohol and cannabis co-users (ACCs) and healthy controls (HCs). This study examined whether ACCs and HCs differed in their emotion recognition across two different behavioral tasks with static or dynamic faces and determined if there were differences in self-reported socio-emotional processing and alexithymia. 22 ACCs (mean age = 21.27 ± 1.75) and 25 HCs (mean age = 21.48 ± 2.68), matched on age, sex, and IQ, completed the Metrisquare Emotion Recognition Task and CANTAB Emotion Recognition Task. The ACCs and HCs were compared on task accuracy and self-reported measures, including the Social Emotional Questionnaire (SEQ) and the Perth Alexithymia Questionnaire (PAQ). No significant main effects of the Group variable or the Emotion-Group interaction variable were present for either task. The ACCs had lower SEQ (p = 0.014) and higher PAQ (p = 0.024) scores relative to the HCs, indicating greater difficulties in socio-emotional processing and identifying one's own emotions, respectively. Understanding the behavioral correlates of the self-reported difficulties in emotion processing reported by ACCs is needed to develop interventions to reduce these symptoms and promote healthy socio-emotional functioning in this population.

The importance of community engagement in experimental stress and substance use research with marginalized groups: Lessons from research with sexual and gender minority populations.

There is a growing need for experimental stress paradigms tailored for use with marginalized groups to better understand the impact of experiencing minoritized stress on substance use outcome. Experimental stress research that examines the role of minority stress in substance use is not only innovative, but also has the potential to improve health equity. However, this research also has anticipated risks. As a result, community-engaged research (CEnR) is critical. CEnR can improve experimental stress and substance use research by engaging applicable communities in research design, recruitment, data interpretation, and dissemination. When conducting CEnR, there are also unique challenges and considerations that need to be taken into account. Recommendations are provided based on prior experiences in experimental stress induction and alcohol research with SGM (sexual and gender minority) groups.

An experimental laboratory-based minority stress paradigm for alcohol research among sexual minority women: A pilot study.

BACKGROUND: Sexual minority women (SMW) use alcohol at higher rates and experience greater alcohol-related harms than their heterosexual counterparts. Evidence from observational studies suggests that minority stress (i.e., stress experienced due to marginalization in society) is an important risk factor among SMW, yet there is a lack of experimental evidence to establish a direct causal role of minority stress on alcohol use in this population. We adapted the preexisting personalized guided stress induction paradigm to conduct a pilot study of how minority stress is related to stress response (assessed via subjective measures and salivary cortisol) and mechanisms of alcohol use (craving, demand, and risky decision making) in SMW. METHODS: Using a within-subjects design (N = 8) cisgender SMW who endorsed high-risk drinking (≥1 heavy drinking episode in the past 30 days) completed three study visits: a script development session and two in-person imagery induction appointments (minority stress and neutral). Analyses examined feasibility and acceptability, stress response, and mechanisms of alcohol use. RESULTS: The paradigm significantly increased subjective stress response (g = 1.32). Data supported the feasibility, acceptability, and appropriateness of the paradigm for use with SMW. While the paradigm did not significantly change scores on minority stress and alcohol outcomes measures, effect sizes for craving and minority stress outcomes were in the small-to-medium range (gs = 0.24-0.54). CONCLUSIONS: The adapted minority stress paradigm appears to be feasible and appropriate for use with SMW to induce stress in laboratory settings. Future research can use this paradigm to understand the causal effects of minority stress on alcohol use and related outcomes.

Distress tolerance and problematic cannabis use: does the form of cannabis matter?

BACKGROUND: Low distress tolerance may result in greater vulnerability to problematic cannabis use. However, the role of the primary form of cannabis used has not been examined as a moderator of this association. While marijuana flower remains the preferred form of cannabis, the popularity of other forms of cannabis, including concentrates and edibles, is on the rise. OBJECTIVES: We examined the association between distress tolerance and problematic cannabis use and whether the primary form of cannabis used moderates this relationship. METHODS: Participants were 695 (67.6% male) past-month cannabis users who completed an online survey. Multiple linear regressions assessed whether distress tolerance, the primary form of cannabis used, and their interaction were related to problematic cannabis use while controlling for demographic variables and past 30-day alcohol and cannabis use frequency. RESULTS: Lower tolerance for distress was associated with more problematic cannabis use. Endorsing concentrates as the primary form of cannabis used vs. marijuana flower was related to more problematic cannabis use while reporting edibles as the primary form of cannabis used vs. marijuana flower or concentrates was related to less problematic cannabis use. Individuals preferring marijuana flower or concentrates reported more problematic cannabis use at lower levels of distress tolerance. CONCLUSIONS: Cannabis users exhibiting low distress tolerance or a preference for concentrates may be at greatest risk for experiencing negative consequences related to their cannabis use. Additionally, building tolerance for stressful situations, among both concentrates and marijuana flower users, may aid in minimizing problematic cannabis use.

Sex Moderates Associations Between Dimensions of Emotion Dysregulation and Problematic Cannabis Use.

The current study examined whether sex moderates associations between emotion dysregulation (overall and six dimensions of emotion dysregulation) and problematic cannabis use. 741 adult past-month cannabis users (31.44% female) completed questionnaires on problematic cannabis use (Marijuana Problems Scale) and emotion dysregulation (Difficulties in Emotion Regulation Scale). Mann-Whitney U tests and hierarchical multiple linear regressions were performed. Male cannabis users reported greater difficulties with overall emotion dysregulation, nonacceptance, goals, impulse, strategies, and clarity. Overall emotion dysregulation, nonacceptance, goals, impulse, and strategies were associated with more severe problematic cannabis use, with relationships weaker in female cannabis users. Lack of emotional awareness was associated with less severe problematic cannabis use in male cannabis users only. Examining individual differences in emotion dysregulation as they relate to problematic cannabis use suggests that treatments may need to be tailored for male cannabis users with a focus on specific emotion dysregulation dimensions.

Cannabis and emotion processing: A review of behavioral, physiological, and neural responses.

While previous research has indicated that alcohol use is associated with difficulties in emotion processing and socioemotional functioning, less is known about the effects of cannabis on these functions. The purpose of this review article is to provide the current state of knowledge on the effects of cannabis on emotion processing with regard to behavioral, physiological, and neural responses. This narrative review synthesizes previous research investigating the effects of cannabis on emotion processing across studies that have utilized a number of experimental approaches to determine both the acute and chronic effects of cannabis on emotion processing. Limitations of current research and steps for future directions are discussed. Existing research has shown that cannabis use is associated with difficulties in emotion processing, such as impairments in correctly identifying emotions and problems with emotion differentiation. Electroencephalography (EEG) studies have produced mixed findings, but have considered a number of variables, such as participant sex, and comorbid depression. In addition, while there are mixed findings for the effects of cannabis on amygdalar brain activity across functional magnetic resonance imaging studies, several studies indicate that cannabis use is linked with decreased brain response in the frontal lobe while viewing emotional stimuli. To our knowledge, this is one of the first critical review articles focused on an emerging research area of cannabis and emotion processing. Synthesizing the existing findings in this developing research field is important for future prevention and intervention studies focused on promoting healthy socioemotional functioning in cannabis users. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Ratings of executive function as a risk factor for adolescents' frequent cannabis use: A prospective longitudinal study.

OBJECTIVE: We examined the extent to which behavioral ratings of children's executive function (EF) in early adolescence predicted adolescents' cannabis use, and whether associations were independent of parents' cannabis and alcohol use and adolescents' alcohol use. METHOD: Participants were 198 offspring (44% boys) of 127 mothers and 106 fathers. Parents and teachers completed the Behavior Rating Inventory of Executive Function (BRIEF) at ages 11-14 years. Youth were interviewed repeatedly from ages 14 to 20 years regarding frequency of cannabis and alcohol use. Two-level models regressed dichotomous cannabis outcomes (annual, weekly, or daily use) on age at the within-person level and the random intercept of cannabis use on EF, parent substance use, and covariates (age 7 IQ indicators, child gender, parent education, and mean of ages assessed) at the between-person level. RESULTS: Poorer child EF predicted significantly (p < .05) higher likelihood of weekly (b[SE] = .64[.24]) and daily (b[SE] = .65[.25]), but not annual (b[SE] = .38[.22]), cannabis use. Parent cannabis use (b[SE] = .53[.25] to .81[.39], p < .05) independently predicted all three outcomes, and effects were distinct from those explained by parent alcohol use (b[SE] = .66[.29] to .81[.35], p < .05). EF remained a significant predictor of weekly and daily cannabis use after adjusting for parental alcohol and cannabis use, and adolescents' alcohol use. CONCLUSIONS: Children exhibiting poorer EF were more likely to use cannabis weekly and daily in later adolescence. Whereas literature suggests poorer EF may be a consequence of cannabis use, these findings suggest EF should be considered prior to cannabis use initiation. EF during childhood may be a fruitful prevention target. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Effort-based decision making and self-reported apathy in frequent cannabis users and healthy controls: A replication and extension.

INTRODUCTION: Amotivational syndrome is a term used to refer to lack of motivation and passive personality related to chronic cannabis use. Given mixed findings, the current study aimed to replicate and extend previous research on frequent cannabis use, motivated behavior, and self-reported apathy. METHOD: Cannabis users (on average, ≥3 days/week of cannabis use over the past year), and healthy controls (≤1 day/month of cannabis use over the past year) completed the Apathy Evaluation Scale (AES), and the Effort Expenditure for Rewards Task (EEfRT). Repeated measures analysis of covariance was used to 1) examine the effects of group, reward magnitude, probability, and their interaction on hard task selections on the EEfRT, and 2) examine between-group differences on the AES, controlling for alcohol use and depressive symptoms. RESULTS: There were significant main effects of reward magnitude, probability, and an interaction between reward magnitude and probability on hard task selection (p's < 0.05). Specifically, as reward magnitude and probability of winning the reward increased, participants were more likely to select hard tasks on the EEfRT. Relative to healthy controls, cannabis users were significantly more likely to select hard tasks on the EEfRT (F(1,56) = 6.49, p = 0.014, ηp2 = 0.10). When controlling for alcohol use and depressive symptoms, no significant group differences in self-reported apathy were present (p = 0.46). CONCLUSIONS: Cannabis users exhibit a greater likelihood of exerting more effort for reward, suggesting enhanced motivation relative to healthy controls. Thus, the current results do not support amotivational syndrome in adult frequent cannabis users. Despite some harms of long-term cannabis use, amotivation may not be among them.

Effects of frequent marijuana use on risky decision-making in young adult college students.

Marijuana (MJ) is the most widely used illicit substance among adolescents and young adults. Frequent MJ use has been associated with impairments in cognitive flexibility and inhibition, both of which play important roles in decision-making. However, the impact of frequent MJ use on decision-making performance is mixed and not well understood. The current study examined the influence of frequent MJ use on risky decision-making in college students, 18-22 years old. Methods: From 2017 to 2019, data was collected from young adult college students (n = 65) consisting of 32 healthy controls (HC) and 33 frequent marijuana users (MJ+). Participants completed the Iowa Gambling Task (IGT), a measure of risky decision-making, and net IGT scores (advantageous-disadvantageous decisions) were used as a measure of optimal decision-making. Results: The main finding indicated there was a significant effect of group on net IGT scores (p = 0.018), which remained significant when sex was included in the model (p = 0.006), such that MJ+ had lower net IGT scores than HC. Conclusions: These findings highlight potential differences in risky decision-making between MJ+ and HC, but it is uncertain whether these differences are pre-existing and increase vulnerability for frequent MJ use or if they are related to the effects of frequent MJ use on decision-making.

Emotion Dysregulation Moderates the Association Between Stress and Problematic Cannabis Use.

Background: Research suggests emotion dysregulation is a transdiagnostic risk factor for substance use and addiction and that stress may lead to problematic cannabis use. Thus, the current study examines how emotion dysregulation moderates the associations between stress (stressful life events and perceived stress) and problematic cannabis use. Methods: Eight hundred and fifty-two adults reporting any lifetime cannabis use completed an anonymous online survey. Participants completed a brief demographic questionnaire and were asked to report their past 30-day use of cannabis, alcohol, nicotine, and illicit substances. Problematic cannabis use (via the Marijuana Problem Scale), emotion dysregulation (via the Difficulties in Emotion Regulation Scale), perceived stress (via the Perceived Stress Scale), and stressful life events (via the Holmes-Rahe Life Stress Inventory) were assessed. Hierarchical multiple linear regressions were conducted. Results: Findings indicate that when examining the moderating role of emotion dysregulation, more stressful life events and less perceived stress were associated with more severe problematic cannabis use, and these associations were stronger at higher levels of emotion dysregulation. Conclusions: These results demonstrate a strong step toward understanding how emotion dysregulation moderates the relationship between stress and problematic cannabis use; however, longitudinal studies are needed to determine directionality of effects. Overall, these results suggest the importance of examining emotion dysregulation as a moderator of both stressful life events and stress perception as they relate to problematic cannabis use.

Marijuana Use and Hypothalamic-Pituitary-Adrenal Axis Functioning in Humans.

Preclinical studies suggest cannabinoids affect functioning of the hypothalamic-pituitary-adrenal (HPA) axis, but little is known about the effects of marijuana (MJ) use on HPA axis functioning in humans. Since previous work indicates substances of abuse may dysregulate the HPA axis, it is critical to understand how MJ use affects HPA axis activity. Here, we review studies that (a) examined the effects of acute MJ administration on HPA axis functioning, (b) investigated the impact of stress on HPA axis functioning in MJ users, (c) examined the effect of chronic MJ use on basal cortisol levels, and (d) studied the relationship between MJ use and the cortisol awakening response (CAR). Findings indicate acute MJ administration typically raises cortisol levels, but this increase is blunted in MJ-dependent users relative to controls. Frequent MJ users have blunted adrenocorticotropic hormone and cortisol reactivity in response to acute stress. These findings suggest HPA axis activity may be dysregulated by heavy MJ use. Alternatively, dysregulation of the HPA axis may be a risk marker for heavy MJ use. There is mixed evidence for how MJ use affects basal cortisol levels and the CAR. Future studies should consider MJ use characteristics, method of hormone collection, time when samples are collected, and environmental factors that may influence HPA axis activity in MJ users. By examining existing studies we provide one of the first reviews aimed at synthesizing the literature on HPA axis functioning in MJ users.

The Burden of Binge and Heavy Drinking on the Brain: Effects on Adolescent and Young Adult Neural Structure and Function.

Introduction: Adolescence and young adulthood are periods of continued biological and psychosocial maturation. Thus, there may be deleterious effects of consuming large quantities of alcohol on neural development and associated cognition during this time. The purpose of this mini review is to highlight neuroimaging research that has specifically examined the effects of binge and heavy drinking on adolescent and young adult brain structure and function. Methods: We review cross-sectional and longitudinal studies of young binge and heavy drinkers that have examined brain structure (e.g., gray and white matter volume, cortical thickness, white matter microstructure) and investigated brain response using functional magnetic resonance imaging (fMRI). Results: Binge and heavy-drinking adolescents and young adults have systematically thinner and lower volume in prefrontal cortex and cerebellar regions, and attenuated white matter development. They also show elevated brain activity in fronto-parietal regions during working memory, verbal learning, and inhibitory control tasks. In response to alcohol cues, relative to controls or light-drinking individuals, binge and heavy drinkers show increased neural response mainly in mesocorticolimbic regions, including the striatum, anterior cingulate cortex (ACC), hippocampus, and amygdala. Mixed findings are present in risky decision-making tasks, which could be due to large variation in task design and analysis. Conclusions: These findings suggest altered neural structure and activity in binge and heavy-drinking youth may be related to the neurotoxic effects of consuming alcohol in large quantities during a highly plastic neurodevelopmental period, which could result in neural reorganization, and increased risk for developing an alcohol use disorder (AUD).

Development, Initial Testing and Challenges of an Ecologically Valid Reward Prediction Error FMRI Task for Alcoholism.

AIMS: To advance translational studies of the role of reward prediction error (PE) in alcohol use disorder, the present study sought to develop and conduct an initial test of an alcohol-specific PE task paradigm using functional magnetic resonance imaging in humans. METHODS: Alcohol dependent or social drinkers received small tastes of their preferred alcohol beverage or control beverage, with preceding visual cues indicating whether alcohol (or water) would be delivered. To assess both positive and negative PE signals, expectancies were systematically violated in both positive (i.e. expecting water and receiving alcohol) and negative (i.e. expecting alcohol and receiving water) directions. Exploratory trial-by-trial analyses were conducted to explore temporal fluctuations of activation within a priori-defined regions of interest that have been implicated in cue reactivity and PE processing. RESULTS: Across the entire sample of participants, positive PE-related brain activation was found in a large cluster comprised of frontal lobe regions, as well as insular cortex, and motor/sensory cortices. Compared to social drinking subjects, alcohol dependent subjects had greater positive PE-related brain activity in left superior parietal lobule, lateral occipital cortex and postcentral gyrus. Exploratory trial-by-trial analyses indicated differences in activation specific to type of taste, mostly at earlier trials. CONCLUSIONS: This task-development oriented pilot study found that PE signaling may not be detected in expected brain regions when image analyses average across all PE trials of the task. Rather, a trial-by-trial analysis approach may help detect sparse, temporally distinct PE signaling in expected reward processing regions. SHORT SUMMARY: This fMRI study of reward prediction error found greater positive prediction error-related activity (i.e. expecting water taste, receiving alcohol taste) in alcohol dependent individuals relative to social drinkers in parietal and occipital cortices. Trial-by-trial analyses may be able to better detect sparse prediction error signaling in expected reward processing regions.

Effects of Alcohol Dependence Severity on Neural Correlates of Delay Discounting.

AIMS: The current study examines the relationship between alcohol dependence severity and delay discounting neural activation. METHODS: Participants (N = 17; 6 female) completed measures of alcohol use and severity and a functional magnetic resonance imaging version of a delay discounting task. RESULTS: Alcohol dependence severity was negatively associated with activation in superior frontal gyrus during impulsive relative to delayed decisions, and positively associated with activation in paracingulate gyrus and frontal pole in delayed relative to impulsive decisions. CONCLUSIONS: These results indicate that alcohol dependence severity tracks closely with dysregulations in cognitive control and reward evaluation areas during impulsive and delayed decisions, respectively. Delay discounting may be a useful construct in capturing these cognitive dysregulations as alcohol use disorders become more severe. SHORT SUMMARY: Among alcohol-dependent individuals, alcohol dependence severity is associated with overactivation of ventromedial prefrontal areas during delayed and underactivation of dorsolateral prefrontal regions during impulsive reward decisions.

Review: Pharmacogenetics of alcoholism treatment: Implications of ethnic diversity.

BACKGROUND AND OBJECTIVES: Pharmacogenetic studies of alcohol use disorder (AUD) have suggested that the efficacy of treatments for AUD is, in part, influenced by the genetic background of an individual. Since the frequency of alleles associated with pharmacotherapy for AUD varies by ancestral background, the effectiveness of medications used to treat AUD may vary among different populations. The purpose of this review is to summarize the existing pharmacogenetic studies of treatments for AUD in individuals of European, East Asian, African, and American Indian/Alaska Native ancestry. METHODS: Electronic databases were searched for pharmacogenetic studies of AUD treatment that included individuals of diverse ancestral backgrounds. RESULTS: Pharmacogenetic studies of AUD reviewed here have primarily investigated genetic variation thought to play a role in the response to naltrexone, ondansetron, and topiramate. There is support that the A118G polymorphism should be further investigated in individuals of East Asian ancestry. DISCUSSION AND CONCLUSIONS: Given the lack of pharmacogenetic research on response to AUD medication in ethnic minority populations and the mixed results, there is a critical need for future studies among individuals of different ancestries. More efforts should be devoted to standardizing procedures such that results can be more readily integrated into a body of literature that can directly inform clinical practice. SCIENTIFIC SIGNIFICANCE: This review highlights the importance for future research to aim for inclusiveness in pharmacogenetic studies of AUD and increase diversity of clinical trials in order to provide the best treatment outcomes for individuals across different racial and ethnic groups. (Am J Addict 2017;26:516-525).

Adolescence and Drug Use Vulnerability: Findings from Neuroimaging.

Adolescence is a period of vulnerability for developing substance use disorder. Recent neuropsychological and neuroimaging studies have elucidated underlying neural vulnerabilities that contribute to initiation of substance use during adolescence. Findings suggest poorer performance on tasks of inhibition and working memory, smaller brain volumes in reward and cognitive control regions, less brain activation during executive functioning tasks, and heightened reward responsivity are predictive of youth initiating substance use during adolescence. In youth who are family history positive (FHP) for substance use disorder, poorer executive functioning, smaller volume of limbic brain regions (e.g., amygdala), sex-specific patterns of hippocampal volume, and a positive association between nucleus accumbens volume and family history density have been reported. Further, reduced white matter integrity, altered brain response during inhibitory control, including both greater and less frontal lobe response, blunted emotional processing, and weaker neural connectivity have also been found in FHP youth. Thus, there is significant overlap among the neural precursors shown to be predictive of alcohol and substance use initiation during adolescence and those that distinguish FHP from youth without a family history of substance use disorder, suggesting common targets for prevention and intervention. Understanding these predictive factors helps identify at-risk youth for prevention efforts, as well as create interventions targeting cognitive weaknesses or brain regions involved in substance use initiation.

Severity of alcohol dependence is negatively related to hypothalamic and prefrontal cortical gray matter density in heavy drinking smokers.

BACKGROUND: While research has examined brain structure in individuals who use alcohol or nicotine, heavy drinking smokers comprise a unique subpopulation of substance users for whom less is known about the relationship between alcohol or nicotine use and structural brain abnormalities. OBJECTIVES: The present study examined gray matter morphometry in a sample of 39 heavy drinking smokers (24 males, 15 females) in relation to alcohol and nicotine dependence and quantity of use. METHODS: Traditional voxel-based morphometry techniques were employed for preprocessing of imaging data. One multiple regression analysis for alcohol and nicotine dependence severity and another for alcohol and nicotine quantity of use were conducted, while controlling for age, gender, and total intracranial volume (ICV). RESULTS: Alcohol dependence severity was significantly negatively associated with gray matter density in the hypothalamus (p < 0.001, uncorrected) and the right superior frontal gyrus (p < 0.001, uncorrected), while controlling for nicotine dependence severity, age, gender, and ICV. There were no significant relationships observed with respect to nicotine dependence severity, the quantity of alcohol use, or the quantity of nicotine use variables and gray matter density. CONCLUSIONS: These findings suggest that within heavy drinking smokers, alcohol dependence severity is significantly related to alterations in brain structure, while this effect is not seen for the quantity of alcohol or nicotine use, or severity of nicotine dependence. The current findings help clarify the contribution of alcohol and nicotine effects on brain structure, which could aid in understanding their neurocognitive consequences in heavy drinking smokers.

Adolescent neural response to reward is related to participant sex and task motivation.

Risky decision making is prominent during adolescence, perhaps contributed to by heightened sensation seeking and ongoing maturation of reward and dopamine systems in the brain, which are, in part, modulated by sex hormones. In this study, we examined sex differences in the neural substrates of reward sensitivity during a risky decision-making task and hypothesized that compared with girls, boys would show heightened brain activation in reward-relevant regions, particularly the nucleus accumbens, during reward receipt. Further, we hypothesized that testosterone and estradiol levels would mediate this sex difference. Moreover, we predicted boys would make more risky choices on the task. While boys showed increased nucleus accumbens blood oxygen level-dependent (BOLD) response relative to girls, sex hormones did not mediate this effect. As predicted, boys made a higher percentage of risky decisions during the task. Interestingly, boys also self-reported more motivation to perform well and earn money on the task, while girls self-reported higher state anxiety prior to the scan session. Motivation to earn money partially mediated the effect of sex on nucleus accumbens activity during reward. Previous research shows that increased motivation and salience of reinforcers is linked with more robust striatal BOLD response, therefore psychosocial factors, in addition to sex, may play an important role in reward sensitivity. Elucidating neurobiological mechanisms that support adolescent sex differences in risky decision making has important implications for understanding individual differences that lead to advantageous and adverse behaviors that affect health outcomes.