Sixteen-year trends in multiple lifestyle risk behaviours by socioeconomic status from 2004 to 2019 in New South Wales, Australia.

Few studies have examined trends in inequalities related to lifestyle risk behaviours. This study examined 1) 16-year (2004-2019) trends of individual lifestyle risk factors and a combined lifestyle risk index and 2) trends in socioeconomic inequalities in these risk factors, in New South Wales (NSW; Australia) adults. Data was sourced from the NSW Adult Population Health Survey, an annual telephone survey of NSW residents aged ≥16 years, totalling 191,905 completed surveys. Excessive alcohol consumption, current smoking, insufficient physical activity, insufficient fruit and/or vegetable consumption, sugar-sweetened beverage [SSB] consumption, and a combined lifestyle risk index (overall high-risk lifestyle defined as total number of lifestyle risk behaviours ≥2) were examined. Socioeconomic status was assessed using education attainment, postal area-level disadvantage measured by Index of Relative Socioeconomic Disadvantage (IRSD), and remoteness based on Accessibility-Remoteness Index of Australia Plus (ARIA+). Socioeconomic inequalities were examined as prevalence difference for absolute inequalities and prevalence ratio for relative inequalities. The prevalence of lifestyle behaviours by levels of each socioeconomic status variable were estimated using predicted probabilities from logistic regression models. After adjusting for covariates, there was a decrease in prevalence over time for most lifestyle risk behaviours. Between 2004 and 2019, the prevalence decreased for current smoking from 21.8% to 17.1%, insufficient physical activity from 39.1% to 30.9%, excessive alcohol consumption from 15.4% to 13.7%, daily SSB consumption from 29.9% to 21.2%, and overall high-risk lifestyle from 50.4% to 43.7%. Socioeconomic inequalities, based on one or more of the socioeconomic variables, increased over time for current smoking, insufficient physical activity, daily SSB consumption, and an overall high-risk lifestyle. Overall, the health behaviours of the NSW population improved between 2004 and 2019. However, some socioeconomic inequalities increased during this time, highlighting the need for effective public health strategies that seek to improve health behaviours among the most socioeconomically disadvantaged.

Improving access to public physical activity events for disadvantaged communities in Australia.

BACKGROUND: Physical activity has numerous health benefits, but participation is lower in disadvantaged communities. 'parkrun' overcomes one of the main barriers for disadvantaged communities, the cost of activities, by providing a free, regular community-based physical activity event for walkers, runners and volunteers. This study assesses equity of access (in terms of distance to the nearest parkrun) stratified by socioeconomic deprivation, and identifies the optimal location for 100 new events to increase equity of access. METHODS: We combined information about population location and socioeconomic deprivation, with information about the location of 403 existing parkrun events, to assess the current level of access by deprivation quintile. We then used a two-step location-allocation analysis (minimising the sum of deprivation-weighted distances) to identify optimal regions, then optimal towns within those regions, as the ideal locations for 100 new parkrun events. RESULTS: Currently, 63.1% of the Australian population lives within 5 km of an event, and the average distance to an event is 14.5 km. A socioeconomic gradient exists, with the most deprived communities having the largest average distance to an event (27.0 km), and the least deprived communities having the best access (living an average 6.6 km from an event). Access improves considerably after the introduction of new event locations with around 68% of the population residing within 5 km of an event, and the average distance to the nearest event approximately 8 km. Most importantly, the improvement in access will be greatest for the most deprived communities (now an average 11 km from an event). CONCLUSIONS: There is a socioeconomic gradient in access to parkrun events. Strategic selection of new parkrun locations will improve equity of access to community physical activity events, and could contribute to enabling greater participation in physical activity by disadvantaged communities.

Placental MRI: Identification of radiological features to predict placental attachment disease regardless of reader expertise.

PURPOSE: To compare the accuracy of placental MRI in reporting placental adhesive disease in readers with different expertise and to identify the most reliable MRI features that predict placental pathology regardless of reader expertise. METHODS: Retrospective analysis of 27 placental MRI studies by six radiologists with different expertise levels; specificity, sensitivity, and accuracy were used to quantify the predictive performance of eight radiological features previously described in the literature. Histopathological evaluation was used as a diagnostic gold standard when available and the presence of the radiological features was decided by consensus. Features with higher sensitivity and specificity were identified and the optimal cut-off was calculated to obtain the resulting accuracy. RESULTS: The accuracy for seniors with expertise was non-statistically higher (0.83) compared to senior with no expertise (SWE) (0.65) and juniors (0.74) with SWE having tendency to over-estimate the severity of abnormality (26% vs 17%), whilst junior underestimated the degree of placental infiltration when compared to seniors with expertise (18.5% vs 0%, p = 0.006). Dark bands was the criteria with the highest sensitivity (95%) and high specificity (74%), followed by myometrial thinning (89%-76%) and uterine bulging (86%-81%). These three features demonstrated substantial (K) agreement. Using these features with optimal diagnostic cut-off, the accuracy increased to 0.91 for both the seniors and SWE and to 0.93 for the juniors. CONCLUSION: Placental MRI is most accurately interpreted by experienced radiologists; however, less experienced readers can obtain an accurate diagnosis relying on set criteria that are easier to be identified.

MRI of the endometrium - from normal appearances to rare pathology.

MRI was recently included as a standard pre-operative diagnostic tool for patients with endometrial cancer. MR findings allow a better risk assessment and ultimately guides the surgical planning. Therefore, it is vital that the radiological interpretation is as accurate as possible. This requires essential knowledge regarding the appropriate MRI protocol, as well as different appearances of the endometrium, ranging from normal peri- and post-menopausal changes, benign findings (e.g. endometrial hyperplasia, polyp, changes due to exogenous hormones) to common and rare endometrium-related malignancies. Furthermore, this review will emphasize the role of MRI in staging endometrial cancer patients and highlight pitfalls that could result in the underestimation or overestimation of the disease extent.

MRI findings in-between leiomyoma and leiomyosarcoma: a Rad-Path correlation of degenerated leiomyomas and variants.

Leiomyomas are the most common benign tumors of the uterus. On the opposite side, leiomyosarcomas are rare malignant uterine tumors that account for a significant proportion of uterine cancer deaths. Especially when large and degenerated, leiomyomas and leiomyoma variants can have overlapping imaging characteristics with those of leiomyosarcomas. Although not always possible, it is paramount to be able to differentiate between leiomyomas and leiomyosarcomas on imaging, as the therapeutic management can differ. This pictorial review aims to familiarize radiologists with imaging features of leiomyomas and various types of leiomyoma degeneration and variants, together with their pathology correlates.

Serous borderline ovarian tumours: an extensive review on MR imaging features.

Serous borderline ovarian tumours (SBOTs) are an intermediate group of neoplasms, which have features between benign and malignant ovarian tumours and for which, fertility-sparing surgery can be offered. MRI in imaging of SBOTs is, therefore, crucial in raising the possibility of the diagnosis, in order to present the patient with the most appropriate treatment options. There are characteristic MRI features that SBOTs demonstrate. In addition, recent advanced techniques, and further classification into subtypes within the borderline group have been developed. The aim of this article is to review the MRI features of SBOT and provide the reporter with an awareness of the imaging tips and tricks in the differential diagnosis of SBOT.

Diagnostic interpretation of non-contrast qualitative MR imaging features for characterisation of uterine leiomyosarcoma.

OBJECTIVE: To assess the value of non-contrast MRI features for characterisation of uterine leiomyosarcoma (LMS) and differentiation from atypical benign leiomyomas. METHODS: This study included 57 atypical leiomyomas and 16 LMS which were referred pre-operatively for management review to the specialist gynaeoncology multidisciplinary team meeting. Non-contrast MRIs were retrospectively reviewed by five independent readers (three senior, two junior) and a 5-level Likert score (1-low/5-high) was assigned to each mass for likelihood of LMS. Evaluation of qualitative and quantitative MRI features was done using uni- and multivariable regression analysis. Inter-reader reliability for the assessment of MRI features was calculated by using Cohen's κ values. RESULTS: In the univariate analysis, interruption of the endometrial interface and irregular tumour shape had the highest odds ratios (ORs) (64.00, p < 0.001 and 12.00, p = 0.002, respectively) for prediction of LMS. Likert score of the mass was significant in prediction (OR, 3.14; p < 0.001) with excellent reliability between readers (ICC 0.86; 95% CI, 0.76-0.92). The post-menopausal status, interruption of endometrial interface and thickened endometrial stripe were the most predictive independent variables in multivariable estimation of the risk of leiomyosarcoma with an accuracy of 0.88 (95%CI, 0.78-0.94). CONCLUSION: At any level of expertise as a radiologist reader, the loss of the normal endometrial stripe (either thickened or not seen) in a post-menopausal patient with a myometrial mass was highly likely to be LMS. ADVANCES IN KNOWLEDGE: This study demonstrates the potential utility of non-contrast MRI features in characterisation of LMS over atypical leiomyomas, and therefore influence on optimal management of these cases.

Differentiating uterine sarcoma from leiomyoma: BET1T2ER Check!

Although rare, uterine sarcoma is a diagnosis that no one wants to miss. Often benign leiomyomas (fibroids) and uterine sarcomas can be differentiated due to the typical low T2 signal intensity contents and well-defined appearances of benign leiomyomas compared to the suspicious appearances of sarcomas presenting as large uterine masses with irregular outlines and intermediate T2 signal intensity together with possible features of secondary spread. The problem is when these benign lesions are atypical causing suspicious imaging features. This article provides a review of the current literature on imaging features of atypical fibroids and uterine sarcomas with an aide-memoire BET1T2ER Check! to help identify key features more suggestive of a uterine sarcoma.

Non-contrast MRI can accurately characterize adnexal masses: a retrospective study.

OBJECTIVE: To determine the accuracy of interpretation of a non-contrast MRI protocol in characterizing adnexal masses. METHODS AND MATERIALS: Two hundred ninety-one patients (350 adnexal masses) who underwent gynecological MRI at our institution between the 1st of January 2008 and the 31st of December 2018 were reviewed. A random subset (102 patients with 121 masses) was chosen to evaluate the reproducibility and repeatability of readers' assessments. Readers evaluated non-contrast MRI scans retrospectively, assigned a 5-point score for the risk of malignancy and gave a specific diagnosis. The reference standard for the diagnosis was histopathology or at least one-year imaging follow-up. Diagnostic accuracy of the non-contrast MRI score was calculated. Inter- and intra-reader agreement was analyzed with Cohen's kappa statistics. RESULTS: There were 53/350 (15.1%) malignant lesions in the whole cohort and 20/121 (16.5%) malignant lesions in the random subset. Good agreement between readers was found for the non-contrast MRI score (к = 0.73, 95% confidence interval [CI] 0.58-0.86) whilst the intra-reader agreement was excellent (к = 0.81, 95% CI 0.70-0.88). The non-contrast MRI score value of ≥ 4 was associated with malignancy with a sensitivity of 84.9%, a specificity of 95.9%, an accuracy of 94.2% and a positive likelihood ratio of 21 (area under the receiver operating curve 0.93, 95% CI 0.90-0.96). CONCLUSION: Adnexal mass characterization on MRI without the administration of contrast medium has a high accuracy and excellent inter- and intra-reader agreement. Our results suggest that non-contrast studies may offer a reasonable diagnostic alternative when the administration of intravenous contrast medium is not possible. KEY POINTS: • A non-contrast pelvic MRI protocol may allow the characterization of adnexal masses with high accuracy. • The non-contrast MRI score may be used in clinical practice for differentiating benign from malignant adnexal lesions when the lack of intravenous contrast medium precludes analysis with the O-RADS MRI score.

Can Inhibitory Training Produce Reductions in Drinking? Evaluating the Influence of the Control Condition.

OBJECTIVE: Training in an inhibitory control task has produced reductions in alcohol use among heavy drinkers. However, the longevity of effects remains unknown, and much research has used suboptimal control conditions. Here, we assess the effectiveness of "Beer-NoGo" inhibitory training to reduce consumption up to 4 weeks after training compared with a "Beer-Go" control task, an online version of the Brief Alcohol Intervention (BAI), and an Oddball control condition. METHOD: Eighty-one regular drinkers were randomized into one of four training conditions. In the Beer-NoGo condition, participants responded to a letter superimposed on water-related images and refrained from responding to another letter superimposed on beer-related images. The mapping was reversed for the Beer-Go condition, whereas the Oddball control condition was presented with letters only and inhibition was not required. The last condition was an online BAI. Alcohol use was assessed using a bogus taste test and weekly alcohol consumption. RESULTS: Taste-test consumption was greater in the Beer-Go condition than in the Beer-NoGo, which did not differ from the Oddball and BAI conditions. All groups reduced alcohol intake during the study; however, in the first week the Beer-Go group reduced their drinking while the Beer-NoGo group increased. No group differences were apparent at the fourth week. CONCLUSIONS: The Beer-NoGo task did not produce effects beyond simple assessment on reducing alcohol use among regular drinkers. Previously reported training effects may be artifacts of the Beer-Go task as a suboptimal control. More robust forms of inhibitory training are necessary if a useful clinical adjunct for managing alcohol abuse is to be developed.

Verbal Learning and Memory in Cannabis and Alcohol Users: An Event-Related Potential Investigation.

Aims: Long-term heavy use of cannabis and alcohol are known to be associated with memory impairments. In this study, we used event-related potentials to examine verbal learning and memory processing in a commonly used behavioral task. Method: We conducted two studies: first, a small pilot study of adolescent males, comprising 13 Drug-Naive Controls (DNC), 12 heavy drinkers (HD) and 8 cannabis users (CU). Second, a larger study of young adults, comprising 45 DNC (20 female), 39 HD (16 female), and 20 CU (9 female). In both studies, participants completed a modified verbal learning task (the Rey Auditory Verbal Learning Test, RAVLT) while brain electrical activity was recorded. ERPs were calculated for words which were subsequently remembered vs. those which were not remembered, and for presentations of learnt words, previously seen words, and new words in a subsequent recognition test. Pre-planned principal components analyses (PCA) were used to quantify the ERP components in these recall and recognition phases separately for each study. Results: Memory performance overall was slightly lower than published norms using the standardized RAVLT delivery, but was generally similar and showed the expected changes over trials. Few differences in performance were observed between groups; a notable exception was markedly poorer delayed recall in HD relative to DNC (Study 2). PCA identified components expected from prior research using other memory tasks. At encoding, there were no between-group differences in the usual P2 recall effect (larger for recalled than not-recalled words). However, alcohol-related differences were observed in a larger P540 (indexing recollection) in HD than DNC, and cannabis-related differences were observed in a smaller N340 (indexing familiarity) and a lack of previously seen > new words effect for P540 in Study 2. Conclusions: This study is the first examination of ERPs in the RAVLT in healthy control participants, as well as substance-using individuals, and represents an important advance in methodology. The results indicate alterations in recognition memory processing, which even if not manifesting in overt behavioral impairment, underline the potential for brain dysfunction with early exposure to alcohol and cannabis.

Current forms of inhibitory training produce no greater reduction in drinking than simple assessment: A preliminary study.

BACKGROUND: Disinhibition is apparent in users of many substances, including heavy drinkers. Previous research has shown that brief training to improve inhibitory control is associated with reduced alcohol consumption. We investigated whether a new form of inhibitory training would produce greater reductions, relative to a carefully designed control condition and a proven method of reducing consumption, the Brief Alcohol Intervention (BAI). METHODS: One hundred and fourteen regular drinkers were assigned randomly to one of five training conditions: Control (no inhibitory training); Beer-NoGo (inhibit responses linked to task-irrelevant pictures of beer); Restrained-Stop (requiring more urgent inhibition but without pictures of beer); Combined (a previously untested form of training requiring urgent inhibition to pictures of beer); or BAI. The outcome measures were alcohol consumption in the week before and after training, and in a bogus taste test administered immediately post-training. RESULTS: Participation in the study, regardless of condition, was associated with reductions in weekly consumption. However, only the BAI produced a greater reduction relative to the Control condition. The training tasks were not associated with reductions in taste test consumption. CONCLUSIONS: Although concerns about low power limit confidence, the current study suggests that three forms of inhibitory training do not have a substantial effect on drinking beyond the effect of simple assessment, in comparison to a control task which does not promote impulsive responding. Future research needs to establish a training protocol that produces greater reductions in consumption not only relative to the effect of assessment but also relative to a BAI.

Error detection and behavioural inhibition in young heavy drinkers.

BACKGROUND: Increases in inhibitory errors in heavy drinkers are established; less well-studied is whether heavy drinkers are aware of these errors in performance. Reductions in error detection and awareness limit the possibility for remedial action to be taken, and have implications for substance abusers seeking to control use: failure to monitor and/or adjust ongoing behaviour may be linked to using more or more often than intended, and failing to adjust behaviour after a slip. Here we report the first study of both inhibitory control and error awareness in young heavy drinkers, using behavioural and psychophysiological measures. METHODS: Heavy drinkers (n=25) and light- or non-drinking controls (n=35) completed a difficult inhibitory task which required signaling the awareness of inhibitory errors on the subsequent trial, while brain electrical activity was recorded. RESULTS: Heavy drinkers made more inhibitory errors than controls, but we observed no difference in error awareness, both via overt signaling and with equivalent amplitude of the error positivity (Pe), indexing conscious error detection. Similarly, controls and heavy drinkers showed no difference in amplitude or latency of the error-related negativity (ERN), indexing early pre-conscious error detection. CONCLUSIONS: This research suggests no significant difference in detection of errors in heavy drinkers, even as they are more prone to make these errors, a result seen in dependent drinkers reported elsewhere. Future research with larger sample sizes, and a more difficult task producing sufficient errors, should determine whether heavy drinkers employ sufficient post-error remedial action.

Feedforward consequences of isometric contractions: effort and ventilation.

The onset of voluntary muscle contractions causes rapid increases in ventilation and is accompanied by a sensation of effort. Both the ventilatory response and perception of effort are proportional to contraction intensity, but these behaviors have been generalized from contractions of a single muscle group. Our aim was to determine how these relationships are affected by simultaneous contractions of multiple muscle groups. We examined the ventilatory response and perceived effort of contraction during separate and simultaneous isometric contractions of the contralateral elbow flexors and of an ipsilateral elbow flexor and knee extensor. Subjects made 10-sec contractions at 25, 50, and 100% of maximum during normocapnia and hypercapnia. For simultaneous contractions, both muscle groups were activated at the same intensities. Ventilation was measured continuously and subjects rated the effort required to produce each contraction. As expected, ventilation and perceived effort increased proportionally with contraction intensity during individual contractions. However, during simultaneous contractions, neither ventilation nor effort reflected the combined muscle output. Rather, the ventilatory response was similar to when contractions were performed separately, and effort ratings showed a small but significant increase for simultaneous contractions. Hypercapnia at rest doubled baseline ventilation, but did not affect the difference in perceived effort between separate and simultaneous contractions. The ventilatory response and the sense of effort at the onset of muscle activity are not related to the total output of the motor pathways, or the working muscles, but arise from cortical regions upstream from the motor cortex.

Sex differences in the relationship between heavy alcohol use, inhibition and performance monitoring: Disconnect between behavioural and brain functional measures.

Previous research has reported mixed evidence of sex differences in the relationship between heavy alcohol use and deficits in behavioural control. Here, we examine sex differences in behavioural and event-related potential (ERP) markers of deficient inhibition. Participants were 71 young adults aged 18-21, who either drank heavily regularly (i.e., four standard drinks on one occasion, at least once a month, n=33, 20 male) or drank heavily less often than this (including never, n=38, 21 male). They completed a stop-signal task while ERPs were recorded. Increases in stop-signal reaction time, the time required to stop a response, were related to heavy drinking only in female participants. P3 amplitude, ERN amplitude and ERN latency did not display a significant interaction between group and sex. Heavy drinkers, regardless of sex, displayed a marginally larger successful>failed effect for P3 amplitude, and a marginally smaller error-related negativity. An apparent disconnect exists in behavioural and psychophysiological measures of sex differences in the relationship between heavy alcohol consumption and inhibitory processing; male heavy drinkers display only psychophysiological but not behavioural deficits, while female heavy drinkers display both. Future research may determine whether sex differences are apparent for other substances besides alcohol.

Female but not male young heavy drinkers display altered performance monitoring.

Difficulties in monitoring ongoing behaviour may be linked to real-life problematic drinking behaviours. Prior research suggests female heavy drinkers in particular display greater cognitive control deficits. Here, we examine trial-to-trial behavioural adaptations in a conflict monitoring task, relative to drinking behaviour and sex. Heavy drinkers (n=31, 16 male) and controls (n=35, 18 male) completed an Eriksen flanker task while brain electrical activity was recorded. For reaction time, error rates, and N2 and P3 amplitude of the event-related potential, trial-to-trial conflict adaptation was evidenced by a differential response to the current (congruent vs. incongruent) trials dependent on the identity of the previous trial. For the proportion of errors, heavy drinkers showed increased conflict adaptation compared to controls. Conflict adaptation for N2 (indexing monitoring) was larger for female heavy drinkers than controls, and the opposite was observed for males. There were no interactions involving group or sex for the P3 (indexing inhibition). The results suggest a compensatory response, such that heavy drinkers are required to increase performance monitoring in order to achieve the same behavioural outcome as controls. We also confirm the importance of sex as a factor in the relationship between behavioural control and heavy alcohol use.

Temporal assessment of pancreatic blood flow and perfusion following secretin stimulation using noninvasive MRI.

PURPOSE: To dynamically quantify pancreatic perfusion and flow within the arteries supplying the pancreas in response to secretin stimulation. MATERIALS AND METHODS: Twelve healthy male subjects were scanned at 1.5T with arterial spin labeling to measure tissue perfusion and phase contrast magnetic resonance imaging (MRI) to measure vessel flow. Superior mesenteric (SMA), gastroduodenal (GDA), common hepatic (HA), and splenic (SA) arterial flow and pancreatic perfusion were serially measured for 50 minutes following 1 IU/kg intravenous secretin. The significance of differences between timepoints was tested using a repeated measures one-way analysis of variance (ANOVA). RESULTS: Baseline blood flow (mean ± SEM or median [IQR]) for SMA, HA, SA, and GDA was 7.6 ± 1.3, 4.0 ± 0.5, 8.2 ± 0.8, and 0.9 (0.8-1.4) ml/s, respectively. Baseline pancreatic perfusion was 200 ± 25 ml/100g/min. Blood flow increased in the SMA (234%, P < 0.0001) and GDA (155%, P = 0.015) immediately after secretin injection. Reduced HA blood flow was observed after 10 minutes (P = 0.066) with no change in SA flow (P = 0.533). Increased pancreatic perfusion was maintained for 40 minutes after injection with a maximal increase at 5 minutes (16.8%, P = 0.025). CONCLUSION: Intravenous secretin resulted in significant temporal changes in pancreatic perfusion and arterial blood flow.

Deficits in behavioural inhibition in substance abuse and addiction: a meta-analysis.

AIMS: Deficits in behavioural inhibitory control are attracting increasing attention as a factor behind the development and maintenance of substance dependence. However, evidence for such a deficit is varied in the literature. Here, we synthesised published results to determine whether inhibitory ability is reliably impaired in substance users compared to controls. METHODS: The meta-analysis used fixed-effects models to integrate results from 97 studies that compared groups with heavy substance use or addiction-like behaviours with healthy control participants on two experimental paradigms commonly used to assess response inhibition: the Go/NoGo task, and the Stop-Signal Task (SST). The primary measures of interest were commission errors to NoGo stimuli and stop-signal reaction time in the SST. Additionally, we examined omission errors to Go stimuli, and reaction time in both tasks. Because inhibition is more difficult when inhibition is required infrequently, we considered papers with rare and equiprobable NoGo stimuli separately. RESULTS: Inhibitory deficits were apparent for heavy use/dependence on cocaine, MDMA, methamphetamine, tobacco, and alcohol (and, to a lesser extent, non-dependent heavy drinkers), and in pathological gamblers. On the other hand, no evidence for an inhibitory deficit was observed for opioids or cannabis, and contradictory evidence was observed for internet addiction. CONCLUSIONS: The results are generally consistent with the view that substance use disorders and addiction-like behavioural disorders are associated with impairments in inhibitory control. Implications for treatment of substance use are discussed, along with suggestions for future research arising from the limitations of the extant literature.

Evidence of deficits in behavioural inhibition and performance monitoring in young female heavy drinkers.

BACKGROUND: New models of the development and maintenance of substance abuse give increasing importance to the role of deficits in inhibitory function. Much of the evidence to support this claim comes from male participants, despite some researchers showing greater disinhibition in females. Clearly, more research on female heavy drinkers is warranted. In this study, we examine behavioural and psychophysiological measures of inhibitory function in female young adults who do and do not regularly drink heavily. METHODS: Participants were thirty female young adults (aged 18-21) who drink heavily (four or more standard drinks per occasion) at least once a month (n=13) or who drink heavily less often than this (n=17); none regularly used any other drugs, including tobacco. They underwent interviews assessing prior use of alcohol, before completing a stop-signal task while brain electrical activity was recorded. RESULTS: Regular heavy drinkers displayed a longer stop-signal reaction time (the time required to stop an inappropriate response), and a larger P3 increase for successful compared to failed inhibition trials. Heavy drinkers also displayed a smaller error-related negativity (ERN) amplitude, indexing a deficit in performance monitoring. CONCLUSION: These results indicate that large deficits in inhibitory processing and performance monitoring occur in young female heavy drinkers, and that heavy drinkers may have to work harder in order to successfully inhibit a response. Future research may determine whether these deficits pre-date or are caused by alcohol abuse.