Decision-making and facial emotion recognition as predictors of substance-use initiation among adolescents.

This 4-year longitudinal study examined whether performance on a decision-making task and an emotion-processing task predicted the initiation of tobacco, marijuana, or alcohol use among 77 adolescents. Of the participants, 64% met criteria for an externalizing behavioral disorder; 33% did not initiate substance use; 13% used one of the three substances under investigation, 18% used two, and 36% used all three. Initiation of substance use was associated with enhanced recognition of angry emotion, but not with risky decision-making. In conclusion, adolescents who initiate drug use present vulnerability in the form of bias towards negative emotion but not toward decisions that involve risk.