Laine B Butler and Kate B Nooner*

Psychology Department, University of North Carolina Wilmington, USA

*Corresponding Author: Kate B Nooner, Psychology Department, University of North Carolina Wilmington, USA.

Received: October 13, 2025; Published: January 31, 2026

Abstract

Given the unique harms of substance use in early adolescence, it is important to understand factors that predispose adolescents to such behaviors. Externalizing pathology is known to increase substance use risk, yet research on brain-based factors underlying both externalizing and substance use behaviors is limited. This investigation evaluated the role of brain function in externalizing pathology and substance use among adolescents. Participants included 54 adolescents (ages 12-14) and their parents/guardians. In this home-based study, adolescents completed a resting-state electroencephalography focused on alpha power and clinical measures assessing substance use and externalizing pathology. Parents/guardians completed clinical measures of their adolescents’ behavior. Externalizing pathology was most consistently associated with substance use on the behavioral level, yet less frequently on the diagnostic level. Frontal and central alpha power were also most consistently related to behavior-level externalizing pathology, yet less often on the diagnostic level. While frontal alpha power was associated with substance use, central alpha power was associated with alcohol craving. Our findings indicate that alpha power may relate to externalizing pathology, as well as substance use behaviors and urges. The results highlight the importance of behavior-level assessment of externalizing pathology among adolescents, in addition to providing direction for theoretical and clinical work

Keywords: Adolescent; Substance Use; Electroencephalography; Functional Neuroimaging; Attention Deficit Hyperactivity Disorder; Disruptive; Impulse Control; Conduct Disorders

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Citation

Citation: Laine B Butler and Kate B Nooner. “Externalizing Pathology and Substance Use Among Adolescents: The Intersection of Functional Brain Activity". Acta Scientific Scientific Neurology 9.2 (2026): 22-42.

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Copyright: © Laine B Butler and Kate B Nooner. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.