Examining cortical thickness in male and female DWI offenders

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Examining cortical thickness in male and female DWI offenders

Katarina Dedovic

^a,b,∗

, Jens Pruessner

^a,c

, Jacques Tremblay

^a,c

, Louise Nadeau

^d

, Marie Claude Ouimet

^e

, Martin Lepage

^a,c

, Thomas G. Brown

^a,c,f

aDouglasHospitalResearchCentre,Montreal,Canada

bDepartmentofPsychology,UniversityofCalifornia,LosAngeles,USA

cDepartmentofPsychiatry,McGillUniversity,Montreal,Canada

dDepartmentofPsychology,UniversitédeMontréal,Montreal,Canada

eFacultyofMedicineandHealthSciences,UniversityofSherbrooke,Longueuil,Canada

fFosterAddictionRehabilitationCentre,St.PhilippedeLaPrairie,Canada

Keywords:

First-timeoffenders Drivingwhileimpaired Alcohol

DWI DUI

Magneticresonanceimaging Executivecontrol

a b s t r a c t

Somesexdifferenceshavebeendetectedindrivingwhileimpairedbyalcohol(DWI)offenders.However, understandingofthekeyfactorscontributingtoDWIamongmaleandfemaledriversremainselusive, limitingdevelopmentoftargetedinterventions.Sex-basedneurocognitiveanalysescouldprovidethe much-neededinsight.WeexaminedwhethermaleDWIoffendersshowcorticalthicknessanomalies thatdifferfromthoseinfemaleDWIoffenders,whencomparedtotheirrespectivecontrols.Moderating roleofsexandalcoholuseonDWIstatuswasalsoinvestigated.Sixty-oneDWIoffenders(29male;32 female)and58controls(29male;29female)completedananatomicalbrainscanandassessmentson otherrelevantcharacteristics.OnlymaleDWIoffendershadreducedcorticalthicknessintherightdorsal posteriorcingulatecortex(PCC),aregioninvolvedincognitivecontrol.Lowercorticalthicknesswas associatedwithincreasedoddsofDWIstatusonlyamongmaleswhohavenotengagedinveryhazardous patternofalcoholmisuseintheprevious12months.Thus,forthesemaleDWIdrivers,interventionsthat couldimpactPCCcouldbemostadvantageous.Continuedmultidimensionalsexanalysisoftheneural characteristicsofmaleandfemaleDWIoffendersiswarranted.

1. Introduction

Driving whileimpaired byalcohol (i.e.,DWI;legallydefined by per seblood alcohol levels in excess of 0.05–0.08%in most jurisdictions)isinvolved inapproximately30 −40%of allfatal trafficrelateddeaths[27].Markedheterogeneityofthefirst-time DWIoffendersintheirpsychosocial,personality, andevenalco- hol use characteristics vexes efforts to develop more effective individualizedinterventionstrategies[6,28].Giventheindications ofsex-based selectivetreatmentresponsivity[36],driversexis

∗ Correspondingauthor.DouglasHospitalResearchCentre,6875LaSalleBlvd E−4109,Montreal,QuebecH4H1R3,Canada.

E-mailaddress:katarina.dedovic@mail.mcgill.ca(K.Dedovic).

anobviousbasisforselectiveremedialtreatment[20].However, systematicinvestigationintosexdifferencesinDWIisinfactinfre- quent[26]andoftenyieldsinconsistentﬁndings.

For example,earlypsychometricresearch[18,34]foundevi- dencefora relationshipbetweenDWIand sensationseekingin males,whoareover-representedamongDWIoffenders,whileneu- ropsychologicalstudiesprimarilywithmaleDWIoffendershave detectedweaknessesin severaldimensionsofexecutivecontrol [e.g.,[9,14,29]].Nevertheless,recentsystematicsex-basedanalysis failedtosupportthespeciﬁcityofthesedimensionstomaleoffend- ers [10]. Furthermore, greater problem alcohol misuse among femaleoffendershasbeenreportedinsomestudies[23,24]but notinothers[20,23].

Importantly, psychometric personality assessment and neu- ropsychological task performance are distal to more direct

Konstanzer Online-Publikations-System (KOPS) URL: http://nbn-resolving.de/urn:nbn:de:bsz:352-2-7wp2dkuon3ty5

Erschienen in: Neuroscience Letters ; 619 (2016). - S. 189-195 https://dx.doi.org/10.1016/j.neulet.2016.03.034

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assessmentof brainhealth.Poorexecutivefunctionis afeature linked tomaladaptive structure and function in multiple brain regionsincludinganteriorinsula,dorsalanteriorcingulatecortex, andposterior cingulatecortex[e.g.,[8,11]].Magnetic resonance imaging(MRI)studieshavedetectedanomaliesintheseregions incriminalandotherrisk-takingpopulations[2,15].Neuroimaging mayhelptoidentifyendophenotypesofacommonexplanatory pathwaytohigh-riskbehaviourthat couldbeviable targetsfor moretailoredinterventions[17].Toourknowledge,thisistheﬁrst studytodatetoimagethebrainsofDWImaleandfemaleoffenders.

Thepresentstudyexaminedwhetherneuroimagingcanpro- vide new insight into DWIbehaviour among male and female drivers and novel directions for intervention development.We hypothesizedthatmaleoffenderswouldhave corticalthickness abnormalitiesconsistentwithweaknessinexecutivecontrolcom- paredtofemales.Ifconﬁrmed,additionalanalyseswouldbecarried outtotestthehypothesisthatalcoholuseandsexmoderatethe associationbetweencorticalthicknessandDWIstatus.

2. Methods

Ethics Boards of the Douglas Hospital Research Centre and MontrealNeurologicalInstitute(MNI),approvedthestudy.Allpar- ticipantsprovidedwritteninformedconsent.

2.1. Participantinclusion/exclusionandrecruitment

Subjectswererecruitedfromasampleof participantstaking partinalargelongitudinalstudyexaminingneurobiologicalmark- ersof DWIrecidivism riskin first-timeDWIoffenders.General inclusioncriteriawere:i)being18–44yearsofage;ii)possessing avaliddriver’slicense,andiii)consentingtoaccesstotheirofficial Quebecdrivingdata.ForDWIoffenders,theinclusioncriterionwas havingacriminalconvictionforafirstDWIoffencewithinthepre- vious24months.Non-DWIdrivershadtohavealifetimeDWI-free drivingrecord.Exclusioncriteriawere:i)readingskillsoflessthan 6thgradelevel;ii)anymedicalcontraindicationtostudypartici- pation;andiii)beingundertheinfluenceofalcoholand/ordrugs duringstudyparticipation.

2.2. Procedures

At the baseline laboratory session, eligible, consenting par- ticipantsunderwent:i) a Breathalyzer^® and drugurinalysis; ii) examinationformedicalinclusion/exclusion;andiii)assessments of personality characteristics, executive function, sociodemo- graphicinformation,andalcoholanddruguse.Thoseeligiblefor andconsentingtotheMRIsessioncompletedananatomicalbrain scanonaseparateday.

Duetodifﬁcultiesinscheduling,someparticipantscompleted theirMRIsessionclosertoafollow-uplaboratoryvisit.Thus,we analyzedinitialsessiondataforpersonalityandexecutivefunction forallparticipants.Forcharacteristicsthatdo(e.g.age)orcould changeover time(e.g.substanceuse) weanalyzed dataclosest intimetotheMRIsession.Whenapplicable,thenumberofdays betweenthelaboratoryandMRIsessionswasusedasa covari- ate.Twenty-ninemaleﬁrsttimeDWI(MDWI)offenders,32female DWI(FDWI)offenders,29malenon-DWI(MCTRL)and29female non-DWI(FCTRL)driverscompletedtheMRIsession.

2.3. Measures

2.3.1. Sociodemographics

Age, marital status, education, and employment data were obtainedusingsubsectionsofastandardizedquestionnaire[25].

2.3.2. Personalityandexecutivefunction

TheBarrattImpulsivityScaleversion 11(BIS)measuredcog- nitive,behavioural and planningimpulsivity domains [30]. The SensationSeekingScaleV(SSS-V)[40]measuredexperienceseek- ing, thrill and adventure seeking, disinhibition, and boredom susceptibility.TheD-KEFSColor-WordInterferenceTestmeasured executivefunctionregardingtheabilitytoinhibitanoverlearned response[22].WeexaminedscaledscoresonCondition3(Inhibi- tion:namingthecolouroftheinkthatlettersareprintedinandnot readingtheword)vsCondition1(colournaming)forInhibition,and Condition4(Inhibition/Switching:switchingbetweeneithernam- ingthecolouroftheinkthatlettersareprintedinandnotreading theword,orreadingthewordandignoringthecolouroftheink) vsCondition3forSet-Shifting.

2.3.3. Substancemisuseseverityandriskybehaviours

TheAlcoholUseDisorder IdentiﬁcationTest(AUDIT)[4] and theDrugAbuseScreeningTest(DAST)[39]screenedfor alcohol anddrugproblemsintheprevious12monthsrespectively.The TimelineFollowback(TLFB)[33]measuredthefrequencyofrisky drinkingdaysduringwhich≥3or≥5standarddrinksforwomen andmenrespectivelywereconsumedovertheprevious90days.

TheCompositeInternationalDiagnosticInterview(CIDI)provided diagnosticDSM-IVclassiﬁcationoflifetimealcoholanddrugabuse anddependence[19].Participantsalsoreportedonnumberoftimes inthelastyearthatthey:i)droveafterdrinking1or2drinks;and ii)gotintoacardrivenbyadriverwhohaddrunk≥3drinksinthe previoustwohours;thesewereconsideredindicesofpropensity toengageinDWI-relatedriskybehaviours.

2.3.4. MRIacquisitionandcorticalthicknessanalysis

MRIs were acquired on a 1.5-T Siemens SonataVision (Siemens,Malvern,Pennsylvania),withahigh-resolutionT1three- dimensionalmagnetization-preparedFlairsequence(slicethick- ness=1mmisotropic;repetitiontime=22ms;echotime=9.2ms;

ﬂipangle=30^◦).Corticalthicknessanalyseswerecompletedusing theautomatedanalysispipelineCIVET1.1.12[1]availableviathe CBRAIN interface[32]. All imageswere processed accordingto CIVETguidelines(fordetailsandreferencesseeSI).

2.4. Mainanalyticstrategy

2.4.1. Sociodemographic,psychologicaltraitandexecutive functiondata

Plannedcomparisonswithina sexbygroup(i.e.,CTRL,DWI) analysisofvariance(ANOVA)framework[31]testedfordifferences betweenmaleandfemaleDWIoffendersandtheirrespectivecon- trols,andfordifferencesbetweenmaleandfemaleDWIoffenders whileaccountingforbaselinesexdifferences.Whendatadeviated fromassumptionsforANOVAorwerecategorical,groupcompar- isonsusedMann-WhitneyUstatisticsandtestsofindependence (i.e.,␹²statisticorFisher’sexacttest).Alphaforallinferenceswas p<0.05,correctedformultiplecomparisons.

2.4.2. Corticalthickness

For comparisonsof cortical thicknessat everyvertex of the wholebrain,thegenerallinearmodelwasusedviaSurfstat(http://

www.math.mcgill.ca/keith/surfstat/).The model includedageat thetime of theMRI and handednessas covariatesof nointer- est,sexandgroupasthebetween-groupfactors,andsex×group interactionterm.Thesex×groupinteractiontermresultedinfour columns(FDWI,FCTRL,MDWI,MCTRL).Themaincontrastofinter- estwas(MCTRL-MDWI)>(FCTRL-FDWI)toestablishwhetherthe effectofhavingDWI-offenderstatusamongmalesisdifferentfrom theeffectofhavingthisstatusamongfemales.Correctionformulti-

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Table1

Measuresofsociodemographiccharacteristics,substanceuse,riskybehaviour,personalityandexecutivefunctioninthestudysample.

Male Females

Non-DWI(n=29) DWI(n=29) Non-DWI(n=29) DWI(n=32)

M(%) SD M(%) SD M(%) SD M(%) SD

Age 30.3 8.5 29.7 6.9 31.3 7.9 33 8.2

Education(years) 12.8 5.8 11.9 5.7 9.6 6.8 9.7 7.7

MaritalStatus

Marriedorcohabitating (44.8) (27.6) (34.5) (25)

Righthandedness (79.3) (79.3) (93.1) (90.6)

SubstanceUse

AUDIT 6.0 6.1 6.9 4.1 3.2 3.2 7.4^* 5.5

DAST 1.2 1.6 1.5 2.9 0.6 1.3 1.0^* 1.1

RiskyDrinkingdays(last90days) 4.4 7.2 8.4^* 8.7 4.3 6.7 13.1^* 17.7

AlcoholDependenceDx (27.6) (31.0) (10.3) (46.9)^*

AlcoholAbuseDx (27.6) (62.1)^* (34.5) (53.1)^*

Riskybehaviour(numberoftimes)inthelastyear

Drivingafter1or2drinks 2.8 1.7 2.9 1.4 2.3 1.4 2.8 1.7

Gotintoacarwithadriverwhoconsumed≥3drinksinlast2hrs 2.1 1.3 2.4 1.3 1.7 1.0 2.5^* 1.4

BIS

Planning 23.8 5.9 23.9 3.7 23.8 4.0 25.2 3.7

Motor 23.6 6.6 21.4 3.6 20.4 3.2 22.0 3.9

Cognitive 17.8 4.1 17.1 2.9 16.5 2.8 16.8 2.7

SSS

Thrill 7.1 2.9 6.7 2.8 6.0 2.5 6.2 2.8

Experience 6.7 2.0 5.8 1.8 6.6 2.1 6.8 1.9

Disinhibition 5.1 2.7 4.9 2.5 3.7 2.2 4.4 2.4

Boredom 3.4 2.3 2.6 2.4 2.6 2.1 2.6 1.8

Executivefunction

Inhibition 11.4 1.9 11.6 2.1 11.1 1.9 11.1 1.9

Set-Shifting 9.4 3.3 9.3 2.5 10.4 1.9 9.6 2.3

DWI:drivingwhileimpairedbyalcohol,AUDIT:AlcoholUseDisorderidentiﬁcationTest;DAST:DrugAbuseScreeningtest;Dx:Diagnosis;BIS:BarrattImpulsivityScale;

SSS:SensationSeekingScale.

*p<.05,correctedformultiplecomparisons,forcontrastswithgroups’respectivenon-offendercontrols.

plecomparisonswasconductedviarandomﬁeldtheoryforclusters atalevelofp<0.05,corrected.

2.4.3. Additionalanalyses

We used PROCESS [16] to model multiplicative moderation effects of sex and alcohol misuse onassociation between cortical thickness and DWI status in male and female drivers.

Heteroscedasticity-consistentstandarderrorestimator,HC3,was usedtoensurethevalidityofinferences.Statisticalsigniﬁcanceof indirecteffectswasdeterminedbyusingbias-correctedbootstrap- pingmethodwith1000samples.

3. Results

Table1summarizesthesample’ssociodemographic,substance use,personalitycharacteristicsandexecutivefunction.

3.1. Samplesociodemographics

Plannedcomparisonsyieldednosigniﬁcanteffectsformarital status,age,andyearsofeducation.

3.2. Impulsivepersonalityandexecutivefunction

PlannedcomparisonsregardingSSS-VandBISsubscales,and indicesofexecutivefunctiondidnotrevealanysigniﬁcanteffects.

3.3. Substanceuseandriskybehaviour

ComparedtoFCTL,FDWIreportedgreateralcohol-relatedprob- lems in the last 12 months via the AUDIT (U=210, p<0.001)

and endorsed more risky drinking days on TLFB (U=260.5, p=0.003).Furthermore,FDWIcomparedtoFCTLshowedmorelife- time alcohol dependency (␹²(1)=9.76, p=0.002), alcohol abuse (Fisher’sexacttest,p<0.001),anddrugproblemseverity(U=306.5, p=0.01),andweremorefrequentlydrivenbyadriverwhohad consumed≥3drinksin thelast hourduringtheprecedingyear (U=290, p=0.007). Finally, MDWI compared to MCTL showed greater incidence of alcohol abuse (␹²(1)=11.90, p=0.001). No otherdifferenceswereobserved.

3.4. MRI

Data from 10 participants (4 MCTRL; 3 MDWI; 2 FCTRL; 1 FDWI) were identified by quality control analysis as compro- misedduetohighnumberofsurface-surfaceintersectionsbetween whiteandgraymattersurfaces,andwereexcludedfromanaly- ses.Whole-brainanalysesofthespecificsex×groupinteraction contrastrevealedasignificant60-vertexclusterintherightdor- salposteriorcingulatecortex(PCC)withthepeak voxellocated attheMNIcoordinates,X=3,Y=−12,Z=32,witht=3.59,while controllingforageandhandedness(Fig.1A).Wedecomposedthis effectat thewholebrain levelbyconducting separatecompar- isonsbetweenmaleandfemaleDWIoffendergroupsandbetween thesegroupsandtheircontrols.ComparisonofMDWIandMCTRL groupsrevealedasignificantclusterof132voxelsintherightdor- salPCC(peakatX=4,Y=−7, Z=31, t=3.78)showingthatmale DWIoffendershavereducedcorticalthicknesscomparedtotheir controls(Fig.1B).NodifferenceswerefoundbetweenfemaleDWI andtheircontrols.ComparingmaleandfemaleDWIoffendersdid notrevealanysignificantdifferenceswithinthePCC,butwedid

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Fig1. Resultsofthemaininteractioncontrastforcorticalthicknessanalysis(A)(MCTRL-MDWI)-(FCTRL-FDWI)Interactioncontrastrevealingasignificantclusterintheright posteriorcingulatecortex(greencircle).(B)Decomposingoftheeffectrevealsareducedcorticalthicknessintherightposteriorcingulatecortex(greencircle)inMDWI groupcomparedtoMCTRL.MCTRL:malecontrols;MDWI:malefirsttimedrivingwhileimpairedbyalcohol(DWI)offenders;FCTRL:femalecontrols;FDWI:femalefirst timeDWIoffenders.(Forinterpretationofthereferencestocolourinthisfigurelegend,thereaderisreferredtothewebversionofthisarticle.)

observeasigniﬁcantclusterintheleftfusiformgyrus(329vertices, peakatX=−13,Y=−40,Z=2,t=3.65).

3.5. Moderationoftherelationshipbetweencorticalthickness andDWIstatusbyalcoholandsex

Inthewholegroup,weranamultiplicativemoderationanal- ysis,includingthemeancorticalthicknessfromtherightdorsal PCCclusterthatshowedthesigniﬁcantinteractioncontrasteffect asapredictor(X),alcoholmisusemeasuresasamoderator(M), sex as an additional moderator (W), and DWI status as the outcome(Y)(Fig.2A);thetimeperiodbetweenthetestingses-

sionswasacovariate.OnlywithAUDITasaprimarymoderator, the PCC×alcoholmisuse×Sex interaction term wassigniﬁcant (Z=−2.35,p=0.02).Thisindicatedthatonlyinmales,withvery lowtohighlevelsofalcoholproblemsintheprevious12months (10–75thpercentileinclusive),lowercorticalthicknessinthePCC wasassociatedwithheightenedriskofpossessingDWIstatus;in thosefallingwithinthe90thpercentileofalcoholmisuselevels,the associationwasnotsigniﬁcant(Fig.2B,C).

Explorative investigationof theassociationbetweencortical thickness in the right dorsal PCC and psychometric measures yieldednosigniﬁcanteffectsforthekeycontrastsofinterest(see SI).

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Fig.2. ResultsofthemultiplicativemoderationofAUDITxSEXxcorticalthicknessintherightposteriorcingulatecortex(RPCC)ontheoddsofhavingadrivingwhile impaired(DWI)status(A)Conceptualmodelofthemultiplicativemoderationtested.(B)Moderatingeffectshownamongmaledrivers.(C)Moderatingeffectshownamong femaledrivers.AUDIT:AlcoholUseDisorderIdentiﬁcationTest.

4. Discussion

OnlymaleDWIoffenderscomparedtotheircontrolsshowed detectablebrainanomalies−lowercorticalthicknessintheright dorsalPCC.Furthermore,onlyinmalesnotengaginginthemost hazardouspatternsofalcoholconsumptioninthelast12months, lowercorticalthicknesswasassociatedwithincreasedriskofDWI status.Overall,theﬁndingssuggestthatsexualdimorphismatthe corticalthicknesslevelisassociatedwithDWIstatus.

DorsalPCCisinvolvedincognitivecontrolandin“detectingand respondingtoenvironmentaleventsthatmayrequireachangein behaviourandthatarenotpartofthecurrentcognitiveset”[p.

[24,21]].FormaleDWIoffenders,reduceddorsalPCCmightcom- promisetheabilitytochangetypicalbehaviour(e.g.,drivingtheir carversustakingataxiorpublictransport)inresponsetoachange incircumstances(e.g.,whengoingtoavenuewhereheavydrink- ingislikelytooccur).Forexample,reducedthicknessindorsalPCC hasbeenassociatedwithdifﬁcultiesinjudginglong-termconse- quencesofillegalsocialactions(e.g.,beinginvolvedinhit-and-run, orunderagedrinking)inastudyonadolescents[12].Ontheother hand,wedidnotobservedirectassociationsbetweenPCCcorti- calthicknessandneuropsychologicalindicesrelatedtorisktaking (e.g.inhibition,set-shifting,)orself-reportedriskydriving,anull ﬁndingconsistentwithapreviousreportinalargersampleofDWI

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offenders[10].Asrisktakingcanbecontextspeciﬁc[e.g.,[5,7]], neuropsychologicalmeasuresmaynotpossessadequateecological validitytodiscernsuchrelationships.Futureneuroimagingstudies couldincludeexperimentalassessmentofparticipants’behaviour inadrivingsimulationenvironmenttotestthispossibility.

Alcoholmisuse,asignalcharacteristicofDWI,hasbeenconsis- tentlyrelatedtostructuralbrainanomalies[e.g.,11].Ourfindings reveal that the linkage between alcohol, brain anomalies, and DWIstatusis complex.Notably,thestrongestnegativeassocia- tionbetweenPCC corticalthickness andodds of havinga DWI statuswasactuallyobservedamongmalesreportingminimalalco- holusageinthelast12months;thisassociationsteadilyflattened tonon-significancewitheachincreaseinalcoholmisuse.Thissug- geststhatatlowlevelsofalcoholmisusecommonlyobservedin thegeneralpopulation, a structuralanomalywithina localized brainregionmayselectivelyprofferhigherriskforDWIinmale drivers.On theotherhand,asalcohol misuse increasestohaz- ardouslevels,therisktoengageinDWImightberelatedtomore complexbrainandbehaviouraleffects[38].Indeed,consistentwith social-pushtheory,greatersocial,psychologicalandenvironmen- taldysfunctionaccompanyingmoreseverealcoholmisuseislikely toweakendirectrelationshipsbetweenbiologicalriskfactorsand asocialbehaviour[37].

Overall,corticalthicknessanomalies in themaleDWIgroup revealamaladaptiveneuroanatomicalproﬁlethatonitsownand incombinationwithalcoholmisusecouldcontributetosomeof theneuropsychological deﬁcitspreviously observed in samples ofpredominantly male DWIoffenders.For females, incontrast, sociodemographic,substanceuseandpersonalitydescriptorsseem moreprominentinDWIrisk.Thesesexdifferencesareinlinewith proposition that psychosocial dysfunction characterizes female DWImorethanmaleDWI[35].

4.1. Implicationsforfutureresearch

These preliminary findings suggest that DWI among male driversisassociatedwithastructuralbraindeficit.Iftheyarerepli- cated,interventionstrategies thattargettheseneuralsubstrates couldbeexplored.Forexample,clientchangetalk,atargetedstrat- egyofMotivationalInterviewing,mayinmaleshaveaselectively positive impact on emotional learning/memory circuits, which encompassthePCC[13].Overall,theresultsreinforcetheneedfor moremultidimensionalstudiestoprospectivelytesttherelative advantageofspecificinterventionbyDWIdriversex.

4.2. Limitations

Whilethisstudyisthefirsttoassesscorticalthicknessinmale andfemaleDWIoffenders,itpossessessomenoteworthylimita- tions. Samplesizesweremoderate,thereby potentially limiting statisticalsensitivitytodetectsubtlergroupdifferences.Usinga DWIconvictionasanindexforgroupmembershipispotentially biasedbyindividualaswellasenvironmentalfactors[3].These circumstances may limit the representativeness of this sample andhencethegeneralizabilityoffindingstojurisdictionswhere conditions significantlydiffer fromthose of the studysite. The cross-sectionalstudydesign cannotclarifytheorigins ofpoten- tialbrainabnormalitiesinDWIoffenders.Nevertheless,weapplied statisticalmodelstotesttheover-archinghypothesesthatDWIisa complexbehaviournotuniquelyordirectlyaconsequenceofalco- holmisuse.Replicationoftheseassociationsinanotherstudyis warranted.Finally,thenon-DWIdrivergroupshowedahigherthan expectedrateofalcoholusedisorder.Whilethisdoesnotneces- sarilyconfoundthemainfindingswithrespecttotheassociation betweencorticalthicknessandgroupmembership,itmayhave

attenuatedsomebetween-groupdistinctionsthatcouldstemfrom alcoholusepatterns.

Acknowledgements

The authors acknowledge Ms. Lucie Legault, Ms. Laurence Fecteau-FortinandMs.LysianeRobidoux-Leonardfortheirassid- uouscoordinationofthisstudy,ourresearchassistantsfortheir dedicationincollectingthedata,andstudyparticipantsfortheir precioustime.ThestudywasfundedbyagrantfromtheCanadian InstitutesofHealthResearch(MOP-86451)awardedtothesenior author,Dr. Brown.Dr.Ouimet wassupportedthrougha career grantfromtheQuebecHealthResearchFund(Fondsderecherche duQuébec−Santé).

References

[1]Y.Ad-Dab’bagh,etal.,TheCIVETimage-processingenvironment:afully automatedcomprehensivepipelineforanatomicalneuroimagingresearch,in:

M.Corbetta(Ed.),HumanBrainMapping,Neuroimage,Florence,Italy,2006.

[2]E.Aharoni,G.M.Vincent,C.L.Harenski,V.D.Calhoun,W.Sinnott-Armstrong, M.S.Gazzaniga,K.A.Kiehl,Neuropredictionoffuturerearrest,Proc.Natl.

Acad.Sci.U.S.A.110(2013)6223–6228.

[3]K.A.Armstrong,H.Watling,A.Watson,J.Davey,Proﬁleofwomendetected drinkdrivingviaroadsidebreathtesting(RBT)inqueenslandAustralia, between2000and2011,Accid.Anal.Prev.67(2014)67–74.

[4]T.F.Babor,J.R.delaFuente,J.Saunders,M.Grant,TheAlcoholUseDisorders IdentiﬁcationTest:GuidelinesforUseinPrimaryHealthCare,WorldHealth Organization,Geneva,1992.

[5]M.D.J.Baker,J.K.Maner,Malerisk-takingasacontext-sensitivesignaling device,J.Exp.Soc.Psychol.45(2009)1136–1139.

[6]S.A.Ball,A.J.Jaffe,M.S.Crouse-Artus,B.J.Rounsaville,S.S.O’Malley, Multidimensionalsubtypesandtreatmentoutcomeinﬁrst-timeDWI offenders,Addict.Behav.25(2000)167–181.

[7]J.Baumann,D.DeSteno,Contextexplainsdivergenteffectsofangeronrisk taking,Emotion12(2012)1196–1199.

[8]A.Bechara,Decisionmaking,impulsecontrolandlossofwillpowertoresist drugs:aneurocognitiveperspective,Nat.Neurosci.8(2005)1458–1463.

[9]S.M.Bouchard,T.G.Brown,L.Nadeau,Decision-makingcapacitiesand affectiverewardanticipationinDWIrecidivistscomparedtonon-offenders:a preliminarystudy,Accid.Anal.Prev.45(2012)580–587.

[10]T.G.Brown,M.C.Ouimet,L.Nadeau,J.Tremblay,J.Pruessner,Sexdifferences inthepersonalityandcognitivecharacteristicsofﬁrst-timeDWIoffenders,J.

Stud.AlcoholDrugs76(2015)928–934.

[11]E.D.Claus,K.E.Hutchison,Neuralmechanismsofrisktakingandrelationships withhazardousdrinking,Alcohol.Clin.Exp.Res.36(2012)408–416.

[12]L.G.Cook,G.Hanten,K.D.Orsten,S.B.Chapman,X.Li,E.A.Wilde,K.P.Schnelle, H.S.Levin,Effectsofmoderatetoseveretraumaticbraininjuryon

anticipatingconsequencesofactionsinadolescents:apreliminarystudy,J.

Int.Neuropsychol.Soc.19(2013)508–517.

[13]S.W.FeldsteinEwing,F.M.Filbey,C.S.Hendershot,A.D.McEachern,K.E.

Hutchison,Proposedmodeloftheneurobiologicalmechanismsunderlying psychosocialalcoholinterventions:theexampleofmotivational interviewing,J.Stud.AlcoholDrugs72(2011)903–916.

[14]R.J.Glass,G.Chan,D.Rentz,Cognitiveimpairmentscreeninginsecondoffense DUIprograms,J.Subst.AbuseTreat.19(2000)369–373.

[15]R.Z.Goldstein,A.D.Craig,A.Bechara,H.Garavan,A.R.Childress,M.P.Paulus, N.D.Volkow,Theneurocircuitryofimpairedinsightindrugaddiction,Trends Cogn.Sci.13(2009)372–380.

[16]A.F.Hayes,J.Matthes,Computationalproceduresforprobinginteractionsin OLSandlogisticregression:sPSSandSASimplementations,Behav.Res.

Methods41(2009)924–936.

[17]K.E.Hutchison,Alcoholdependence:neuroimagingandthedevelopmentof translationalphenotypes,Alcohol.Clin.Exp.Res.32(2008)1111–1112.

[18]V.Johnson,H.R.White,Aninvestigationoffactorsrelatedtointoxicated drivingbehaviorsamongyouth,J.Stud.Alcohol50(1989)320–330.

[19]R.C.Kessler,J.Abelson,O.Demler,J.I.Escobar,M.Gibbon,M.E.Guyer,M.J.

Howes,R.Jin,W.A.Vega,E.E.Walters,P.Wang,A.Zaslavsky,H.Zheng,Clinical calibrationofDSM-IVdiagnosesintheworldmentalhealth(WMH)versionof theworldhealthorganization(WHO)compositeinternationaldiagnostic interview(WMHCIDI),Int.J.MethodsPsychiatr.Res.13(2004)122–139.

(7)

[20]S.C.Lapham,B.J.Skipper,W.C.Hunt,I.Chang,Doriskfactorsforre-arrest differforfemaleandmaledrunk-drivingoffenders?Alcohol.Clin.Exp.Res.24 (2000)1647–1655.

[21]R.Leech,D.J.Sharp,Theroleoftheposteriorcingulatecortexincognitionand disease,Brain137(2014)12–32.

[22]S.M.Lippa,R.N.Davis,Inhibition/switchingisnotnecessarilyharderthan inhibition:ananalysisoftheD-KEFScolor-Wordinterferencetest,Arch.Clin.

Neuropsychol.25(2010)146–152.

[23]J.C.Maxwell,J.Freeman,GenderdifferencesinDUIoffendersintreatmentin texas,TrafﬁcInj.Prev.8(2007)353–360.

[24]V.V.McCutcheon,A.Agrawal,A.C.Heath,H.J.Edenberg,V.M.Hesselbrock, M.A.Schuckit,J.R.Kramer,K.K.Bucholz,Functioningofalcoholusedisorder criteriaamongmenandwomenwitharrestsfordrivingundertheinﬂuence ofalcohol,AlcoholClin.Exp.Res.35(2011)1985–1993.

[25]A.T.McLellan,H.Kushner,D.Metzger,R.Peters,I.Smith,G.Grissom,H.

Pettinati,M.Argeriou,Theﬁftheditionoftheaddictionseverityindex,J.

Subst.AbuseTreat.9(1992)199–213.

[26]M.McMurran,R.Riemsma,N.Manning,K.Misso,J.Kleijnen,Interventionsfor alcohol-relatedoffendingbywomen:asystematicreview,Clin.Psychol.Rev.

31(2011)909–922.

[27]NHTSA,Trafﬁcsafetyfacts:2011data,in:N.s.N.C.f.S.a.Analysis,U.S.

DepartmentofTransporation,1200NewJerseyAvenueSE.,Washington,DC 20590,2013.

[28]T.H.Nochajski,P.R.Stasiewicz,Relapsetodrivingundertheinﬂuence(DUI):a review,Clin.Psychol.Rev.26(2006)179–195.

[29]M.C.Ouimet,T.G.Brown,L.Nadeau,M.Lepage,M.Pelletier,S.Couture,J.

Tremblay,L.Legault,M.Dongier,C.Gianoulakis,N.M.NgYingKin, NeurocognitivecharacteristicsofDUIrecidivists,Accid.Anal.Prev.39(2007) 743–750.

[30]J.H.Patton,M.S.Stanford,E.S.Barratt,FactorstructureoftheBarratt impulsivenessscale,J.Clin.Psychol.51(1995)768–774.

[31]G.D.Ruxton,G.Beauchamp,Timeforsomeapriorithinkingaboutposthoc testing,Behav.Ecol.19(2008)690–693.

[32]T.Sherif,P.Rioux,M.-E.Rousseau,N.Kassis,N.Beck,R.Adalat,S.Das,T.

Glatard,A.Evans,CBRAIN:aweb-based,distributedcomputingplatformfor collaborativeneuroimagingresearch,Front.Neuroinf.8(2014).

[33]L.C.Sobell,M.B.Sobell,TimelineFollowback:ATechniqueforAssessing Self-reportedAlcoholConsumption,HumanaPress,NewJersey,1992.

[34]A.W.Stacy,M.D.Newcomb,P.M.Bentler,Personality,problemdrinking,and drunkdriving:mediatingmoderating,anddirect-effectmodels,J.Pers.Soc.

Psychol.60(1991)795–811.

[35]TrafﬁcInjuryResearchFoundationofCanada,FemaleDrunkDrivers:a QualitativeStudy,TrafﬁcInjuryResearchFoundationofCanada,Ottawa,2013.

[36]E.Wells-Parker,M.G.Pang,B.J.Anderson,D.L.McMillen,D.I.Miller,Female DUIoffenders:acomparisontomalecounterpartsandanexaminationofthe effectsofinterventiononwomen’srecidivismrates,J.Stud.Alcohol52(1991) 142–147.

[37]L.Wilson,A.Scarpa,Theneedforanintegrativeapproachthatincorporates biologicalinﬂuences,J.Contemp.Crim.Justice(2012)366–381.

[38]P.Xiao,Z.Dai,J.Zhong,Y.Zhu,H.Shi,P.Pan,Regionalgraymatterdeﬁcitsin alcoholdependence:ameta-analysisofvoxel-basedmorphometrystudies, DrugAlcoholDepend.153(August1)(2015)22–28.

[39]E.Yudko,O.Lozhkina,A.Fouts,Acomprehensivereviewofthepsychometric propertiesofthedrugabusescreeningtest,J.Subst.AbuseTreat.32(2007) 189–198.

[40]M.Zuckerman,ThesensationseekingscaleV(SSS-V):stillreliableandvalid, Personal.Individ.Diff.43(2007)1303–1305.