Externalizing Polygenic Liability, Brain Imaging Phenotypes, and Adolescent Substance Use Initiations: A Multistage Association and Mediation Analysis in ABCD
Using data from the ABCD Study, this multistage analysis reveals that while externalizing polygenic liability robustly predicts earlier adolescent substance initiation through both direct genetic pathways and specific brain imaging phenotypes, the neurobiological mediation by baseline brain measures accounts for less than 2% of the total effect, indicating that direct genetic influences are the dominant mechanism.