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Chunk #9 — INTRODUCTION

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Pathways to post-traumatic stress disorder and alcohol dependence: Trauma, executive functioning, and family history of alcoholism in adolescents and young adults.
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One task that has been used to assess planning and problem‐solving aspects of executive functioning is the Tower of London test (TOLT) (Ruocco et al., 2014). Although activation of different brain areas has been observed depending on the different versions of the TOLT, one area consistently activated is the prefrontal cortex, which plays a significant role in executive function by monitoring activities in other cortical and subcortical regions (Baker et al., 1996; Ruocco et al., 2014). Therefore, executive dysfunction in PTSD and alcohol dependence may be partly due to the shared neurocircuitry of PTSD and addiction, involving hypoactivation of prefrontal regions (Aupperle et al., 2012; Koob & Volkow, 2016). A particularly vulnerable period for prefrontal development is adolescence, when the brain undergoes important developmental changes, including synaptic pruning in this region (Juraska & Willing, 2017; Laviola & Marco, 2011). This period also coincides with peak alcohol experimentation shown to impact brain development (Koob & Volkow, 2016). In part, this may contribute to why trauma experienced during childhood and adolescence has particularly adverse and enduring consequences on the individual's mental health