Alcohol and drug use are outcomes of decisions supported by both cognitive and behavioral functions; the young adults in our study with early high resiliency were less likely to smoke, had tried fewer illicit drugs, and had fewer alcohol problems than their less resilient counterparts independent of familial liability. The STN may represent a neural link between individual resiliency and cognitive processing, potentially influencing substance abuse risk. Our PPI analysis linking resiliency with connectivity strength between the STN and cingulate regions potentially represents efficiency of communication between salience assigned by limbic regions and flexible adaptation facilitated by cognitive neural circuits. The extensive developmental time span of the resiliency/substance involvement relationship suggests that neural connections may be present considerably earlier than observed here. Other studies will need to examine this possibility.
