Psychosocial and neural indicators of resilience among youth with a family history of substance use disorder

•Resilient youth showed heightened prefrontal activation during inhibitory control.•Reward responsivity did not differentiate resilient versus high-risk groups.•Psychosocial and neuroimaging measures each uniquely characterize resilience. Little is known regarding the combined influence of psychosocial and neural protective mechanisms against substance use. The present study examined the extent to which neuroimaging measures of disinhibition predicted resilience against binge drinking and marijuana use among youth with a family history of substance use disorder (SUD; FH+), accounting for psychosocial measures of behavioral control. Participants were 57 FH+ youth from the Michigan Longitudinal Study categorized into resilient and high-risk groups based on patterns of weekly binge drinking and monthly marijuana use during early adulthood. Psychosocial measures of behavioral control (reactive control and externalizing behavior during early and late adolescence) and neural measures of disinhibition (Go/No-Go task and Monetary Incentive Delay Task (MIDT) measured through functional magnetic resonance imaging (fMRI)) were entered sequentially in hierarchical logistic regression models to predict resilient versus high-risk groups. Greater activation in the right dorsolateral prefrontal cortex (DLPFC) during correctly inhibited trials on the Go/No-Go task was a significant predictor of resilience (OR = 2.46, p