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392 REVERSIBLE DISORDERS OF BRAIN DEVELOPMENTthat stimulant treatment in adolescents could have adverse effects. A history ofmethylphenidate has been associated with severity of subsequent bipolar disorderin a sample of 80 adolescent bipolar patients (Soutullo et al., 2002), and thereis a concern about the rare association of methylphenidate with cardiac arrhythmias(Chernoff, Wallen, & Muller, 1962; Lucas, Gardner, Wolkowitz, Tucker, & Cowdry,1986).AlcoholExposure to alcohol begins at an early age in the United States, with 44% of 8thgraders already reporting alcohol use, increasing to 77% by the 12th grade in 2004(L. Johnston, O’Malley, Bachman, & Schulenberg, 2005). Binge drinking, definedas five or more drinks at a single occasion, is reported by 11% of 8th graders and29% of 12th graders. Binge drinking in college has been reported for several yearsto be in the 44% range (Knight et al., 2002; Wechsler, Lee, Kuo, & Lee, 2000)and is associated with significant health and accident problems. Although stresshas been found to be a powerful predictor of alcohol and other drug abuse (Spear,2000), binge-type drinking behavior is so widespread among college students thatsome might consider it to be a cultural norm even for nonstressed individuals(Shedler & Block, 1990).Because so many adolescents are exposed to alcohol, is there any evidence thatthis produces lasting effects? Correlational studies in human populations suggestthat this might occur. Just as was found with nicotine exposure, early exposure toalcohol increases the risk of abuse and dependence in adulthood. In one largesample, the rate of lifetime alcoholism was 40% when drinking was started at age14 or younger, but only 10% when drinking was initiated at age 20 or older(Fergusson, Lynskey, & Horwood, 1994).There is also evidence for the role of heredity in the sensitivity to alcohol and therisk of developing alcoholism. Young men with a family history of alcoholism showless sensitivity (i.e., more tolerance) to graded doses of alcohol in the laboratorythan men of similar age and drinking experience with a negative family history foralcoholism (Schuckit & Smith, 2004). The researchers continued the testing longitudinallyand found a significant increase in sensitivity to alcohol with increasingage among light drinkers, but little change among heavy drinkers.Alcohol acts as a sedative on the brain. The annual toll of alcohol overdose deathsamong college students is testimonial to the sedating effects of a drug that manyadolescents consider to be a stimulant. Among heavy drinkers during adolescence,neuropsychological deficits have been reported. Heavy drinking adolescents tested3 weeks after detoxification from alcohol showed deficits in visuospatial functioningand in retrieval of verbal and nonverbal information (Brown, Tapert,Granholm, & Delis, 2000). What is not clear is the degree to which neurocognitive