Neural Basis of alcohol/substance use disorders and suicide in American Indians

美洲印第安人酒精/药物使用障碍和自杀的神经基础

• 批准号: 10349445
• 负责人: CINDY L EHLERS
• 金额: $ 61.53万
• 依托单位: SCRIPPS RESEARCH INSTITUTE, THE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-02-05 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10349445
• 关键词: Address; Adolescence; Adolescent; Adult; Alaska Native; Alcohol consumption; Alcohols; American Indians; Automobile Driving; Biological; Biological Markers; Cessation of life; Clinical; Clinical Data; Cohort Studies; Communities; Crime; Cross-Sectional Studies; Data; Data Set; Databases; Development; Disease; Disease remission; Distal; Drug Use Disorder; Elderly; Electrophysiology (science); Environment; Environmental Risk Factor; Ethnic group; Family; Foundations; General Population; Genetic; Genetic Risk; Genome; Guns; Heavy Drinking; High Prevalence; Individual; Intervention; Lead; Literature; Longevity; Measures; Mental Health; Methodology; Mission; Modeling; Pathway interactions; Pattern; Persons; Play; Population; Prevalence; Prevention; Recording of previous events; Research; Reservations; Retrospective cohort; Risk Factors; Role; Rural; Sampling; Severities; Sleep; Substance Use Disorder; Suicide; Symptoms; Teenagers; Testing; Time; Variant; age difference; alcohol and other drug; alcohol measurement; alcohol use disorder; alcohol use initiation; base; biopsychosocial; community-level factor; density; depressive symptoms; design; disability; drinking; early alcohol use; epidemiology study; evidence base; experience; follow-up; gender difference; genetic analysis; genome sequencing; health disparity; high risk population; ideation; innovation; low socioeconomic status; mortality; neuromechanism; pleiotropism; predictive modeling; protective factors; psychiatric comorbidity; psychosocial; relating to nervous system; socioeconomics; substance use; suicidal behavior; suicidal risk; suicide rate; symptomatology; trauma exposure; whole genome; young adult

PROJECT SUMMARY Suicide is an important mental health problem but nowhere is this problem more striking and extreme as it is in American Indian/Alaska Native (AI/AN) and First Nations (FN) people. Although suicide rates vary among AI/AN communities, rates in some communities are almost 10 times the national average. Additionally, U.S. epidemiological studies demonstrate that compared with other U.S. ethnic groups, AI/AN teens and adults have the highest rates of alcohol use disorders (AUDs), that are associated with significant disability and mortality. Thus, studies identifying the risk factors and psychopathological mechanisms for suicide risk and substance use disorders in AI/AN teens and adults are needed to address the substantial health disparities experienced by AI/AN. Yet comprehensive evidence-based studies of suicide risk and AUDs, especially those that include biological measures, are completely lacking in AI/AN and FN people. The overall objective of this research plan is to identify neural mechanisms, as well as individual and community risk factors for alcohol and other substance use disorders and suicidal behaviors (SB) in a community sample of American Indians (AI) residing on rural reservations. Our previous studies have documented a high lifetime prevalence of moderate and severe alcohol use disorders (AUD) (45%) in this group, and have recently identified an excess of suicidal behaviors (>15% attempted) in AI adults. Our data set is unique in that it includes extensive clinical data, psychosocial measures, sleep, electrophysiology and whole genome sequencing data. Using this rich data set we propose to determine whether this group of AI have distal and proximal risk factors and biomarkers (electrophysiological and genetic), that are similar to general population samples described in the literature, or have unique determinants for SB. Since living on a reservation may add particularly unique risk factors for SB in AI we also propose to use state of the art geocoding methodology to obtain new community based data on risk factors for SB. Unique to our approach is our emphasis on the role that high levels of alcohol use and AUDs play in inducing depressive symptomatology, combined with unique environmental conditions on reservations, as critical factors in driving SB. We additionally propose to collect new longitudinal data to follow up on SB over the life span. Finally, we will use data from the existing and expanded cross-sectional cohort studies of teens and adults as well as the new longitudinal retrospective multi-cohort studies to develop comprehensive bio- psychosocial models of AUD and SB. The proposed analyses have the possibility of uncovering important risk and protective factors for SB in this unique high-risk population of AI, as well as identifying developmentally-relevant points of prevention and intervention to reduce the negative impacts of AUD and SB in adolescence and adulthood.

项目概要 自杀是一个重要的心理健康问题，但这个问题在任何地方都比在其他国家更引人注目和极端。 美洲印第安人/阿拉斯加原住民 (AI/AN) 和原住民 (FN)。尽管 AI/AN 之间的自杀率有所不同 社区，一些社区的比率几乎是全国平均水平的 10 倍。此外，美国流行病学 研究表明，与美国其他族裔群体相比，AI/AN 青少年和成年人的饮酒率最高 使用障碍（AUD），与严重残疾和死亡率相关。因此，研究确定了风险 AI/AN 青少年和成人自杀风险和药物使用障碍的因素和精神病理学机制 需要解决 AI/AN 所经历的巨大健康差异。然而全面的基于证据的研究 AI/AN 和 FN 中完全缺乏自杀风险和 AUD，尤其是包含生物措施的 AUD 人们。该研究计划的总体目标是确定神经机制以及个人和社区 美国社区样本中酒精和其他物质使用障碍和自杀行为 (SB) 的危险因素 居住在农村保留地的印第安人 (AI)。我们之前的研究记录了中度疾病终生患病率很高 该群体中患有严重酒精使用障碍 (AUD) (45%)，并且最近发现有过度的自杀行为 （>15% 尝试过）AI 成人。我们的数据集是独一无二的，因为它包括广泛的临床数据、心理社会测量、 睡眠、电生理学和全基因组测序数据。我们建议使用这个丰富的数据集来确定是否 这组人工智能具有远端和近端危险因素和生物标志物（电生理和遗传），与 文献中描述的一般人群样本，或者具有 SB 的独特决定因素。由于住在保留地 可能会为人工智能中的 SB 添加特别独特的风险因素，我们还建议使用最先进的地理编码方法来 获取有关 SB 风险因素的新社区数据。我们方法的独特之处在于我们强调高层次的角色 饮酒水平和 AUD 会诱发抑郁症状，再加上独特的环境 预订条件是推动 SB 的关键因素。我们还建议收集新的纵向数据 在 SB 的整个生命周期内进行跟进。最后，我们将使用现有和扩展的横断面队列研究的数据 青少年和成人的研究以及新的纵向回顾性多队列研究，以开发全面的生物 AUD 和 SB 的心理社会模型。所提出的分析有可能发现重要的风险和 在这个独特的人工智能高风险人群中，SB 的保护因素，以及识别发展相关点 预防和干预以减少 AUD 和 SB 对青春期和成年期的负面影响。