Vulnerability Factors Among Migrant Puerto Rican Fami

波多黎各移民家庭的脆弱因素

• 批准号: 6982809
• 负责人: kathleen r merikangas
• 金额: --
• 依托单位: NATIONAL INSTITUTE OF MENTAL HEALTH
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/6982809
• 关键词: Puerto Rican; adolescence (12-20); behavioral /social science research tag; comorbidity; culture; disease /disorder proneness /risk; epidemiology; family structure /dynamics; human migration; human subject; longitudinal human study; psychopathology; social psychology; socioenvironment; statistics /biometry; substance abuse related behavior; substance abuse related disorder

Substance abuse and its sequelae, particularly AIDS and interpersonal violence, constitute a contemporary public health crisis of ever-widening impact. The increasing risk of substance abuse in youth, particularly among urban minorities, reveals the need for prevention and early intervention measures. Elucidation of the role of specific familial and sociocultural factors in the development of drug use and abuse would yield targets for primary and secondary prevention of substance abuse and its complications. This application proposes to integrate family and migrant study methodology in a five-year prospective epidemiologic study of adolescent offspring of native and migrant Puerto Rican substance abusers and controls. The wave of migration of Puerto Ricans to Connecticut over several decades provides an exceptional opportunity to differentiate cultural, familial, and individual risk and protective factors for adolescent drug use and abuse. Puerto Ricans are an important yet understudied ethnic subgroup characterized by an apparently low prevalence of substance use and abuse on the island of Puerto Rico, yet by a prevalence of AIDS that is among the greatest in the world. Migrant study methodology permits identification of environmental risk factors for substance use/abuse by comparing the disease experience of biologically similar subgroups in their native and adopted environments. The family study method enables the identification of transmissible components of a condition by comparing the rates and risk factors for diseases in relatives of cases with those of controls. Combining these two approaches in a single study to investigate risk factors for substance abuse allows us to: a) identify the relative contribution of family history of substance abuse and psychopathology on drug use and abuse in Puerto Rican adolescents while taking into account the influence of cultural environment, and b) identify the relative contribution of cultural factors on the risk of adolescent substance use and abuse, while taking into account background familial factors. The main aims of the study are: (1) to elucidate familial patterns of substance use and abuse and comorbid psychopathology among island and mainland Puerto Ricans; (2) to investigate the role of specific sociocultural factors in the development of adolescent substance use and abuse; (3) to identify and model the dynamics of the salient risk and protective factors at the individual, familial, and environmental levels for Puerto Rican adolescents at high and low risk for the development of substance abuse by virtue of parental substance abuse, and; (4) to conduct a longitudinal follow-up of the offspring to examine transitions in substance use status, and the association between the early patterns of substance use and comorbid psychopathology (including course and outcomes), as well as examine the stability of the assessments. Data collection of this study was completed at Yale University before the Principal Investigator?s relocation to the NIMH. The resources of our section have been devoted to developing analytic models for this complex data set comprised of families nested within sites. With outside statistical consultation, we have completed the initial analyses of these data. There are several manuscripts in preparation to report the results of this unique study. During the next year, we expect to submit several papers on this project for publication. This project serves as a model for cross-cultural research that uses the migrant study design to identify specific cultural risk factors that may serve as targets for prevention and intervention.

药物滥用及其后遗症，特别是艾滋病和人际暴力，构成了影响日益扩大的当代公共卫生危机。青少年（尤其是城市少数民族）滥用药物的风险日益增加，这表明需要采取预防和早期干预措施。阐明特定家庭和社会文化因素在药物使用和滥用发展中的作用将为药物滥用及其并发症的一级和二级预防提供目标。 该申请提议将家庭和移民研究方法纳入对波多黎各本土和移民药物滥用者和对照青少年后代的为期五年的前瞻性流行病学研究。几十年来波多黎各人向康涅狄格州移民的浪潮为区分青少年吸毒和滥用的文化、家庭和个人风险及保护因素提供了绝佳的机会。波多黎各人是一个重要但尚未得到充分研究的族裔亚群，其特点是波多黎各岛上药物使用和滥用的流行率明显较低，但艾滋病流行率却是世界上最高的。 移民研究方法允许通过比较生物学上相似的亚群在其原生环境和收养环境中的疾病经历来识别物质使用/滥用的环境风险因素。家庭研究方法通过比较病例亲属与对照组亲属的疾病发生率和危险因素，能够识别疾病的可传播成分。将这两种方法结合在一项研究中来调查药物滥用的危险因素，使我们能够：a）确定药物滥用家族史和精神病理学对波多黎各青少年药物使用和滥用的相对贡献，同时考虑到文化的影响b) 确定文化因素对青少年药物使用和滥用风险的相对影响，同时考虑背景家庭因素。该研究的主要目的是： (1) 阐明岛屿和大陆波多黎各人物质使用和滥用的家族模式以及共病精神病理学； (2) 调查特定社会文化因素在青少年药物使用和滥用发展中的作用； (3) 确定和模拟因父母滥用药物而处于药物滥用高风险和低风险的波多黎各青少年在个人、家庭和环境层面的显着风险和保护因素的动态； (4) 对后代进行纵向随访，以检查物质使用状况的转变，以及早期物质使用模式与共病精神病理学（包括病程和结果）之间的关联，并检查评估的稳定性。 本研究的数据收集是在首席研究员调往 NIMH 之前在耶鲁大学完成的。我们部门的资源致力于为这个由嵌套在站点内的家庭组成的复杂数据集开发分析模型。通过外部统计咨询，我们完成了对这些数据的初步分析。有几份手稿正在准备报告这项独特研究的结果。明年，我们预计将提交有关该项目的几篇论文以供发表。该项目作为跨文化研究的模型，利用移民研究设计来确定可作为预防和干预目标的特定文化风险因素。