Early onset vs. pre-existing vulnerabilities in adolescent drug use

青少年吸毒的早期发病与预先存在的脆弱性

• 批准号: 8342916
• 负责人: DANIEL ROMER
• 金额: $ 50.35万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-15 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8342916
• 关键词: Adolescence; Adolescent; Adult; Adverse drug effect; Adverse effects; Age; Alcohols; Behavior; Cross-Sectional Studies; Data; Deltastab; Dimensions; Disease; Drug usage; Early treatment; Esthesia; Gambling; Goals; Impairment; Impulsivity; Intervention; Late Effects; Lead; Life; Link; Mediating; Outcome; Pattern; Performance; Pharmaceutical Preparations; Philadelphia; Prevention; Prevention strategy; Problem behavior; Reporting; Research; Research Personnel; Risk; Risk Factors; Risk-Taking; Short-Term Memory; Social Behavior; Source; Substance Use Disorder; Symptoms; Testing; Thinking; Tobacco; Training; adolescent drug use; adverse outcome; anti social; base; cognitive function; cohort; disability; discounting; early adolescence; early onset; early onset drug use; follow-up; mortality; prevent; underage drinking

DESCRIPTION (provided by applicant): Early onset of drug use in adolescence, especially alcohol and tobacco, has been repeatedly linked to later symptoms of SUD. In addition, use of alcohol during adolescence has been linked to impairment of cognitive function, especially working memory ability (WMA). These findings suggest that intervention to prevent the initiation of drug use during early adolescence could help to avert many of the adverse consequences of drug use, including not only SUD but also impairment of WMA. Despite this evidence, the mechanisms underlying the effects of early onset remain unclear. The present research aims to clarify those mechanisms so that firmer implications for prevention can be drawn. In particular, previous research has been based primarily on cross- sectional studies of adults with retrospective reports of drug use during adolescence. This research cannot determine whether early initiation of drug use includes mere experimentation with drugs or only the early progression of drug use. The early onset hypothesis would predict that early progression is the more critical factor for later adverse outcomes. In addition, previous research suggests that early drug use is merely a marker for more general pre-existing vulnerabilities that increase the risks of those outcomes in later adolescence and adulthood. The present research aims to provide a test of these competing hypotheses by conducting a follow-up study of a longitudinal-cohort of Philadelphia adolescents (N=387) that started at ages 10-12 and that were assessed annually for 5 years by our team of researchers. The Philadelphia Trajectory Study (PTS) has longitudinal data on WMA as well as different forms of impulsivity that indicate that early use of drugs, whether it leads to progression or not, is related to impulsive tendencies that reflect weakness in WMA. The PTS suggests that WMA and associated forms of impulsivity are the underlying risk factors for later adverse drug effects rather than early initiation per se. If this hypothesis were confirmed, it would suggest that early WMA training might be a valuable prevention strategy to prevent the adverse effects of drugs. The proposed study with a single follow-up assessment of the PTS when the cohort will be in an age range of high drug-use initiation and risk for SUD (18-19) can determine whether early vulnerabilities for drug use can explain differences in early experimentation vs. progression in drug use as well as later initiatio for symptoms of SUD (Aim 1). It can also determine whether early weakness in WMA and associated forms of impulsivity remain as risk factors for potential impairment in WMA linked to later drug use (Aim 2). Finally, it can determine whether other adverse outcomes apart from drug use are traceable to early weakness in WMA, such as problem gambling, anti-social behavior, sexual risks, and poor academic performance (Aim 3). PUBLIC HEALTH RELEVANCE: Disorders resulting from drug use are a major source of disability and mortality in the U.S. Initiation of drug use, especially alcohol and tobacco, prior o age 15 has been more strongly linked to the emergence of those disorders than initiation that occurs later in life. Understanding the mechanism linking early drug use with later adverse outcomes has important implications for strategies to prevent those outcomes. The present research will test two competing explanations for this association that can help to identify prevention strategies for the adverse effects of drug use.

描述（由申请人提供）：青春期早期吸毒，尤其是酗酒和吸烟，已多次与 SUD 的后期症状相关。此外，青春期饮酒与认知功能受损有关，尤其是工作记忆能力（WMA）。这些发现表明，预防青春期早期开始吸毒的干预措施可能有助于避免吸毒的许多不良后果，不仅包括 SUD，还包括 WMA 受损。尽管有这些证据，但早发影响的机制仍不清楚。本研究旨在阐明这些机制，以便对预防产生更明确的影响。特别是，之前的研究主要基于对成年人的横断面研究以及青春期吸毒情况的回顾性报告。这项研究无法确定早期开始吸毒是否包括单纯的药物实验或仅包括吸毒的早期进展。早发假说预测，早期进展是后期不良后果的更关键因素。此外，之前的研究表明，早期吸毒只是更普遍的先前存在的脆弱性的一个标志，这些脆弱性增加了青春期后期和成年期出现这些结果的风险。本研究旨在通过对费城青少年纵向队列 (N=387) 进行后续研究，对这些相互竞争的假设进行检验，该研究从 10-12 岁开始，我们的团队在 5 年内每年进行一次评估的研究人员。费城轨迹研究 (PTS) 有关于 WMA 以及不同形式的冲动的纵向数据，这些数据表明，早期使用药物，无论是否导致进展，都与反映 WMA 弱点的冲动倾向有关。 PTS 表明，WMA 和相关形式的冲动是后来药物不良反应的潜在危险因素，而不是早期开始用药本身。如果这个 假设得到证实，这表明早期 WMA 训练可能是预防药物不良反应的一种有价值的预防策略。当队列处于高吸毒开始和 SUD 风险的年龄范围（18-19 岁）时，拟议的研究对 PTS 进行单一后续评估，可以确定早期吸毒脆弱性是否可以解释早期吸毒的差异。药物使用的实验与进展以及 SUD 症状的后期启动（目标 1）。它还可以确定早期 WMA 无力和相关形式的冲动是否仍然是与后期吸毒相关的 WMA 潜在损害的危险因素（目标 2）。最后，它可以确定除吸毒之外的其他不良后果是否可归因于 WMA 的早期弱点，例如赌博问题、反社会行为、性风险和学业成绩不佳（目标 3）。 公共卫生相关性：在美国，吸毒引起的疾病是残疾和死亡的一个主要原因。15 岁之前开始吸毒，尤其是酗酒和吸烟，与这些疾病的出现的关联性比 15 岁以后开始吸毒的关联性更强。在生活中。了解早期药物使用与后期不良后果之间的联系机制对于预防这些后果的策略具有重要意义。目前的研究将测试这种关联的两种相互竞争的解释，这有助于确定药物使用不良反应的预防策略。