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: 8507705
• 负责人: DANIEL ROMER
• 金额: $ 43.22万
• 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/8507705
• 关键词: Adolescence; Adolescent; Adult; Adverse drug effect; Adverse effects; Age; Alcohols; Behavior; Cross-Sectional Studies; Data; Deltastab; Dimensions; Disease; Drug usage; Early Intervention; 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; drug abuse prevention; 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).

描述（由申请人提供）：青春期药物使用的早期发作，尤其是酒精和烟草，已与后来的SUD症状有关。此外，青春期中酒精的使用与认知功能的损害有关，尤其是工作记忆能力（WMA）。这些发现表明，防止青春期初期使用药物使用的干预措施可以帮助避免吸毒的许多不利后果，包括不仅SUD，而且包括WMA的损害。尽管有这些证据，但早期发作影响的基础机制仍不清楚。本研究旨在阐明这些机制，以便可以提出对预防的更坚定的影响。特别是，以前的研究主要基于对青春期药物使用的回顾性报告的成年人的横断研究。这项研究无法确定药物使用的早期开始是否仅仅包括对药物的实验，或者仅仅是药物使用的早期进展。早期开始假设将预测早期进展是后期不良结果的更关键因素。此外，先前的研究表明，早期的药物使用仅是更普遍存在的易于疾病的标志物，这些漏洞会增加青春期和成年后的结果的风险。本研究旨在通过对费城青少年（N = 387）的纵向研究进行后续研究来对这些相互竞争的假设进行测试，该研究的年龄为10-12岁，并每年由我们的研究人员团队每年评估5年。费城轨迹研究（PTS）具有有关WMA的纵向数据以及不同形式的冲动性，表明早期使用药物（无论是导致进展是否导致进展）与反映WMA无力无力的冲动趋势有关。 PT表明，WMA和相关的冲动性是后来不良药物影响的潜在风险因素，而不是早期开始本身。如果这个 假设已得到证实，这表明早期的WMA培训可能是预防药物不利影响的宝贵预防策略。拟议的研究对PT进行了一次随访评估，当该队列的药物使用率高的年龄和SUD风险的年龄范围（18-19）可以确定早期的药物使用脆弱性是否可以解释早期实验中的差异与药物使用的进展以及SUD症状的后期开始（AIM 1）。它还可以确定WMA的早期弱点和相关的冲动性形式是否仍然是与后期药物使用有关的WMA潜在损害的风险因素（AIM 2）。最后，它可以确定除了吸毒之外的其他不良结果是否可以追溯到WMA的早期弱点，例如问题赌博，反社会行为，性风险和学习成绩不佳（AIM 3）。