Pathways to adult substance use and abuse from childhood ADHD in the MTA

MTA 儿童多动症导致成人药物使用和滥用的途径

• 批准号: 9150603
• 负责人: BROOKE S.G. MOLINA
• 金额: $ 25.92万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-30 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9150603
• 关键词: Academic support; Address; Adolescence; Adolescent; Adult; Affect; Age; Alcohol or Other Drugs use; Attention deficit hyperactivity disorder; Behavior Therapy; Child; Childhood; Combined Modality Therapy; Comorbidity; Conduct Disorder; Data; Data Analyses; Data Collection; Development; Diagnosis; Drug Addiction; Drug abuse; Etiology; Funding; Growth; Health; Heterogeneity; Impairment; Individual; Intervention; Knowledge; Literature; Measures; Mediating; Mediator of activation protein; Medication Management; Mental Health; Methods; Modeling; National Institute of Drug Abuse; Outcome; Paper; Parents; Participant; Pathway interactions; Pharmaceutical Preparations; Population; Prevention; Process; Publishing; Randomized Clinical Trials; Recurrence; Reporter; Reporting; Research; Risk; Risk Factors; Sampling; Series; Services; Site; Smoker; Smoking; Specificity; Substance Use Disorder; Substance abuse problem; Symptoms; Testing; Time; United States; Work; adolescent substance use; base; binge drinking; design; disorder risk; early onset; emerging adult; follow-up; high risk; improved; inattention; innovation; insight; marijuana use; mood symptom; novel; parental involvement; peer; prospective; psychologic; theories; therapy development; young adult

 DESCRIPTION (provided by applicant): Attention-Deficit/Hyperactivity Disorder (ADHD), one of the most common mental health conditions with origins in childhood, predicts early adulthood substance use disorders (SUDs). However, these outcomes are highly variable and often emanate from research that was not developmentally informed. Most importantly, research that seeks to explain this variability by focusing on mediators and moderators of SUD risk, beyond Conduct Disorder comorbidity and stimulant treatment, needs expansion to inform treatment and prevention. The prospective longitudinal follow-up of the children in the MTA (Multimodal Treatment of ADHD), a multi-site study that began as a randomized clinical trial of medication management, behavior therapy, and their combination for childhood ADHD Combined Subtype, provides a unique opportunity to address these concerns. The MTA sample is large (579 ADHD; 289 classmate comparison children), with good retention over 16 years into early adulthood, and it provides ample power for new and innovative tests of theory-driven hypotheses about mediators and moderators of ADHD-related risk of SUD. The narrow age range at recruitment (7-9.9) combined with longitudinal tracking improves power to test age-specific associations and developmental unfolding of contributing variables with implications for timing of interventions. The multi-site design and recruitment strategies improve generalizability of findings. Prospective data from childhood (pre- substance use) to early adulthood include comprehensive substance use measures and multiple-reporter assessments of variables pertinent to SUD risk. Data collection for the 16-year follow-up of the MTA sample, when participants were in their mid-20s, was completed in 2013 with NIDA contractual support. Funds were provided for data collection but limited support was provided for data analysis-and this support ended before adult data were available. Thus, this application seeks funding crucial to support the collaborative analytic work needed to test mechanistic developmental hypotheses, beyond simple bivariate associations tested to date, about ADHD-related onset, escalation, course, and causes of substance use and SUD into early adulthood in the MTA. We emphasize tests of theory-informed hypotheses from our recent published review that integrated literature on the etiology of drug abuse risk in typical and high risk children with the recent literature on ADHD- related impairments in adolescence and adulthood. Innovative tests of these hypotheses will have implications for understanding developmental specificity of risk processes, particularly in the transition to adulthood. Insights from the findings may identify novel treatment targets for this developmental bridge into adulthood.

 描述（由申请人提供）：注意力缺陷/多动障碍 (ADHD) 是起源于儿童期的最常见的心理健康状况之一，可预测成年早期的物质使用障碍 (SUD)。然而，这些结果变化很大，并且经常出现。最重要的是，除了行为障碍合并症和兴奋剂治疗之外，试图通过关注 SUD 风险的中介因素和调节因素来解释这种变异性的研究需要扩大到MTA（ADHD 多模式治疗）中儿童的纵向随访是一项多中心研究，最初是针对儿童 ADHD 联合亚型的药物管理、行为疗法及其组合的随机临床试验。 ，为解决这些问题提供了一个独特的机会，MTA 样本量很大（579 名多动症儿童；289 名同学比较儿童），在成年早期的 16 年内保持良好，并且为新的和创新的测试提供了充足的动力。关于 ADHD 相关 SUD 风险的中介因素和调节因素的理论驱动假设，招募时的狭窄年龄范围 (7-9.9) 与纵向跟踪相结合，提高了测试年龄特异性关联和影响变量的发育展开的能力，并对招募时间产生影响。多地点设计和招募策略提高了从儿童（药物使用前）到成年早期的前瞻性数据，包括全面的药物使用措施和与 SUD 风险相关的变量的多报告者评估。 MTA 样本的 16 年随访于 2013 年完成，当时参与者为 20 多岁，NIDA 为数据收集提供了合同支持，但为数据分析提供了有限的支持，并且这种支持在成年之前结束。因此，除了迄今为止测试的简单双变量关联之外，该申请还寻求资金来支持测试机制发展假设所需的协作分析工作，这些假设涉及 ADHD 相关的发病、升级、病程以及物质使用和原因。在 MTA 中，我们强调对基于理论的假设进行检验，该综述将典型和高危儿童药物滥用风险病因学的文献与青春期和成年期 ADHD 相关障碍的最新文献相结合。这些假设的创新测试将对理解风险过程的发育特异性产生影响，特别是在向成年期的过渡过程中。研究结果的见解可能会为这一通往成年期的发育桥梁确定新的治疗目标。