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

基本信息

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
项目类别：
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

项目摘要

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（通过应用程序提供）：注意力缺陷/多动症（ADHD）是最常见的心理健康状况之一，起源于儿童时期，可以预测早期的成人药物使用障碍（SUDS）。但是，这些结果是高度可变的，并且经常从未经了解的研究中散发出来。最重要的是，试图通过专注于SUD风险的介体和主持人的研究来解释这种可变性，超越行为障碍合并症和兴奋剂治疗，需要扩展以为治疗和预防提供信息。 MTA中儿童的前瞻性纵向随访（ADHD的多模式治疗），这是一项多站点研究，开始是一项对药物管理，行为疗法及其对儿童ADHD组合组合亚型组合的随机临床试验，为解决这些问题提供了独特的机会。 MTA样本很大（579 ADHD； 289个同学比较儿童），在成年初期有16年的时间保留良好，它为理论驱动的有关ADHD相关SUD的介体和主持人的新的和创新的假设提供了新的力量。招募时狭窄的年龄范围（7-9.9）与纵向跟踪相结合，可以提高测试年龄特定关联的功率，以及贡献变量的发展发展，对干预时间的影响。多站点的设计和招聘策略可提高发现的普遍性。从儿童期到成年早期的前瞻性数据包括对与SUD风险有关的变量的全面药物使用措施和多重携带者评估。当参与者在20年代中期，MTA样本的16年随访的数据收集在2013年完成了NIDA合同支持。提供了用于数据收集的资金，但提供了有限的支持以进行数据分析，并且在可获得成人数据之前，此支持就结束了。该应用程序旨在支持测试机械发育假设所需的协作分析工作，除了迄今为止测试的简单双变量协会外，关于ADHD与ADHD有关的发作，升级，课程和毒品使用和SUD的原因和SUD的原因和MTA成年初期。我们强调了我们最近发表的评论中对理论知识的假设的检验，该假设与典型和高风险儿童中药物滥用风险的病因相结合，并与最近有关ADHD相关障碍的文献和青少年和成年后的近期文献融合了文献。这些假设的创新测试将对理解风险过程的发展特异性有影响，尤其是在过渡到成年期间。从发现的洞察力可以确定成年后这种发展桥梁的新型治疗目标。