Early Substance Use in Rural American Indian and White/Anglo Youth

美国农村印第安人和白人/盎格鲁青年的早期药物使用

• 批准号: 8811113
• 负责人: Lilly Shanahan
• 金额: $ 22.28万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-03-01 至 2017-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8811113
• 关键词: 15 year old; Accounting; Achievement; Adolescent; Adult; Age; Age of Onset; Alcohol or Other Drugs use; American Indians; Antibodies; Basic Science; Biological; Brain; C-reactive protein; Child; Child Behavior; Child Rearing; Childhood; Communities; Coupled; Crime; Data; Data Analyses; Data Set; Dependence; Development; Drug abuse; Environment; Environmental Risk Factor; Ethnic Origin; Event; Exposure to; Family history of; Female; Fetal Alcohol Exposure; Funding; Goals; Health; Human Herpesvirus 4; Individual; Interpersonal Relations; Intervention Studies; Knowledge; Life; Life Cycle Stages; Long-Term Effects; Longitudinal Studies; Low Birth Weight Infant; Methods; Modeling; National Institute of Drug Abuse; Outcome; Pathway interactions; Perinatal; Physiological; Population; Poverty; Prevalence; Prevention; Prevention Research; Puberty; Race; Research; Research Personnel; Risk; Risk Behaviors; Risk Factors; Rural; Sampling; Schools; Services; Sex Characteristics; Socioeconomic Status; Staging; Stress; Substance Use Disorder; Surgeon; Symptoms; Testing; Time; Tribes; Youth; addiction; adolescent substance use; design; developmental disease; deviant; environmental stressor; experience; high risk; innovation; insight; male; parental involvement; parental monitoring; peer; prenatal; prevent; programs; psychologic; psychosocial; resilience; response; social; tobacco exposure; young adult

DESCRIPTION (provided by applicant): Early substance use (E-SU) is known to increase the risk of abuse, dependence, addiction, polydrug use, and other problematic outcomes in adulthood. Therefore, the U.S. Surgeon General's office has issued a call-to-action to stop underage use, especially in adolescents less than 15 years of age. This goal is especially compelling for American Indians, for some of whom lifetime burden from substance use is particularly high. In order to prevent E-SU effectively, however, we need firm evidence regarding the childhood environment that increases (or decreases) children's risk for E-SU. Yet very little is presently known about early environmental risks for E-SU specifically and in diverse samples, which constitutes a major gap in knowledge with substantial implications for prevention. The proposed research fills in this gap by applying a developmental life course model to longitudinal data spanning childhood to age 30. Specifically, we propose to examine developmental features of environmental risk, including distinctions of timing, duration, and co-occurrence with other risks; the earliest ages of onset; protective factors that could neutralize risk; and vulnerability factors that could exacerbate the contributions of the risk environment to E-SU. Many studies are also not informative about sex differences in associations between risk and E-SU or co-occurring adolescent psychological, social, and biological transitions such as puberty. The proposed program of secondary data analyses tests a life-course developmental model of E-SU that examines whether youth with E-SU are characterized by distinct profiles of risk and protective factors compared to their peers. Because E-SU occurs during periods of major psychosocial and brain developments, our life-course model also tests whether E-SU itself contributes to poor adult outcomes, even when holding constant prior environmental risk and child behaviors. Data come from a large ongoing, community-representative, prospectively longitudinal, study, the Great Smoky Mountains Study (GSMS). The GSMS has assessed a wide array of risk factors, use of many different substances, additional psychiatric symptoms and disorders, and the developmental transitions from childhood to young adulthood on up to eleven occasions spanning ages 9 to 30, providing an unparalleled opportunity to study pathways to and from E-SU. The dataset also includes a sizable American Indian subsample, allowing us to test our life-course model of E-SU in this understudied population. The proposed analyses offer an unprecedented opportunity to generate new insights into risk, resilience, and outcomes for E-SU in rural American Indian and Anglo females and males. Results from the proposed research will have implications for both prevention and intervention research by identifying who is most at risk for early substance use, when, and why. Results will also have implications for basic research investigating associations between E-SU and long- term outcomes, because such associations can only be understood when the early risk environment of E-SU is well-characterized and taken into account.

描述（由申请人提供）：众所周知，早期物质使用（E-SU）会增加成年后滥用、依赖、成瘾、多种药物使用和其他问题结果的风险。因此，美国卫生局局长办公室发出了停止未成年人使用的号召，特别是15岁以下的青少年。这一目标对于美国印第安人来说尤其引人注目，因为他们中的一些人终生因药物滥用而承受的负担特别高。然而，为了有效预防 E-SU，我们需要关于增加（或减少）儿童 E-SU 风险的童年环境的确凿证据。然而，目前对 E-SU 的早期环境风险（特别是在不同样本中）知之甚少，这构成了对预防具有重大影响的知识空白。拟议的研究通过将发展生命历程模型应用于从童年到 30 岁的纵向数据来填补这一空白。具体来说，我们建议检查环境风险的发展特征，包括时间、持续时间以及与其他风险共现的区别；最早发病年龄；可以抵消风险的保护因素；和脆弱性 可能加剧风险环境对 E-SU 影响的因素。许多研究也没有提供有关风险与 E-SU 或同时发生的青少年心理、社会和生物转变（例如青春期）之间关联的性别差异的信息。拟议的二次数据分析计划测试了 E-SU 的生命历程发展模型，该模型检查 E-SU 青少年与同龄人相比是否具有不同的风险和保护因素特征。由于 E-SU 发生在主要的心理社会和大脑发育时期，因此我们的生命历程模型还测试了 E-SU 本身是否会导致不良的成人结果，即使在先前的环境风险和儿童行为保持不变的情况下也是如此。数据来自一项大型正在进行的、具有社区代表性的、前瞻性纵向研究，即大烟山研究 (GSMS)。 GSMS 评估了 9 至 30 岁之间的 11 次风险因素、多种不同物质的使用、其他精神症状和疾病以及从儿童期到青年期的发育转变，为研究途径提供了无与伦比的机会往返 E-SU。该数据集还包括相当大的美洲印第安人子样本，使我们能够在这个未被充分研究的人群中测试我们的 E-SU 生命历程模型。拟议的分析提供了前所未有的机会，可以对美洲印第安人和盎格鲁女性和男性农村地区 E-SU 的风险、复原力和结果产生新的见解。拟议研究的结果将通过确定谁最有可能早期使用药物、何时以及为何而对预防和干预研究产生影响。结果还将对调查 E-SU 与长期结果之间关联的基础研究产生影响，因为只有在充分描述并考虑 E-SU 的早期风险环境时才能理解这种关联。