The Pittsburgh ADHD Longitudinal Study: Predicting alcohol misuse, problems and disorder in mid-adulthood

匹兹堡多动症纵向研究：预测中年时期的酒精滥用、问题和障碍

基本信息

批准号：
10686855
负责人：
BROOKE S.G. MOLINA
金额：
$ 53.72万
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：
2020
资助国家：
美国
起止时间：
2020-09-25 至 2025-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10686855
关键词：
Address Adolescence Adolescent and Young Adult Adult Age Aging Alcohol abuse Alcohol consumption Alcoholism Alcohols Attention deficit hyperactivity disorder Behavioral Buffers Child Childhood Chronic Coupled Data Depressed mood Development Developmental Process Diagnosis Dimensions Disease Ecological momentary assessment Elderly Employment Environmental Risk Factor Etiology Family Goals Growth Health Heavy Drinking Impulsivity Individual Life Literature Longevity Longitudinal Studies Measurement Measures Mental Health Mental disorders Methods Moods National Institute on Alcohol Abuse and Alcoholism Nature Negative Reinforcements Outcome Pathway interactions Persons Phase Predictive Factor Process Prospective Studies Protocols documentation Psychiatric Diagnosis Recording of previous events Recovery Reporting Research Risk Risk Factors Sampling Sampling Studies Self Assessment Severities Sleep Sleep disturbances Social Environment Social support Stress Stretching Symptoms Testing Time Transact Vulnerable Populations Work alcohol misuse alcohol risk alcohol use disorder cohort coping cost design drinking emerging adult high risk drinking high risk population improved indexing informant longitudinal design middle age negative mood novel personalized medicine prospective stressor young adult

项目摘要

There is a striking dearth of longitudinal studies of alcoholism ontogeny to mid-adulthood from earlier developmental periods. The extent to which heavy drinking in adolescence and early adulthood persists into later life, and the reasons for its progression to mid-adulthood when employment and family responsibilities are approaching the “ascendant” midlife phase, is vastly under-studied. This is particularly problematic considering that high-risk drinking has increased 37% and AUD 47% among 30-44 year olds. NIAAA has prioritized a developmental approach to the identification of mechanisms underlying alcohol misuse and problems and co- occurring mental health conditions across the lifespan (Goals 1-2, Objective 1a). Cross-sectional research suggests shifting mechanisms of vulnerability with age, from positive to negative reinforcement processes. The Pittsburgh ADHD Longitudinal Study (PALS) is uniquely suited to address these important questions for a high-risk population: adults with a childhood diagnosis of Attention Deficit Hyperactivity Disorder (ADHD). The PALS was designed to prospectively study the onset, course, and causes of AUD in a large cohort of children with ADHD -- an established risk factor for adolescent and young adult AUD. The sample is currently aging through their 30s with > 90% retention (360 ADHD, 224 nonADHD) and provides a unique opportunity to test hypotheses about changing mechanisms of AUD risk and recovery over a large age span, into the late 30s, without empirical precedent. We propose to capitalize on the current age of the PALS sample to take advantage of this opportunity, with a novel emphasis on understanding the intersection of impulsivity and mood as it relates to ADHD risk for AUD. In addition to a wealth of prospectively assessed self- and informant-reported variables collected longitudinally in the PALS, the proposed new, expanded assessments stretching into mid-adulthood will include an ecological momentary assessment protocol (EMA) and behavioral task indices of impulsivity. The proposed 20-day EMA burst embedded in the prospective longitudinal design will characterize the dynamic nature and temporal ordering of alcohol risk processes (e.g., shift in impulsivity) not captured in traditional assessments and will integrate environmental (e.g., interpersonal stress) and individual factors (e.g., negative mood, sleep disturbances) to which individuals with ADHD may be more sensitive. Coupled with integrated examination of etiological processes across important developmental windows (adolescence, young adulthood, mid-adulthood), the prospective, expanded assessments (at ages 35, 37, and 39, with a 20-day EMA at age 35 or 37) will enhance understanding of developmental processes in relation to worsening and improving course of heavy drinking and alcohol problems through mid-adulthood when life altering consequences become especially costly. Results hold promise for developing personalized medicine treatment targets that may be particularly efficacious for reducing AUD risk among adults with a history of ADHD.

从早期的发育时期开始，酗酒的纵向研究到中期的纵向研究显着死亡。青少年和成年早期的大量饮酒持续到以后的生活，以及当就业和家庭责任临近“上升”中年生活阶段时，其发展的原因非常不足。考虑到30-44岁的高风险饮酒增加了37％，AUD 47％，这尤其有问题。 NIAAA优先考虑开发方法来识别滥用酒精和问题以及整个生命周期的精神健康状况的机制（目标1-2，目标1A）。横截面研究表明，随着年龄的增长，脆弱性的转移机制，从正面到负强化过程。匹兹堡ADHD纵向研究（PALS）非常适合针对高危人群解决这些重要问题：患有注意力不足多动过度活跃障碍（ADHD）的成年人。这些朋友旨在前瞻性地研究大量ADHD儿童的发作，过程和原因，这是青少年和年轻成人AUD的既定风险因素。该样本目前正在衰老30年代，保留率> 90％（360 ADHD，224 NONADHD），并提供了一个独特的机会，可以测试有关在30年代后期，在30年代后期变化的AUD风险和恢复机制，而没有经验先例。我们建议利用PALS样本的当前年龄，以利用这一机会，重点是理解冲动性和情绪与ADHD风险有关的相交。除了大量预期评估的自我和线人报告的变量外，在朋友们纵向收集的变量外，拟议的新的，扩展的评估延伸到中期，还包括生态瞬时评估方案（EMA）和冲动性的行为任务指数。预期纵向设计中嵌入的20天EMA爆发将表征未在传统评估中捕获的酒精风险过程的动态性质和临时订购（例如，冲动性的转变），并将综合的环境（例如，际交往压力）和个人因素（例如，负面的情绪，睡眠，睡眠障碍）对具有更高敏感的个人的综合性。再加上对重要发育窗口（青春期，成年，年轻人，中期）的病因过程的一体化检查，预期的，扩大的评估（在35、37和39岁之间，在35岁或37岁时的EMA都有20天的EMA年龄在35岁或37岁之间）将加强对饮酒和饮酒的发展，并增强对饮酒的发展，而饮酒的发展过程会加剧，并且饮酒的发展过程会增强 - 饮酒的发展过程 - 昂贵。结果有望建立个性化医学治疗目标，这对于降低ADHD史的成年人的AUD风险可能特别有效。