Alcohol Use Disorders Across the Lifespan: Subtypes, Course, Comorbidity

整个生命周期的酒精使用障碍：亚型、病程、合并症

• 批准号: 7623200
• 负责人: KENNETH JAMES SHER
• 金额: $ 26.34万
• 依托单位: UNIVERSITY OF MISSOURI-COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-15 至 2012-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7623200
• 关键词: Address; Adolescence; Adolescent; Adult; Affect; Age; Alcohols; Classification; Clinical; Cluster Analysis; Comorbidity; Cross-Sectional Studies; DSM-IV; Data; Data Set; Dependence; Development; Disease; Disease remission; Drug Use Disorder; Ethnic Origin; Etiology; Factor Analysis; Family; Frequencies; Friends; Gender; Genetic; Goals; Health; Individual; Investigation; Literature; Longevity; Measurement; Mental disorders; Methodology; Methods; Mind; Modeling; Morphologic artifacts; NIH Program Announcements; National Institute on Alcohol Abuse and Alcoholism; Nature; Nicotine Dependence; Pathology; Personality; Personality Assessment; Personality Disorders; Phenotype; Play; Prevalence; Probability; Property; Psychometrics; Psychopathology; Public Health; Race; Research; Research Personnel; Research Project Grants; Role; Sample Size; Sampling; Societies; Staging; Statistical Methods; Structure; Surveys; Symptoms; Syndrome; Targeted Research; Techniques; Time; Work; Writing; age related; alcohol epidemiology; alcohol use disorder; developmental disease; disease classification; disorder subtype; emerging adult; follow-up; functional hypothalamic amenorrhea; interest; meetings; novel; person centered; population based; prognostic; remission/regression; response; scaffold; sex

DESCRIPTION (provided by applicant): This is a revision of an amended application (1 R01 AA016392-01A1) written in response to NIAAA Program Announcement (05-088) Secondary Analysis of Existing Alcohol Epidemiology Data and reviewed by the BGES IRG at its October, 2006, meeting. In this revision, we have attempted to address concerns raised by the reviewers of the initial submission while maintaining our original primary goals which involve characterizing the structure and course of alcohol use disorders (AUDs) as a function of late adolescent and adult development by exploiting the unique aspects of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) study which include extensive assessment of psychopathology (including both Axis I and Axis II disorders), population-based sampling, large (~43,000 individuals) sample size, coverage of the adult age span, and three-year longitudinal follow-up. Our main focus is on the psychometric structure and course (e.g., onset, progression, regression, and remission/desistence) of AUDs as a function of development (chronological age). Although alcohol researchers increasingly view AUDs as developmental disorders, little is known about whether the structure of the dependence syndrome (assessed either dimensionally or categorically) varies as a function of development and the role that various covariates play in determining course at different points along the lifespan. In addition to focusing on age as critical scaffolding for understanding AUDs from both a measurement and prognostic perspective, we plan to examine how other major demographic (i.e., sex and race/ethnicity) and clinical variables (i.e., Axis I and Axis II pathology) interact with age to affect the structure and course of AUDs. We are particularly interested in extending previous work by using the NESARC's assessment of personality pathology, a unique aspect of this data set. We believe personality pathology plays an important but under-recognized role in the etiology and course of AUDs, and plan extensive and systematic analyses to portray the nature of AUD/personality disorder (Axis II) comorbidity. Because of the high comorbidity between Axis I "clinical syndromes" and Axis II disorders, it is unclear to what extent the existing literature on AUD comorbidity with Axis I disorders represents an artifact of pathology. Only by comprehensively and simultaneously modeling both Axis I and Axis II pathology can we resolve the extent that various comorbid syndromes have a statistically unique relation with AUDs. In addition to the substantive goals of the research project, we also propose to develop and refine methodologies for characterizing alcohol-related syndromes and studying their stabilities over time. We believe these psychometric investigations can inform both clinical nosology and researchers interested in novel phenotypes that may be useful in genetic investigations. Relevance to public health: Alcohol use disorders (AUDs) are among the most prevalent psychological disorders in the Nation and produce substantial burden to affected individuals, their friends and families, and society at large. Although primarily a disorder of adolescence and early adulthood, AUDs represent significant health challenges throughout the course of adulthood. The proposed study seeks to characterize factors important in the development and course of AUDs as a function of stage of adult development in order to better understand the causes and consequences of AUDs in a developmental context.

描述（由申请人提供）：这是对NIAAA计划公告（05-088）编写的修订申请（1 R01 AA016392-01A1）的修订版，对现有酒精流行病学数据的次要分析，并由BGES IRG IRG于2006年10月在2006年10月的会议上进行了审查。 In this revision, we have attempted to address concerns raised by the reviewers of the initial submission while maintaining our original primary goals which involve characterizing the structure and course of alcohol use disorders (AUDs) as a function of late adolescent and adult development by exploiting the unique aspects of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) study which include extensive assessment of psychopathology (including both Axis I and Axis II disorders),基于人群的抽样，大（约43,000个个体）样本量，成人年龄跨度的覆盖范围和三年的纵向随访。我们的主要重点是AUDS的心理测量结构和过程（例如，发作，进展，回归和缓解/抑制）作为发展的函数（年代年龄）。尽管酒精研究人员越来越多地将AUD视为发育障碍，但对依赖综合征的结构（尺寸或分类评估）是否随发育的函数以及各种协变量在寿命沿不同点确定过程中所起的作用而有所不同。除了关注年龄作为从测量和预后的观点了解auds的关键脚手架外，我们计划研究其他主要人口统计学（即性别和种族/种族）以及临床变量（即Axis I和Axis II病理学）与年龄相互作用的其他主要人口（即性别和种族/种族）如何影响听闻的结构和过程。我们特别有兴趣通过使用NESARC对人格病理学的评估来扩展以前的工作，这是该数据集的独特方面。我们认为，人格病理学在auds的病因和过程中起着重要但不认可的作用，并计划进行广泛而系统的分析来描绘AUD/人格障碍（AXIS II）合并症的性质。由于轴I“临床综合征”和II轴II疾病之间的合并症很高，因此尚不清楚有关与轴I障碍的AUD合并症现有文献在多大程度上代表了病理的伪像。只有通过全面和同时对轴I和Axis II病理进行建模，我们才能解决各种合并症综合征与AUDS具有统计独特的关系的程度。除了研究项目的实质目标外，我们还建议开发和完善与酒精相关综合症并随时间研究其稳定性的方法。我们认为，这些心理测量调查可以为临床疾病学和对新表型感兴趣的研究人员提供信息，这可能在遗传研究中有用。 与公共卫生有关：饮酒障碍（AUD）是全国最普遍的心理障碍之一，并给受影响的个人，他们的朋友和家人以及整个社会带来巨大负担。尽管主要是青春期和成年早期的疾病，但在整个成年期间，AUDS代表着重大的健康挑战。拟议的研究旨在表征在成人发展阶段的函数中，在AUD和过程中重要的因素，以便更好地了解在发育环境中AUD的原因和后果。