Risk and resilience pathways linking community adversity, decision making, and alcohol misuse: A prospective study of Appalachian adolescents

将社区逆境、决策和酒精滥用联系起来的风险和复原力途径：对阿巴拉契亚青少年的前瞻性研究

• 批准号: 10013108
• 负责人: Alfgeir Kristjansson
• 金额: $ 55.09万
• 依托单位: WEST VIRGINIA UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-10 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10013108
• 关键词: Address; Adolescent; Adolescent Development; Adult; Affective; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; American; Appalachian Region; Area; Arousal; Attention; Attenuated; Behavior Therapy; Behavioral Mechanisms; Behavioral inhibition; Beverages; Caffeine; Censuses; Child; Child Rearing; Chronic; Cities; Communities; Consumption; Data; Data Collection; Decision Making; Development; Disadvantaged; Dose; Drowsiness; Drug usage; Emotional; Emotions; Ensure; Environment; Epidemic; Failure; Family; Fatigue; Frustration; Future; Geographic state; Growth; Headache; Health Promotion; Health behavior; Impairment; Individual Differences; Investigation; Learning; Link; Literature; Marijuana; Mental Health; Methods; Middle School Student; Modeling; Motor; Nausea; Neighborhoods; Neurocognitive; Nicotine; Pathway interactions; Patient Self-Report; Poverty; Prevalence; Process; Program Effectiveness; Property; Prospective Studies; Reporting; Research; Resources; Rewards; Risk; Risk Factors; Rural; Rural Community; Schools; Sleep; Sleep Disorders; Sleeplessness; Societies; Specific qualifier value; Stress; Students; Substance abuse problem; Symptoms; System; Task Performances; Testing; Well in self; West Virginia; Youth; affective disturbance; alcohol and other drug; alcohol misuse; alcohol use disorder; cognitive control; contextual factors; discounting; drug abuse vulnerability; early alcohol use; eighth grade; emotion regulation; junior high school; lifestyle factors; novel; opioid abuse; peer; prospective; protective factors; psychosocial; psychostimulant; resilience; rural area; rural poverty; rural setting; social; social determinants; teacher; underage drinking; urban setting; virtual

Abstract: Early adolescent alcohol use impairs psychosocial and neurocognitive development and increases vulnerabilities to drug abuse, academic failure, and mental health problems. The proposed research focuses on youth alcohol use in rural areas of West Virginia (WV), within the Appalachian region. Marginalized in American society, many Appalachian communities suffer chronic poverty and epidemic levels of opioid abuse. Emerging neurocognitive research stresses the maturation and integration of reward-salience and cognitive control systems asso- ciated with adolescent emotion regulation and healthy decision-making abilities. Development in decision making systems forecasts alcohol misuse, however, the factors that contribute to differ- ences in decision making trajectories are poorly understood. Also, accumulating research by our team and others links widespread use of caffeinated beverages by rural youth to alcohol use vulnerabilities. A psychostimulant possessing arousal, motor activation, and reinforcing proper- ties, even moderate doses of caffeine produce symptoms in children and adolescents, including headache, nausea, drowsiness, fatigue, mood disturbances, and sleeplessness. Despite these dangers, prospective investigations of routine caffeine use and the mechanisms through which it confers alcohol use vulnerability are virtually non-existent. We propose to investigate contextual protective factors hypothesized to attenuate the influence of community disadvantage on nega- tive emotionality, maladaptive health behavior, and decision-making trajectories. These factors include regulated, affectively positive family environments, health promoting classroom and school environments, and collective efficacy in local communities. We propose to address these issues in a prospective study of ~2,400 middle school youth from a range of rural, small town, and small city (< 30k) public schools in WV. Our specific aims are: 1. To test pathways linking community disadvantage to alcohol misuse. We expect community disadvantage to forecast slower growth in decision making processes directly and indirectly via negative emotionality which is reinforced by use of caffeine and attendant problems with sleep. In turn, we expect negative emotionality and decision making trajectories to forecast alcohol misuse via proximal vulnerability factors (affiliation with risky peers, academic disengagement). 2. To test hypotheses of contextual factors that protect youth from community disadvantage. We expect contextual protective factors to attenuate the influence of community disadvantage on (a) negative emotionality, (b) caffeine use, sleep problems, and (c) decision making. 3. To explore these alcohol antecedents in the onset of nicotine, marijuana, and other drug use.

摘要：青少年早期饮酒会损害心理社会和神经认知发展 并增加了吸毒、学业失败和心理健康问题的脆弱性。这 拟议的研究重点是西弗吉尼亚州 (WV) 农村地区的青少年饮酒情况， 阿巴拉契亚地区。许多阿巴拉契亚社区在美国社会中被边缘化，深受其害 长期贫困和阿片类药物滥用的流行程度。新兴神经认知研究 强调奖励显着性和认知控制系统相关的成熟和整合 与青少年情绪调节和健康决策能力有关。发展于 决策系统预测酒精滥用，然而，导致不同酒精滥用的因素 人们对决策轨迹的了解知之甚少。此外，我们还不断积累研究 研究小组和其他人将农村青年广泛使用含咖啡因饮料与饮酒联系起来 漏洞。一种具有唤醒、运动激活和增强适当能力的精神兴奋剂 即使是中等剂量的咖啡因也会对儿童和青少年产生症状，包括 头痛、恶心、嗜睡、疲劳、情绪紊乱和失眠。尽管有这些 危险、对常规咖啡因使用的前瞻性调查及其机制 导致酒精使用脆弱性的情况几乎不存在。我们建议调查上下文 假设可以减弱社区劣势对负面影响的保护因素 积极的情绪、适应不良的健康行为和决策轨迹。这些因素 包括规范的、积极的家庭环境、促进健康的课堂和 学校环境和当地社区的集体效能。我们建议解决这些问题 对来自农村、小镇、 以及西弗吉尼亚州的小城市（< 30k）公立学校。我们的具体目标是： 1. 测试将社区劣势与酗酒联系起来的途径。我们期待社区 直接和间接预测决策过程增长放缓的缺点 使用咖啡因和随之而来的睡眠问题会加剧负面情绪。 反过来，我们预计负面情绪和决策轨迹可以预测酒精含量 通过近端脆弱性因素（与有风险的同伴的关系、学术脱离）而滥用。 2. 检验保护青少年免受社区不利影响的背景因素的假设。我们 期望情境保护因素能够减弱社区劣势对（a）的影响 负面情绪，(b) 咖啡因使用，睡眠问题，以及 (c) 决策。 3. 探索尼古丁、大麻和其他药物使用的这些酒精前因。