Initiation and Progression through Early Drinking Milestones in Underage Drinkers

未成年饮酒者早期饮酒里程碑的开始和进展

基本信息

批准号：
7921480
负责人：
Kristina Melia Jackson
金额：
$ 74.83万
依托单位：
BROWN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-09-30 至 2013-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7921480
关键词：
21 year old Academic achievement Acceleration Address Adolescent Age Alcohol abuse Alcohol consumption Alcohol dependence Alcohol or Other Drugs use Alcohols Behavior Characteristics Complement Development Event Exhibits Expectancy Family Feeling Goals Growth Health behavior Individual Individual Differences Knowledge Leisure Activities Maintenance Maps Modeling Nature Outcome Population Prevention Prevention strategy Problem behavior Psyche structure Recruitment Activity Regulation Research Research Personnel Rhode Island Risk Risk Factors Sampling Schools Secondary Schools Severities Staging Survival Analysis Techniques Theoretical model Time United States Youth adverse outcome alcohol involvement alcohol related problem alcohol risk alcohol use disorder alcohol use initiation binge drinking career drinking early alcohol use early drinking early onset emotional distress experience high risk drinking improved legal drinking age meetings multilevel analysis peer influence physical conditioning prognostic public health relevance response theories underage drinker underage drinking underage drinking reduction

项目摘要

DESCRIPTION (provided by applicant): Although the legal drinking age in the United States is age 21, underage drinking is highly prevalent. Early onset of alcohol use is associated with increased risk of a number of subsequent adverse outcomes, including later heavy or problem drinking, likelihood of developing an alcohol use disorder, other substance involvement, and behavioral problems. Yet, there is a gap in our knowledge regarding what happens between first drink and the development of alcohol-related problems. Most research fails to characterize the very early course of alcohol involvement as it unfolds. The goal of the proposed study is to explore characteristics of the early drinking career including sequencing of, attainment of, and progression through what we term "drinking-related milestones." These include landmark events such as ever drinking, feeling high or drunk, regular drinking, binge drinking, and experience of alcohol-related problems of varying severity. The normative ordering of and progression through early drinking milestones will be described, with consideration of inter- and intra-individual variability. Because the importance of given risk factors and moderating influences may vary according to the stage of an individual's drinking trajectory, we will explain inter-individual differences in intra-individual change by determining the influence of individual (e.g., behavior regulation, expectancies, leisure activity) and contextual (e.g., family and peer influence, availability of alcohol) risk factors on onset and progression. Examination of these risk factors will be guided by an overarching theoretical model that draws on theories of substance use and health behavior. In addition, we will explore the extent to which both early initiation of alcohol use and a course characterized by rapid progression are associated with various outcomes such as academic achievement, substance use, and alcohol problems. To address these aims, 1,000 6th through 8th graders recruited from Rhode Island secondary schools will be assessed over a three-year period using a combination of relatively intensive (i.e., frequent) assessments of a narrow focus complemented by less frequent assessments that are broader in terms of content. The sample will be enriched by oversampling youth at risk for drinking. Specific aims will be addressed primarily using techniques of item response theory modeling, multilevel modeling, survival analysis, latent growth modeling, and latent transition analysis. When the specific aims are met, we will better be able to understand the prognostic significance of age of first drink and we will be able to isolate the unique influence of early drinking course on adverse outcomes. The proposed study will permit researchers to accurately pinpoint the stage at which an adolescent first exhibits risk for problematic drinking. The current application offers a more nuanced study that will finely map what happens between initiation and later use. Our findings will inform prevention efforts by identifying modifiable stage- specific risk factors for progression, maintenance, and regression (or desistence) of drinking during adolescence. Public Health Relevance: Early use of alcohol is associated with increased risk of a number of subsequent adverse outcomes, including heavy or problem drinking, likelihood of developing an alcohol use disorder, other substance involvement, and behavioral problems. It is only by understanding the early course of alcohol use that we can implement successful prevention strategies to reduce underage drinking and ultimately improve the mental and physical health of our population.

描述（由申请人提供）：虽然美国的法定饮酒年龄是 21 岁，但未成年人饮酒现象非常普遍。早期饮酒与一系列后续不良后果的风险增加相关，包括后来酗酒或酗酒、患酒精使用障碍的可能性、其他物质参与和行为问题。然而，我们对第一次饮酒和酒精相关问题的发生之间发生的情况的了解存在差距。大多数研究未能描述酒精参与的早期过程。拟议研究的目标是探索早期饮酒生涯的特征，包括我们所说的“饮酒相关里程碑”的顺序、实现和进展。其中包括标志性事件，例如曾经饮酒、感觉兴奋或醉酒、经常饮酒、酗酒以及经历不同严重程度的酒精相关问题。将描述早期饮酒里程碑的规范顺序和进展，并考虑个体间和个体内的变异性。由于给定风险因素和调节影响的重要性可能会根据个人饮酒轨迹的阶段而变化，因此我们将通过确定个体的影响（例如行为调节、期望、休闲活动）来解释个体内部变化的个体间差异。）和背景（例如家庭和同伴的影响、是否有酒精）对发病和进展的危险因素。对这些风险因素的检查将以借鉴物质使用和健康行为理论的总体理论模型为指导。此外，我们将探讨早期开始饮酒和快速进展的过程与学业成绩、物质使用和酒精问题等各种结果的相关程度。为了实现这些目标，将从罗德岛州中学招募的 1,000 名 6 至 8 年级学生将在三年内接受评估，采用相对密集（即频繁）的狭窄焦点评估与较不频繁的范围更广泛的评估相结合。内容方面。通过对有饮酒风险的青少年进行过度采样，可以丰富样本。将主要使用项目反应理论建模、多级建模、生存分析、潜在增长建模和潜在转变分析技术来解决具体目标。当特定目标得到满足时，我们将能够更好地理解首次饮酒年龄的预后意义，并且我们将能够分离出早期饮酒过程对不良结果的独特影响。拟议的研究将使研究人员能够准确地确定青少年首次表现出酗酒风险的阶段。当前的应用程序提供了更细致的研究，将精细地映射启动和以后使用之间发生的情况。我们的研究结果将为预防工作提供信息，通过识别青春期饮酒进展、维持和消退（或戒断）的可改变的特定阶段风险因素。公共卫生相关性：早期饮酒会增加随后出现一系列不良后果的风险，包括酗酒或酗酒、患酒精使用障碍的可能性、其他物质参与和行为问题。只有了解饮酒的早期过程，我们才能实施成功的预防策略，以减少未成年人饮酒，并最终改善我国人口的身心健康。