Substance Use and Psychological Problems Among African Americans into Midlife

非裔美国人中年的药物使用和心理问题

• 批准号: 7895910
• 负责人: Kerry M Green
• 金额: $ 34万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-01 至 2012-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7895910
• 关键词: Accounting; Address; Adolescence; Adolescent; Adult; Affect; African American; Age; Aggressive behavior; Alcohol consumption; Alcohol or Other Drugs use; Characteristics; Childhood; Cluster Analysis; Communities; Crime; Data; Dependence; Development; Dimensions; Disease; Disease remission; Distress; Drug usage; Educational Status; Employment; Epidemiologic Studies; Epidemiology; Equation; Etiology; Family; Feeling suicidal; Growth; HIV; Health; Income; Individual; Investigation; Joints; Knowledge; Learning; Life; Life Cycle Stages; Mediating; Mental Depression; Mental disorders; Methods; Modeling; Paranoia; Pattern; Performance; Pharmaceutical Preparations; Population; Poverty; Prevention program; Prospective Studies; Psychopathology; Public Health; Research; Resources; Risk; Risk Factors; Role; Sampling; Schools; Self Medication; Socioeconomic Status; Staging; Substance Use Disorder; Symptoms; Testing; Time; Victimization; Work; adolescent substance use; alcohol involvement; base; cardiovascular risk factor; cohort; criminal behavior; depressive symptoms; design; diabetes risk; emerging adult; experience; follow-up; health disparity; improved; insight; intervention program; middle age; mortality; neglect; physical conditioning; psychologic; psychological distress; public health relevance; racial discrimination; social; social integration; socioeconomics; theories

DESCRIPTION (provided by applicant): National data indicate that both substance use and psychological problems become more pronounced for African Americans in midlife, but few studies have examined the development of risk for these problems in African American communities, particularly into mid adulthood. Moreover, high rates of co-occurrence demand an approach that explores both unique and shared risk factors; however, these problems rarely have been studied together. Applying a developmental perspective, we aim to examine specific risk, protective, mediating, and moderating factors that influence later substance use and psychological problems among a community- based African American population followed longitudinally. In addition, there is a great need to determine how substance use and psychological problems contribute to physical health decline in mid adulthood. Spanning more than 35 years of life, the Woodlawn Study, an epidemiological, prospective study of an African American community cohort, provides extensive data for understanding risk and protective factors and the short- and long-term consequences of substance use and psychological problems outside the context of treatment. With data extending into midlife - a neglected dimension of the life course - early risk factors and key mediating and moderating influences can be identified in an understudied population. This cohort was assessed initially as first graders in 1966-67 (N=1242), and followed up in adolescence (age 15-16), early adulthood (age 32-33), and mid-adulthood (age 42-43), creating an unprecedented chronicle of individual, family, and environmental characteristics, diverse life-course experiences, and their ultimate consequences. Guided by the Life Course Social Field Theory, the study focuses on: the developmental epidemiology of substance use and disorders and psychological problems through midlife, identifying onset, persistence, remission, co-occurrence, and reciprocal effects; childhood and adolescent risk factors for adult substance use and disorders and psychological problems; mediating and moderating influences on early risk factors; and physical health consequences in adulthood. Analytic methods include structural equation modeling, propensity score matching, general growth mixture modeling, and latent class, survival, and cluster analyses. Improved understanding of the timing and mechanisms for development of risk for substance use and psychological problems will provide essential guidance in designing effective prevention and intervention programs. PUBLIC HEALTH RELEVANCE: PROJECT NARRATIVE/PUBLIC HEALTH SIGNIFICANCE The public health relevance of this project is to inform the design of prevention and intervention programs for substance use and psychological problems among African Americans into midlife. The project will also provide critical insight into physical health problems of urban African Americans during mid-adulthood, identifying the contribution of psychopathology to specific health problems.

描述（由申请人提供）：国家数据表明，在中年的非洲裔美国人对非裔美国人的使用和心理问题都变得更加明显，但是很少有研究研究了非裔美国人社区中这些问题风险的发展，尤其是到成年中期。此外，高相处的高率需要一种探索独特风险和共享风险因素的方法；但是，这些问题很少被一起研究。采用发展观点，我们旨在检查特定的风险，保护性，调解和调节因素，这些因素会影响以后的基于社区的非洲裔美国人口中的物质使用和心理问题。此外，非常需要确定吸毒和心理问题如何导致成年中期的身体健康下降。伍德劳恩（Woodlawn）研究涵盖了超过35年的生活，这是一项对非裔美国人社区队列的流行病学，前瞻性研究，为了解风险和保护因素以及在治疗背景以外的毒品使用和心理问题的短期和长期后果提供了广泛的数据。随着数据扩展到中年 - 生命过程中被忽视的维度 - 早期的危险因素以及关键的调解和调节影响可以在研究的人群中确定。最初在1966 - 67年（n = 1242）中评估了该队列，并在青春期（15-16岁），成年早期（32-33岁）和中期（42-43岁）中进行了随访，创造了前所未有的个人，家庭，家庭和环境特征，多样化的生活经验，并创造了前所未有的记录。在生活课程社会领域理论的指导下，该研究重点是：通过中年生活的物质使用和疾病以及心理问题的发展流行病学，确定发作，持久，缓解，共同出现和相互影响；成人物质使用和疾病和心理问题的儿童和青少年危险因素；调解和调节对早期危险因素的影响；和成年后的身体健康后果。分析方法包括结构方程建模，倾向得分匹配，一般生长混合物建模以及潜在类别，生存和聚类分析。对开发物质使用风险和心理问题风险的时间和机制的了解得以提高，将为设计有效的预防和干预计划提供必不可少的指导。公共卫生相关性：项目叙事/公共卫生的意义，该项目的公共卫生相关性是为非裔美国人在中年的预防和干预计划的设计提供信息。该项目还将在阿德纳中期对城市非洲裔美国人的身体健康问题进行批判性洞察力，从而确定心理病理学对特定健康问题的贡献。