Persistence of Alcohol Use Disorders: Person and Environment Effects

酒精使用障碍的持续存在：人和环境的影响

基本信息

批准号：
9180204
负责人：
Diana R Samek
金额：
$ 7.4万
依托单位：
AUBURN UNIVERSITY AT AUBURN
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-08-01 至 2018-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9180204
关键词：
Address Adolescence Adolescent Adolescent Development Adolescent and Young Adult Adult Age Alcohol or Other Drugs use Cannabis Cessation of life Characteristics Child Data Development Diagnosis Distal Divorce Drug Use Disorder Education Employment Environment Environmental Risk Factor Etiology Family Family Study Female Gender Guide prevention Health Individual Investigation Knowledge Legal Marriage Measures Mediating Minnesota Nature Parents Personality Persons Preventive Intervention Recurrence Research Risk Role Sample Size Schools Series Substance Use Disorder Twin Multiple Birth Twin Studies Work adverse outcome alcohol use disorder career collaborative environment cost effective design deviant gender difference illicit drug use innovation peer physical conditioning population based preadolescence prospective psychosocial public health relevance theories young adult

项目摘要

Project Summary There is consistent evidence for the influence of person-environment interplay in the development of adolescent SU and SUDs, such that adverse environmental contexts appear to amplify dispositional risk and protective environmental contexts appear to offset dispositional risk for SU. Although this has been demonstrated across key adolescent family, peer, and school factors in relation to adolescent SU, there is a dearth of research evaluating person-environment interplay in relation to adult onset SUDs or overall SUD course (i.e., recurrence, desistence) into adulthood. Given that the majority of SUDs are adult onset and that recurrent SUD is associated with particularly problematic health consequences (e.g., early death), it is crucial to fill this gap. We hypothesize that similar mechanisms of person-environment interplay that have been demonstrated for adolescent SU continue to operate in adulthood, but that the environmental factors that offset or amplify risk for adult onset and recurrent SUD course will be those that are most relevant to adult development. Thus, much like aspects of the adolescent parent-child, peer, and school context are expected to moderate dispositional risk for adolescent onset SUD (H1), aspects of adult romantic partner, family, peer, education, and employment context are expected to moderate dispositional risk for adult onset SUD and overall course (H2). We expect distal environmental contexts (those that happened long ago, i.e., adolescence) will only be relevant to adult onset SUD and recurrence insofar as they are mediated through more proximal adult environmental contexts (e.g., adult peer and romantic partner characteristics) (H3). To investigate these hypotheses, we propose a series secondary analyses of the population-based Minnesota Twin and Family Study (MTFS; R37DA005147, R01AA009367). The MTFS (N = 2,769, 52% female) has six prospective waves of rich data collected from preadolescence (age 11) through young adulthood (age 29). In this study, dispositional risk will be measured using personality scales shown to be highly relevant to SUDs (aggressive undercontrol, negative emotionality, and constraint). This study focuses on alcohol use disorder given it is the most prevalent SUD, but will directly compare similarity of etiologies with illicit drug use disorder (e.g., cannabis). This study is innovative because it will evaluate person-environment interplay in relation to trajectories of clinically diagnosed SUDs rather than focusing on adolescent SU alone. Investigation of the proposed hypotheses will elucidate key factors important to disrupting or amplifying the cascading development of recurrent SU problems, which provides invaluable information regarding the most critical and cost-effective points of entry for SUD prevention and intervention. The proposed study is significant as it will address a key gap in the research and will advance knowledge on the etiology of SUD onset and trajectory. Findings will clarify which environmental contexts are most relevant to amplifying or offsetting risk for developmentally-limited versus recurrent SUD course, which is crucial to guiding prevention not only in adolescence, but also in early and later young adulthood when SUDs are most prevalent.

项目摘要有一个一致的证据表明人与环境相互作用在青少年发展中的影响苏和泡沫，使不利的环境环境似乎会扩大处置风险和保护性环境环境似乎抵消了SU的处置风险。尽管这已经证明了关键的青少年家庭，同伴和学校因素与青少年SU有关，缺乏研究评估与成人发作SUDS或整体SUD课程有关的人环境相互作用（即复发，欲望）成年。鉴于大多数SUD是成人发病率，并且反复发作的SUD是相关的由于健康后果特别有问题（例如，早期死亡），填补这一空白至关重要。我们假设已经证明了青春期SU的人环境相互作用的类似机制在成年期继续运作，但要抵消或扩大成人发病风险的环境因素经常出现的SUD课程将是与成人发展最相关的SUD课程。因此，很像预计青少年的父母，同伴和学校环境将适应青少年的处置风险发作SUD（H1），成人浪漫伴侣，家庭，同伴，教育和就业环境的各个方面预计对成人发作SUD和整体过程（H2）的处置风险中度。我们期望远端环境环境（很久以前发生的环境，即青春期）仅与成人发作有关在更近端的成人环境环境中介导的泡沫和复发（例如，成人同伴和浪漫伴侣特征）（H3）。为了研究这些假设，我们提出了一个系列基于人口的明尼苏达双胞胎和家庭研究的次要分析（MTFS； R37DA005147， R01AA009367）。 MTF（n = 2,769，52％女性）有六个从中收集的丰富数据的前瞻性波青年（11岁）至年轻成年（29岁）。在这项研究中，将测量处置风险使用显示与SUD高度相关的人格量表（激进的控制，负面情绪，负面情绪，和约束）。鉴于它是最普遍的SUD，这项研究侧重于酒精疾病，但会直接比较病因与非法药物使用障碍（例如大麻）的相似性。这项研究是创新的，因为它将评估与临床诊断的泡沫轨迹相关的人环境相互作用，而不是专注于青春期su。对所提出的假设的研究将阐明关键因素重要的因素破坏或扩大复发性SU问题的级联发展，这提供了无价的有关预防和干预的最关键，最具成本效益的入境点的信息。拟议的研究很重要，因为它将解决研究中的关键差距，并将提高知识 SUD发作和轨迹的病因。调查结果将阐明哪些环境环境与放大或抵消开发限制与经常性SUD课程的风险，这对于指导至关重要不仅在青春期，而且在肥皂水最普遍的时候成年时期的早期和后期的预防。