Drug Abuse and Related Health Disparities: An Intergenerational Longitudinal Study of Offspring of Delinquent Youth (Northwestern Offspring Project)

在美国，每年有超过90万名青少年被逮捕，约有25万人在法庭上 案件会导致监禁。少数族裔青年和成年人被监禁的比例不成比例， 尤其是毒品犯罪。为了解决健康不平等问题，我们目前正在进行西北地区 青少年项目(NJP)，一项为期16年的关于拘留后青少年健康结果的纵向研究。物质 使用障碍(SOD)是拘留期间最常见的精神障碍(影响约一半 男性和女性)，这是最常见的共病疾病，也是最持久的疾病，影响五分之一 青年时期的参与者。许多犯罪的青少年年轻时就当了父母；他们的后代在 肥皂泡和相关问题行为的风险很大。拟议的调查，西北子孙 该项目将是第一个关于肥胖症在儿童中代际传播的前瞻性研究。 少年犯。西北子孙项目解决了以前代际项目的局限性 许多研究是在海外进行的，因此无法解决健康方面的不平等问题 美国。我们计划研究n=428名子女(年龄12-15岁)、他们的父母，n=428名，以及 其他主要照顾者，估计n=261人。我们选择12-15岁是因为这是一个关键的发育阶段 滥用药物的时期。利用已经收集的关于父母的预期数据(最多14 访谈)，具体目标将调查：(1)物质使用、肥皂水和 后代的相关问题行为；(2)代际传递机制，重点是 使儿童暴露于父母的药物滥用和父母滥用药物的附带后果 监狱；(3)复原力，考察支持性和亲社会环境的保护效果。 这项拟议的调查具有创新性，主要集中在：(1)曾经在管教系统中的父母； (2)监禁的后果；(3)非裔美国人和西班牙裔美国人，这两个群体比例不成比例 被监禁并面临药物滥用最严重后果的人；(4)使用和混乱，审查10 亚类物质：大麻、可卡因、致幻剂/五氯苯酚、阿片类药物、苯丙胺、吸入剂、镇静剂、 未指明的药物、酒精和烟草；(5)对代际传播的弹性 高危人群；(6)同型和异型延续模式。拟议的研究回应了 (1)美国国家医学研究院呼吁进行转化研究，以解决 健康差异；(2)NIMHD战略计划，该计划要求进行研究以解决因果关系中的差异 药物滥用的因素；(3)NIAAA健康差距战略计划，以建立一个知识库 在酒精滥用研究中受到较少关注的人群；以及(4)NIDA 2016-2020战略 计划确定上瘾的环境、行为和社会原因和后果，并确定 构成个体成瘾风险和恢复能力的机制。

Every year in the United States, more than 900,000 juveniles are arrested and approximately 250,000 court cases result in incarceration. Racial/ethnic minority youth and adults are disproportionately incarcerated, especially for drug crimes. To address health inequities, we are currently conducting the Northwestern Juvenile Project (NJP), a 16-year longitudinal study of health outcomes of youth after detention. Substance use disorders (SUDs) were the most common psychiatric disorders at detention (affecting about one-half of males and females), the most common comorbid disorder, and the most persistent disorder, affecting 1 in 5 participants in young adulthood. Many delinquent youth become parents when young; their offspring are at great risk for SUDs and related problem behaviors. The proposed investigation, the Northwestern Offspring Project, will be the first prospective study of intergenerational transmission of SUDs in the children of delinquent youth. The Northwestern Offspring Project addresses the limitations of prior intergenerational studies, many of which were conducted overseas and therefore unable to address health inequities in the United States. We propose to study n=428 offspring (ages 12-15 years), their parents, n=428, and an additional primary caregiver, estimated n=261. We chose ages 12-15 years because it is a critical developmental period for substance abuse. Leveraging prospective data that have already been collected on parents (up to 14 interviews), the Specific Aims will investigate: (1) intergenerational transmission of substance use, SUDs, and related problem behaviors in offspring; (2) mechanisms of intergenerational transmission, focusing on the exposure of the child to the parents' substance abuse and to the collateral consequences of the parents' incarcerations; and (3) resilience, examining the protective effect of a supportive and prosocial environment. The proposed investigation is innovative by focusing on: (1) parents who have been in the correctional system; (2) the consequences of incarceration; (3) African Americans and Hispanics, groups that are disproportionately incarcerated and who face the most serious consequences of drug abuse; (4) use and disorder, examining 10 subcategories of substances: marijuana, cocaine, hallucinogen/PCP, opioid, amphetamine, inhalant, sedative, unspecified drug, alcohol, and tobacco; (5) resilience to intergenerational transmission in an exceptionally high-risk population; (6) patterns of homotypic and heterotypic continuity. The proposed study responds to (1) the National Academy of Medicine's call for translational research to address the social determinants of health disparities; (2) the NIMHD Strategic Plan, which requests studies to address disparities in the causal factors of substance abuse; (3) the NIAAA Health Disparities Strategic Plan to build a knowledge base for populations that have received less attention in studies of alcohol abuse; and (4) the NIDA 2016-2020 Strategic Plan to identify environmental, behavioral, and social causes and consequences of addiction and determine mechanisms that underlie individual risk and resilience for addiction.