Family processes underlying adolescent substance use and conduct problems: disentangling correlation and causation

项目摘要/摘要 在青春期，药物滥用和行为问题是同时发生的，并且相互促进。 对青少年、他们的家庭和社会造成严重和长期负担的问题。基于家庭的 治疗和预防计划可以减少其发病率，但这些干预措施的规模有限， 持续时间和影响范围，实施起来可能很麻烦。限制提炼的一个因素 这些现有干预措施的困难之处在于，难以对 作为改变机制的目标家庭因素。家长监控、家长 温暖和家庭冲突以及许多其他变量(例如，基因、社会经济)相互影响 身份、生活环境、父母的精神病理)，所以很难分离出它们对 青少年从更大的风险因素因果网络中获得的结果。这项建议是有因果关系的。 有根基的机械式方法，以理清家庭过程的影响，并确定它们的特征 在人群水平上因暴露的严重性、长期性和发展时机而异。我们绘制数据 来自青少年大脑和认知发展SM(ABCD)的研究-一项多样化的、纵向的、全国性的 前瞻性地跟踪了11,880名9/10岁的年轻人，直到19岁至20岁，其中 在半年期评估中同时衡量发展的许多相互关联的方面 自始至终都是。我们将尝试隔离父母监督、父母温暖和家庭冲突的影响 使用三种截然不同和相辅相成的方法防止其他影响：(A)主体间方法 使用边际结构模型；(B)使用固定效应小组估计数的受试者内办法；(C)a 使用336对同卵双胞胎、430对异卵双胞胎的双胞胎/兄弟姐妹不协调方法，以及 1805个非双胞胎兄弟姐妹。我们追求四个具体目标。目标1：确定三个家庭的因果影响 过程--父母监督、父母温暖和家庭冲突--对青少年近端物质的影响 11至18岁之间的虐待和行为问题。目标2：确定家庭的影响是否 程序因青年性别、种族/民族认同或药物滥用倾向和行为而异。 有问题。目标3：确定三个家庭过程的影响是否因严重性、慢性或 暴露的发育时间。总而言之，这项研究将产生一个更科学准确的 青少年滥用药物和青少年犯罪的发展精神病理学，从而为 以家庭为基础的干预措施的设计、改进和个性化，以减少此类事件的发生 人口层面的问题。

PROJECT SUMMARY/ABSTRACT During adolescence, substance abuse and conduct problems are co-occurring and mutually reinforcing problems with significant acute and long-term burden to adolescents, their families, and society. Family-based treatments and prevention programs can reduce their incidence, but these interventions are limited in the size, duration, and scope of effects and can be cumbersome to implement. One factor limiting the refinement of these existing interventions is the difficulty of conducting rigorous science about the specific causal effects of the family factors that are targeted as mechanisms of change. Factors such as parental monitoring, parental warmth, and family conflict covary with each other as well as many other variables (e.g., genes, socioeconomic status, living environment, parent psychopathology), so it is difficult to isolate their unique impacts on adolescent outcomes from the larger causal network of risk factors. This proposal pursues a causally grounded, mechanistic approach to disentangle the impacts of family processes and characterize how they vary by the severity, chronicity, and developmental timing of exposure at the population level. We draw data from the Adolescent Brain and Cognitive DevelopmentSM (ABCD) Study—a diverse, longitudinal, nationwide, population-based cohort of 11,880 youth ages 9/10 years old followed prospectively until ages 19-20, with simultaneous measurement of many intercorrelated aspects of development at biannual assessments throughout. We will attempt to isolate the effects of parental monitoring, parental warmth, and family conflict from other influences using three distinct, and complementary approaches: (A) a between-subjects approach using marginal structural models; (B) a within-subjects approach using the fixed effects panel estimator; (C) a twin/sibling discordancy approach using 336+ pairs of monozygotic twins, 430+ pairs of dizygotic twins, and 1,805 non-twin siblings. We pursue four specific aims. Aim 1: Determine the causal impacts of three family processes—parental monitoring, parental warmth, and family conflict—on proximal adolescent substance abuse and conduct problems between ages 11 to 18 years. Aim 2: Determine whether the effects of the family processes vary by youth sex, racial/ethnic identification, or predisposition to substance abuse and conduct problems. Aim 3: Determine whether the effects of three family processes vary by severity, chronicity, or developmental timing of exposure. Altogether, this research will yield a more scientifically accurate developmental psychopathology of adolescent substance abuse and delinquency and thereby inform the design, refinement, and personalization of family-based interventions to reduce the incidence of these problems at the population level.