The Symptom-Associated Pathway to Substance Use and Misuse during Adolescence

青春期药物使用和滥用的症状相关途径

• 批准号: 10472604
• 负责人: Terri Diane Voepel-Lewis
• 金额: $ 37.05万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10472604
• 关键词: 10 year old; 13 year old; Address; Adolescence; Adolescent; Adolescent Development; Adult; Age Factors; Alcohols; Anti-Anxiety Agents; Anxiety; Behavior; Behavior Therapy; Behavioral; Brain; Cannabis; Characteristics; Child; Child Health; Childhood; Chronic; Cognition; Cognitive Therapy; Complex; Data; Diagnosis; Drowsiness; Drug Exposure; Drug Prescriptions; Early Intervention; Education; Enrollment; Environment; Environmental Risk Factor; Epidemiology; Evolution; Exhibits; Family; Family health status; Fatigue; Future; Gender Identity; Goals; Health; Individual; Intervention; Knowledge; Medical; Mental Depression; Mental Health; Modeling; Motivation; Opioid; Outcome; Pain; Parents; Pathway interactions; Pattern; Perception; Persistent pain; Pharmaceutical Preparations; Pharmacological Treatment; Post-Traumatic Stress Disorders; Puberty; Recurrence; Recurrent pain; Reporting; Research; Risk; Risk Behaviors; Risk Factors; Self Management; Self Medication; Sleep Disorders; Social Impacts; Substance Use Disorder; Supervision; Symptoms; Teenagers; Testing; Time; Tobacco; Trauma; Youth; associated symptom; base; cognitive development; comorbidity; cost; critical developmental period; early adolescence; early onset; grandparent; health care availability; hypnotic; improved; in silico; innovation; intergenerational; longitudinal analysis; misuse of prescription only drugs; models and simulation; multidisciplinary; pain model; pain symptom; peer; persistent symptom; person centered; preadolescence; predictive modeling; predictive signature; prescription opioid misuse; prevent; preventive intervention; psychologic; psychological symptom; reduce symptoms; resilience; response; risk perception; sex; simulation; social factors; substance misuse; substance use; symptom cluster; symptom self management; trauma exposure

PROJECT SUMMARY Pain and other symptoms such as anxiety, fatigue, and somnolence often co-occur, persist into adulthood, and heighten health risks for adolescents. For instance, poorly managed pain, fatigue and psychological symptoms may contribute to risky self-management behavior such as use and misuse of prescription drugs and other substances. These risky behaviors and drug exposures during teenage years have been associated with prescription drug misuse and substance use (PDM/SU) into adulthood. Importantly, we know little about how persistent symptom trajectories develop during childhood and adolescence. We also know little about how family and other environmental factors influence children’s symptom trajectories or how they contribute to symptom-motivated PDM/SU behavior. Since persistent or recurrent pain, psychologic problems, and PDM/SU often emerge during adolescence, a better understanding of the relationship between these factors is critical. Equally important is that we understand the family and environmental factors that can help protect teens with persistent symptom trajectories from engaging in risky self-medication or PDM/SU behavior. Our overall goal with this research is to identify and strategize optimal interventions to prevent or reduce symptom-associated PDM/SU among teens. Our first objective is to identify a symptom profile (or “signature”) during early adolescence that indicates vulnerability to 1) persistent or worsening pain, psychological, and somatic (body) symptoms (P-PSS). We will also identify key factors in the family and environment that are relevant and primary targets for early intervention. To accomplish this, we will use data from the 11,875 children enrolled in the national longitudinal Adolescent, Brain, and Cognitive Development (ABCD) Study. In Aim 1, we will differentiate children based on their P-PSS (symptom) trajectories at age 13 years, and will determine the degree to which child health, family health and environmental factors influence these trajectories. In Aim 2, we will demonstrate how children with the most vulnerable (persistent/worsening) symptom trajectory are at risk for ongoing symptoms and PDM/SU behavior by age 15/16 years. We will also identify key interventional targets (child, family and environmental) that enhance or reduce the risk for ongoing symptoms and PDM/SU behavior. In Aim 3, we will use dynamic simulation modeling to examine the potential impact of selected interventions addressing these prime targets to disrupt the path from symptoms to PDM/SU. This research will provide the most comprehensive understanding of the symptom-related pathway to PDM/SU in teens, to date. Our findings will not only improve our knowledge about adolescent symptom progression and key risk factors, but will inform the optimal application of interventions to prevent or curtail the symptom-to-substance use pathway.

项目概要 疼痛和其他症状，如焦虑、疲劳和嗜睡经常同时出现，并持续到成年期，并且 增加青少年的健康风险。例如，疼痛、疲劳和心理症状管理不善 可能导致危险的自我管理行为，例如使用和滥用处方药和其他药物 物质。青少年时期的这些危险行为和药物暴露与 处方药滥用和物质使用 (PDM/SU) 到成年期。重要的是，我们对如何做到知之甚少 持续的症状轨迹在儿童期和青春期形成。我们也对如何做到知之甚少 家庭和其他环境因素影响儿童的症状轨迹或他们如何促成 症状驱动的 PDM/SU 行为。由于持续性或复发性疼痛、心理问题和 PDM/SU 通常在青春期出现，因此更好地理解这些因素之间的关系至关重要。 同样重要的是，我们了解可以帮助保护青少年的家庭和环境因素 从事危险的自我药疗或 PDM/SU 行为导致的持续症状轨迹。我们的总体目标 这项研究的目的是确定最佳干预措施并制定策略，以预防或减少与症状相关的症状 青少年中的 PDM/SU。我们的首要目标是在早期识别症状特征（或“特征”） 青春期，表明容易遭受 1) 持续或恶化的疼痛、心理和躯体（身体）疼痛 症状（P-PSS）。我们还将确定家庭和环境中相关且重要的关键因素。 早期干预的主要目标。为了实现这一目标，我们将使用来自 11,875 名儿童的数据 国家纵向青少年、大脑和认知发展（ABCD）研究。在目标 1 中，我们将 根据 13 岁时的 P-PSS（症状）轨迹区分儿童，并将确定 儿童健康、家庭健康和环境因素对这些轨迹的影响程度。在目标 2 中，我们 将展示具有最脆弱（持续/恶化）症状轨迹的儿童如何面临风险 15/16 岁时持续出现的症状和 PDM/SU 行为。我们还将确定关键的干预措施 增强或降低持续症状风险的目标（儿童、家庭和环境）和 PDM/SU 行为。在目标 3 中，我们将使用动态仿真建模来检查所选项目的潜在影响 针对这些主要目标的干预措施，以破坏从症状到 PDM/SU 的路径。这项研究将 迄今为止，对青少年 PDM/SU 症状相关途径提供了最全面的了解。 我们的研究结果不仅会提高我们对青少年症状进展和关键风险因素的了解， 但会告知干预措施的最佳应用，以预防或减少症状与药物的使用 途径。