ALCOHOL ABUSE IN URBAN INDIAN ADOLESCENTS AND WOMEN

这项建议是一项前瞻性纵向研究的第二阶段 两代城市居民饮酒和吸毒的自然历史 美国印第安人家庭。这一阶段包括风险最高的年龄 与酒精相关的不良后果在这些 青少年。拟议研究的一个扩展特征是检查 老年人的心理功能和物质使用模式 美国印第安人的青少年母亲，并将这一群体调查为 一个特殊的利益群体本身就是这样的。以下是 具体目标提出：1)继续研究流行性出血热的流行病学 美国城市居民的酒精使用、药物使用和精神病理学研究 印度青少年。定义模式的三个因变量 酒精使用、酒精使用的不良后果和滥用的诊断 或依赖，因为它们与主要的 正在进行的关于青少年酗酒的研究；1a)描述了 和基于酒精使用模式的酒精滥用发生率，不利的 酒精使用的后果和诊断性面谈；1b)描述 酒精滥用与药物滥用和其他精神病态的共病； 1c)描述青少年酗酒对以下方面构成的相对风险 自杀、辍学、不安全的性行为和其他 与酒精相关的不良后果；2)继续探讨风险 美国城市印第安人青少年酒精和毒品的聚焦模型 滥用；2a)开发和测试附加风险因素模型 评估16个危险因素的分层多元Logistic回归分析 每年在拟议的赠款期限内；2b)制定可靠的、 用于早期识别美洲印第安人的高效筛查电池 青少年酗酒和吸毒的风险增加；3)探索 调节和调节品行障碍的影响，母亲的情绪 酗酒和酗酒之间的地位、文化认同和性别 家族史因素增加危险状态；4)流行病学研究 酒精使用、药物使用和精神病理学的关系 美国印第安人妇女；4a)描述了 基于酒精使用模式的酒精滥用，不良后果 酒精使用和诊断性面谈；4b)描述了 酗酒与药物滥用和其他精神病态；4c)描述 美国印第安人女性饮酒的自然历史， 特别强调预测疾病发生和变化的因素 酗酒成问题。该提案的显著特点包括：1) 高危人群两代人的纵向随访研究 人口；2)表现出招聘和最大限度减少自然减员的能力；3) 后续行动以社区为基础；4)平行问题，用于比较 正在进行的国家研究；5)使用多种数据来源来证实 青少年自我报告的有效性；6)研究人员 已经在这个美洲印第安人社区接受过训练并为人所知。

This proposal is the second phase of a prospective longitudinal study of the natural history of alcohol and drug use in two generations of urban American Indian families. This phase includes the age of highest risk for development of alcohol-related adverse consequences in these adolescents. An expanded feature of the proposed study is to examine both the psychological function and substance use patterns among the American Indian mothers of the adolescents, and investigate this group as a special population of interest in its own right. The following specific aims are proposed: 1) Continue to study the epidemiology of alcohol use, drug use, and psychopathology in a sample of urban American Indian adolescents. Three dependent variables that define patterns of alcohol use, adverse consequences of alcohol use, and diagnosis of abuse or dependence, have been selected for their consistency with major ongoing studies of adolescent alcohol abuse; 1a) Describe the prevalence and incidence of alcohol abuse based on patterns of alcohol use, adverse consequences of alcohol use, and diagnostic interviews; 1b) Describe the comorbidity of alcohol abuse with drug abuse and other psychopathologies; 1c) Describe the relative risk posed by adolescent alcohol abuse for suicide, school dropout, unsafe sexual activity, and other alcohol-related adverse consequences; 2) Continue to explore risk focussed models of urban American Indian adolescent alcohol and drug abuse; 2a) Develop and test an additive risk factor model using hierarchical multiple logistic regression with 16 risk factors assessed annually in the proposed grant period; 2b) Develop a reliable, and efficient screening battery for early identification of American Indian adolescents at elevated risk for alcohol and drug abuse; 3) Explore the mediating and moderating affects of conduct disorder, mother's emotional status, cultural identification, and gender between alcohol abuse and family history factors increasing risk status; 4) Study the epidemiology of alcohol use, drug use and psychopathology in a sample of urban American Indian women; 4a) Describe the prevalence and incidence of alcohol abuse based on patterns of alcohol use, adverse consequences of alcohol use, and diagnostic interviews; 4b) Describe the comorbidity of alcohol abuse with drug abuse and other psychopathologies; 4c) Describe the natural history of alcohol use in American Indian women, with particular emphasis on factors predictive of the onset and change of problematic drinking. Distinctive features of the proposal include: 1) longitudinal follow-up study of two generations from a high risk special population; 2) Demonstrated ability to recruit and minimize attrition; 3) Follow-up is community based; 4) Parallel questions for comparison to ongoing national studies; 5) Use of multiple data sources to corroborate validity of adolescent self report; and 6) Research personnel that are already trained and known in this American Indian community.