SUBSTANCE USE AMONG CHILDREN OF ALCOHOLICS

提议的项目研究物质使用研究中的一个核心重要问题——即，风险是如何在多代之间传递的？首先，我们对酗酒儿童（COAs）和对照组进行随访，直至成年，以检查持续和发育受限的物质使用/滥用的风险，并确定这种风险的中介机制。其次，我们使用多方法的实验室研究来检查下一代出现的风险，研究反应性和调节作为我们研究对象幼儿家族酒精中毒风险的中介。我们研究了风险和风险中介的共同传播，我们研究了父母在调节和改变这种风险中的作用。为了实现这些目标，我们建议对我们的样本（23-30岁）进行随访，并对他们的幼儿进行实验室研究。样本来自社区，包括酗酒的母亲和父亲，以及“活跃”和“缓解”的酗酒者。直接确定了父母酗酒和其他障碍，多个报告数据将反应偏差的影响降至最低。从青春期开始（M=12.7岁），受试者及其父母每年接受3次计算机辅助访谈。第四次评估（现在包括亲生兄弟姐妹和同伴信息提供者）发生在从青春期晚期到成年期（18-25岁）的过渡时期。在建议的随访中，将对成年受试者进行计算机辅助访谈和心理生理评估。信息将通过邮寄调查收集。我们将采用多种方法对被试幼儿进行评估，包括心理生理反应、面部表情、行为观察、反应性和调节能力的多重举报人报告，以及后来滥用药物的风险标志（行为问题、社交能力、自我恢复力和学业成绩）。数据分析策略包括多层建模，用于对家庭内随时间聚集的观察结果进行建模。这些发现对预防特别有用，因为它们关注的是一个高风险群体，它们追踪了物质使用的自然历史，从它的前体到临床重要的终点，它们包括潜在的可改变因素，它们检查了风险在三代之间的传递。

The proposed project studies a centrally important question in substance use research-namely, how is risk transmitted across multiple generations? First, we follow children of alcoholics (COAs) and controls into adulthood to examine risk for persistent and developmentally limited substance use/abuse, and to identify mediating mechanisms underlying this risk. Second, we examine emerging risk in the next generation using a multi-method laboratory study of reactivity and regulation as mediators of familial alcoholism risk in the young children of our subjects. We examine co-transmission of risk and risk mediators, and we examine the role of parenting in mediating and modifying this risk. To achieve these aims, we propose a follow-up of our sample (at ages 23-30) and a laboratory study of their young children. The sample is drawn from the community, and includes alcoholic mothers and fathers, and both active" and "remitted" alcoholics. Parent alcoholism and other disorders were directly ascertained, and multiple reporter data minimize the impact of response biases. Beginning in adolescence (M=12.7 years), subjects and their parents received 3 annual computer-assisted interviews. A 4th assessment (now including full biological siblings and peer informants) occurred during the transition from late adolescence to adulthood (ages 18-25). At the proposed follow-up, computer-assisted interviews and psychophysiological assessments will be conducted with the adult subjects. Informant data will be collected in mailed surveys. The young children of our subjects will be assessed with multiple methods, including psychophysiological responses, facial expression, behavioral observation, and multiple informant reports of reactivity and regulation, as well as markers of risk for later substance abuse (conduct problems, social competence, ego-resilience and academic achievement). Data analytic strategies include multilevel modeling for modeling observations clustered within families over time. The findings will be particularly useful for prevention because they focus on a high risk group, they track the natural history of substance use from its precursors to clinically important end points, they include potentially modifiable factors, and they examine the transmission of risk across three generations.