Adolescent AUDs: Nosology, Comorbidity and Course

关于酒精使用障碍(AUDS)的DSM-IV标准应用于青少年的有效性，以及青春期AUDS和共病精神病理学的自然病史，人们知之甚少。这项申请提出了一个关于AUDS的病因学、合并症和病程的纵向研究计划，从青春期到青春期。我们将前瞻性地研究504名来自成瘾治疗项目的青少年，并以206名具有代表性的社区青少年为样本。所有受试者都已经参与了对终生和当前AUDS、其他物质使用障碍(SUDS)和共病精神病理学、酒精和药物使用史以及其他功能和问题严重性衡量标准的广泛基线评估。拟议的研究将完成对这些受试者的1年、3年和5年的后续评估，使用与基线评估相同的措施以及其他关于年轻人心理和心理社会功能的衡量标准。纵向数据将被用来解决三个具体目标：1)开发和完善青少年AUDS诊断标准的新发展模型，并将其同时和预测效度与DSM-IV标准进行比较；2)表征AUDS从青春期到青春期的路径和预测因素；以及3)确定共病精神病理学对青春期AUDS发展轨迹的影响。这项研究将纳入更广泛的多药使用和其他肥皂剧的背景，其中青春期起病的AUD通常嵌入其中。已经在大量临床样本和社区对照小组上收集的大量数据使这一纵向项目具有很高的可行性。这一结果将提供有关AUDS的自然历史和青春期发育期的共病状况的重要新信息，以及它们对年轻人酒精和物质障碍以及心理社会功能的影响。

Little is known about the validity of DSM-IV criteria for Alcohol Use Disorders (AUDs) when applied to adolescents, and the natural history of adolescent-onset AUDs and comorbid psychopathology. This application proposes a program of longitudinal research on the nosology, comorbidity and course of AUDs through adolescence and into young adulthood. We will prospectively study 504 adolescents from addiction treatment programs, and a representative community sample of 206 adolescents. All subjects already have participated in an extensive baseline assessment of lifetime and current AUDs, other Substance Use Disorders (SUDs) and comorbid psychopathology, alcohol and drug use history, and other measures of functioning and problem severity. The proposed research will complete 1- year, 3-year and 5-year follow-up assessments of these subjects, using the same measures as the baseline assessment as well as other measures of young adult psychological and psychosocial functioning. Longitudinal data will be used to address three specific aims: 1) to develop and refine a new developmental model of diagnostic criteria for adolescent AUDs, and contrast its concurrent and predictive validity with DSM-IV criteria; 2) to characterize pathways and predictors of the course of AUDs through adolescence and into young adulthood; and 3) to determine the effects of comorbid psychopathology on the developmental trajectories of adolescent-onset AUDs. This research will incorporate the broader context of polydrug use and other SUDs in which adolescent-onset AUDs are usually embedded. The extensive data already collected on a large clinical sample and a community comparison group make this a highly feasible longitudinal project. The results will provide important new information about the natural history of AUDs and comorbid conditions across the developmental period of adolescence, and their impact on young adult alcohol and substance disorders and psychosocial functioning.