Adolescent AUDs: Nosology, Comorbidity and Course

关于DSM-IV酒精使用障碍（AUDs）标准应用于青少年的有效性，以及酒精使用障碍和共病精神病理学的自然史知之甚少。 本申请提出了一个纵向研究计划的疾病分类，合并症和过程中的AUDs通过青春期和进入年轻的成年。 我们将前瞻性地研究504名青少年从成瘾治疗计划，和一个代表性的社区样本的206名青少年。 所有受试者均已参与了对终生和当前AUD、其他物质使用障碍（SUD）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程度指标的广泛基线评估。 拟议的研究将完成对这些受试者的1年、3年和5年随访评估，使用与基线评估相同的措施以及年轻人心理和社会心理功能的其他措施。 纵向数据将用于解决三个具体目标：1）开发和完善一个新的青少年AUDs诊断标准的发展模型，并将其与DSM-IV标准的同时和预测效度进行对比; 2）描述AUDs从青春期到青年期的过程和预测因素;和3）确定共病精神病理学对复发性AUDs发展轨迹的影响。 本研究将纳入多种药物使用和其他SUD的更广泛背景，这些SUD通常嵌入了初发性AUD。 已经收集的大量临床样本和社区比较组的广泛数据使其成为一个非常可行的纵向项目。 这些结果将提供关于青少年发育期AUD和共病状况的自然史及其对年轻成人酒精和物质障碍以及心理社会功能的影响的重要新信息。

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.