Adolescent AUDs: Nosology, Comorbidity and Course

关于DSM-IV酒精使用障碍（AUDs）标准在青少年中的有效性，以及青少年发病的AUDs和共病精神病理的自然史，我们所知甚少。本申请提出了一个关于AUDs从青春期到青年期的分诊、合并症和病程的纵向研究项目。我们将前瞻性地研究来自成瘾治疗项目的504名青少年，以及一个有代表性的206名青少年社区样本。所有受试者都已经参与了广泛的基线评估，包括终生和当前的aud、其他物质使用障碍（sud）和共病精神病理、酒精和药物使用史，以及其他功能和问题严重程度的测量。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测量方法以及其他测量年轻人心理和社会心理功能的方法。纵向数据将用于解决三个具体目标：1)开发和完善青少年aud诊断标准的新发展模型，并将其与DSM-IV标准的并发性和预测效度进行比较；2)描述AUDs从青春期到青年期的发展途径和预测因素；3)确定共病精神病理对青少年发病AUDs发展轨迹的影响。这项研究将纳入更广泛的多种药物使用和其他sud的背景，其中通常包含青少年发病的aud。从一个大型临床样本和一个社区比较组中已经收集到的大量数据使这成为一个高度可行的纵向项目。该研究结果将提供重要的新信息，了解青春期发育期间AUDs和共病的自然史，以及它们对年轻人酒精和物质障碍以及社会心理功能的影响。

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.