Child Psychopathology and Risk for Drug Use Disorders

描述(由申请人提供)：先前的研究表明，儿童和青少年的精神病理学与药物使用障碍(DUDS)有关，而药物使用障碍又与严重的功能障碍和负面健康后果有关。然而，不同类型的精神病理学与家族史和同伴风险因素对DUDS的发展的潜在相互作用的影响还知之甚少。这项研究的总体目标是检查从青春期晚期到成年期早期的DUDS的发展轨迹是否与儿童严重抑郁症(MDD)和品行障碍(CD)、DUDS的家族史、同伴药物使用和性别有关。这些因素彼此之间以及与发育阶段(青春期晚期至成年期早期)之间的潜在相互作用尤其令人感兴趣。这项研究的参与者将从明尼苏达州双胞胎家庭研究的以人口为基础的样本中抽取，这是一项关于双胞胎及其家庭的纵向研究。参与者在17岁时被全面评估，随后在20岁和24岁时回到研究中。这项研究的第一个具体目的是检查四个诊断组--CD、MDD、CD和MDD，以及这两种疾病--的参与者，以确定他们是否(以及如何)在从青春期晚期到成年早期的哑巴的患病率和发展方面存在差异。预计这四个诊断小组的DUD模式将有所不同。这项研究的第二个目的是检查家族史、同伴吸毒和性别如何随着时间的推移与这些形式的精神病理学相互作用。具体的假设包括：(1)哑巴的家族史将与后代的哑巴有关；这种影响预计在较大的年龄和在儿童时期有精神病理学史的参与者中尤其明显；(2)一旦考虑到哑巴的家族史和儿童精神病理学，同伴吸毒行为不太可能有助于预测哑巴；(3)到24岁，只有CD或MDD(而不是其他障碍)病史的参与者将不再面临持续患有哑巴的风险增加，除非本研究中包括的其他危险因素也存在；(4)性别可能会缓和其中的一些关系。这些假设将使用生存分析、优势比、逻辑回归和分层线性建模来检验；本研究中使用的双胞胎数据的相关性将得到统计控制。

DESCRIPTION (provided by applicant): Prior research suggests that psychopathology in children and adolescents is associated with drug use disorders (DUDs), which are in turn associated with significant functional impairment and negative health consequences. However, the potential interacting influences of different types of psychopathology with family history and peer risk factors on the development of DUDs are poorly understood. The overall goal of this study is to examine whether the trajectory of DUDs during the transition from late adolescence to early adulthood is associated with childhood major depression (MDD) and conduct disorder (CD), family history of DUDs, peer drug use, and gender. Potential interactions of these factors with each other and with developmental stage (late adolescence through early adulthood) are of particular interest. Participants for this study will be drawn from the population-based sample of the Minnesota Twin Family Study, a longitudinal study of twins and their families. Participants were comprehensively assessed at age 17 and subsequently returned to the study at ages 20 and 24. The first specific aim of this study is to examine participants in four diagnostic groups--CD, MDD, CD and MDD, and neither disorder--to determine whether (and how) they differ in terms of the prevalence and development of DUDs from late adolescence through early adulthood. It is expected that these four diagnostic groups will differ in their patterns of DUDs. The second aim of this study is to examine how family history, peer drug use, and gender may interact with these forms of psychopathology across time. Specific hypotheses include: (1) family history of DUDs will be associated with DUDs in offspring; this effect is expected to be particularly pronounced at older ages and among participants with a history of psychopathology in childhood; (2) once family history of DUDs and child psychopathology are taken into account, peer drug use behavior is unlikely to aid in the prediction of DUDs; (3) by age 24, participants with a history of only CD or only MDD (and not the other disorder) will no longer be at increased risk for persisting DUDs unless another risk factor included in this study is also present; and (4) gender may moderate some of these relationships. These hypotheses will be examined using survival analyses, odds ratios, logistic regression, and hierarchical linear modeling; the correlated nature of the twin data used in this study will be statistically controlled.