Childhood Origin of Disparities in Alcohol Use Disorders

酒精使用障碍差异的童年根源

• 批准号: 6748423
• 负责人: Stephen E Gilman
• 金额: $ 8.2万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-05-15 至 2006-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6748423
• 关键词: alcoholism /alcohol abuse; clinical research; comorbidity; disease /disorder proneness /risk; early experience; family structure /dynamics; health disparity; human data; interview; longitudinal human study; major depression; mental disorder diagnosis; residential mobility; socioeconomics; substance abuse epidemiology; substance abuse related disorder

DESCRIPTION (provided by applicant): There is compelling evidence that alcohol abuse and dependence are concentrated among individuals of disadvantaged socioeconomic status. However, the origins of socioeconomic disparities in alcohol use disorders remain poorly understood. While emerging data on health disparities point to the importance of childhood conditions in shaping individuals' long-term risk for health problems, the childhood origins of disparities in alcohol use disorders have been difficult to study due to the lack of prospective data needed to link childhood conditions with subsequent alcohol abuse and dependence. Moreover, previous research on this subject has often focused on socioeconomic differences in the level of alcohol consumption rather than alcohol use disorders. This proposal is submitted by a new investigator to study the childhood origins of socioeconomic disparities in alcohol abuse and dependence using a longitudinal design and with reliable measures of alcohol use disorders. We hypothesize that adult disparities in alcohol use disorders originate early in life, and that childhood conditions pose long-term consequences for the development and continuation of alcohol abuse and dependence. This proposal overcomes the limitations of prior studies by 1) investigating risks for alcohol use disorders in a longitudinal study of 1,267 individuals who were enrolled at birth and systematically followed for an average of 27.8 years, and 2) utilizing diagnostic criteria to define alcohol abuse and dependence. These investigations will be based on secondary analyses of the Providence, Rhode Island cohort of the National Collaborative Perinatal Project, initiated in 1959. Comprehensive assessment of socioeconomic and environmental conditions was obtained at multiple points in early childhood and in adulthood; adult psychiatric diagnoses were obtained using structured diagnostic interviews. The major aims of this study are: 1) to investigate the prospective relation between socioeconomic status, family disruption, and residential stability in childhood and the long-term risk for the onset and persistence of alcohol abuse and dependence; 2) to investigate adult socioecononomic disparities in alcohol use disorders; and 3) to investigate the childhood origins of the comorbidity between alcohol use disorders, other substance use disorders, and major depression.

描述（由申请人提供）：有令人信服的证据表明，酒精滥用和依赖集中在社会经济地位不利的个人中。然而，酒精使用障碍中社会经济差异的起源仍然知之甚少。虽然关于健康差异的新数据表明，儿童时期的状况在形成个人健康问题的长期风险方面很重要，但由于缺乏将儿童时期的状况与随后的酒精滥用和依赖联系起来所需的前瞻性数据，因此很难研究酒精使用障碍差异的童年起源。此外，之前关于这一主题的研究往往侧重于酒精消费水平的社会经济差异，而不是酒精使用障碍。这项建议是由一名新的研究者提出的，该研究者使用纵向设计和可靠的酒精使用障碍测量来研究酒精滥用和依赖中社会经济差异的童年起源。我们假设成人在酒精使用障碍方面的差异起源于生命早期，儿童时期的情况对酒精滥用和依赖的发展和持续造成长期影响。本研究克服了以往研究的局限性：1)通过纵向研究调查酒精使用障碍的风险，研究对象为1267名出生时登记的个体，平均随访27.8年；2)利用诊断标准来定义酒精滥用和依赖。这些调查将基于1959年开始的国家围产期合作项目的普罗维登斯，罗德岛队列的二次分析。在幼儿期和成年期的多个时间点对社会经济和环境条件进行了综合评估；成人精神病诊断是通过结构化诊断访谈获得的。本研究的主要目的是：1)探讨儿童时期社会经济地位、家庭破裂和居住稳定性与酒精滥用和依赖发生和持续的长期风险之间的潜在关系；2)调查成人酒精使用障碍的社会经济差异；3)探讨酒精使用障碍、其他物质使用障碍和重度抑郁症共病的儿童期起源。