Internalizing Symptoms and Alcohol Involvement

描述(由申请人提供)：本次修订的R01申请的目标是使用现有的预期收集的数据来检查从最初的酒精使用到导致酒精依赖的过渡阶段的途径。尽管先前的临床和基于人群的研究已经提供了强有力的证据表明焦虑和抑郁等内在化症状与酒精使用的共生关系，但关于焦虑和抑郁症状在潜在的酒精依赖病因途径中的关系的数据仍然相对较少。在这项申请中，使用从儿童早期(一年级)到成年前的前瞻性收集的数据，并基于纳入生命过程发展模型的概念框架，提出了两项具体研究。第一项研究建议1)评估焦虑和抑郁症状与酒精参与不同阶段的发病风险的关系：a)酒精使用机会的报告，b)酒精的开始和使用，c)与酒精有关的问题的发生，以及d)酒精滥用和/或依赖的发展。这些分析将按发展阶段(如儿童期、青春期和青壮年)分开完成。此外，我们建议评估内在化症状与酒精参与的关系是否因种族和性别而不同。第二项研究建议使用潜在类别分析来检查与酒精相关的共病内化症状的轨迹。我们建议：1)经验地定义酒精参与每个发育阶段的潜在结构，并研究其与焦虑和抑郁症状的关系；2)使用潜伏期转换分析来检验内化症状对酒精参与各阶段进展的影响；3)表征饮酒行为的增长模式及其与内化症状的关系。这项建议旨在解决我们对酒精相关的焦虑和抑郁症状之间关系的一些认识上的差距。这些分析的结果可能会对阐明涉及酒精使用的前因以及确定预防和干预计划的潜在可塑性目标具有重要意义，最终可能会减少与酒精相关的问题和酒精使用障碍的发生率和流行率。

DESCRIPTION (provided by applicant): The goal of this revised R01 application is to use existing prospectively gathered data to examine the pathways from initial alcohol use through transitional phases that lead to alcohol dependence. Although prior clinical and population-based studies have provided strong evidence for the comorbid relationship of internalizing symptoms such as anxiety and depression with alcohol use, there is still relatively little data that provide information on the relationships of anxiety and depressive symptoms in the potential etiologic pathways towards alcohol dependence. In this application, using prospectively gathered data from early childhood (grade 1) through young adulthood, and based on a conceptual framework that incorporates the life-course developmental model, 2 specific studies are proposed. The first study proposes 1) To assess the association of anxiety and depressive symptoms with risk for onset of varying stages of alcohol involvement: a) the report of opportunities to use alcohol, b) initiation and use of alcohol, c) occurrence of alcohol-related problems, and d) development of alcohol abuse and/or dependence. These analyses would be completed separately by developmental stage (e.g., childhood, adolescence, and young adulthood). In addition, we propose to assess whether the relationships of internalizing symptoms with alcohol involvement differ by race, and gender. The second study proposes to examine trajectories of comorbid internalizing symptoms with alcohol involvement using latent class analysis. We propose: 1) To empirically define the underlying structure of alcohol involvement at each developmental stage and examine its relationship to anxiety and depressive symptoms; 2) To examine the effects of internalizing symptoms on the progression across stages of alcohol involvement using latent transition analysis; and 3) To characterize patterns of growth in drinking behavior and their relationship to internalizing symptoms. This proposal aims to address some of the gaps in our knowledge of relationships between anxiety and depressive symptoms with alcohol involvement. Findings from these analyses would have potentially significant application to the elucidation of antecedents for alcohol use involvement and for identifying potentially malleable targets for preventive and intervention programs, which ultimately may reduce the incidence and prevalence of alcohol-related problems and alcohol use disorders.