Internalizing Symptoms and Alcohol Involvement

描述（由申请人提供）：本修订后的R01申请的目标是使用现有的前瞻性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为焦虑和抑郁等内化症状与酒精使用的共病关系提供了强有力的证据，但在酒精依赖的潜在病因途径中，关于焦虑和抑郁症状之间关系的数据仍然相对较少。在本应用程序中，使用前瞻性收集的从幼儿（一年级）到青年期的数据，并基于包含生命历程发展模型的概念框架，提出了2项具体研究。第一项研究提出1)评估焦虑和抑郁症状与不同阶段酒精介入风险的关联：a)使用酒精的机会报告，b)开始和使用酒精，c)酒精相关问题的发生，d)酒精滥用和/或依赖的发展。这些分析将根据发育阶段（如童年、青春期和青年期）分别完成。此外，我们建议评估内化症状与酒精参与的关系是否因种族和性别而异。第二项研究建议使用潜在类别分析来检查酒精参与共病内化症状的轨迹。我们建议：1)从经验上定义每个发育阶段酒精涉入的潜在结构，并研究其与焦虑和抑郁症状的关系；2)利用潜在转化分析检验内化症状对酒精涉入各阶段进展的影响；3)研究饮酒行为的成长模式及其与内化症状的关系。这一建议旨在解决我们对焦虑和抑郁症状与酒精参与之间关系的认识上的一些空白。这些分析的发现对于阐明酒精使用的前因和确定预防和干预计划的潜在可塑目标具有潜在的重要意义，最终可能会减少酒精相关问题和酒精使用障碍的发病率和流行程度。

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.