Internalizing Symptoms and Alcohol Involvement

描述（由申请人提供）：本修订版R 01申请的目标是使用现有的前瞻性收集的数据来检查从初始酒精使用到导致酒精依赖的过渡阶段的途径。虽然先前的临床和人群为基础的研究提供了强有力的证据，共病关系的内化症状，如焦虑和抑郁与酒精使用，仍然有相对较少的数据，提供信息的关系，焦虑和抑郁症状的潜在病因学途径对酒精依赖。在本申请中，使用从幼儿期（1年级）到青年期前瞻性收集的数据，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酒精参与阶段发病风险的相关性：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，以及d）酒精滥用和/或依赖的发展。这些分析将按发育阶段单独完成（例如，儿童期、青少年期和青年期）。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。第二项研究提出了检查轨迹的共病内化症状与酒精的参与，使用潜在的类分析。我们建议：1）以经验为基础，定义在每个发展阶段的酒精参与的基础结构，并检查其与焦虑和抑郁症状的关系; 2）检查内化症状的影响，跨阶段的酒精参与使用潜在的过渡分析;和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参与的焦虑和抑郁症状之间关系的认识中的一些差距。这些分析的结果将有潜在的重大应用，以阐明酒精使用参与的前因，并确定潜在的可塑性目标的预防和干预计划，这最终可能会减少酒精相关的问题和酒精使用障碍的发生率和患病率。

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.