Chronic stressors and drug abuse in 2 Indian populations

描述(由申请人提供)： 美国印第安人(AI)保留地人口面临着许多长期的压力。贫困、失业、暴力和事故都很常见，有人认为，历史创伤、不一致和破坏性的政府政策以及强制寄宿学校的结合，使得目前保留人口中的许多人特别容易受到日常慢性应激因素的影响，特别容易被滥用物质，以及创伤后应激障碍。在人工智能中也有药物使用的记录，人工智能青年报告的毒品和烟草使用量往往比美国其他许多人更多。直到最近才有关于药物障碍流行率的数据；这些数据表明药物障碍的比率与其他人群相当，但年龄趋势反映出，与年长的人相比，人工智能青年终生使用毒品和烟草的风险更高，这表明人工智能中药物障碍的上升趋势。因此，拟议的关于慢性应激源与药物使用和精神障碍之间的关系的研究的重点特别及时。 来自美国印第安人服务利用、精神病学流行病学、风险和保护因素项目(AI-SUPERPFP)的数据提供了一个独特的机会，通过综合评估慢性压力源(历史创伤、家族史、童年压力源、创伤事件、慢性紧张、频繁的终身事件和宏观水平的压力源)以及9种药物的标准使用和紊乱指标，对研究不足的人群中的压力和药物障碍进行流行病学调查。这项工作以以下具体目标为指导：1)描述和评估这两个保留人群中慢性应激源的流行病学；2)了解和描述慢性应激源、药物使用和DSM定义的药物滥用和依赖之间的关系；3)调查和描绘慢性应激源、药物使用和障碍与共生问题之间的关系，包括创伤后应激障碍、其他DSM定义的问题(抑郁、焦虑和酒精障碍)以及暴力和反社会行为。在每个具体目标中，将调查重要的人口相关因素(例如，性别、部落、社会经济地位和年龄)和个人资源(应对、自尊、外部控制点、社会支持、精神、种族认同和治疗史)的作用。 美国印第安人和阿拉斯加原住民项目(AIANP)为开展这项工作提供了一个独特的多学科环境。拟议的工作有望提供迄今为止最全面和最有重点的调查，调查铝人群中的慢性压力源，以及各种压力源与药物使用和精神障碍的关系。

DESCRIPTION (provided by applicant): American Indian (AI) reservation populations face numerous chronic stressors. Poverty, unemployment, violence, and accidents are all common, and it has been argued that the combination of historical trauma, inconsistent and disruptive governmental policies, and mandated boarding schools, have rendered many in current reservation populations especially vulnerable to both the impact of everyday chronic stressors, to substance misuse, and to PTSD. Drug use has also been documented among AIs, with AI youth often reporting greater use of drugs and tobacco than many others in the U.S. Only recently have data about the prevalence of drug disorders become available; such data suggest drug disorder rates that are comparable to other populations, but with age trends reflecting that AI youth are at increased risk for lifetime use of both drugs and tobacco compared to their elders suggesting an upward trend in drug disorders among AIs. Thus, the focus of the proposed research on the relationship between chronic stressors and drug use and disorders in this population is particularly timely. The data from the American Indian Service Utilization, Psychiatric Epidemiology; Risk and Protective Factors Project (AI-SUPERPFP) provide a unique opportunity for an epidemiological investigation of stress and drug disorders in an understudied population with a comprehensive assessment of chronic stressors (historical traumas, family history, childhood stressors, traumatic events, chronic strains, frequent lifetime events, and macro level stressors) in combination with standard measures of use and disorder for 9 drugs. The following specific aims guide this work: 1) To characterize and estimate the epidemiology of chronic stressors in these 2 reservation populations; 2) To understand and describe the relationships between chronic stressors, drug use, and DSM-defined drug abuse and dependence in these populations; 3) To investigate and portray the relationships between chronic stressors, drug use and disorders, and co-occurring problems including PTSD, other DSM-defined problems (depressive, anxiety, and alcohol disorders), and violence and antisocial behavior. Within each specific aim, the role of important demographic correlates (e.g., gender, tribe, SES, and age) and personal resources (coping, self-esteem, external locus of control, social support, spirituality, ethnic identity, and treatment history) will be investigated. The American Indian and Alaska Native Programs (AIANP) provide a distinctive multidisciplinary environment in which to conduct this work. The proposed work promises to provide the most comprehensive and focused investigation to date of chronic stressors within Al populations and of the relationship of various stressors with drug use and disorder.