The Natural History and Consequences of Ecstasy Use

描述（由申请人提供）：摇头丸（MDMA）的使用在美国和世界各地的年轻人中急剧增加。尽管医学文献中充满了与摇头丸相关的严重身体后果的研究，但对摇头丸使用的自然历史及其对行为和精神健康的影响知之甚少。拟议研究的目标是提供关于成为摇头丸使用者的危险因素，摇头丸使用模式及其长期后果的急需流行病学信息。该研究还将对大学生中一般非法药物使用模式的描述和预测产生更广泛的影响。马里兰大学帕克分校（University of Maryland, college Park）是一所拥有多元化学生群体的主要公立大学，将对该校的大量大学生样本进行纵向前瞻性研究。该项目的三个具体目标是：1)确定摇头丸使用开始的预测因素；2)描述摇头丸的使用模式并建立模型，以更好地了解摇头丸的使用变化；描述并预测在大学生中使用摇头丸的后果。将采用两个阶段的程序来招募学生参加研究。首先，通过与学校迎新办公室的合作，对所有即将入学的新生进行筛选。其次，根据筛选的信息，我们将招募18-19岁的学生，他们分为三组，并将有资格进行纵向随访：1)一个“高风险样本”，在基线时使用过大麻的非摇头丸使用者（具体目标# 1）；2)“普遍”案例，即基线的摇头丸使用者，他们与来自特定目标# 1的意外摇头丸使用者将组成研究摇头丸使用模式的样本（特定目标# 2），以及3)基线的非大麻和摇头丸使用者的“低风险”样本，主要用于特定目标# 3的比较目的。这些学生将在三年内每年接受一次面对面的面试，每半年接受一次邮寄问卷的评估。假设与摇头丸使用的开始和使用模式的改变有关的风险因素包括家庭因素（例如家族史和关系质量）、社会影响（例如同伴影响、参加“狂欢”）、个人特征（例如行为失调/寻求刺激）、环境变量和药物使用史。随着时间的推移，样本中需要研究的后果类别是：1)酒精和其他药物依赖；2)高危性行为；3)学习成绩；4)心理健康问题（即焦虑和抑郁）。本研究将补充关于摇头丸使用风险和后果的神经生物学机制的研究，增加现有的大学药物使用知识体系，并对识别摇头丸使用高风险人群和需要预防和早期干预服务的人群具有重要意义。

DESCRIPTION (provided by applicant): Ecstasy (MDMA) use has increased sharply among youth in both the US and worldwide. Although the medical literature is replete with studies documenting serious physical consequences associated with ecstasy, little is known about the natural history of ecstasy use and its effects on behavior and mental health. The goal of the proposed research is to contribute critically needed epidemiologic information about the risk factors for becoming an ecstasy user, the patterns of ecstasy use, and its longer-term consequences. The study will also have broader implications for the description and prediction of illicit drug use patterns in general among college students. A longitudinal prospective study of a large sample of college students at the University of Maryland, College Park, a major public University with a diverse student body, will be conducted. The three specific aims of the project are to: 1) identify the predictors of onset of ecstasy use; 2) characterize ecstasy use patterns and develop models to better understand changes in ecstasy use; and 3) describe and predict the consequences of ecstasy use, among college students. A two-stage procedure will be used to recruit students into the study. First, a screening instrument will be administered to all incoming freshman via cooperation with the University's Orientation Office. Second, based on information from the screening, we will recruit 18-19 year old students who fall into three groups and will be eligible for longitudinal follow-up: 1) A "high-risk sample" of non-users of ecstasy at baseline who have used marijuana (Specific Aim# 1); 2) "Prevalent" cases, ecstasy users at baseline, who, in conjunction with incident ecstasy users from Specific Aim# 1 will comprise the sample to study ecstasy use patterns (Specific Aim# 2), and, 3) A "low-risk" sample of non-users of both marijuana and ecstasy at baseline, primarily for comparative purposes for Specific Aim # 3. These students will be assessed annually for three years with a face-to-face interview and semi-annually with mail-in questionnaires. Risk factors that are hypothesized to be related to the initiation of ecstasy use and changes in the pattern of use include family factors (e.g. family history and quality of relationships), social influences (e.g., peer influences, attendance at "raves"), personal characteristics (i.e., behavioral dysreguhtion/sensation-seeking), contextual variables and drug use history. The classes of consequences to be studied in the sample over time are: 1) alcohol and other drug dependence; 2) high risk sexual activity; 3) academic performance; and 4) mental health problems (i.e., anxiety and depression). This study will complement research about the neurobiological mechanisms of risks and consequences of ecstasy use, add to the existing body of knowledge on college drug use, and have important implications for the identification of persons at high risk for ecstasy use and those in need of prevention and early intervention services.