Course of Alcohol and Drug Problems in Treated Teens

描述（由申请人提供）：对接受治疗的青少年酒精和物质问题过程的研究主要限于1年的结果。此外，由于现有的研究排除了对物质使用模式的细粒度时间分析，因此对物质使用减少的变化机制知之甚少。拟议的项目将使用1年以上的密集、有时间限制的短期随访。结合长达2年的长期随访，确定影响药物使用过程和问题的因素，重点是酒精、大麻和烟草。我们将对总共300名青少年（14-18岁）进行前瞻性研究，每个青少年都有一个父母作为辅助信息提供者：200名青少年将从成瘾治疗中招募，100名青少年将从社区招募。社区样本将作为参照组，以确定临床参与者观察到的变化的临床意义。所有青少年将在基线时进行评估（临床受试者在开始治疗后一周内）。6个月，12个月，18个月和24个月。在随访的第一年，临床青少年也将完成每月的电话随访。在第一个随访年和为期2年的长期随访期间，每月随访数据将用于实现三个具体目标：(1)开发并验证一个物质使用和问题过程的模型，该模型将短期的反应、缓解和复发过程与长期的恢复和复发过程结合起来；(2)表征与酒精、大麻和尼古丁不同过程开始相关的时间过程和因素；(3)确定接受治疗的青少年物质问题过程的途径和预测因素。结果将提供重要的新信息，将加强青少年物质使用干预的时间和内容。

DESCRIPTION (provided by applicant): Research on the course of alcohol and substance problems in treated adolescents is limited largely to 1-year outcomes, Further, little is known about mechanisms of change underlying reductions in substance use because existing studies preclude fine-grained temporal analysis of substance use patterns, The proposed project will use intensive, time-limited short term follow-up over 1-year, combined with longer-term follow-up through 2-years to identify factors influencing course of substance use and problems, with an emphasis on alcohol, cannabis and tobacco. We will prospectively study a total of 300 adolescents (age 14-18), each with a parent collateral informant: 200 adolescents will be recruited from addictions treatment and 100 adolescents will be recruited from the community. The community sample will serve as a reference group to determine the clinical significance of changes observed in clinical participants. All adolescents will be assessed at baseline (within I week of treatment entry for clinical subjects). 6-, 12-, 18-, and 24-months. Clinical adolescents also will complete monthly phone follow-ups during the first year of follow-up. Monthly follow-along data during the first follow-up year and longer-term follow-up through 2-years will be used to address three specific aims: (1) to develop and validate a model of the course of substance use and problems that integrates shorter-term processes of response, remission, and relapse with longer-term processes of recovery and recurrence, (2) to characterize the time course and factors associated with the onset of different course processes for alcohol, cannabis and nicotine, (3) to identify pathways and predictors of the course of substance problems in treated youth. Results will provide important new information that will enhance the timing and content of substance use interventions for adolescents.