Development and Prevention of Substance Use Problems

描述（由申请人提供）：本项目的目标是了解行为障碍在青年期物质使用问题发展中的作用。为了实现这一目标，拟议的项目将扩大两个正在进行的，联邦资助的，多地点，纵向研究。儿童发展项目（CDP）是一项前瞻性研究，涉及来自三个地点的585名青年（50%为女性; 19%为少数民族），他们从4岁开始接受随访，现在已年满19岁（原始样本保留率为84%）。快速通道（FT）项目是一项预防实验，其中892个早期开始的行为问题的青少年（31%女性; 55%少数民族）从四个地点被确定在一年级，并随机分配到接受10年的干预或不，并一直跟踪到18岁（83%的样本保留）。研究结果表明，分配到FT干预的青年在高中比对照组少40%的行为障碍诊断。FT还包括387名青年（50%为女性; 49%为少数民族）的规范代表性样本，这些青年正在被跟踪研究行为障碍如何发展。到目前为止，在CDP和FT中的物质使用情况都得到了测量，但没有深入。对于这两项研究，拟议项目的新数据收集将包括对参与者在成年早期使用、依赖和滥用非法物质、酒精和烟草的详细测量。将讨论三个目标。第一个目的是了解早期行为障碍如何导致物质使用问题。一个交易发展模型将进行测试，假定在儿童行为，社会文化背景，养育，同伴关系，学校教育和社会认知领域的风险和保护因素。CDP中出现的结果将与FT规范样本重复。第二个目标是了解韧性的物质使用的发展行为问题的儿童。FT高风险对照组，已知是在高风险的物质使用，将进行检查，以确定保护因素，占弹性物质使用。假设将进行测试，专业服务中度风险，具体而言，服务，聚集越轨儿童群体将提高风险，而个人服务，专注于家庭过程将降低风险。第三个目的是测试FT干预在预防成年早期物质使用问题方面的有效性，以及减少行为障碍作为这种影响的中介的作用。

DESCRIPTION (provided by applicant): The goal of this project is to understand the role that conduct disorder plays in the development of substance-use problems in young adulthood. To reach this goal, the proposed project will amplify two ongoing, federally funded, multi-site, longitudinal studies. The Child Development Project (CDP) is a prospective study of 585 youth (50% female; 19% minority) from three sites, who have been followed since age four years and are now 19 years old (with 84% retention of original sample). The Fast Track (FT) Project is a prevention experiment in which 892 early-starting conduct-problem youth (31% female; 55% minority) from four sites were identified in first grade and randomly assigned to receive a ten-year intervention or not and have been followed through age 18 (83% retention of sample). Findings indicate that youth assigned to the FT intervention display 40% fewer diagnoses of conduct disorder in high school than controls. FT also includes a normative-representative sample of 387 youth (50% female; 49% minority) who are being followed to study how conduct disorder develops. To date, substance use in both the CDP and FT has been measured but not in depth. For both studies, new data collection for the proposed project will include detailed measurement of participants' use, dependence, and abuse of illicit substances, alcohol, and tobacco in early adulthood. Three aims will be addressed. The first aim is to understand how early conduct disorder leads to substance-use problems. A transactional-developmental model will be tested that posits risk and protective factors in the domains of child behavior, socio-cultural contexts, parenting, peer relations, schooling, and social cognitions. Findings that emerge from the CDP will be replicated with the FT normative sample. The second aim is to understand resilience to substance-use development among conduct-problem children. The FT high-risk control group, known to be at elevated risk for substance use, will be examined to identify protective factors that account for resilience to substance use. The hypothesis will be tested that professional services moderate risk; specifically, services that aggregate deviant children in groups will enhance risk, whereas individual services that focus on family process will decrease risk. The third aim is to test the efficacy of the FT intervention in preventing substance-use problems in early adulthood and the role of reduced conduct disorder as a mediator of this effect.