RISK FOR SUBSTANCE ABUSE IN DEPRESSED ADOLESCENTS

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。在青少年中，抑郁症和物质使用障碍（SUD）的共病发生率很高。这些疾病的共同发生与显著增加的社会心理和经济负担有关，因此强调需要确定增加合并症风险的因素。压力极大地增加了药物使用的风险，尤其是那些患有抑郁症的人。抑郁症患者的应激物质使用相互作用可能由下丘脑轴介导。然而，HPA对压力的反应程度以及调节滥用药物的自我给药能力存在个体间差异。更好地了解HPA反应的变化可能有助于开发和测试针对这种高度致残疾病的更具体的干预措施。具体目的：1)探讨青少年抑郁症患者下丘脑-垂体-肾上腺（HPA）系统异常与SUD发生风险的关系。2)评估心理社会压力对抑郁青年SUD的预测是否有贡献，以及在HPA失调和非HPA失调的情况下，心理社会压力的贡献如何变化。3)探讨抑郁青少年眶额皮质及相关脑区反应性与SUD发生风险的关系。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. There is a high prevalence of comorbidity between depression and substance use disorder (SUD) in adolescents. Co-occurence of these disorders is associated with significant added psychosocial and economic burden, thus emphasizing the need to identify factors that increase the risk for comorbid illness. Stress acutely increases the risk for substance use, specifically in those with depression. Stress-substance use interactions in depressed persons might be mediated by HPA axis. However, there is inter-individual variability in the degree of HPA response to stress, as well as its ability to modulate self-administration of drugs of abuse. A better understanding of the variations in HPA response potentially might be helpful in the development and testing of more specific interventions for this highly disabling illness. Specific aims: 1) To examine the association between dysregulation in hypothalamic-pituitary-adrenal (HPA) system and risk for the development of SUD in depressed adolescents. 2) To assess whether psychosocial stress makes a contribution to the prediction of SUD in depressed youth, and to evaluate how the contribution of stress varies in those with and without HPA dysregulation. 3) To relate responsivity of the orbitofrontal cortex and associated brain regions to risk for development of SUD in depressed adolescents.