Longitudinal Study of Adolescent Marijuana Use and Neurodevelopment

描述（由申请人提供）：尽管对大麻的使用进行了大量的研究，但在将大麻使用的潜在神经认知后果与其神经认知前体分开的研究中，存在许多差异和不足。因此，尚不清楚使用回顾性设计在成年人群中确定的大麻使用的一些“后果”是否实际上早于使用，作为随后因最终使用大麻而加剧的脆弱性因素。此外，还没有关于青少年大麻使用者相对于非使用者和其他药物使用者的神经认知技能发展进展的研究。许多研究报告称，严重和长期使用大麻与成人执行认知功能（ECF）损伤和影响调节有关。这些技能的发展可能会在青春期被微妙地推迟，因为青春期通常是发病的时候，大脑最容易受到发育紊乱的影响。当青少年早期频繁使用大麻时，发育迟缓的脆弱性可能特别明显。虽然青少年的大脑极易受到环境的伤害，但它的可塑性提供了一个机会，可以通过有针对性的干预来改变通向负面结果的途径。需要更好地了解影响最终大麻使用的开始和水平的神经认知因素，并描述这些因素如何因大麻使用可能造成的损害而加剧。为了解决这些关键问题，提出的纵向研究将确定在大麻使用之前和预测大麻使用的特定神经认知因素，并评估这些因素在青春期前儿童进入大麻使用的普遍时期时的发育变化。此外，假定的大麻使用的神经认知后果，控制使用前的条件，将与前体分离。从早期大麻使用率很高的社区招募10岁、11岁和12岁尚未使用大麻的青春期前儿童（n=600）和每个孩子相应的主要照顾者，以确保有足够的最终使用者样本。无药物使用史的参与者将在基线和随后的3次年度波浪中进行评估，这些波浪跨越了这一早期和高流行人群的起始期和升级期。发展因素及其与大麻使用时间的相互作用将通过经验指导和发展适当的神经认知任务电池和综合访谈进行检查。将评估心理障碍（如焦虑、抑郁、多动症）和性别的潜在调节作用，并对共同发生的药物使用、社会经济地位、智商、青春期发育、邻里条件和父母药物滥用障碍进行调整。在纵向面板设计中阐明这些发育脆弱性和后果可以为青少年大麻使用者的针对性干预设计提供信息。

DESCRIPTION (provided by applicant): Despite considerable research on marijuana use, there are many discrepancies and insufficient research has been conducted to disentangle the potential neurocognitive consequences of marijuana use from its neurocognitive precursors. Thus, it is unknown whether some of the "consequences" of marijuana use identified in adult populations using retrospective designs actually predated use, acting as vulnerability factors that are subsequently exacerbated by the eventual use of marijuana. Moreover, there are no studies of the developmental progression of neurocognitive skills in adolescent marijuana users relative to nonusers and users of other drugs. Many studies report that severe and chronic marijuana use is associated with impairments in executive cognitive functions (ECF) and affect regulation in adults. It is possible that development of these skills may be subtly delayed during adolescence when onset commonly occurs and the brain is most vulnerable to developmental perturbations. Vulnerability to developmental delays may be particularly pronounced when marijuana use occurs early in adolescence and is frequent. Although the adolescent brain is highly vulnerable to environmental insults, its plasticity provides an opportunity to alter pathways to negative outcomes using well-targeted interventions. A better understanding is needed of neurocognitive factors that influence onset and levels of eventual marijuana use and delineation of how these factors may be exacerbated by damage potentially caused by marijuana use. To address these critical issues, the proposed longitudinal study will identify specific neurocognitive factors that antedate and predict marijuana use and assess developmental change in these factors as preadolescent children age into a period when onset of marijuana use is common. Further, the putative neurocognitive consequences of marijuana use, controlling for pre-use conditions, will be isolated from precursors. Preadolescents who are 10, 11, and 12 years old (n=600) who have not yet used marijuana and a corresponding primary caregiver for each child will be recruited from a community with very high rates of early marijuana use to ensure a sufficient sample of eventual users. Participants with no history of drug use will be assessed at baseline and 3 subsequent annual waves, spanning the period of initiation and escalation for this early and high prevalence population. Developmental factors and their interaction with marijuana use overtime will be examined using an empirically guided and developmentally appropriate neurocognitive task battery and comprehensive interview. The potential moderating role of psychological disorders (e.g., anxiety, depression, ADHD) and gender will be assessed and adjustments will be made for co-occurring drug use, socioeconomic status, IQ, pubertal development, neighborhood conditions, and parental substance abuse disorder. Elucidation of these developmental vulnerabilities and consequences in a longitudinal panel design can inform the design of targeted interventions for adolescent marijuana users.