Underage Alcohol Use: Sequence and Progression of Early Drinking Milestones

描述(申请人提供)：虽然美国的法定饮酒年龄是21岁，但未成年人饮酒非常普遍，甚至是规范的。早期开始饮酒与随后出现一些适应不良结果的风险增加有关，包括酗酒或问题饮酒、患酒精使用障碍的可能性、其他物质参与和行为问题。然而，对未成年饮酒者的早期饮酒过程研究相对较少。这个应用程序的目标是探索早期饮酒生涯的特征，包括与饮酒相关的里程碑的排序和进展，例如第一次饮酒、第一次醉酒、第一次规律饮酒、第一次酗酒以及第一次经历与酒精相关的问题。此外，尽管早发者和晚发者的早期饮酒过程可能不同，但这种联系的性质尚不清楚。与问题行为理论和工作显示的共同脆弱性早期开始和随后的酒精参与，早期发病的个人可能有更快的进展到有问题的酒精使用和相关问题。相比之下，由于酒精在社会和身体上的可获得性有限，早发性患者的进展可能会更慢。这项研究项目将使用三个二级数据集对青春期早期到中期的饮酒过程进行分析，包括国家青少年健康纵向研究(AddHealth)、全国青年纵向调查(NLSY97)和青少年药物滥用治疗结果研究(DATOS-A)。其中两个数据集是具有全国代表性的预期样本，第三个是治疗样本，其中对不同里程碑的开始年龄进行了丰富的评估。这三个数据集的不同特征允许解决特定问题，从而发挥每个数据集的优势。此外，通过使用临床治疗样本，我们可以描述已经开始大量饮酒的高危样本的饮酒过程，这将补充使用两个一般人群样本的研究结果，这些样本主要由饮酒处于非常早期和非危险阶段的青少年组成。这项研究的具体目的是探索早期饮酒里程碑进展速度的正常以及个体间和个体内的差异，并使用项目反应理论建模、生存分析和潜在转变分析技术来检验早期饮酒过程与外源性、内源性、分组和混杂变量的关系。当这些具体目标实现时，我们将能够更好地理解首次饮酒年龄的预后意义，我们将更接近于了解早期饮酒风险较高的年轻人在各种早期饮酒里程碑方面的经验是否与普通人群不同。

DESCRIPTION (provided by applicant): Although the legal drinking age in the United States is age 21, underage drinking is highly prevalent, even normative. Early onset of alcohol use is associated with increased risk of a number of subsequent maladaptive outcomes, including heavy or problem drinking, likelihood of developing an alcohol use disorder, other substance involvement, and behavioral problems. However, early course of drinking among underage drinkers has been relatively understudied. The goal of this application is to explore characteristics of the early drinking career including sequencing of and progression through drinking-related milestones such as first drink, first time drunk, first regular drinking, first binge drinking, and first experience of an alcohol-related problem. In addition, although it is likely that early drinking course differs for those with early versus late onset, the nature of this association is unclear. Consistent with problem behavior theory and work showing common vulnerability to early initiation and subsequent alcohol involvement, early onset individuals may have a more rapid progression to problematic alcohol use and related problems. In contrast, early onset individuals may progress more slowly due to the limited social and physical availability of alcohol. This research project will conduct analysis of drinking course in early- to mid- adolescence using three secondary datasets, including the National Longitudinal Study of Adolescent Health (AddHealth), the National Longitudinal Survey of Youth (NLSY97), and the Drug Abuse Treatment Outcome Study for Adolescents (DATOS-A). Two of these datasets are nationally representative prospective samples and the third is a treatment sample which has a rich assessment of age of initiation of different milestones. The different characteristics of the three datasets permit resolution of specific questions that play to the strengths of each dataset. In addition, by using a clinical treatment sample, we can depict drinking course among a high-risk sample who has already initiated heavy drinking which will complement findings using two general population samples primarily comprised of adolescents whose drinking is at a very early and non-risky stage. Specific aims of the proposed study are to explore normative as well as inter- and intra-individual variation in velocity of progression through early drinking milestones, and to examine the association of early drinking course with exogenous, endogenous, grouping, And confounding variables using techniques of item response theory modeling, survival analysis, and latent transition analysis. When these specific aims are met, we will better be able to understand the prognostic significance of age of first drink and we will be closer to understanding whether youth who show early risky drinking differ from the general population with regard to their experience with various early drinking milestones.