Internalizing pathways to drug use: A multi-sample analysis

描述(申请人提供)：在本申请中，我们评估物质使用障碍(SUDS)的内化途径，并考虑负性情感障碍的病因学，这是一种潜在的SUDS表型，可通过与涉及负面情感的疾病(即抑郁和焦虑)的共病来识别。我们进行了一项综合(二级)分析(在我们之前的项目期间进行了改进)，包括同时分析三项全国知名的纵向研究，这些研究涉及酗酒父母的儿童和匹配的对照组，这些研究总共跨越了生命的前40年(2岁至38岁)。了解导致SUDS的发育途径对于为青少年设计和实施有效的干预和治疗方案至关重要。尽管青少年物质参与风险的行为指标早在2-5岁就出现了，但很少有关于SUDS的发育途径的理论考虑到从学龄前几年开始的风险过程。此外，很少有研究能够评估关于这些发展途径的理论。在生命的前40年，肥皂水出现、达到顶峰并开始下降的纵向研究很少见。现有的基于队列或基于人群的研究往往产生的病例太少，无法理清SUD的不同途径。因此，对高危人群(如酗酒父母的子女)进行长期的纵向研究，对于阐明肥胖症的发育途径是非常宝贵的。使用这种方法，我们追求五个具体目标：(1)定义和测试一条内化的SOD途径，并评估证据是否支持负性情感SUD的异型连续性(即，单个潜在特征的不同发育表达)；(2)考察内化和外化过程作为物质参与和负性情感SUD的预测因子在生命的前40年中的发育变化的独特、中介和交互作用；(3)考察性别、父母抑郁酗酒和环境因素作为发育时机的函数，作为朝着负性情感SUD的内在化路径进展的重要调节因素。(4)检查内化模型的预测效用是否不同于单独使用的各种物质(即酒精、烟草、大麻、兴奋剂和镇静剂)，以及(5)开发综合分析方法，利用这些方法测试目标1-4，并将这些方法传播给其他应用研究人员。 与公共健康相关：我们的应用程序测试了在生命的前40年内导致物质使用障碍的内化途径。对这种早期出现但持续存在的途径的研究很少见，但对于为青年设计和实施有效的干预和治疗方案的努力至关重要。

DESCRIPTION (provided by applicant): In this application, we evaluate an internalizing pathway to substance use disorders (SUDs) and consider the etiology of Negative Affect SUDs, a potential phenotype of SUDs identifiable by comorbidity with disorders involving negative affect (i.e., depression and anxiety). We conduct an integrative (secondary) analysis (refined in our prior project period) involving the simultaneous analysis of three nationally prominent longitudinal studies of children of alcoholic parents and matched controls that collectively span the first four decades of life (ages 2 through 38). Understanding developmental pathways leading to SUDs is critical in efforts to design and implement effective intervention and treatment programs for youth. Although behavioral indicators of risk for adolescent substance involvement appear as early as 2-5 years of age, few theories about developmental pathways to SUDs consider risk processes that begin in the preschool years. Moreover, few studies are capable of evaluating theories about these developmental pathways. Longitudinal studies that span the first four decades of life, when SUDs emerge, peak and begin to decline, are rare. Available cohort- or population-based studies often yield too few cases to disentangle different pathways for SUDs. Thus, long-term, longitudinal studies of high-risk populations, such as children of alcoholic parents, are invaluable for articulating developmental pathways to SUDs. Using this method, we pursue five specific aims: (1) to define and test an internalizing pathway to SUDs and to evaluate whether evidence supports heterotypic continuity (i.e., different developmental expressions of a single underlying trait) of Negative Affect SUDs over time, (2) to examine the developmentally-varying unique, mediated and interactive effects of internalizing and externalizing processes as predictors of substance involvement and Negative Affect SUDs across the first four decades of life, (3) to examine gender, parental depressive alcoholism, and contextual factors as important moderators of progression along an internalizing pathway toward Negative Affect SUDs as a function of developmental timing, (4) to examine whether the predictive utility of an internalizing model differs over various substances used in isolation (i.e., alcohol, tobacco, marijuana, stimulant and depressant drug) or in combination with one another, and (5) to develop methods for integrative analysis, to utilize these methods to test Aims 1-4, and to disseminate these methods to other applied researchers. PUBLIC HEALTH RELEVANCE: Our application tests an internalizing pathway to substance use disorder over the first four decades of life. Studies of such early emerging but persistent pathways are rare but critical to efforts to design and implement effective intervention and treatment programs for youth.