Resilience through the High School Years

描述(由申请人提供)：这项重新提交的竞赛延续研究旨在将一项非常成功的纵向诊断性研究扩展到青春期和高中阶段，研究对象是345名部落招收的奥吉布儿童(第一波年龄为10-12岁)及其465名照顾者。延续将支持从14-16岁到17-19岁的四个额外的数据波。这项研究和它的伙伴研究401名Ojibwe儿童和他们的511名照顾者(早一年启动)构成了当代唯一一项对这些年龄段的美国印第安人儿童的纵向诊断研究。本研究的总体目标是调查前四波中报告的早发性情绪/行为问题和精神障碍对关键高中年限的适应、精神障碍和心理健康服务利用模式的影响。这项研究将使用前瞻性数据来1)调查奥吉布文化中存在的特定文化保护因素，这些因素可以预防、推迟或减少早发性情绪和行为问题以及精神障碍的后果；以及2)调查与奥吉布儿童高中期间的个人特征和历史和社会背景相关的风险因素。我们的基线数据表明，在10-12岁和13-15岁之间，单一精神障碍的患病率从26.2%上升到44.8%，两种或两种以上精神疾病的患病率[增加了一倍多，从10.4%上升到26.6%](合并Disk 4.0儿童和女性照顾者报告)。保留地/保留地的历史和社会背景为美国印第安人和加拿大原住民青少年提供了独特的发展背景。这项前瞻性研究是研究发育过程中重要的文化差异的理想地点：1)它包含了适应文化的风险和保护因素的关键结构；2)它提供了研究开始时创建的创新的、针对文化的风险和保护因素的新衡量标准；3)它将提供有关青少年在高中阶段早期出现的情绪/行为问题和精神障碍对关键过渡和调整的影响的信息。调查人员正在与部落政府密切合作，将这些发现转化为基于经验的预防措施，旨在减少奥吉布儿童早期出现的情感、行为和药物滥用问题。与公共卫生相关：这是目前对土著青少年进行的唯一纵向诊断研究，从10-12岁开始，一直持续到高中。这项研究已经记录了保留地和保留地的精神健康/药物使用危机，大约四分之一的青年在13-15岁时达到了行为障碍或药物滥用障碍的终生标准。终生单身精神障碍的患病率为44.8%，这一比例与国家共病研究复制中成年人的比例相当。这些结果将在干预的最佳年龄、性别特定的风险和保护因素以及文化特定的风险和保护因素方面指导预防研究。

DESCRIPTION (provided by applicant): This resubmitted competitive continuation seeks to extend a highly successful longitudinal, diagnostic study of 345 tribally enrolled Ojibwe children (aged 10-12 years at wave 1) and 465 of their caretakers through adolescence and the high school years. The continuation would support four additional waves of data from ages 14 16 years through ages 17 19 years. This study and its companion study of 401 Ojibwe children and 511 of their caretakers (launched one year earlier) make up the only contemporary longitudinal diagnostic study of American Indian children at these ages.The overall goal of this continuation is to investigate the effects of early onset emotional/behavioral problems and mental disorders reported in the first four waves on adjustment, mental disorder, and mental health services utilization patterns during the critical high school years. The study will use prospective data to 1) investigate culturally specific protective factors that exist within the Ojibwe culture that may prevent, delay, or reduce the consequences of early onset emotional and behavioral problems and mental disorders; and 2) investigate risk factors that are associated with indiviudal characteristics and the historical and social contexts of Ojibwe children during their high school years. Our baseline data indicate the prevalence rate for a single mental disorder increased from 26.2 percent to 44.8 percent between the ages of 10-12 years and 13-15 years and that the prevalence of two or more mental disorders [more than doubled from 10.4 percent to 26.6 percent] (combined DISC 4.0 child and female caretaker reports). The historical and social contexts of reservations/reserve present a unique developmental context for American Indian and Canadian First Nations adolescents. This prospective study is ideally situated to investigate important cultural variation in developmental pathways: 1) it incorporates culturally adapted key constructs of risk and protective factors; 2) it provides innovative new culturally specific measures of risk and protective factors that were created at the study's onset; and 3) it will provide information regarding the influence of early onset of emotional/behavioral problems and mental disorders on critical transitions and adjustment as the adolescents move through their high school years. The investigators are working closely with the tribal governments to translate these findings into empirically-based preventions aimed at reducing early onset emotional, behavioral and substance abuse problems among Ojibwe children. PUBLIC HEALTH RELEVANCE: This is the only current longitudinal diagnostic study of Indigenous adolescents beginning at ages 10-12 years and continuing through the high school years. The study has already documented a mental health/substance use crisis on the reservations and reserves with approximately one-fourth of the youth meeting lifetime criteria for conduct disorder or a substance abuse disorder at ages 13 15 years. The prevalence of lifetime single mental disorders is 44.8 percent, a rate comparable to that of adults in the National Comorbidity Study Replication. These results will guide prevention research in terms of optimal ages for interventions, gender specific risk and protective factors, and culturally specific risk and protective factors.