Alcohol and Substance Use Disorders from Adolescence through Age 30

描述（由申请人提供）：自1991年以来，我们提议扩展和丰富NIAAA资助的从青春期到青年期的酒精和其他物质使用障碍的大型纵向研究。从来自成瘾治疗方案的565名青少年和一个由220名青年组成的社区比较组中收集了五波广泛的诊断、医疗、物质使用和心理社会功能数据：基线；随访1年、3年和5年；25岁的时候。目前的项目旨在支持对这一独特数据集的持续分析，以研究青少年发病的酒精和药物问题以及共病精神病理学的长期临床过程；将这个项目扩展到30岁的评估和与这个年龄段特别相关的研究结果；并支持收集参与者的DNA，用于当前和未来与酒精和药物问题表型相关的遗传多态性研究。30岁的评估将包括详细的自我报告和访谈数据、DNA样本、尿液药物筛查、身体检查，以及艾滋病毒、2型单纯疱疹病毒和肝损伤的血液检测。纵向数据将用于测试两个具体目标：1)表征AUDs/ sud诊断标准的有效性，并确定这些疾病从青春期到30岁的临床病程的途径和预测因素；2)确定青少年和年轻人的药物使用和问题如何影响和受教育和职业成就、婚姻、同居和育儿的影响。我们还将描述和探索从青少年成瘾治疗中招募的非裔美国人和白种人在年轻成人结果中的种族差异。在临床样本中解决这些重要问题的工作很少。拟议的研究直接解决了NIAAA关于青春期和青年期纵向研究的战略重点；诊断标准及共病精神病理研究的重要性DNA的收集和临床研究中新表型的发展；以及对物质问题影响的种族差异的研究。多学科研究小组在精神病学、发展精神病理学、遗传学、统计学、刑事司法和公共卫生等交叉领域具有专长。我们的结果将直接转化为临床实践和公共卫生政策。广泛的现有数据库（例如，迄今为止在785名受试者中进行了3031次评估），研究者的生产力历史以及关于青少年成瘾的年轻人结果的新结果使这成为一个高度可行，至关重要且具有成本效益的纵向项目。公共卫生相关性：该项目将研究青少年至30岁期间酒精和物质使用障碍的分类学和临床病程。我们将研究物质问题轨迹对年轻人心理社会功能的影响以及这些结果中潜在的种族差异。结果将增加我们对如何预防和治疗青少年和年轻人物质障碍的理解。

DESCRIPTION (provided by applicant): We propose to extend and enrich a large longitudinal study of alcohol and other substance use disorders from adolescence through young adulthood that has been funded by NIAAA since 1991. Five waves of extensive diagnostic, medical, substance use and psychosocial functioning data have been collected from 565 adolescents from addictions treatment programs and a community comparison group of 220 youth: at baseline; at 1-year, 3-year, and 5-year follow-ups; and at age 25. The current project is designed to support continued analyses of this unique data set to study the long-term clinical course of adolescent-onset alcohol and drug problems and comorbid psychopathology; to extend this project to an age 30 assessment and study outcomes particularly relevant to this age; and, to support the collection of participants' DNA for current and future studies of genetic polymorphisms associated with alcohol and drug problem phenotypes. The age 30 assessment will include detailed self-report and interview data, DNA samples, a urine drug screen, a physical exam, and blood tests for HIV, HSV-2 and liver injury. Longitudinal data will be used to test two specific aims: 1) to characterize the validity of diagnostic criteria for AUDs/SUDs, and to determine pathways and predictors of the clinical course of these disorders, from adolescence through age 30; 2) to determine how adolescent and young adult substance use and problems affect and are affected by educational and occupational achievement, marriage, cohabitation and parenting. We also will describe and explore racial differences in young adult outcomes among African-Americans and Caucasians recruited from addictions treatment as teens. Very little work has addressed these important issues in clinical samples. The proposed research directly addresses NIAAA strategic priorities regarding the longitudinal study of adolescence and young adulthood; the importance of research on diagnostic criteria and comorbid psychopathology; the collection of DNA and the development of novel phenotypes in clinical research studies; and the study of racial differences in the effects of substance problems. The multidisciplinary research team has expertise in cross-fertilizing areas such as psychiatry, developmental psychopathology, genetics, statistics, criminal justice and public health. Our results will be directly translatable to clinical practice and public health policy. The extensive extant database (e.g., 3031 assessments in 785 subjects to date), the investigators' history of productivity and the emerging results regarding young adult outcomes of adolescent-onset addiction make this a highly feasible, critically important and cost-effective longitudinal project. Public Health Relevance: This project will study the Nosology and clinical course of alcohol and substance use disorders from adolescence through age 30. We will examine the effects of substance problem trajectories on young adult psychosocial functioning and potential racial disparities in these outcomes. The results will increase our understanding of how to prevent and treat adolescent and young adult substance disorders.