Early onset vs. pre-existing vulnerabilities in adolescent drug use

青少年吸毒的早期发病与预先存在的脆弱性

• 批准号: 8507705
• 负责人: DANIEL ROMER
• 金额: $ 43.22万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-15 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8507705
• 关键词: Adolescence; Adolescent; Adult; Adverse drug effect; Adverse effects; Age; Alcohols; Behavior; Cross-Sectional Studies; Data; Deltastab; Dimensions; Disease; Drug usage; Early Intervention; Esthesia; Gambling; Goals; Impairment; Impulsivity; Intervention; Late Effects; Lead; Life; Link; Mediating; Outcome; Pattern; Performance; Pharmaceutical Preparations; Philadelphia; Prevention; Prevention strategy; Problem behavior; Reporting; Research; Research Personnel; Risk; Risk Factors; Risk-Taking; Short-Term Memory; Social Behavior; Source; Substance Use Disorder; Symptoms; Testing; Thinking; Tobacco; Training; adolescent drug use; adverse outcome; anti social; base; cognitive function; cohort; disability; discounting; drug abuse prevention; early adolescence; early onset; early onset drug use; follow-up; mortality; prevent; underage drinking

DESCRIPTION (provided by applicant): Early onset of drug use in adolescence, especially alcohol and tobacco, has been repeatedly linked to later symptoms of SUD. In addition, use of alcohol during adolescence has been linked to impairment of cognitive function, especially working memory ability (WMA). These findings suggest that intervention to prevent the initiation of drug use during early adolescence could help to avert many of the adverse consequences of drug use, including not only SUD but also impairment of WMA. Despite this evidence, the mechanisms underlying the effects of early onset remain unclear. The present research aims to clarify those mechanisms so that firmer implications for prevention can be drawn. In particular, previous research has been based primarily on cross- sectional studies of adults with retrospective reports of drug use during adolescence. This research cannot determine whether early initiation of drug use includes mere experimentation with drugs or only the early progression of drug use. The early onset hypothesis would predict that early progression is the more critical factor for later adverse outcomes. In addition, previous research suggests that early drug use is merely a marker for more general pre-existing vulnerabilities that increase the risks of those outcomes in later adolescence and adulthood. The present research aims to provide a test of these competing hypotheses by conducting a follow-up study of a longitudinal-cohort of Philadelphia adolescents (N=387) that started at ages 10-12 and that were assessed annually for 5 years by our team of researchers. The Philadelphia Trajectory Study (PTS) has longitudinal data on WMA as well as different forms of impulsivity that indicate that early use of drugs, whether it leads to progression or not, is related to impulsive tendencies that reflect weakness in WMA. The PTS suggests that WMA and associated forms of impulsivity are the underlying risk factors for later adverse drug effects rather than early initiation per se. If this hypothesis were confirmed, it would suggest that early WMA training might be a valuable prevention strategy to prevent the adverse effects of drugs. The proposed study with a single follow-up assessment of the PTS when the cohort will be in an age range of high drug-use initiation and risk for SUD (18-19) can determine whether early vulnerabilities for drug use can explain differences in early experimentation vs. progression in drug use as well as later initiatio for symptoms of SUD (Aim 1). It can also determine whether early weakness in WMA and associated forms of impulsivity remain as risk factors for potential impairment in WMA linked to later drug use (Aim 2). Finally, it can determine whether other adverse outcomes apart from drug use are traceable to early weakness in WMA, such as problem gambling, anti-social behavior, sexual risks, and poor academic performance (Aim 3).

描述（由申请人提供）：青少年早期开始使用药物，特别是酒精和烟草，一再与后来的SUD症状有关。此外，青少年时期饮酒与认知功能受损有关，尤其是工作记忆能力（WMA）。这些发现表明，在青少年早期预防开始吸毒的干预可能有助于避免吸毒的许多不良后果，不仅包括SUD，还包括WMA的损害。尽管有这些证据，早期发病的影响机制仍不清楚。目前的研究旨在澄清这些机制，以便对预防产生更确切的影响。特别是，以前的研究主要是基于成年人的横断面研究和青少年吸毒的回顾性报告。这项研究不能确定早期开始使用药物是否包括单纯的药物实验或仅仅是药物使用的早期进展。早发假说预测早期进展是后期不良结果的更关键因素。此外，先前的研究表明，早期吸毒仅仅是更普遍的预先存在的脆弱性的一个标志，这些脆弱性会增加青春期后期和成年期出现这些结果的风险。本研究旨在通过对费城青少年（N=387）的纵向队列进行随访研究，对这些相互竞争的假设进行检验，这些青少年从10-12岁开始，由我们的研究小组每年评估5年。费城轨迹研究（PTS）有关于WMA以及不同形式的冲动性的纵向数据，这些数据表明，早期使用药物，无论是否导致进展，都与反映WMA薄弱的冲动倾向有关。PTS表明，WMA和相关的冲动性形式是后期药物不良反应的潜在危险因素，而不是早期开始本身。如果这