Mechanisms Underlying the Relationship between Sleep Problems and Drug Use in Ado

Ado 睡眠问题与吸毒之间关系的潜在机制

• 批准号: 8577244
• 负责人: DIANA H FISHBEIN
• 金额: $ 65.9万
• 依托单位: RESEARCH TRIANGLE INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2014-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8577244
• 关键词: 20 year old; Abstinence; Adolescence; Adolescent; Adrenal Glands; Adult; Affect; Affective; Alcohol abuse; Alcohol consumption; Alcohols; Attention; Child; Childhood; Chronic; Cognition; Communities; DNA Markers; Data; Data Collection; Depressed mood; Development; Divorce; Drowsiness; Drug Exposure; Drug abuse; Drug usage; Drug user; Emotional; Emotions; Esthesia; Exposure to; Funding; Gender; Habits; High Prevalence; Hydrocortisone; Hypothalamic structure; Illicit Drugs; Individual; Individual Differences; Intervention; Lead; Light; Longitudinal Studies; Marijuana; Marijuana Smoking; Measures; Mediator of activation protein; Mental disorders; Modeling; Neurocognitive; Neurosecretory Systems; Parents; Participant; Pathway interactions; Pattern; Pharmaceutical Preparations; Phase; Physiological; Pituitary Gland; Policies; Poverty; Preventive; Probability; Problem behavior; Prospective Studies; Puberty; Recruitment Activity; Relapse; Relative (related person); Reporting; Research; Rewards; Risk; Role; Salivary; Sampling; Sexual Development; Sleep; Sleep Disorders; Sleep disturbances; Stress; Structure; Surface; System; Testing; Urinalysis; Youth; actigraphy; aged; alcohol exposure; alcohol use initiation; base; boys; cognitive function; design; drug of abuse; emotion regulation; girls; hypothalamic-pituitary-adrenal axis; maltreatment; marijuana user; neglect; programs; prospective; public health relevance; serotonin transporter; sex; teacher

DESCRIPTION (provided by applicant): The proposed longitudinal R01 study will elucidate mechanisms underlying the relationship between sleep problems and propensity to drug/alcohol use in adolescents. Many questions remain about this putative relationship given that prospective studies with a pre-drug exposure baseline are few and integrative models are lacking. A systems approach is needed that examines the inherent linkages, temporal dynamics, and mechanisms in the relationship between sleep disturbances and drug abuse. Our integrative, temporal model theorizes that sleep problems will be significant predictors of drug/alcohol initiation and escalation of use in adolescents. We propose further that this relationship can be explained at least in part by emotion dysregulation, as measured by tasks that recruit affective limbic structures and perturbations in neuroendocrine (cortisol) functioning Level of cognitive functioning, which is affected by sleep problems and stress and is associated with emotional dysregulation and risk for drug abuse, will moderate the relationship between sleep problems and drug use. Exposure to prolonged stress (e.g., maltreatment, neglect, divorce, poverty), is expected to amplify the mediational relationship because it has been shown to induce emotion dysregulation, disrupt sleep, and influence drug abuse risk and relapse. Gender and pubertal development also will be included in these models, given findings that sleep problems are reportedly more predictive of drug use initiation in boys than in girls, and that pubertal development in both sexes is associated with poorer sleep quality and duration. Finally, the model predicts that eventual drug use will exacerbate sleep problems and lead to further decrements in sleep, emotion regulation, and cognition, promoting an escalating pattern of use. We have a unique opportunity to study these relationships by accessing participants (529 parent-child dyads) in an unprecedented ongoing longitudinal, prospective study of drug use (with a focus on marijuana, the most commonly used illicit drug in adolescence) use in a community with a high prevalence of use. Baseline data were collected when youth were aged 10-12 and the last wave of data collection is near completion with youth between 12-14.5 years old. The funded study was designed to identify the neurocognitive precursors and consequences of marijuana use relative to other drug and nonuse trajectories. The children are being assessed using measures of lifetime stress exposures, sleep habits and problems, IQ, ECF, emotion regulation, behavioral problems, psychiatric disorders, and drug/alcohol use (only youth drug and alcohol nave at baseline were included). The proposed study would prolong data collection for two additional 28 month waves into later adolescent years (until ~18-20 years old) when pathways of drug use become increasingly clear, transitions to an escalated pattern of use have surfaced, and consequences of use become apparent. To test the proposed hypotheses, we will add cortisol sampling, sleep log, sleep actigraphy, and parent questions regarding the child's sleep patterns. If sleep problems in childhood indeed increase the probability of onset of drug use and treatment intractability, greater attention by parents, teachers, and clinicians to the underlying causes of sleep problems in children and adolescents would have significant preventive and/or ameliorative long-term implications given the malleability of these functions.

描述（由申请人提供）：拟议的纵向R01研究将阐明睡眠问题与青少年毒品/酒精使用之间关系的基础机制。鉴于这种推定关系仍然存在许多问题，因为前瞻性研究具有前药物曝光基线很少，并且缺乏综合模型。需要采用系统方法来检查睡眠障碍与滥用药物之间关系中固有的联系，时间动态和机制。我们的综合时间模型理论上，睡眠问题将是药物/酒精启动和青少年使用升级的重要预测指标。我们进一步提出，这种关系至少可以部分通过情绪失调来解释，这是由招募情感边界结构和神经内分泌（Cortisol）在认知功能水平的功能水平的任务衡量的，这受睡眠问题的影响，受到睡眠问题的影响，并受到情绪障碍和滥用药物滥用的风险，与药物滥用相关性，与药物滥用相关性，与药物滥用相关，将与睡眠相关，并适度地使用。暴露于长时间的压力（例如，虐待，忽视，离婚，贫困）有望扩大中介关系，因为它已被证明会诱导情绪失调，破坏睡眠并影响药物滥用的风险和复发。这些模型还将包括性别和青春期发展，据报道，据报道，睡眠问题比男孩的吸毒开始更具预测性，而两性的青春期发展与睡眠质量和持续时间较差有关。最后，该模型预测，最终的药物使用将加剧睡眠问题，并导致睡眠，情绪调节和认知进一步减少，从而促进使用的升级模式。 我们有一个独特的机会来研究这些关系，通过在一个空前的持续纵向，前瞻性研究中访问参与者（529个亲子二元组），对药物使用（重点是青少年中最常用的非法药物），在一个社区中使用了高普遍使用。当年轻人10至12岁时收集基线数据，而最后一波数据收集浪潮即将完成12-14.5岁的年轻人。这项资助的研究旨在确定大麻使用相对于其他药物和不使用轨迹的神经认知前体和后果。使用终生压力暴露，睡眠习惯和问题的措施，智商，ECF，情绪调节，行为问题，精神病和毒品/酒精使用（仅包括基线时只有青少年药物和酒精含量）来评估儿童。拟议的研究将延长数据收集两个28个月的波浪到后来的青春期（直到约18-20岁），当时药物使用途径变得越来越清晰，过渡到升级的使用模式的过渡已经浮出水面，并且使用的后果显而易见。为了检验提出的假设，我们将添加皮质醇采样，睡眠日志，睡眠行为以及有关孩子睡眠方式的问题。如果童年的睡眠问题确实增加了药物使用和治疗性的发作可能性，那么父母，教师和临床医生对儿童和青少年的睡眠问题的根本原因的关注更大，鉴于这些功能的增强性，儿童和青少年的睡眠问题将具有显着的预防和/或改善长期意义。