Adolescent Alcohol Abuse: A Twin-Study Perspective

描述（由申请人提供）：青少年酒精滥用与成年后持续的药物滥用有关，青少年饮酒的公共卫生负担在与酒后驾车，不想要的和危险的性行为，缩短教育成就，改变生活轨迹和过早死亡的关系中是显而易见的。为了通过适当的干预措施减轻公共卫生负担，我们必须了解为什么这些成人结果与青少年酒精暴露有关。从观察数据中得出因果关系推断的障碍是众所周知的;青少年饮酒与不良成人结果之间的潜在混淆有很多，现有数据不允许有信心的因果关系推断。使用不寻常的资源提供给我们从几十年的纵向研究与芬兰双胞胎，我们提出的研究旨在记录青少年饮酒的后果在整个生命周期，比较结果的不确定性不一致的双胞胎对解决的问题是否成年青少年饮酒的后果是因果关系的性质，或者，相反，他们产生的选择过程和相关的责任。暴露不一致的同卵双生子，关键包括足够数量的暴露不一致的同卵双生子，可以产生尖锐的信息来评估这个问题。我们将获得并分析来自四个大型芬兰队列的数据，这些队列从12-22岁开始纵向研究物质使用，跟踪25-59岁的成人结局。我们的研究计划将为22，000名个体的基于个体的分析和1，250对双胞胎的不确定性不一致的共同双胞胎的稳健分析提供信息数据，包括最具信息性的一个重要子集：青春期酒精暴露不一致的单卵共同双胞胎。这项创新研究的结果将提供重要信息，说明成年人与青少年酗酒的长期联系的意义，为干预工作提供信息，并解决重大的公共卫生负担。

DESCRIPTION (provided by applicant): Adolescent alcohol abuse is associated with continued substance abuse into adulthood, and the public health burden of adolescent drinking is evident in its association with drunk driving, unwanted and risky sexual behavior, truncated educational achievement, altered life trajectories, and premature death. To reduce that public health burden with appropriate interventions, we must understand why these adult outcomes associate with adolescent alcohol exposure. The obstacles in drawing causal inferences from observational data are well-known; potential confounds in the association of adolescent drinking with adverse adult outcomes are many, and the available data do not permit confident causal inferences. Using the unusual resources available to us from decades of longitudinal research with Finnish twins, we propose studies designed to document the consequences of adolescent alcohol use across the lifespan, comparing outcomes in exposure-discordant twin pairs to address the question of whether adult consequences of adolescent drinking are causal in nature, or whether, instead, they arise from selection processes and correlated liabilities. Exposure-discordant co-twins, critically including adequate numbers of exposure-discordant monozygotic co-twins, can yield incisive information with which to evaluate this question. We will obtain and analyze data from four large Finnish cohorts longitudinally studied for substance use from entry ages 12-22, tracking adult outcomes to ages 25-59. Our research plan will yield informative data for individual-based analyses on 22,000 individuals and robust analyses of exposure-discordant co-twins on 1,250 twin pairs, including a substantial subset of the most informative: monozygotic co-twins who are discordant for their alcohol exposure in adolescence. Results of this innovative research will provide important information on the meaning of long-term adult associations with adolescent alcohol abuse, inform intervention efforts, and address a major public health burden.