Adolescent Alcohol Abuse: A Twin-Study Perspective

描述(由申请人提供)：青少年酗酒与成年前持续滥用药物有关，青少年饮酒的公共健康负担明显与酒后驾车、不受欢迎和危险的性行为、教育成就被削减、生活轨迹改变和过早死亡有关。为了通过适当的干预措施减轻这一公共卫生负担，我们必须理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推论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很多，现有数据不允许有自信的因果推论。利用对芬兰双胞胎进行的数十年纵向研究提供的不同寻常的资源，我们提出了一些研究，旨在记录青少年饮酒在整个生命周期中的后果，比较暴露不和谐的双胞胎对结果，以解决青少年饮酒的成人后果是否在本质上是因果关系的问题，或者相反，它们是否源于选择过程和相关的责任。暴露-不协调的同卵双胞胎，关键是包括足够数量的暴露不协调的同卵双胞胎，可以产生尖锐的信息来评估这个问题。我们将获得并分析从12-22岁开始对物质使用进行纵向研究的四个大型芬兰队列的数据，跟踪从25-59岁的成人结果。我们的研究计划将为基于个人的分析提供有用的数据，对22,000个人进行分析，并对1,250对双胞胎中暴露不协调的同卵双胞胎进行强有力的分析，其中包括最有信息的同卵双胞胎中的一个很大子集：在青春期接触酒精不协调的同卵同卵双胞胎。这项创新性研究的结果将提供有关成人长期与青少年酗酒有关的意义的重要信息，为干预工作提供信息，并解决一个主要的公共卫生负担。

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.