Alcohol abuse/dependence and its consequences for Indigenous adolescents

描述（由申请人提供）：这[是我们RO1申请的第二次提交]响应公告：现有酒精流行病学数据的二次分析（PA-08-167）。通过这项申请，我们寻求资金，将我们的社区参与性研究（CBPR）扩展到美国四个保留地和加拿大四个保留地的奥吉布族人，再进行三年，与我们的社区伙伴合作，完成侧重于奥吉布族青少年酒精滥用和依赖障碍发展的数据分析。对青少年（第1波为10 - 12岁，第8波为17 - 19岁）进行的一项独一无二的8年小组研究进行了最新的科学纵向分析，这将促进我们对高风险人群中酒精使用和滥用的发育过程的理解，为创新的、经验驱动的、文化干预和履行CBPR的义务，在社区参与收集这些重要信息八年多之后，留下一些有用的东西。该应用程序所依据的研究计划是由NIDA和NIMH资助的滞后顺序设计。DA13580最初于2000年9月30日获得资助，并于2005年3月9日通过竞争性延期获得续期。MH067281最初于2002年7月1日获得资助，并于2007年7月1日竞争性续期。这项工作包括迄今为止对土著青少年及其父母/照顾者进行的唯一一项长期发展诊断性研究。DA13580的资金将于2010年6月30日到期，我们有能力维持我们的社区伙伴关系。DA13580最初研究应用程序的具体目标已经实现，但仍有大量的分析工作，其中包括极其丰富和复杂的数据集，特别侧重于酒精使用和滥用的开始及其从青春期早期到晚期的后果。分析计划将解决八个重点问题：1)随着时间的推移，酒精使用、滥用和依赖的出现；2)内化和外化行为对酒精使用和滥用的影响；3)防止青少年使用和滥用酒精的保护因素；4)群体成员身份对酒精结局的影响；5)酒精滥用/依赖与其他精神疾病（如重度抑郁发作、广泛性焦虑症和品行障碍）的合并症；6)与酒精使用相关的行为发生时间相互关联；7)酒精使用与反社会行为之间的潜在中介；8)社区特征对酒精使用/滥用的影响。这是我们所知道的唯一一组跟踪土著青年整个青春期的纵向诊断数据。8波数据集有4个DISC-R诊断数据点：波1（10 - 12岁，父母/监护人和青少年报告）；第四阶段（13 - 15岁；父母/监护人和青少年报告）；第六阶段（15 - 17岁，青少年报告）；第8波（17 - 19岁，青少年报告）。除了4个诊断数据点外，该数据还包括症状和行为量表、多报告者（父母/看护人和青少年）父母/看护人与青少年互动和青少年行为的测量以及社区测量。拟议的分析提供了一个独特的机会，可以追踪酒精使用的早期出现及其发展后果，包括酒精滥用和依赖障碍的开始。

DESCRIPTION (provided by applicant): This [is the second submission of our RO1 application] in response to the announcement: Secondary Analysis of Existing Alcohol Epidemiology Data (PA-08-167). With this application we seek funding to extend our community-based participatory research (CBPR) with Ojibwe people on four U.S. reservations and four Canadian reserves for three additional years to work with our community partners to complete data analysis focusing on the development of alcohol abuse and dependence disorders among Ojibwe adolescents. The proposed state-of-the- science longitudinal analyses of a one-of-a-kind eight-year panel study of adolescents (aged 10 - 12 years at Wave 1 and 17 - 19 years at Wave 8) will advance our understanding of developmental processes regarding alcohol use and abuse among a high-risk population, inform innovative, empirically driven, cultural interventions and fulfill the CBPR obligation of leaving something useful behind after more than eight years of community involvement in collecting this important information. The program of research on which this application is based was a lagged sequential design funded by NIDA and NIMH. DA13580 was initially funded 9/30/2000 and renewed via a competitive continuation 9/03/2005. MH067281 was initially funded 7/01/2002 and competitively renewed 7/01/07. The work comprises the only long-term developmental, diagnostic study of Indigenous adolescents and their parents/caretakers to date. Funding for DA13580 runs out 6/30/2010 and with it our ability to maintain our community partnerships. The specific aims of the original research application DA13580 have been accomplished but there remains an enormous amount of analytic work with an extremely rich and complex data set focusing specifically on onset of alcohol use and abuse and its consequences from early to late adolescence. The analytic plan will address eight foci: 1) the emergence of alcohol use, abuse, and dependence across time; 2) the relationship between internalizing and externalizing behaviors on alcohol use and abuse; 3) protective factors against adolescent alcohol use and abuse; 4) the effects of group membership on alcohol outcomes; 5) co morbidities of alcohol abuse/dependence with other psychiatric disorders such as major depressive episode, generalized anxiety disorder, and conduct disorder; 6) the timing of behaviors related to alcohol use in relation to one another, 7) potential mediators between alcohol use and antisocial behaviors; and 8) the effects of community characteristics on alcohol use/abuse. This is the only longitudinal, diagnostic data set of which we are aware that follows Indigenous young people through their entire adolescence. The eight-wave data set has four DISC-R diagnostic data points: Wave 1 (ages 10 - 12 years; parent/caretaker and adolescent reports); Wave 4 (ages 13 - 15 years; parent/caretaker and adolescent reports); Wave 6 (ages 15 - 17 years, adolescent reports); Wave 8 (ages 17 - 19 years, adolescent reports). In addition to four diagnostic data points, the data is replete with symptom and behavioral scales, multiple reporter (parent/caretaker and adolescent) measures of parent/caretaker-adolescent interactions and adolescent behaviors, and community measures. The proposed analyses provide a unique opportunity to trace the early emergence of alcohol use and its developmental consequences, including the onset of alcohol abuse and dependence disorders.