The joint effect of neighborhood-level factors and decision-making on changes in cannibis use

项目摘要。在美国，吸食大麻成瘾的人比其他任何人都多 非法药物，其使用率正在上升，同时其公认的危害也在下降 在青少年中。青春期前额叶皮质的重要成熟变化 可能会使年轻人比成年人更容易受到大麻不良影响的影响。的确， 研究表明，重病患者的记忆表现和决策能力受损 大麻吸毒者，他们中的大多数在青春期开始使用大麻。然而，人们对此知之甚少。 从最初的实验开始，决策和记忆是如何受到影响的 与大麻成瘾的发展有关。此外，在科学界也存在争议 关于在大量大麻中观察到的决策障碍的文献 使用者的原因是大麻对大脑功能的有害影响，或者它们是否可能是 大麻成瘾发展的先行危险因素。这样做的主要目标是 提案的目的是确定：a)决策是否是大麻的先行风险因素 成瘾；以及b)不同时期决策和情景记忆发生了什么变化 大麻使用的是轨迹。参与者将是480名14岁至15岁的年轻人，其中大多数 他们可能已经尝试过大麻，但还没有上瘾。超过三个人 年，将根据决策和插曲的衡量标准来评估他们的业绩 每18个月一次的记忆以及他们的物质使用和大麻成瘾症状 每9个月一次。假设在基线时决策能力较差与 在后续行动中发展成大麻成瘾的风险增加。同样，决策的下降- 在随访期间的制造被假设与大麻的严重程度增加有关 上瘾(即更多的强制使用和更多的负面后果)。最后，那些 随着时间的推移，他们的大麻消费不断升级，将表明他们的发作更严重 与在其他(非升级或停止)大麻使用轨迹中观察到的记忆不同。在……里面 相比之下，决策将显示出在所有轨迹上几乎没有变化，这与其 假想的作用是大麻成瘾的前兆，而不是结果。 更多地了解神经心理功能和大麻之间的联系 上瘾将有助于澄清与他们的时间联系有关的理论模型。在临床上， 更多地了解成瘾的神经心理学预测因素和后遗症将有助于我们 制定更有针对性和量身定做的干预和预防计划，符合 奈达的目标。重要的是，我们的发现将澄清决策是否是先行风险。 大麻使用和上瘾的因素，或使用的后果，或两者兼而有之。

Project Summary. More people in the United States are addicted to cannabis than to any other illicit drug, and prevalence of its use is rising, accompanied by a decline in its perceived harm among adolescents. Important maturational changes in prefrontal cortex during adolescence may make youth more vulnerable than adults to adverse effects from cannabis. Indeed, research shows impairments in memory performance and decision-making abilities of heavy cannabis users, most of whom initiate use during adolescence. However, little is known about how decision-making and memory are affected across the trajectory from initial experimentation to development of cannabis addiction. Furthermore, there is controversy in the scientific literature on whether the impairments in decision-making observed among heavy cannabis users are due to the harmful effects of cannabis on brain functioning, or whether they may be an antecedent risk factor for the development of cannabis addiction. The principal goals of this proposal are to determine whether: a) decision-making is an antecedent risk factor for cannabis addiction; and b) what changes occur in decision-making and episodic memory along different cannabis use trajectories. Participants will be 480 youth ages 14 to 15 at baseline, most of whom will have experimented with cannabis, but have yet to develop addiction. Over three years, their performance will be assessed on measures of decision-making and episodic memory every 18 months and on their substance use and symptoms of cannabis addiction every 9 months. Poorer decision-making at baseline is hypothesized to be associated with increased risk of developing cannabis addiction during follow-up. Similarly, declines in decision- making during follow-up are hypothesized to be associated with increased severity of cannabis addiction (i.e., more compulsive use and more negative consequences). Finally, those who escalate in their cannabis consumption over time will show greater deterioration in their episodic memory than observed in other (non-escalating or desisting) cannabis use trajectories. In contrast, decision-making will show little change across all trajectories, consistent with its hypothesized role as an antecedent, rather than a consequence, of cannabis addiction. Understanding more about the links between neuropsychological functions and cannabis addiction will help clarify theoretical models pertaining to their temporal association. Clinically, knowing more about neuropsychological predictors and sequelae of addiction will help us to develop more targeted and tailored interventions and prevention programs, consistent with NIDA's goals. Importantly, our findings will clarify whether decision-making is an antecedent risk factor for cannabis use and addiction, a consequence of use, or both.