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

项目摘要。美国对大麻上瘾的人比其他任何人都多 非法药物，其使用流行率正在上升，同时其所知的危害也在下降 在青少年中。青春期前额叶皮层的重要成熟变化 可能使青年比成年人更容易受到大麻的不利影响。的确， 研究表明，在记忆性能和决策能力的损害， 大麻使用者，其中大多数在青春期开始使用。然而，人们对 决策和记忆是如何在最初实验的轨迹上受到影响的 大麻成瘾的发展。此外，在科学上也存在争议。 关于在大量大麻中观察到的决策障碍 使用者是由于大麻对大脑功能的有害影响，或者他们是否可能是 大麻成瘾发展的前因风险因素。其主要目标是 （a）决策是否是大麻的一个先行风险因素 成瘾;和B）决策和情景记忆发生了什么变化沿着不同的 大麻使用轨迹参与者将是480名年龄在14至15岁之间的青少年，其中大部分是 他们可能尝试过大麻，但还没有上瘾。超过三 年，他们的表现将评估的措施，决策和情节 记忆每18个月和他们的物质使用和大麻成瘾的症状 每9个月。假设基线时的决策与以下因素相关 在随访期间，大麻成瘾的风险增加。同样，决策的下降- 假设在随访期间的行为与大麻的严重程度增加有关 成瘾（即，更多的强迫性使用和更多的负面后果）。最后，那些 随着时间的推移，他们大麻消费量的增加将表明他们的偶发性疾病的恶化程度更大， 在其他（非升级或停止）大麻使用轨迹中观察到的记忆。在 相比之下，决策在所有轨迹上几乎没有变化，与其 假设的作用作为一个先决条件，而不是结果，大麻成瘾。 了解更多关于神经心理功能和大麻之间的联系 成瘾将有助于澄清有关其时间关联的理论模型。临床上， 了解更多关于神经心理学预测因子和成瘾后遗症的知识将有助于我们 制定更有针对性和更有针对性的干预措施和预防方案， NIDA的目标重要的是，我们的研究结果将澄清决策是否是一个先行风险 大麻使用和成瘾的因素，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.