Adult Progression of Adolescent Onset Substance Use Disorder in a High Risk Sample

本申请中提出的研究旨在了解促进健康的风险和保护因素。 持续和停止问题物质使用（SU）和反社会行为（ASB），开始于 青春期我们建议在首次招募后约18年进行第四波随访， 当他们过渡到成年中期时，这是一个发展时期 当我们期望这些人中的一部分减少或停止有问题的SU和相关的高风险时， 行为，而另一些人会坚持最严重的，破坏性的行为，导致高得惊人的 发病率和死亡率。这项建议的目的是： 目的1：确定预测青春期SU和ASB水平和变化（增长或下降）的风险因素 到中年。 a.我们假设发病年龄早，男性，儿童虐待，神经认知缺陷， 人格特质（行为控制不足/冲动）将预测SU的更高水平和更多增长 ASB的。 B.我们假设，以多基因风险评分（PRS）为指标的遗传脆弱性将更快地预测 SU和ASB的生长持续到成年后期。 C.我们将探讨机械关系;例如，我们假设PRS和 SU和ASB的水平和变化将部分由行为控制不足/冲动性介导。 目的2：确定与SU和ASB水平和变化相关的保护因素。 a.我们假设，接受成人的亲社会角色（教育、就业、婚姻、养育子女） 与SU和ASB的生长减少有关。 B.我们假设，治疗将与更大的停止SU和ASB比 监禁。 C.我们将探讨基因脆弱性的调节因素，特别是亲社会角色和治疗 减轻PRS对SU和ASB水平的影响。 目标3：确定研究结果对我们高度选择的个体样本的特异性程度， 早发性SU和ASB或通过对来自以下数据进行比较和联合分析来更广泛地概括 我们的高风险样本与我们目前资助的双胞胎研究的类似纵向数据， 基于社区的样本 a.我们假设风险和保护因素在两个样本中的作用相似，尽管 在高风险样本中，我们将有更大的风险因素。 B.我们将在高风险和社区双胞胎样本的联合分析中证实这一假设。

The research proposed in this application aims to understand risk and protective factors that promote continuation and desistance of problematic substance use (SU) and antisocial behavior (ASB) that began in adolescence. We propose a fourth wave of follow-up, approximately 18 years after initial recruitment, of an extremely affected adolescent sample as they transition into middle adulthood; this is a developmental period when we expect a portion of these individuals to decrease or desist problematic SU and associated high-risk behaviors, while others will persist with the most serious, destructive behaviors leading to devastatingly high rates of morbidity and mortality. The aims of this proposal are to: Aim 1: Identify risk factors that predict level and change (growth or decline) in SU and ASB from adolescence to middle adulthood. a. We hypothesize that early age of onset, male sex, child maltreatment, neurocognitive deficits, and personality traits (behavioral undercontrol/impulsivity) will predict higher levels and more growth in SU and ASB. b. We hypothesize that genetic vulnerability as indexed by polygenic risks scores (PRS) will predict faster growth in SU and ASB that persists through later adulthood. c. We will explore mechanistic relationships; e.g., we hypothesize that the relationship between PRS and level and change of SU and ASB will be partially mediated by behavioral undercontrol/impulsivity. Aim 2: Identify protective factors associated with level and change in SU and ASB. a. We hypothesize that adopting adult prosocial roles (education, employment, marriage, parenting) will be associated with lessened growth in SU and ASB. b. We hypothesize that treatment will be associated with greater desistance of SU and ASB than incarceration. c. We will explore moderators of genetic vulnerability, specifically whether prosocial roles and treatment attenuate the effect of PRS on level of SU and ASB. Aim 3: Determine the extent to which findings are specific to our highly selected sample of individuals with early-onset SU and ASB or generalize more broadly by conducting comparative and joint analyses of data from our high-risk sample with similar longitudinal data from our currently funded study of twins, an unselected community-based sample. a. We hypothesize that risk and protective factors will operate similarly across the two samples, although we will have a greater magnitude of risk factors in the high-risk sample. b. We will confirm this hypothesis in joint analyses of the high-risk and community twin samples.