Risk and resilience pathways linking community adversity, decision making, and alcohol misuse: A prospective study of Appalachian adolescents

摘要：青少年早期饮酒会损害心理社会和神经认知发展 并增加了药物滥用、学业失败和心理健康问题的易感性。这个 拟议的研究重点是西弗吉尼亚州(WV)农村地区的青少年饮酒情况，在 阿巴拉契亚地区。在美国社会中被边缘化，许多阿巴拉契亚社区遭受 长期贫困和阿片类药物滥用的流行程度。新兴的神经认知研究 强调奖励-突出和认知控制系统的成熟和整合。 与青春期情绪调节和健康决策能力有关。发展中的 决策系统预测酒精滥用，然而，导致不同的因素- 人们对决策轨迹的影响知之甚少。另外，我们积累了我们的研究成果 研究小组和其他人将农村青年广泛使用含咖啡因饮料与饮酒联系起来 漏洞。一种具有唤醒、运动激活和增强功能的精神刺激剂- 即使是中等剂量的咖啡因，也会在儿童和青少年中产生症状，包括 头痛、恶心、嗜睡、疲劳、情绪紊乱和失眠。尽管如此 危险、常规使用咖啡因的前瞻性调查以及咖啡因的机制 几乎不存在酒精使用的脆弱性。我们建议研究上下文 假设保护性因素以减弱社区劣势对Nega的影响。 情绪性、适应不良的健康行为和决策轨迹。这些因素 包括受监管、积极的家庭环境、促进健康的课堂和 学校环境和当地社区的集体效能。我们建议解决这些问题 一项对约2400名来自农村、小城镇、 和西弗吉尼亚州的小城市(30000英镑)公立学校。我们的具体目标是： 1.测试将社区劣势与酗酒联系起来的途径。我们期待社区 通过以下方式直接或间接预测决策流程增长放缓的缺点 消极的情绪性，咖啡因的使用和随之而来的睡眠问题会加剧这种情绪。 反过来，我们预计消极的情绪性和决策轨迹会预测饮酒 通过近端的脆弱性因素(与有风险的同龄人的联系、学术脱节)而滥用。 2.检验保护青少年免受社区不利影响的环境因素的假设。我们 期望背景保护性因素减弱社区不利因素对(A)的影响 消极情绪性、(B)咖啡因的使用、睡眠问题和(C)决策。 3.探讨酒精在尼古丁、大麻和其他毒品使用中的作用。

Abstract: Early adolescent alcohol use impairs psychosocial and neurocognitive development and increases vulnerabilities to drug abuse, academic failure, and mental health problems. The proposed research focuses on youth alcohol use in rural areas of West Virginia (WV), within the Appalachian region. Marginalized in American society, many Appalachian communities suffer chronic poverty and epidemic levels of opioid abuse. Emerging neurocognitive research stresses the maturation and integration of reward-salience and cognitive control systems asso- ciated with adolescent emotion regulation and healthy decision-making abilities. Development in decision making systems forecasts alcohol misuse, however, the factors that contribute to differ- ences in decision making trajectories are poorly understood. Also, accumulating research by our team and others links widespread use of caffeinated beverages by rural youth to alcohol use vulnerabilities. A psychostimulant possessing arousal, motor activation, and reinforcing proper- ties, even moderate doses of caffeine produce symptoms in children and adolescents, including headache, nausea, drowsiness, fatigue, mood disturbances, and sleeplessness. Despite these dangers, prospective investigations of routine caffeine use and the mechanisms through which it confers alcohol use vulnerability are virtually non-existent. We propose to investigate contextual protective factors hypothesized to attenuate the influence of community disadvantage on nega- tive emotionality, maladaptive health behavior, and decision-making trajectories. These factors include regulated, affectively positive family environments, health promoting classroom and school environments, and collective efficacy in local communities. We propose to address these issues in a prospective study of ~2,400 middle school youth from a range of rural, small town, and small city (< 30k) public schools in WV. Our specific aims are: 1. To test pathways linking community disadvantage to alcohol misuse. We expect community disadvantage to forecast slower growth in decision making processes directly and indirectly via negative emotionality which is reinforced by use of caffeine and attendant problems with sleep. In turn, we expect negative emotionality and decision making trajectories to forecast alcohol misuse via proximal vulnerability factors (affiliation with risky peers, academic disengagement). 2. To test hypotheses of contextual factors that protect youth from community disadvantage. We expect contextual protective factors to attenuate the influence of community disadvantage on (a) negative emotionality, (b) caffeine use, sleep problems, and (c) decision making. 3. To explore these alcohol antecedents in the onset of nicotine, marijuana, and other drug use.