Child Psychopathology, Adversity & Developing Drug Abuse

儿童精神病理学，逆境

• 批准号: 6788288
• 负责人: BETH Ellen MOLNAR
• 金额: $ 8.2万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-08-06 至 2006-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6788288
• 关键词: adolescence (12-20); alcoholism /alcohol abuse; anxiety disorders; behavioral /social science research tag; child mental disorders; child psychology; community; comorbidity; disease /disorder proneness /risk; divorce /separation; drug abuse; family structure /dynamics; human data; major depression; middle childhood (6-11); oppositional defiant disorder; peer group; posttraumatic stress disorder; psychopathology; schools; socioeconomics; statistics /biometry; substance abuse related disorder; violence

DESCRIPTION (provided by applicant): Comorbidity of addictive and mental disorders has been shown to be pervasive, with more than half (54%) of those aged 15-54 in the National Comorbidity Survey who had one diagnosable disorder having at least one co-occurring disorder. Less is known about comorbidity in youth or the degree to which it is affected by environmental factors. This proposal describes a two-year, multi-level investigation of the roles that mental disorders and adverse family, school, and community environments play in increasing risk of children and adolescents' misuse of alcohol and other drugs. The primary objective is to identify preventable antecedents of youth substance use disorders, using a developmental psychopathology approach. These investigations will be accomplished through secondary analyses of a multi-level study of 3000 youth and their communities, gathered by the Project on Human Development in Chicago Neighborhoods (PHDCN) from 1995-2001. Comorbidity between mental and addictive disorders among the youth will be described; additionally, the developmental risk processes that gave rise to the disorders themselves on the pathway to subsequent substance problems will be investigated. This proposal is being submitted by a new investigator, trained in social/psychiatric epidemiology. Youth, 9-18 years of age at baseline, and a caregiver were interviewed at home three times. Community characteristics were measured in 1995 and 2001 from independent samples and from videotapes of subjects' neighborhoods. Multilevel statistical methods will be used including discrete time survival analysis, hierarchical linear modeling, and individual growth modeling. This sample is uniquely suited to address the proposed aims, given (1) the longitudinal nature of the study; (2) the ability to compare neighborhoods and schools using an ecological framework and measurement of contextual features; and (3) comprehensive assessments of individual mental health and substance use behaviors. The use of existing data sets represents an opportunity to address these questions in a cost-effective manner. In his 1999 report on mental health, former U.S. Surgeon General Satcher asserted that little is known about the role of mental disorders in increasing the risk of misuse of alcohol and other drugs by youth. By addressing this research silence in a scientifically sound, multi-level study design, the products of the proposed research will be important contributions toward improving the planning and efficacy of health promotion and substance abuse prevention programs at the individual and local community level.

描述（由申请人提供）：成瘾和精神障碍的共病已被证明是普遍存在的，在全国共病调查中，有一种可诊断疾病的15-54岁人群中，超过一半（54%）的人至少有一种共病。对青少年的合并症或其受环境因素影响的程度知之甚少。该提案描述了一项为期两年的多层次调查，调查精神障碍和不利的家庭、学校和社区环境在增加儿童和青少年滥用酒精和其他药物的风险中所起的作用。主要目标是利用发展精神病理学方法确定青少年物质使用障碍的可预防的前因。这些调查将通过对芝加哥社区人类发展项目（PHDCN）从1995年至2001年收集的3000名青年及其社区的多层次研究的二次分析来完成。将描述青少年中精神障碍和成瘾性疾病的共病；此外，将调查在随后的物质问题途径上引起疾病本身的发育风险过程。这项建议是由一位接受过社会/精神流行病学培训的新调查员提交的。基线年龄为9-18岁的青少年和一名护理人员在家中接受了三次采访。1995年和2001年，通过独立样本和受试者所在社区的录像带测量了社区特征。多层次的统计方法将被使用，包括离散时间生存分析、层次线性模型和个体成长模型。这个样本是唯一适合解决提出的目标，鉴于(1)纵向性质的研究；(2)利用生态框架和环境特征测量来比较社区和学校的能力；(3)个体心理健康与药物使用行为的综合评估。现有数据集的使用为以具有成本效益的方式解决这些问题提供了机会。在1999年关于精神健康的报告中，前美国外科医生萨切尔断言，人们对精神障碍在增加青少年滥用酒精和其他药物的风险方面所起的作用知之甚少。通过科学合理的、多层次的研究设计来解决这一研究沉默，所提出的研究成果将对改善个人和地方社区层面的健康促进和药物滥用预防项目的规划和效果做出重要贡献。