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）：在国家合并症调查中，成瘾性和精神障碍的合并症已被证明是普遍的，其中一半以上是15-54岁的人中的一半以上（54％），他们患有一种至少有一种共同发生障碍的可诊断疾病。关于青年合并症或受环境因素影响程度的合并症知之甚少。该提案描述了对精神障碍和不良家庭，学校和社区环境的角色的两年多层次调查，从而增加了儿童和青少年滥用酒精和其他药物的风险。主要目的是使用发展性心理病理学方法来确定可预防的青年物质使用障碍的前身。这些调查将通过对1995年至2001年芝加哥社区（PHDCN）的人类发展项目收集的3000名青年及其社区的多层次研究进行二级分析。将描述年轻人之间的精神和成瘾性障碍之间的合并症；此外，将研究引起疾病本身的发育风险过程。该建议是由一位新的调查员提出的，该调查员接受了社会/精神病流行病学培训。青年，基线时9-18岁，在家接受了三次护理人员的采访。从独立样本和受试者社区的录像带中衡量了1995年和2001年的社区特征。将使用多级统计方法，包括离散的时间生存分析，分层线性建模和个体增长建模。考虑到（1）研究的纵向性质，该样本非常适合解决所提出的目标； （2）使用生态框架和​​上下文特征的测量来比较社区和学校的能力； （3）对个人心理健康和药物使用行为的全面评估。现有数据集的使用代表了以经济有效的方式解决这些问题的机会。前美国外科医生萨奇（Satcher）在1999年的心理健康报告中断言，关于精神障碍在增加青年滥用酒精和其他药物的风险中的作用知之甚少。通过在科学的，多层次的研究设计中解决这一研究的沉默，拟议的研究的产物将是改善个人和地方社区层面健康促进和预防毒品滥用计划的计划和功效的重要贡献。