RISK FOR SUBSTANCE ABUSE IN DEPRESSED ADOLESCENTS

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. There is a high prevalence of comorbidity between depression and substance use disorder (SUD) in adolescents. Co-occurrence of these disorders is associated with significant added psychosocial and economic burden, thus emphasizing the need to identify factors that increase the risk for comorbid illness. Stress acutely increases the risk for substance use, specifically in those with depression. Stress-substance use interactions in depressed persons might be mediated by HPA axis. However, there is inter-individual variability in the degree of HPA response to stress, as well as its ability to modulate self-administration of drugs of abuse. A better understanding of the variations in HPA response potentially might be helpful in the development and testing of more specific interventions for this highly disabling illness. Specific aims: 1) To examine the association between dysregulation in hypothalamic-pituitary-adrenal (HPA) system and risk for the development of SUD in depressed adolescents. 2) To assess whether psychosocial stress makes a contribution to the prediction of SUD in depressed youth, and to evaluate how the contribution of stress varies in those with and without HPA dysregulation. 3) To relate responsivity of the orbitofrontal cortex and associated brain regions to risk for development of SUD in depressed adolescents.