Risks for Transitions in Drug use Among Urban Adults

描述(申请人提供)：这是申请的第二次修订。该小组略有扩大；预算保持不变；并根据审查员的意见对案文进行了广泛重写。尽管大量关于药物使用和依赖的流行病学和病因学研究都集中在青春期，但人们对青年时期的药物使用知之甚少。青壮年是从吸毒升级为依赖的时期，也是区分实验性和慢性吸毒的轨迹确定的时期。由于对青春期转变的影响可能与青春期不同，从童年、青春期和成年期早期到成年期的纵向数据对于理解自然历史很重要。毒品使用阶段转变的影响存在于个体和社会环境及其相互作用的层面。重要的个人层面的影响包括遗传背景和精神和行为障碍的存在，如抑郁、酒精障碍、反社会行为和反社会人格障碍。重要的社会环境影响包括参与成年人的角色，在青年时期发展替代增强剂，以及社区。在那些在这些特征以及这些特征的前体和前驱的早期历史上不同的人中，很可能存在着不同的药物暴露、使用、依赖和缓解的途径。这个应用程序是收集和分析预防研究中心(PRC)研究参与者的访谈和生物数据，该研究由巴尔的摩市19所公立学校的2311名儿童组成，自1985年和1986年(现在接近28-29岁)上一年级以来，有10波先前的数据。先前的评估包括精神和行为问题和障碍，以及上面列出的社会环境特征。建议的评估包括用于DMA的血液或口腔样本，以及在之前的浪潮中评估的许多结构。先前的实地工作表明，80%以上的原始队列可以找到并采访。该队列以人口为基础的方面以及巴尔的摩的地理位置是该项目的重要优势，巴尔的摩的毒品使用率较高，非裔美国人样本较多。在青年时期进行跟踪调查的时机和先前评估的丰富性是无与伦比的。如果预防吸毒的干预措施要有效，并使药物依赖和慢性病升级，执行工作就必须包括针对最有可能发生这种转变的年轻人的战略。这些预防战略在针对风险和保护性因素时可能是最有效的，这些因素有可信的证据表明存在潜在的因果影响，如我们建议收集的那样。

DESCRIPTION (provided by applicant): This is the second revision of an application. The team has expanded slightly; the budget has remained the same; and the text has been extensively rewritten in the light of reviewers' comments. Little is known about drug use in young adulthood, although a great deal of epidemiologic and etiologic research in drug use and dependence has focused on adolescence. Young adulthood is the period in which escalation from drug use to dependence is likely to occur and when trajectories differentiating experimental from chronic drug use are defined. Since influences on transitions in young adulthood likely differ from those in adolescence, longitudinal data that extend from childhood, through adolescence and early adulthood, and into young adulthood are important in understanding natural history. Influences on transitions in stages of drug use exist at the level of the individual and the social environment, and their interactions. Important individual-level influences include genetic background and the presence of psychiatric and behavioral disorders, such as depression, alcohol disorders, antisocial behaviors and antisocial personality disorder. Important social environmental influences include engagement in adult roles, development of alternative reinforcers during young adulthood, and neighborhoods. It is likely that there are distinct pathways to drug exposure, use, dependence, and remission among those who differ on these characteristics, as well as on early history of the precursors and antecedents of these characteristics. This application is to collect and analyze interview and biological data from participants in the Prevention Research Center (PRC) study, a cohort of 2311 children in 19 Baltimore City public schools, with 10 prior waves of data since they were in first grade in 1985 and 1986 (now approaching 28-29 years of age). Prior assessments include psychiatric and behavioral problems and disorders, as well as the social environmental characteristics listed above. Proposed assessments include blood or buccal sample for DMA, and many constructs assessed in prior waves. Prior field work suggests that more than 80% of the original cohort can be located and interviewed. The population-based aspect of the cohort, and the location in Baltimore, with its high level of drug use and large African-American sample, are important advantages of this project. The timing of follow-up in young adulthood, and the richness of prior assessments, is unmatched. If interventions for prevention of drug use, and escalation to dependence and chronicity, are to be effective, the implementation must include strategies targeted for young adults where these transitions are most likely to occur. These prevention strategies can be most effective when targeting risk and protective factors for which there is credible evidence of a potential causal influence such as we propose to gather.