Emergence of Adolescent Substance Use Problems from the Externalizing Spectrum

描述（由申请人提供）：本申请涉及广泛的挑战领域（04）临床研究和特定挑战主题，04- da -102：纵向数据的新视角。先前的研究一致表明，有物质使用障碍风险的青少年表现出外化行为问题，包括更高水平的行为问题（例如，对立行为、攻击、犯罪）和注意力缺陷/多动（ADHD）症状（即，注意力不集中、多动、冲动）。最近的研究已经确定了一种易受去抑制性精神病理学影响的表型，称为外化谱，它被认为是青春期和成年期物质使用、问题和障碍发展的基础，以及贯穿一生的外化行为问题（ADHD、对立违抗性障碍、行为障碍和反社会人格障碍）。然而，外化范围的发展模式尚未得到检验，外化范围内物质使用和问题的出现也未得到检验。鉴于与药物使用有关的公共卫生费用，必须研究药物使用障碍产生的过程，以及在何处、何时或与谁一起进行干预，以防止药物使用问题和障碍的发展。拟议的研究将利用一个广泛的纵向数据集，即快速通道项目，来检查从童年到青春期后期外化光谱的不同指标之间的关系。“快速通道”是一项多地点的纵向研究，从幼儿园到20岁，对社区中有严重行为问题高风险的儿童样本（n = 754）进行年度评估，这些儿童是从9454名儿童的筛选样本中识别出来的。本研究的第一个目标是利用筛选和纵向样本，在三个发育时期（童年、青春期早期和青春期晚期）建立一个外化谱（包括物质使用）的发育敏感模型，并特别关注外化谱的心理测量结构是否在时间、性别、种族和社区环境（城市与农村）中保持一致。第二个目标是测试外化谱是否可以用一个跨发育时期的高阶因子来表示，并确定潜在的外化谱是否最好地被描述为分类（即，定性不同的发展途径）或连续（即，整个青春期的外化问题的连续体）。最终，这些二手数据分析的结果将为预防和治疗物质使用、问题和障碍提供潜在目标。这个项目将增加对从童年到青春期晚期行为的“外化谱”是如何表达的理解。它还将研究如何物质使用，问题和障碍出现作为外化频谱的一部分在这个发展时期。这对于设计更有效的药物使用和相关问题的预防和治疗干预措施具有重要意义。

DESCRIPTION (provided by applicant): This application addresses broad Challenge Area (04) Clinical Research and Specific Challenge Topic, 04-DA-102: A New Look at Longitudinal Data. Prior research has consistently indicated that adolescents who are at risk for developing substance use disorders exhibit externalizing behavior problems, including higher levels of conduct problems (e.g., oppositional behavior, aggression, delinquency) and attention-deficit/hyperactivity (ADHD) symptoms (i.e., inattention, hyperactivity, impulsivity). Recent research has identified a phenotypic vulnerability to disinhibitory psychopathology, called the externalizing spectrum, which is believed to underlie the development of substance use, problems, and disorder during adolescence and adulthood, and externalizing behavior problems that occur across the lifespan (ADHD, oppositional defiant disorder, conduct disorder, and antisocial personality disorder). Yet developmental models of the externalizing spectrum have not been tested, nor has the emergence of substance use and problems within the externalizing spectrum been examined. Given the public health costs associated with substance use, it is imperative to study the process by which substance use disorders emerge and where, when, or with whom it is possible to intervene in order to prevent the development of substance use problems and disorder. The proposed study will capitalize on an extensive longitudinal data set, the Fast Track project, to examine the relationships between different indicators of the externalizing spectrum from childhood to late adolescence. Fast Track was a multisite, longitudinal study that conducted annual evaluations from kindergarten to age 20 in a community sample of children (n = 754) at high risk for serious conduct problems, who were identified from a screening sample of 9,454 children. The first goal of the proposed research is to use the screening and longitudinal samples to develop a developmentally sensitive model of the externalizing spectrum (including substance use) within three developmental periods (childhood, early adolescence, and late adolescence), with a specific focus on testing whether the psychometric structure of the externalizing spectrum is consistent across time, sex, race, and neighborhood setting (urban vs. rural). The second goal is to test whether the externalizing spectrum can be represented by a single higher-order factor across developmental periods, and to determine whether the underlying externalizing spectrum is best characterized as categorical (i.e., qualitatively distinct pathways of development) or continuous (i.e., continuum of externalizing problems throughout adolescence). Ultimately, the results from these secondary data analyses will provide insight into potential targets for the prevention and treatment of substance use, problems, and disorders. This project will increase understanding of how the "externalizing spectrum" of behaviors is expressed from childhood through late adolescence. It will also examine how substance use, problems, and disorder emerge as part of the externalizing spectrum across this developmental period. This has important implications for designing more effective preventive and treatment interventions for substance use and related problems.