Elucidating links between ADHD symptoms and tobacco/alcohol use trajectories

描述（由申请人提供）：烟草和酒精的使用产生了许多不良的健康后果，尽管从青少年早期到成年的烟草和酒精使用途径以及最能预测这些途径的因素还不清楚。被诊断为注意缺陷多动障碍（ADHD）的人吸烟和饮酒的比例高于没有ADHD的人。此外，ADHD症状（即，多动-冲动[HI]、注意力不集中[IN]）低于临床诊断所需的阈值会增加吸烟的风险。更清楚地了解这些症状域和物质使用之间的发展关系，有可能阐明吸烟和问题饮酒的潜在病因，并为临床人群和普通人群提供治疗和预防方法。使用传统的和创新的/先进的分析方法来识别人口亚组和物质使用的动态特性（因子混合模型，潜在曲线模型和增长混合模型），我们将分析现有的纵向数据，其中包含HI和IN症状的历史信息和烟草和酒精使用的结果。将使用两个具有全国代表性的数据库（全国青少年健康纵向调查-附加健康和收入动态小组调查-儿童发展补充/向成年过渡- PSID-CDS/TA）。调查小组在ADHD，成瘾，行为流行病学和纵向数据分析等领域拥有专业知识，因此，已经准备好进行拟议的研究。这项建议的成功完成将导致有关HI和IN症状对从青春期到年轻成年期的物质使用的影响的精确知识。这些知识对于有效的预防性干预规划和实施是必要的。 公共卫生相关性：烟草和过量饮酒与包括许多癌症在内的不良健康结果有关。从青少年早期到成年的烟草和酒精使用途径以及最能预测这些途径的因素还没有得到很好的理解。然而，注意力缺陷多动障碍（ADHD）的症状可能会随着时间的推移在启动和增加使用中发挥作用。本申请的目的是阐明ADHD症状与烟草和酒精使用病因之间的联系。主要的创新是应用先进的分析方法来表征ADHD表型，并使用两个具有全国代表性的大型数据库来表征烟草使用、酒精使用和烟草-酒精联合概率的发展轨迹。这项提案的成功完成将导致有关ADHD症状对青少年到成年早期物质使用影响的精确知识。这些知识对于有效的预防性干预规划和实施是必要的。

DESCRIPTION (provided by applicant): Numerous adverse health consequences arise from tobacco and alcohol use, though the pathways of tobacco and alcohol use from early adolescence into adulthood and the factors that best predict these pathways are not well understood. Individuals diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) smoke and use alcohol at higher proportions than those without ADHD. Moreover, ADHD symptoms (i.e., hyperactivity- impulsivity [HI], inattention [IN]) below the threshold necessary for clinical diagnosis increase the risk of cigarette smoking. A clearer understanding of the developmental relationship between these symptom domains and substance use has the potential to elucidate the potential etiology of smoking and problem drinking as well as inform treatment and prevention approaches in both clinical groups and in the general population. Using traditional and innovative/advanced analytic methods for identifying population subgroups and dynamic properties of substance use (factor mixture modeling, latent curve modeling, and growth mixture modeling), we will analyze extant longitudinal data that contains information on history of HI and IN symptoms and tobacco and alcohol use outcomes. Two nationally representative databases will be used (The National Longitudinal Survey of Adolescent Health-Add Health and Panel Survey of Income Dynamics - Child Development Supplement/Transition to Adulthood - PSID-CDS/TA). The investigative team has expertise in the areas of ADHD, addiction, behavioral epidemiology and longitudinal data analysis and thus, is well poised to undertake the proposed research. The successful completion of this proposal will result in refined knowledge concerning the influence of HI and IN symptoms on substance use from adolescence to young adulthood. Such knowledge is necessary for effective preventive intervention planning and implementation. PUBLIC HEALTH RELEVANCE: Tobacco and excessive alcohol consumption are associated with adverse health outcomes including a number of cancers. The pathways of tobacco and alcohol use from early adolescence into adulthood and the factors that best predict these pathways are not well understood. However, symptoms of Attention Deficit Hyperactivity Disorder (ADHD) may play a role in initiation and heightened use over time. The purpose of this application is to elucidate the link between ADHD symptoms and etiology of tobacco and alcohol use. The main innovation is the application of advanced analytic methods for characterizing ADHD phenotypes and characterizing developmental trajectories of tobacco use, alcohol use and tobacco-alcohol joint probability using two large nationally representative databases. The successful completion of this proposal will result in refined knowledge concerning the influence of ADHD symptoms on substance use from adolescence to young adulthood. Such knowledge is necessary for effective preventive intervention planning and implementation.