Substance Use and Psychological Problems Among African Americans into Midlife

非裔美国人中年的药物使用和心理问题

• 批准号: 7895910
• 负责人: Kerry M Green
• 金额: $ 34万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-01 至 2012-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7895910
• 关键词: Accounting; Address; Adolescence; Adolescent; Adult; Affect; African American; Age; Aggressive behavior; Alcohol consumption; Alcohol or Other Drugs use; Characteristics; Childhood; Cluster Analysis; Communities; Crime; Data; Dependence; Development; Dimensions; Disease; Disease remission; Distress; Drug usage; Educational Status; Employment; Epidemiologic Studies; Epidemiology; Equation; Etiology; Family; Feeling suicidal; Growth; HIV; Health; Income; Individual; Investigation; Joints; Knowledge; Learning; Life; Life Cycle Stages; Mediating; Mental Depression; Mental disorders; Methods; Modeling; Paranoia; Pattern; Performance; Pharmaceutical Preparations; Population; Poverty; Prevention program; Prospective Studies; Psychopathology; Public Health; Research; Resources; Risk; Risk Factors; Role; Sampling; Schools; Self Medication; Socioeconomic Status; Staging; Substance Use Disorder; Symptoms; Testing; Time; Victimization; Work; adolescent substance use; alcohol involvement; base; cardiovascular risk factor; cohort; criminal behavior; depressive symptoms; design; diabetes risk; emerging adult; experience; follow-up; health disparity; improved; insight; intervention program; middle age; mortality; neglect; physical conditioning; psychologic; psychological distress; public health relevance; racial discrimination; social; social integration; socioeconomics; theories

DESCRIPTION (provided by applicant): National data indicate that both substance use and psychological problems become more pronounced for African Americans in midlife, but few studies have examined the development of risk for these problems in African American communities, particularly into mid adulthood. Moreover, high rates of co-occurrence demand an approach that explores both unique and shared risk factors; however, these problems rarely have been studied together. Applying a developmental perspective, we aim to examine specific risk, protective, mediating, and moderating factors that influence later substance use and psychological problems among a community- based African American population followed longitudinally. In addition, there is a great need to determine how substance use and psychological problems contribute to physical health decline in mid adulthood. Spanning more than 35 years of life, the Woodlawn Study, an epidemiological, prospective study of an African American community cohort, provides extensive data for understanding risk and protective factors and the short- and long-term consequences of substance use and psychological problems outside the context of treatment. With data extending into midlife - a neglected dimension of the life course - early risk factors and key mediating and moderating influences can be identified in an understudied population. This cohort was assessed initially as first graders in 1966-67 (N=1242), and followed up in adolescence (age 15-16), early adulthood (age 32-33), and mid-adulthood (age 42-43), creating an unprecedented chronicle of individual, family, and environmental characteristics, diverse life-course experiences, and their ultimate consequences. Guided by the Life Course Social Field Theory, the study focuses on: the developmental epidemiology of substance use and disorders and psychological problems through midlife, identifying onset, persistence, remission, co-occurrence, and reciprocal effects; childhood and adolescent risk factors for adult substance use and disorders and psychological problems; mediating and moderating influences on early risk factors; and physical health consequences in adulthood. Analytic methods include structural equation modeling, propensity score matching, general growth mixture modeling, and latent class, survival, and cluster analyses. Improved understanding of the timing and mechanisms for development of risk for substance use and psychological problems will provide essential guidance in designing effective prevention and intervention programs. PUBLIC HEALTH RELEVANCE: PROJECT NARRATIVE/PUBLIC HEALTH SIGNIFICANCE The public health relevance of this project is to inform the design of prevention and intervention programs for substance use and psychological problems among African Americans into midlife. The project will also provide critical insight into physical health problems of urban African Americans during mid-adulthood, identifying the contribution of psychopathology to specific health problems.

描述（由申请人提供）：国家数据表明，非裔美国人在中年时的药物滥用和心理问题变得更加明显，但很少有研究考察非裔美国人社区中这些问题的风险发展，特别是到成年中期。此外，高共现率需要一种探索独特和共同风险因素的方法；然而，这些问题很少被一起研究。应用发展的视角，我们的目标是纵向研究影响社区非裔美国人人群后期药物使用和心理问题的特定风险、保护性、中介性和调节性因素。此外，非常需要确定药物使用和心理问题如何导致成年中期身体健康状况下降。伍德劳恩研究是一项针对非裔美国人社区队列的流行病学前瞻性研究，涵盖了超过 35 年的生命周期，为了解风险和保护因素以及药物使用和治疗之外的心理问题的短期和长期后果提供了广泛的数据。随着数据延伸到中年（生命历程中被忽视的一个维度），可以在研究不足的人群中识别出早期危险因素以及关键的中介和调节影响。该队列最初于 1966-67 年对一年级学生（N=1242）进行了评估，并在青春期（15-16 岁）、成年早期（32-33 岁）和成年中期（42-43 岁）进行了随访，创造了一个前所未有的个人、家庭和环境特征、多样化的生命历程经历及其最终后果的编年史。在生命历程社会场理论的指导下，该研究的重点是：中年期间物质使用和障碍和心理问题的发展流行病学，识别发病、持续、缓解、共现和相互影响；儿童和青少年成人药物滥用以及疾病和心理问题的危险因素；调节和调节对早期风险因素的影响；以及成年后身体健康的影响。分析方法包括结构方程建模、倾向评分匹配、一般增长混合建模以及潜在类别、生存和聚类分析。更好地了解药物使用和心理问题风险发生的时间和机制将为设计有效的预防和干预计划提供重要指导。公共卫生相关性：项目叙述/公共卫生意义 该项目的公共卫生相关性是为非裔美国人到中年的物质使用和心理问题的预防和干预计划的设计提供信息。该项目还将对城市非裔美国人中年时期的身体健康问题提供重要的见解，确定精神病理学对特定健康问题的贡献。