Substance Use and Psychological Problems Among African Americans into Midlife

描述(申请人提供)：国家数据表明，物质使用和心理问题在中年对非裔美国人来说变得更加明显，但很少有研究研究这些问题在非裔美国人社区中的风险发展，特别是到中年。此外，高重现率要求探索独特的和共同的风险因素的方法；然而，这些问题很少被一起研究。应用发展的观点，我们的目标是检查特定的风险，保护性的，中介的和缓和的因素，这些因素影响到后来的物质使用和纵向跟踪的以社区为基础的非裔美国人的心理问题。此外，很有必要确定物质使用和心理问题如何导致中年身体健康下降。伍德劳恩研究跨越了35年的生命，这是一项针对非裔美国人社区队列的流行病学前瞻性研究，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--生命过程中被忽视的一个维度--可以在研究不足的人群中确定早期风险因素以及关键的中介和调节影响。这个队列最初在1966-67年被评估为一年级学生(N=1242)，并在青春期(15-16岁)、成年早期(32-33岁)和成年中期(42-43岁)进行跟踪，创造了关于个人、家庭和环境特征、多样化的人生经历及其最终后果的史无前例的编年史。在生命历程社会场论的指导下，这项研究的重点是：中年期间物质使用和障碍以及心理问题的发展流行病学，确定发病、持续、缓解、共生和相互影响；儿童和青少年物质使用和障碍和心理问题的风险因素；对早期风险因素的中介和缓和影响；以及成年后的身体健康后果。分析方法包括结构方程模型、倾向得分匹配、一般增长混合模型、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形成的时间和机制，将为设计有效的预防和干预计划提供必要的指导。公共卫生相关性：项目叙述/公共卫生意义本项目的公共卫生相关性是为非裔美国人中年期间药物使用和心理问题的预防和干预计划的设计提供信息。该项目还将提供对城市非裔美国人成年后身体健康问题的重要洞察，确定精神病理学对特定健康问题的贡献。

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.