Understanding Alcohol Use Over Time in Early Mid-Adulthood for At-Risk Men

描述（由申请人提供）：拟议的研究将检查与过程相关的问题，包括男性在成年早期的酒精使用和AUDs的持续性和停止。这种行为在经济上、个人和家庭痛苦上都给社会带来了代价。这些问题将通过利用现有的纵向数据集来审查，该数据集目前涵盖儿童后期至31-32岁，包括23次年度饮酒评估，并增加两波新的35-36岁和37-38岁数据收集。将这两个新的波与29-30岁、30-31岁和31-32岁的现有数据相结合，将在早期中期提供总共5个波。多方法/多代理研究的社区样本的风险进行的问题和其他危险行为开始于两个队列的四年级男孩（总N = 206），在最后一波的留存率为95%的生活科目（N = 191，年龄31-32岁）。这项研究的重点是基于社会学习模型的背景，家庭来源和同伴风险因素，以及浪漫伴侣的数据。我们计划使用动态发展系统方法，基于过去和当前的社会背景影响方面，研究酒精使用过程中的异质性和AUDs以及该过程的预测因素，包括家庭，同伴，精神病理学领域内的一般和特定风险因素，以及早期到中期的风险和社会影响，包括浪漫伴侣行为。通过首次饮酒时的年龄和首次醉酒时的年龄前瞻性地评估早期饮酒。还将检查酒精使用增长的增长和异质性与共病物质使用（烟草、大麻、其他非法药物、非处方药和非处方药）和赌博行为过程中的异质性的关系。此外，还将研究寻求治疗的预测模型。这两个新的评估将包括自我报告，同行报告和记录数据（警察和DMV记录）。亲密伴侣的报告可在一项伴随研究中获得。将使用各种互补的发展建模和预测技术来捕获先前的家庭和背景因素以及儿童和青春期的先前行为（例如，儿童期的反社会行为）以及类似的背景、社会关系和成年期的行为因素，可以解释整个早期成年期行为过程的变化。 公共卫生相关性：在成年早期使用酒精在个人，家庭，社区和国家层面上都是极其昂贵的，并且与早期死亡有关。酒精滥用/依赖是男性所有DSM疾病中最常见的。几乎四分之一的暴力犯罪受害者报告称，犯罪者在犯罪前曾喝酒。1998年，美国酒精滥用和依赖的经济成本估计接近2000亿美元。《2010年健康人》的重点领域包括预防和控制烟草使用和药物滥用。这项拟议中的研究将为处于危险背景的男性在成年早期使用酒精和其他物质的持续性和停止提供新的线索。

DESCRIPTION (provided by applicant): The proposed study would examine issues related to the course, including persistence and desistance, of alcohol use and AUDs in early midadulthood for men. Such behaviors are costly to society both financially and in personal and family distress. These issues would be examined by utilizing an existing longitudinal data set currently spanning later childhood to ages 31-32 years, including 23 yearly assessments of alcohol use, and adding two new waves of data collection at ages 35-36 and 37-38 years. Combining these two new waves with existing data from ages 29-30, 30-31, and 31-32 will provide a total of 5 waves in the early midadult period. The multimethod/multiagent study of a community sample at risk for conduct problem and other risk behaviors began with two cohorts of fourth-grade boys (total N = 206); the retention rate at the last wave was 95% of living subjects (N = 191, ages 31-32 years). The study focused on contextual, family of origin, and peer risk factors based on a social learning model, and data are available on romantic partners. We plan to use a Dynamic Developmental Systems approach, based on aspects of past and current social- contextual influences, to study heterogeneity in the course of alcohol use and AUDs and predictors of the course, including general and specific risk factors within the realms of family, peer, psychopathology, and early to midadult risk and social influences, including romantic partner behaviors. Early onset of alcohol use was assessed prospectively by age at first drink and age at first drunken experience. Association of growth and heterogeneity in growth of alcohol use will be examined also in relation to heterogeneity in the course of co- morbid substance use (tobacco, marijuana, other illicit drugs, non-prescription and over-the-counter drugs), and gambling behavior. In addition, prediction models of treatment seeking will be examined. The two new assessments will include self-report, peer report, and records data (police and DMV records). Reports from intimate partners are available in a companion study. A variety of complementary developmental modeling and prediction techniques will be used to capture the degree to which prior family and contextual factors, and prior behaviors in childhood and adolescence (e.g., antisocial behavior in childhood) and similar contextual, social relationships, and behavioral factors in adulthood, can explain changes in the course of behaviors across the early adult period. PUBLIC HEALTH RELEVANCE: Alcohol use in early mid-adulthood is extremely costly at the personal, family, community, and national levels, and is associated with early mortality. Alcohol abuse/dependence is the most common of all DSM disorders for men. Almost one in four victims of violent crime report that the offender had been drinking prior to the crime. The economic costs of alcohol abuse and dependence were estimated at close to $200 billion in the U.S. in 1998. Focus areas of Healthy People 2010 (U.S. DHHS) include prevention and control of the use of tobacco and substance abuse. The proposed study will shed new light on the persistence and desistance of use of alcohol and other substances in early midadulthood for men from at-risk backgrounds.