Internalizing pathways to drug use: A multi-sample analysis

描述（由申请人提供）：在本申请中，我们评估了物质使用障碍（sud）的内化途径，并考虑了负面影响sud的病因学，这是一种潜在的sud表型，可通过与涉及负面影响的疾病（即抑郁和焦虑）共病来识别。我们进行了一项综合（二次）分析（在我们之前的项目期间进行了完善），包括同时分析三项全国著名的纵向研究，这些研究涉及酗酒父母的孩子和匹配的对照，这些研究总体上跨越了生命的头40年（2岁至38岁）。了解导致sud的发育途径对于设计和实施有效的青少年干预和治疗方案至关重要。虽然青少年物质参与风险的行为指标早在2-5岁就出现了，但很少有关于sud发展途径的理论考虑到学龄前开始的风险过程。此外，很少有研究能够评估这些发展途径的理论。在生命的头40年里，当sud出现、达到顶峰并开始下降时，跨越这段时间的纵向研究很少见。现有的以队列或人群为基础的研究往往产生的病例太少，无法理清sud的不同途径。因此，对高风险人群，如酗酒父母的孩子进行长期的纵向研究，对于阐明sud的发育途径是非常宝贵的。使用这种方法，我们追求五个具体目标：(1)定义和测试南德南德的内化途径，并评估是否有证据支持负面情绪南德随时间的异质性连续性（即单一潜在特质的不同发育表达）；(2)研究内化和外化过程作为物质介入和负面情绪南德的预测因子的发育变化的独特、介导和互动效应；(3)研究性别；(4)检验内化模型的预测效用在单独使用的各种物质（即酒精、烟草、大麻、兴奋剂和抑郁药物）或相互结合使用时是否不同，以及(5)开发综合分析方法。利用这些方法来测试目标1-4，并将这些方法传播给其他应用研究人员。

DESCRIPTION (provided by applicant): In this application, we evaluate an internalizing pathway to substance use disorders (SUDs) and consider the etiology of Negative Affect SUDs, a potential phenotype of SUDs identifiable by comorbidity with disorders involving negative affect (i.e., depression and anxiety). We conduct an integrative (secondary) analysis (refined in our prior project period) involving the simultaneous analysis of three nationally prominent longitudinal studies of children of alcoholic parents and matched controls that collectively span the first four decades of life (ages 2 through 38). Understanding developmental pathways leading to SUDs is critical in efforts to design and implement effective intervention and treatment programs for youth. Although behavioral indicators of risk for adolescent substance involvement appear as early as 2-5 years of age, few theories about developmental pathways to SUDs consider risk processes that begin in the preschool years. Moreover, few studies are capable of evaluating theories about these developmental pathways. Longitudinal studies that span the first four decades of life, when SUDs emerge, peak and begin to decline, are rare. Available cohort- or population-based studies often yield too few cases to disentangle different pathways for SUDs. Thus, long-term, longitudinal studies of high-risk populations, such as children of alcoholic parents, are invaluable for articulating developmental pathways to SUDs. Using this method, we pursue five specific aims: (1) to define and test an internalizing pathway to SUDs and to evaluate whether evidence supports heterotypic continuity (i.e., different developmental expressions of a single underlying trait) of Negative Affect SUDs over time, (2) to examine the developmentally-varying unique, mediated and interactive effects of internalizing and externalizing processes as predictors of substance involvement and Negative Affect SUDs across the first four decades of life, (3) to examine gender, parental depressive alcoholism, and contextual factors as important moderators of progression along an internalizing pathway toward Negative Affect SUDs as a function of developmental timing, (4) to examine whether the predictive utility of an internalizing model differs over various substances used in isolation (i.e., alcohol, tobacco, marijuana, stimulant and depressant drug) or in combination with one another, and (5) to develop methods for integrative analysis, to utilize these methods to test Aims 1-4, and to disseminate these methods to other applied researchers. PUBLIC HEALTH RELEVANCE: Our application tests an internalizing pathway to substance use disorder over the first four decades of life. Studies of such early emerging but persistent pathways are rare but critical to efforts to design and implement effective intervention and treatment programs for youth.