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）的内在化途径，并考虑了负性情感SUD的病因学，负性情感SUD是一种潜在的SUD表型，可通过与涉及负性情感的障碍（即，抑郁和焦虑）。我们进行了综合（二次）分析（在我们之前的项目期间进行了改进），涉及同时分析三个全国性的酗酒父母和匹配的对照组的儿童的纵向研究，这些研究共同跨越了生命的前四十年（2岁至38岁）。了解导致SUD的发展途径对于设计和实施有效的青少年干预和治疗计划至关重要。虽然青少年物质参与风险的行为指标早在2-5岁时就出现了，但很少有关于SUD发展途径的理论考虑开始于学龄前的风险过程。此外，很少有研究能够评估这些发展途径的理论。在SUD出现、达到峰值和开始下降的前40年进行纵向研究是罕见的。现有的基于队列或人群的研究通常产生的病例太少，无法理清SUD的不同途径。因此，对高风险人群（如酗酒父母的儿童）的长期纵向研究对于阐明SUD的发展途径非常重要。使用这种方法，我们追求五个具体目标：（1）定义和测试SUD的内在化途径，并评估证据是否支持异型连续性（即，不同的发展表达的一个单一的潜在特征）的负面影响SUD随着时间的推移，（2）检查发展变化的独特的，介导的和互动的影响，内化和外化的过程作为预测的物质参与和负面影响SUD在前四十年的生活，（3）检查性别，父母抑郁性酗酒，和背景因素作为沿着内化途径向负面情绪SUD发展的重要调节因子，作为发展时间的函数，（4）检查内化模型的预测效用是否在孤立使用的各种物质上不同（即，酒精、烟草、大麻、兴奋剂和兴奋剂）或相互结合;（5）开发用于综合分析的方法，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。 公共卫生相关性：我们的应用程序测试了生命最初四十年中物质使用障碍的内在途径。对这种早期出现但持续存在的途径的研究很少，但对于设计和实施有效的青年干预和治疗方案至关重要。

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.