Sexual differences in long-term health implications of adolescent risk behavior

描述（由申请人提供）：关于青少年冒险（物质使用和性风险）与抑郁症之间潜在因果关系的研究结果是混合的。一些研究表明，风险行为会导致抑郁，而另一些研究则认为抑郁会增加风险行为。1 -5压力模型表明，风险行为通过刺激身体的压力反应（对新奇事物的内分泌反应）导致抑郁，这随后会增加炎症和抑郁症的风险。6 -10另一种自我-药物模型表明，抑郁的青少年可能会使用物质或从事性冒险来自我抑制他们的抑郁。1在后一种模型中，抑郁会降低冲动控制并改变心理社会功能（例如，降低动机）。5，11生物性别使这些问题进一步复杂化;女性不太可能从事风险行为，但抑郁症的发病率较高，而男性承担更多风险，但抑郁症的发病率较低。除了青春期的健康风险外，这些关联可能对健康产生长期影响，包括物质依赖和疾病前途径的建立，因为抑郁和压力都会增加炎症，慢性时会损害免疫功能。（添加健康），以解决两个研究目标：1）检查，分别为男性和女性，时间滞后的风险之间的联系，（物质使用/性风险）和抑郁症状，以评估方向性; 2）确定青少年和成年初显期的冒险/抑郁症状特征，并将具有相似特征的青少年分组为潜在类别; 3）检查潜在的年轻人健康影响（例如，物质滥用/依赖，性传播感染（STI），疾病前途径）的潜在类成员（即，随时间变化的风险模式）使用自我报告和生物标志物数据。健康数据允许在一个大的、种族多样的国家样本中前瞻性地检查从青春期到年轻成年期这些关联中的性别差异。分析方法将包括重复测量和混合回归模型，以研究抑郁症状与风险承担之间的关联，潜在的类增长模型将个人的风险承担和抑郁症状轨迹按类型分组，以及适当的回归方法将类成员资格与年轻人的健康结果联系起来。研究结果将加强我们对青少年冒险模式的直接和长期健康影响的理解，并为干预工作提供信息。

DESCRIPTION (provided by applicant): Research findings on the potential causal association between adolescent risk taking (substance use and sexual risk) and depression are mixed. Some studies suggest risk behavior leads to depression while others suggest depression increases risk behavior.1-5 A Stress Model suggests risk behavior leads to depression by inciting the body's stress response, an endocrine reaction to novelty exposure, which subsequently increases inflammation and risk of depressive symptoms.6-10 An alternative Self-Medication Model suggests depressed adolescents may use substances or engage in sexual risk taking to self-medicate their depression.1 In the latter model, depression decreases impulse control and modifies psychosocial functioning (e.g., reduces motivation).5,11 Biological sex further complicates these issues; females are less likely to engage in risk behavior but have higher rates of depression, whereas males take more risks but have lower rates of depression.1,2,12,13 It is not clear whether or how the developmental processes linking risk behavior and depression vary by sex, however. In addition to health risk during adolescence, these associations may have long-term implications for health, including substance dependency and establishment of pre-disease pathways, as both depression and stress can increase inflammation, and when chronic, harm immune function.14-17 This project will use data from the National Longitudinal Study of Adolescent Health (Add Health) to address two research aims: 1) examine, separately for males and females, time lagged associations between risk taking (substance use/sexual risk) and depressive symptoms to assess directionality; 2) identify risk taking/depressive symptom profiles across adolescence and emerging adulthood, and group adolescents with similar profiles into latent classes; 3) examine the potential young adult health implications (e.g., substance abuse/dependency, sexually transmitted infections (STIs), pre-disease pathways) of latent class membership (i.e., patterns of risk over time) using both self-report and biomarker data. Add Health data allow for prospective examination of sex differences in these associations from adolescence into young adulthood in a large, racially diverse, national sample. Analytical methods will include repeated measures and mixed regression models to look at associations between depressive symptoms and risk taking over time, Latent Class Growth Models to group individuals' risk taking and depressive symptom trajectories by type, and appropriate regression methods to link class membership to health outcomes in young adulthood. Findings will enhance our understanding of the immediate and long-term health implications of patterns of adolescent risk taking, and inform intervention efforts.