Role of Childhood Cumulative Risk in Substance Misuse and Co-occurring Problems

描述（由申请人提供）：药物滥用的脆弱性在经历多种背景风险的青少年中最高，例如在早期发育期间与出生有关的风险和社会经济劣势。事实上，累积风险，定义为独立于任何特定风险的存在或不存在的背景风险因素的数量，是青少年和年轻成人药物滥用的一个强有力的预测因素。然而，在累积背景风险与药物滥用之间的关联方面，存在着重大的知识空白。累积风险通常被作为一种静态现象进行研究，因此这种风险在一段时间内和跨时间累积的程度是未知的。此外，累积风险传统的研究通常将药物滥用作为单一结果进行研究，但药物滥用往往与外部化和内部化问题同时发生。重要的是，潜在的中介机制和调节的影响很少被认为是在药物滥用的累积风险效应的分析，和性别适度很少被测试。物质滥用是一个普遍的公共卫生问题，与单一问题相比，物质滥用合并症与高度损害有关;因此，需要进行更多的研究。目前的赠款申请有助于解决这些差距，建议研究在早期发展期间与药物滥用以及青春期和成年早期共同发生的外部化和内部化问题有关的时间内和跨时间的累积背景风险（目标1）。社会发展中介将被视为干预机制（目标2a），并将使用1986年北方芬兰出生队列研究（NFBCS）的现有纵向数据进行假设缓冲风险（目标2b）的社会发展调节剂测试。NFBCS是一项大规模的出生队列研究，采用多信息者（父母，教师，青少年），多来源（调查，人口登记）数据，收集了9，432名青年的样本，从产前到20多岁。在社会发展模型的指导下，中心假设是，青少年和年轻成人药物滥用和共同发生的问题的累积风险将有积极的关联，这些关联将通过SDM风险过程介导; SDM保护因素将作为缓冲调节剂。还将探讨性别差异。这个应用是非常创新的。NFBCS是一项独特的大规模出生队列研究，具有非常广泛的生物心理学和社会背景评估，非常适合研究一般风险和弹性过程。拟议研究的目标将由来自大学和服务提供商的跨学科研究人员团队完成，以促进将研究结果转化为实践。研究结果有望通过阐明选择性预防干预措施中潜在的可塑性调解人和调节人，帮助促进脆弱青年面对风险的复原力。

DESCRIPTION (provided by applicant): Vulnerability for substance misuse is highest among youth who experience multiple contextual risks, such as birth-related risks and socioeconomic disadvantage, during early development. Indeed, cumulative risk, defined as the number of contextual risk factors independent of the presence or absence of any particular risk, is a robust predictor of adolescent and young adult substance misuse. However, there are significant gaps in knowledge about the associations of cumulative contextual risk with substance misuse. Cumulative risk often has been studied as a static phenomenon, therefore the degree to which such risk accumulates both within and across time is unknown. Moreover, research in the cumulative risk tradition typically has examined substance misuse as a singular outcome, yet substance misuse often co-occurs with externalizing and internalizing problems. Importantly, potential mediating mechanisms and moderating influences infrequently have been considered in analyses of cumulative risk effects on substance misuse, and gender moderation rarely has been tested. Substance misuse is a prevalent public health concern, and substance misuse comorbidity is associated with heightened impairment compared to singular problems; thus, additional research is needed. The current grant application helps address these gaps by proposing to study cumulative contextual risk both within and across time during early development in relation to substance misuse and co- occurring externalizing and internalizing problems in adolescence and early adulthood (Aim 1). Social developmental mediators will be examined as intervening mechanisms (Aim 2a) and tests of social developmental moderators hypothesized to buffer risk (Aim 2b) will be conducted using existing longitudinal data from the 1986 Northern Finland Birth Cohort Study (NFBCS). The NFBCS is a large-scale birth cohort study with multi-informant (parent, teacher, adolescent), multi-source (surveys, population registries) data collected on a sample of 9,432 youth followed from the prenatal period to the 20s. Guided by the social development model (SDM), the central hypotheses are that there will be positive associations of cumulative risk with adolescent and young adult substance misuse and co-occurring problems, and that those associations will be mediated through SDM risk processes; SDM protective factors will serve as buffering moderators. Gender differences also will be explored. This application is highly innovative. The NFBCS is a unique, large-scale birth cohort study with an exceptionally broad range of biopsychological and social contextual assessments ideal for studying general risk and resilience processes. Aims of the proposed study will be accomplished by an interdisciplinary team of investigators from both university and service provider settings to facilitate translation of findings into practice. Study findings hold promise for helping to promote resilience in the face of risk among vulnerable youth by elucidating potentially malleable mediators and moderators to target in selective preventive interventions.