Risk and resilience pathways linking community adversity, decision making, and alcohol misuse: A prospective study of Appalachian adolescents

翻译后摘要：早期青少年饮酒损害心理和神经认知发展 并增加了对药物滥用、学业失败和心理健康问题的脆弱性。的 拟议的研究重点是西弗吉尼亚州（WV）农村地区的青少年饮酒， 阿巴拉契亚地区。在美国社会中被边缘化，许多阿巴拉契亚社区遭受 长期贫困和阿片类药物滥用的流行程度。新兴的神经认知研究 强调成熟和整合的奖励显着性和认知控制系统阿索， 与青少年情绪调节和健康决策能力有关。发展 决策系统预测酒精滥用，然而，导致不同的因素- 人们对决策轨迹的影响知之甚少。此外，通过我们的研究积累， 研究小组和其他人将农村青年广泛使用含咖啡因饮料与饮酒联系起来 漏洞一种精神兴奋剂，具有唤醒，运动激活和加强适当的- 即使是中等剂量的咖啡因也会在儿童和青少年中产生症状， 头痛、恶心、困倦、疲劳、情绪紊乱和失眠。尽管有这些 危险，对常规咖啡因使用的前瞻性研究及其机制， 导致酒精使用脆弱性的因素几乎不存在。我们建议调查上下文 保护因素假设，以减轻社区不利的影响，对负， 积极的情绪，适应不良的健康行为和决策轨迹。这些因素 包括规范、积极的家庭环境、促进健康的教室， 学校环境和当地社区的集体效能。我们建议解决这些问题 在一项前瞻性研究中，来自农村、小城镇、 和西弗吉尼亚州的小城市（<30 k）公立学校。我们的具体目标是： 1.测试将社区弱势与酒精滥用联系起来的途径。我们期待社区 直接和间接地预测决策过程中增长放缓的不利因素， 负面情绪，这是加强使用咖啡因和随之而来的睡眠问题。 反过来，我们预计负面情绪和决策轨迹预测酒精 通过近端脆弱性因素（与风险同行的联系，学术脱离）滥用。 2.检验保护青少年免受社区不利因素影响的假设。我们 期望环境保护因素减弱社区弱势对（a）的影响 消极情绪，（B）咖啡因使用，睡眠问题，和（c）决策。 3.探讨尼古丁、大麻和其他药物使用的酒精前因。

Abstract: Early adolescent alcohol use impairs psychosocial and neurocognitive development and increases vulnerabilities to drug abuse, academic failure, and mental health problems. The proposed research focuses on youth alcohol use in rural areas of West Virginia (WV), within the Appalachian region. Marginalized in American society, many Appalachian communities suffer chronic poverty and epidemic levels of opioid abuse. Emerging neurocognitive research stresses the maturation and integration of reward-salience and cognitive control systems asso- ciated with adolescent emotion regulation and healthy decision-making abilities. Development in decision making systems forecasts alcohol misuse, however, the factors that contribute to differ- ences in decision making trajectories are poorly understood. Also, accumulating research by our team and others links widespread use of caffeinated beverages by rural youth to alcohol use vulnerabilities. A psychostimulant possessing arousal, motor activation, and reinforcing proper- ties, even moderate doses of caffeine produce symptoms in children and adolescents, including headache, nausea, drowsiness, fatigue, mood disturbances, and sleeplessness. Despite these dangers, prospective investigations of routine caffeine use and the mechanisms through which it confers alcohol use vulnerability are virtually non-existent. We propose to investigate contextual protective factors hypothesized to attenuate the influence of community disadvantage on nega- tive emotionality, maladaptive health behavior, and decision-making trajectories. These factors include regulated, affectively positive family environments, health promoting classroom and school environments, and collective efficacy in local communities. We propose to address these issues in a prospective study of ~2,400 middle school youth from a range of rural, small town, and small city (< 30k) public schools in WV. Our specific aims are: 1. To test pathways linking community disadvantage to alcohol misuse. We expect community disadvantage to forecast slower growth in decision making processes directly and indirectly via negative emotionality which is reinforced by use of caffeine and attendant problems with sleep. In turn, we expect negative emotionality and decision making trajectories to forecast alcohol misuse via proximal vulnerability factors (affiliation with risky peers, academic disengagement). 2. To test hypotheses of contextual factors that protect youth from community disadvantage. We expect contextual protective factors to attenuate the influence of community disadvantage on (a) negative emotionality, (b) caffeine use, sleep problems, and (c) decision making. 3. To explore these alcohol antecedents in the onset of nicotine, marijuana, and other drug use.