Early Adolescents Polysubstance Use Patterns: Longitudinal Changes and Bidirectional Relations with Externalizing Behaviors

项目总结 青春期早期使用药物与各种不良后果有关。早期青少年 经常开始使用一种以上的物质(即使用多种物质)，这会增加他们患上阴性反应的风险 结果，包括成人药物使用障碍、精神健康障碍以及社会和法律问题。 然而，很少有研究确定早期青少年使用多种物质的模式。有一个 多物质使用在青春期早期如何发展以及风险和防护知识的严重差距 多物质使用的因素。有明确的证据表明，早期青少年的药物使用与 外化行为，包括身体攻击和犯罪行为。不太清楚的是， 从事外化行为预示着物质使用的后续变化，或者 物质使用预示着外化行为的变化。此外，很少有研究对理论进行检验 可能解释这些关系的机制。拟议研究的目标是解决以前的限制 通过确定代表早期青少年多物质使用模式的亚组进行研究，建立 它们随时间的转变，并检查它们与物理的并发和纵向双向关系 攻击性和犯罪。拟议的研究还将探索同伴和照顾者因素作为潜在的 这些关系的调停者。这些目标与NIDA确定原因和后果的目标一致 物质使用，以及处理现实世界物质使用复杂性的优先重点(主题3)，包括 多药使用和同时发生的健康状况。这些目标将通过分析4波 每3个月从主要是非洲裔美国人的2755名早期青少年样本中收集的数据 生活在贫困率和暴力率高的城市社区。潜伏期分析与纵向分析 交叉滞后结构方程模型将被用来检验随时间的变化。具体目标是： 1)检查所有三所中学内部和整个中学多物质使用模式的纵向变化 等级，2)评估身体攻击和身体攻击之间的并发和纵向双向关系 青少年犯罪和多种药物的使用模式，以及3)探索同伴犯罪和照顾者的知识，如 青少年外化和物质使用行为随时间推移的中介者或预测者。差异 对于每个目标，都将进行性别和年级的测试。这些发现将通过提炼我们的 了解早期使用多物质的风险，潜在地强调最佳干预期，以及 确定可能的干预目标。此外，NRSA F31预览版中概述的研究和培训 博士奖学金申请将使申请者具备从事 独立研究生涯，包括对影响青少年药物使用的因素的了解， 具备高级纵向统计方法的能力，以及与科学写作相关的专业技能 和传播。

PROJECT SUMMARY Substance use during early adolescence is associated with a variety of adverse outcomes. Early adolescents often initiate use of more than one substance (i.e., polysubstance use), which increases their risk for negative outcomes, including adult substance use disorders, mental health disorders, and social and legal problems. However, few studies have identified patterns of polysubstance use among early adolescents. There is a critical gap in knowledge of how polysubstance use develops during early adolescence and risk and protective factors for polysubstance use. There is clear evidence that early adolescents’ substance use co-occurs with externalizing behaviors, including physical aggression and delinquent behavior. What is less clear is the extent to which engaging in externalizing behaviors predicts subsequent changes in substance use, or whether substance use predicts changes in externalizing behaviors. Moreover, few studies have tested theoretical mechanisms that may explain these relations. The goal of the proposed study is to address limitations of prior research by identifying subgroups representing patterns of early adolescents’ polysubstance use, establishing their transitions over time, and examining their concurrent and longitudinal bidirectional relations with physical aggression and delinquency. The proposed study will also explore peer and caregiver factors as potential mediators of these relations. These goals align with NIDA’s goal of identifying causes and consequences of substance use, and priority focus (Theme 3) of addressing real-world complexities of substance use, including polydrug use and co-occurring health conditions. The aims will be addressed through analysis of 4 waves of data that were collected every 3 months from a primarily African American sample of 2,755 early adolescents living in urban communities with high rates of poverty and violence. Latent transition analysis and longitudinal cross-lagged structural equation models will be used to examine changes over time. The specific aims are to: 1) Examine longitudinal changes in polysubstance use patterns within and across all three middle school grades, 2) Evaluate concurrent and longitudinal bidirectional relations between physical aggression and delinquency and polysubstance use patterns, and 3) Explore peer delinquency and caregiver knowledge as mediators or predictors of adolescents’ externalizing and substance use behaviors over time. Differences across sex and grade will be examined for each aim. The findings will inform prevention efforts by refining our understanding of risk for early polysubstance use, potentially highlighting optimal intervention periods, and identifying possible intervention targets. Moreover, the research and training outlined in this NRSA F31 pre- doctoral fellowship application will equip the applicant with skills and mentoring needed to pursue an independent research career, including knowledge of factors that impact adolescents’ substance use, competences in advanced longitudinal statistical methods, and professional skills related to scientific writing and dissemination.