ALCOHOL ABUSE IN URBAN INDIAN ADOLESCENTS AND WOMEN

本建议是对以下方面进行前瞻性纵向研究的第二阶段： 两代城市居民饮酒和吸毒的自然史 美国印第安人家庭 这一阶段包括最高风险年龄 对于这些与酒精相关的不良后果的发展， 青少年。 拟议研究的一个扩展特点是审查 心理功能和物质使用模式， 美国印第安母亲的青少年，并调查这一群体， 一个特殊的利益群体。 以下 提出了具体目标：1）继续研究 美国城市人群中的酒精使用、药物使用和精神病理学 印度青少年。 三个因变量定义了 酒精使用、酒精使用的不良后果和滥用诊断 或依赖，已被选定为他们的一致性，主要 正在进行的关于青少年酗酒的研究; 1a）描述青少年酗酒的流行情况， 根据酒精使用模式、不良影响和 酒精使用的后果，和诊断访谈; 1b）描述 酒精滥用与药物滥用和其他精神病理学的共病; 1c）描述青少年酗酒对以下方面造成的相对风险： 自杀、辍学、不安全性行为和其他 酒精相关的不良后果; 2）继续探索风险 美国印第安人城市青少年酗酒和吸毒的集中模型 2a）开发和测试一个加性风险因素模型， 分层多因素logistic回归，评估16个危险因素 在拟议的赠款期内每年; 2b）制定一个可靠的， 用于早期识别美洲印第安人的有效筛选组合 酒精和药物滥用风险较高的青少年; 3）探索 行为障碍的中介和调节作用，母亲的情绪 酒精滥用与性别、文化认同之间的关系 家族史因素增加危险状态; 4）流行病学研究 酒精使用，药物使用和精神病理学在城市的样本 美洲印第安妇女; 4a）描述 基于酒精使用模式的酒精滥用， 酒精使用和诊断访谈; 4 b）描述以下并发症 酒精滥用与药物滥用和其他精神病理学; 4c）描述 美国印第安妇女饮酒的自然史， 特别强调预测疾病发生和变化的因素， 酗酒问题 建议书的特色包括：1） 一项对一名高危特殊人群两代人的纵向随访研究 2）有能力招募和尽量减少自然减员; 3） 后续行动以社区为基础; 4）与 5）使用多种数据来源来证实 青少年自我报告的有效性;和6）研究人员是 已经在美国印第安人社区受过训练并为人所知。

This proposal is the second phase of a prospective longitudinal study of the natural history of alcohol and drug use in two generations of urban American Indian families. This phase includes the age of highest risk for development of alcohol-related adverse consequences in these adolescents. An expanded feature of the proposed study is to examine both the psychological function and substance use patterns among the American Indian mothers of the adolescents, and investigate this group as a special population of interest in its own right. The following specific aims are proposed: 1) Continue to study the epidemiology of alcohol use, drug use, and psychopathology in a sample of urban American Indian adolescents. Three dependent variables that define patterns of alcohol use, adverse consequences of alcohol use, and diagnosis of abuse or dependence, have been selected for their consistency with major ongoing studies of adolescent alcohol abuse; 1a) Describe the prevalence and incidence of alcohol abuse based on patterns of alcohol use, adverse consequences of alcohol use, and diagnostic interviews; 1b) Describe the comorbidity of alcohol abuse with drug abuse and other psychopathologies; 1c) Describe the relative risk posed by adolescent alcohol abuse for suicide, school dropout, unsafe sexual activity, and other alcohol-related adverse consequences; 2) Continue to explore risk focussed models of urban American Indian adolescent alcohol and drug abuse; 2a) Develop and test an additive risk factor model using hierarchical multiple logistic regression with 16 risk factors assessed annually in the proposed grant period; 2b) Develop a reliable, and efficient screening battery for early identification of American Indian adolescents at elevated risk for alcohol and drug abuse; 3) Explore the mediating and moderating affects of conduct disorder, mother's emotional status, cultural identification, and gender between alcohol abuse and family history factors increasing risk status; 4) Study the epidemiology of alcohol use, drug use and psychopathology in a sample of urban American Indian women; 4a) Describe the prevalence and incidence of alcohol abuse based on patterns of alcohol use, adverse consequences of alcohol use, and diagnostic interviews; 4b) Describe the comorbidity of alcohol abuse with drug abuse and other psychopathologies; 4c) Describe the natural history of alcohol use in American Indian women, with particular emphasis on factors predictive of the onset and change of problematic drinking. Distinctive features of the proposal include: 1) longitudinal follow-up study of two generations from a high risk special population; 2) Demonstrated ability to recruit and minimize attrition; 3) Follow-up is community based; 4) Parallel questions for comparison to ongoing national studies; 5) Use of multiple data sources to corroborate validity of adolescent self report; and 6) Research personnel that are already trained and known in this American Indian community.