Development of Drug Use and Abuse in ADHD Adolescents

描述：本申请在一项正在进行的研究(R01AA11873)的基础上扩展到 对500名青少年酒精滥用的发生和发展进行调查 之前被诊断为注意力缺陷多动障碍(ADHD)。这个 拟议的研究要求适度的额外资金以增加措施 合法和非法药物使用和滥用(自我报告、父母报告、生物 评估)和评估其他与毒品有关的领域，例如 亚诊断性滥用症状、药物滥用家族史和预期 对药物的影响。参与者将是500名青少年，其中74%的人 同时患有对立违抗(44%)或品行障碍(30%)， 之前在西方精神病学研究所被诊断为ADHD的人 和ADHD的临床夏季治疗计划。这些青少年，他们将成为 每年面谈四年，最初的年龄从12岁到26岁不等 后续接触，代表了广泛的发展阶段 代表了药物滥用发展的不同程度的风险。这 队列序贯设计将使我们能够评估药物的使用、滥用和其 随着时间的推移，ADHD儿童在三个发育阶段出现。这个 拟议的研究还将使ADHD青少年的药物使用与200人进行比较 人口统计学上相似的非ADHD对照青少年将接受跟踪 在同一时间段内。该数据集在几个方面将是唯一的， 允许调查人员解决有关药物的ADHD风险的问题 使用和滥用的范围和精确度比以前大得多 调查。本研究的独特优势包括：(1)样本量 将是现有最大规模后续研究的四倍，提供 对ADHD样本的关键风险因素(例如，品行障碍， 学习功能、父母吸毒和酗酒)，(2)广泛的年龄范围 我们的样本与以前的研究相比，将得到关于 药物使用的发展(青少年)以及常规药物使用 和滥用(年长的受试者)；(3)药物使用和滥用评估 将比以前的研究更全面，(4) 临床参考样本具有丰富的标准化、客观性信息 儿童和他们的家庭在童年时期第一次接触时就能发挥作用 在以前的研究中没有提供，提供了童年之间的区别 和青少年功能；和(5)评估将包括 对先证者和他们的一些领域的综合评价 可能解释或增加ADHD儿童以后用药风险的家庭 虐待。

DESCRIPTION: This application expands upon an ongoing study (R01AA11873) to examine the onset and development of alcohol abuse in 500 adolescents previously diagnosed with Attention Deficit Hyperactivity Disorder ADHD). The proposed study requests a modest amount of additional funding to add measures of licit and illicit drug use and abuse (self-report, parent report, biological assessment) and assessment of additional drug-relevant domains such as subdiagnostic symptoms of abuse, family history of drug abuse, and expectancies for drug effects. Participants will be 500 adolescents, 74 percent of whom had comorbid oppositional defiant (44 percent) or conduct (30 percent) disorder, who were previously diagnosed with ADHD at the Western Psychiatric Institute and Clinic Summer Treatment Program for ADHD. These adolescents, who will be interviewed annually for four years, will range in age from 12 to 26 at initial follow-up contact, representing a wide range of developmental stages that represent different levels of risk for the development of drug abuse. This cohort-sequential design will permit us to evaluate drug use, abuse, and its emergence over time in ADHD children across three developmental periods. The proposed study will also enable comparison of ADHD adolescents' drug use to 200 non-ADHD demographically similar comparison adolescents who will be followed for the same time period. This data set will be unique in several ways, allowing the investigators to address questions regarding ADHD risk for drug use and abuse with much greater scope and precision than previous investigations. Unique advantages of this study include: (1) the sample size will be four times that of the largest existing follow-up study, affording subgrouping on the ADHD sample on key risk factors (e.g., conduct disorder, academic functioning, parental drug and alcohol use), (2) the wide age range of our sample compared to previous studies will yield information both on development of drug use (younger adolescents), as well as on routine drug use and abuse (older subjects) in the same study; (3) drug use and abuse assessment will be far more comprehensive than in previous studies, (4) the clinic-referred sample has a wealth of standardized, objective information on the children and their family functioning at initial contact during childhood not available in previous studies, affording differentiation between childhood and adolescent functioning in our models; and (5) assessment will include comprehensive evaluation of a number of domains in the probands and their families that may explain or escalate ADHD children's risk for later drug abuse.