PTSD and Substance Use/Abuse in Youth

说明(申请人提供)：这份R01申请是为了回应最近的RFA，儿童精神病理学和童年干预对随后药物滥用的影响，并研究创伤后应激障碍(PTSD)与青少年药物使用/滥用的关系。随着世界贸易中心9/11恐怖袭击、随后的恐怖主义威胁和有据可查的青少年创伤后应激障碍发生率上升，如果我们要向这些人口提供充分的预防和干预，特别是在未来可能发生恐怖袭击的情况下，了解创伤后应激障碍与随后的药物使用/滥用之间的关系是重要的。 这项拟议的研究基于对4个现有数据集的二级数据分析，其中包含有关青少年创伤后应激障碍和药物使用/滥用的信息。其中两个数据集来自纽约市教育委员会学校在9/11事件后6个月(6-12年级，N=4690)和18个月(6-12年级，预计N=4000)进行的两次调查。另外两个是来自社区样本的纵向数据集。社区中的儿童(CIC，N=717)样本，1975年从纽约州北部的两个县随机选择平均年龄为5岁的儿童，进行了5次跟踪调查，包括年轻的成年人。此外，Boricua青年研究的一个子样本是那些在基线访谈(N=1300)时年龄在10到15岁之间的人，并每隔12个月重新采访两次。 本研究将探讨：(1)9·11事件后的创伤后应激障碍(或创伤后应激障碍症状)是否与青少年中更多的药物使用和滥用有关；(2)9/11事件后青少年是否使用药物自我治疗他们的创伤后应激障碍症状；(3)青少年暴露于创伤和相关的创伤后应激障碍(或症状)是否会对以后的药物使用和滥用产生影响；(4)创伤后应激障碍(或症状)与药物使用/滥用的关系是否因性别、种族和家庭社会地位等社会人口学因素而有所不同；以及(5)创伤后应激障碍(或症状)与药物使用/滥用之间的关系是否可以通过其他常见精神障碍的存在来解释，如严重的抑郁和焦虑。希望该项目的结果将为临床医生和政策制定者提供有用的信息，从而改善对患有创伤后应激障碍和创伤后药物使用/滥用的青少年的服务。

DESCRIPTION (provided by applicant): This R01 application is in response to the recent RFA, the Impact of Child Psychopathology & Childhood Interventions on Subsequent Drug Abuse, and is to study the relationship between Post-traumatic Stress Disorder (PTSD) and substance use/abuse in youth. With the 9/11 terrorist attack on the World Trade Center, subsequent terrorist threats and documented elevated rates of PTSD in youth, it is important to understand the relationship between PTSD and subsequent substance use/abuse, if we are to provide adequate prevention and intervention to this population, particularly in light of possible future terrorist attacks. The proposed study is based on secondary data analysis of 4 existing data sets with information about PTSD and substance use/abuse in youth. Two of the data sets are from two New York City Board of Education School Surveys conducted at 6 months (grades 6 - 12, N=4,690) and 18 months (grades 6-12, projected N=4,000) after 9/11. Two others are longitudinal data sets from community samples. The Children in the Community (CIC, N=717) sample, with children randomly selected from two upstate New York counties in 1975 at mean age of 5, followed-up 5 times, including as young adults. Also, a sub-sample from the Boricua Youth Study, those ages who were 10 to 15 at the baseline interview (N=1,300), and re-interviewed twice at 12 month intervals. This study will examine: (1) whether or not PTSD (or PTSD symptoms) after 9/11 are associated with increased substance use and abuse in youth; (2) whether or not youth use substances to self-medicate their PTSD symptoms after 9/11; (3) whether or not youth exposure to trauma and related PTSD (or symptoms) has an impact on later substance use and abuse; (4) whether or not the relationship between PTSD (or symptoms) and substance use/abuse differ by socio-demographic factors, such as gender, ethnicity, and family SES; and (5) whether or not the relationship between PTSD (or symptoms) and substance use/abuse can be explained by the existence of other comobid psychiatric disorders, such as major depression and anxiety. It is hoped that the findings from this project will provide useful information for clinicians and policy makers, so as to improve service delivery for youth with PTSD and substance use/abuse after traumatic events.