Childhood Origin of Disparities in Alcohol Use Disorders

描述（由申请人提供）：有令人信服的证据表明，酒精滥用和依赖集中在社会经济地位不利的个人中。然而，酒精使用障碍的社会经济差异的起源仍然知之甚少。虽然关于健康差异的新数据表明儿童期状况在形成个人长期健康问题风险方面的重要性，但由于缺乏将儿童期状况与随后的酒精滥用和依赖联系起来所需的前瞻性数据，难以研究酒精使用障碍差异的儿童期根源。此外，以前关于这个问题的研究往往集中在饮酒水平的社会经济差异，而不是酒精使用障碍。 这项建议是由一位新的研究人员提交的，目的是使用纵向设计和可靠的酒精使用障碍措施来研究酒精滥用和依赖的社会经济差异的童年起源。我们假设，成人的差异在酒精使用障碍起源于生命的早期，儿童条件的发展和酒精滥用和依赖的持续造成长期的后果。该提案通过以下方式克服了先前研究的局限性：1）在一项纵向研究中调查了1，267名在出生时登记并系统随访平均27.8年的个体的酒精使用障碍风险，以及2）利用诊断标准来定义酒精滥用和依赖。这些调查将基于1959年启动的国家围产期合作项目的普罗维登斯、罗得岛队列的二次分析。在幼儿期和成年期的多个时间点获得社会经济和环境条件的综合评估;使用结构化诊断访谈获得成人精神病诊断。本研究的主要目的是：1）调查儿童期社会经济地位、家庭破裂和居住稳定性与酒精滥用和依赖的发生和持续的长期风险之间的前瞻性关系; 2）调查成人酒精使用障碍的社会经济差异;（3）探讨酒精使用障碍、其他物质使用障碍和重性抑郁症之间共病的童年起源。

DESCRIPTION (provided by applicant): There is compelling evidence that alcohol abuse and dependence are concentrated among individuals of disadvantaged socioeconomic status. However, the origins of socioeconomic disparities in alcohol use disorders remain poorly understood. While emerging data on health disparities point to the importance of childhood conditions in shaping individuals' long-term risk for health problems, the childhood origins of disparities in alcohol use disorders have been difficult to study due to the lack of prospective data needed to link childhood conditions with subsequent alcohol abuse and dependence. Moreover, previous research on this subject has often focused on socioeconomic differences in the level of alcohol consumption rather than alcohol use disorders. This proposal is submitted by a new investigator to study the childhood origins of socioeconomic disparities in alcohol abuse and dependence using a longitudinal design and with reliable measures of alcohol use disorders. We hypothesize that adult disparities in alcohol use disorders originate early in life, and that childhood conditions pose long-term consequences for the development and continuation of alcohol abuse and dependence. This proposal overcomes the limitations of prior studies by 1) investigating risks for alcohol use disorders in a longitudinal study of 1,267 individuals who were enrolled at birth and systematically followed for an average of 27.8 years, and 2) utilizing diagnostic criteria to define alcohol abuse and dependence. These investigations will be based on secondary analyses of the Providence, Rhode Island cohort of the National Collaborative Perinatal Project, initiated in 1959. Comprehensive assessment of socioeconomic and environmental conditions was obtained at multiple points in early childhood and in adulthood; adult psychiatric diagnoses were obtained using structured diagnostic interviews. The major aims of this study are: 1) to investigate the prospective relation between socioeconomic status, family disruption, and residential stability in childhood and the long-term risk for the onset and persistence of alcohol abuse and dependence; 2) to investigate adult socioecononomic disparities in alcohol use disorders; and 3) to investigate the childhood origins of the comorbidity between alcohol use disorders, other substance use disorders, and major depression.