Course of Alcohol and Drug Problems in Treated Teens

说明(申请人提供)：对接受治疗的青少年酒精和物质问题的过程的研究主要限于一年的成果，此外，对物质使用减少背后的变化机制知之甚少。由于现有研究无法对物质使用模式进行细粒度的时间分析，拟议的项目将使用为期一年的密集、有时间限制的短期跟踪，并结合两年的长期跟踪，以确定影响物质使用过程和问题的因素，重点是酒精、大麻和烟草。我们将前瞻性地研究总共300名青少年(14-18岁)，每个人都有一名父母附带的告密者：200名青少年将从成瘾治疗中招募，100名青少年将从社区招募。社区样本将作为参考组，以确定在临床参与者中观察到的变化的临床意义。所有青少年都将在基线(临床受试者进入治疗后一周内)进行评估。6个月、12个月、18个月和24个月。临床青少年还将在第一年的随访期间完成每月的电话随访。将利用第一个后续年度的每月后续数据和通过两年的长期后续行动来解决三个具体目标：(1)建立和验证药物使用和问题过程的模型，将短期反应、缓解和复发过程与较长期的康复和复发过程结合起来；(2)描述与酒精、大麻和尼古丁不同过程的开始相关的时间过程和因素；(3)确定接受治疗的青少年物质问题过程的途径和预测因素。结果将提供重要的新信息，加强青少年药物使用干预的时机和内容。

DESCRIPTION (provided by applicant): Research on the course of alcohol and substance problems in treated adolescents is limited largely to 1-year outcomes, Further, little is known about mechanisms of change underlying reductions in substance use because existing studies preclude fine-grained temporal analysis of substance use patterns, The proposed project will use intensive, time-limited short term follow-up over 1-year, combined with longer-term follow-up through 2-years to identify factors influencing course of substance use and problems, with an emphasis on alcohol, cannabis and tobacco. We will prospectively study a total of 300 adolescents (age 14-18), each with a parent collateral informant: 200 adolescents will be recruited from addictions treatment and 100 adolescents will be recruited from the community. The community sample will serve as a reference group to determine the clinical significance of changes observed in clinical participants. All adolescents will be assessed at baseline (within I week of treatment entry for clinical subjects). 6-, 12-, 18-, and 24-months. Clinical adolescents also will complete monthly phone follow-ups during the first year of follow-up. Monthly follow-along data during the first follow-up year and longer-term follow-up through 2-years will be used to address three specific aims: (1) to develop and validate a model of the course of substance use and problems that integrates shorter-term processes of response, remission, and relapse with longer-term processes of recovery and recurrence, (2) to characterize the time course and factors associated with the onset of different course processes for alcohol, cannabis and nicotine, (3) to identify pathways and predictors of the course of substance problems in treated youth. Results will provide important new information that will enhance the timing and content of substance use interventions for adolescents.