Development and Prevention of Substance Use Problems

描述(由申请者提供)：本项目的目标是了解品行障碍在青少年药物使用问题发展中所起的作用。为了实现这一目标，拟议的项目将扩大两项正在进行的、由联邦政府资助的、多地点的纵向研究。儿童发展项目(CDP)是对来自三个地点的585名青年(50%为女性；19%为少数民族)进行的前瞻性研究，他们从4岁开始接受跟踪，现在19岁(保留了84%的原始样本)。快速通道(FT)项目是一项预防实验，来自四个地点的892名早期行为问题青少年(31%为女性，55%为少数民族)在一年级被确定，并随机分配接受十年干预或不接受干预，并一直跟踪到18岁(样本保留率为83%)。研究结果表明，与对照组相比，接受英国《金融时报》干预的青少年在高中期间被诊断为品行障碍的人数减少了40%。英国《金融时报》还包括了387名年轻人(50%为女性，49%为少数民族)的具有规范代表性的样本，他们被跟踪研究品行障碍是如何发展的。到目前为止，CDP和FT中的物质使用都得到了测量，但没有深入。对于这两项研究，拟议项目的新数据收集将包括对参与者在成年早期使用、依赖和滥用非法物质、酒精和烟草的详细测量。将解决三个目标。第一个目标是了解早期行为障碍是如何导致物质使用问题的。将测试一个交易-发展模型，该模型假设在儿童行为、社会文化背景、父母养育、同伴关系、学校教育和社会认知领域中的风险和保护因素。CDP得出的结论将被复制到英国《金融时报》的规范样本中。第二个目标是了解行为问题儿童对物质使用发展的适应能力。英国《金融时报》已知的高风险对照组使用药物的风险较高，他们将接受检查，以确定对药物使用具有弹性的保护性因素。这一假设将被检验，即专业服务降低风险；具体地说，将异常儿童聚集在一起的服务将提高风险，而专注于家庭过程的个人服务将降低风险。第三个目的是测试英国《金融时报》干预措施在预防成年早期药物使用问题方面的有效性，以及减少品行障碍作为这一效果的中介所起的作用。

DESCRIPTION (provided by applicant): The goal of this project is to understand the role that conduct disorder plays in the development of substance-use problems in young adulthood. To reach this goal, the proposed project will amplify two ongoing, federally funded, multi-site, longitudinal studies. The Child Development Project (CDP) is a prospective study of 585 youth (50% female; 19% minority) from three sites, who have been followed since age four years and are now 19 years old (with 84% retention of original sample). The Fast Track (FT) Project is a prevention experiment in which 892 early-starting conduct-problem youth (31% female; 55% minority) from four sites were identified in first grade and randomly assigned to receive a ten-year intervention or not and have been followed through age 18 (83% retention of sample). Findings indicate that youth assigned to the FT intervention display 40% fewer diagnoses of conduct disorder in high school than controls. FT also includes a normative-representative sample of 387 youth (50% female; 49% minority) who are being followed to study how conduct disorder develops. To date, substance use in both the CDP and FT has been measured but not in depth. For both studies, new data collection for the proposed project will include detailed measurement of participants' use, dependence, and abuse of illicit substances, alcohol, and tobacco in early adulthood. Three aims will be addressed. The first aim is to understand how early conduct disorder leads to substance-use problems. A transactional-developmental model will be tested that posits risk and protective factors in the domains of child behavior, socio-cultural contexts, parenting, peer relations, schooling, and social cognitions. Findings that emerge from the CDP will be replicated with the FT normative sample. The second aim is to understand resilience to substance-use development among conduct-problem children. The FT high-risk control group, known to be at elevated risk for substance use, will be examined to identify protective factors that account for resilience to substance use. The hypothesis will be tested that professional services moderate risk; specifically, services that aggregate deviant children in groups will enhance risk, whereas individual services that focus on family process will decrease risk. The third aim is to test the efficacy of the FT intervention in preventing substance-use problems in early adulthood and the role of reduced conduct disorder as a mediator of this effect.