Distress Tolerance and Adolescent Substance Use

描述（由申请人提供）：尽管大规模的公共卫生努力减少其发生率和流行率，但青少年物质使用问题仍在继续增长。这尤其令人烦恼，因为青少年药物使用，特别是滥用药物，往往预示着今后身心健康以及社会和职业功能的受损。为了加强预防工作，理论家们试图了解导致药物滥用的病因和维持的因素。消极情绪状态和回避性应对行为可能是与青少年物质使用的开始和随后的物质滥用发展特别相关的两个变量。综合考虑这些变量，成人药物使用文献的研究人员已经开始利用痛苦耐受性的行为测量来评估一个人在强烈的情绪不适中坚持目标导向行为的能力，或者简单地说，一个人有效应对情绪困扰的能力。具体来说，通过计算机化的实验室测量来评估痛苦耐受力，参与者参与一项具有挑战性的任务，难度不断增加，直到任务的成功几乎不可能，这时他们对任务的持续坚持被测量。利用成人样本进行的研究一致表明，低水平的痛苦承受能力与增加的物质使用、更短的戒烟尝试时间、更短的非法药物使用戒断尝试时间和更高的住院药物治疗辍学率之间存在关系。然而，还没有对青少年进行这样的研究。鉴于早期使用与后来的问题之间的联系，以及一旦发生滥用和依赖，预防工作在限制负面后果方面可能比治疗工作更有效，因此，研究青少年的痛苦耐受性与药物使用之间的联系具有很大的潜在公共卫生意义。因此，我们建议对148名10年级学生（15-16岁）进行横断面评估，以测试痛苦耐受性与当前物质使用频率的关系程度。此外，当考虑到其他理论相关的风险和弹性因素时，我们将研究在预测物质使用频率方面的痛苦耐受性的独特性。最后，我们将研究物质使用预期、种族和性别在痛苦耐受性和物质使用之间的关系中的潜在调节作用。我们建议对148名10年级学生（15-16岁）进行横断面评估，以测试痛苦耐受性与当前物质使用频率的关系程度。此外，当考虑到其他理论相关的风险和弹性因素时，我们将研究在预测物质使用频率方面的痛苦耐受性的独特性。最后，我们将研究物质使用预期、种族和性别在痛苦耐受性和物质使用之间的关系中的潜在调节作用。

DESCRIPTION (provided by applicant): The problem of substance use in adolescence continues to grow despite large-scale public health efforts to reduce both its incidence and prevalence. This is particularly troublesome given that adolescent substance use and especially misuse often signals future impairments in physical health and mental health, as well as social and occupational functioning. To enhance prevention efforts, theorists have attempted to understand factors that contribute to the etiology and maintenance of substance misuse. Two variables that may be especially related to the initiation of adolescent substance use and the subsequent development of substance misuse are negative emotional states and avoidant coping behavior. Considering these variables together, researchers in the adult substance use literature have begun to utilize behavioral measures of distress tolerance to assess one's ability to persist in goal directed behavior in the presence of intense emotional discomfort, or simply, ones ability to effectively cope with emotional distress. Specifically, distress tolerance is assessed with computerized laboratory measures in which participants engage in a challenging task that increases in difficulty until success on the task is virtually impossible, at which point their continued persistence on the task is measured. Studies utilizing adult samples have consistently demonstrated a relationship between low levels of distress tolerance and increased substance use, shorter durations of smoking cessation attempts, shorter durations of illicit drug use abstinence attempts, and increased dropout rates from residential drug treatment. However, no such work has been conducted with adolescents. Given the link between early use and later problems as well as the fact that prevention efforts are likely to be more effective in limiting negative consequences than treatment efforts once abuse and dependence have occurred, there is great potential public health relevance in examining the link between distress tolerance and substance use in adolescents. Thus, we propose to examine 148 10th graders (15-16 year olds) in a cross-sectional evaluation to test the extent to which distress tolerance is related to frequency of current substance use. In addition, we will examine the uniqueness of distress tolerance in predicting frequency of substance use when accounting for other theoretically relevant risk and resiliency factors. Finally, we will examine the potential moderating role of substance use expectancies, race, and gender in the relationship between distress tolerance and substance use. We propose to examine 148 10th graders (15-16 year olds) in a cross-sectional evaluation to test the extent to which distress tolerance is related to frequency of current substance use. In addition, we will examine the uniqueness of distress tolerance in predicting frequency of substance use when accounting for other theoretically relevant risk and resiliency factors. Finally, we will examine the potential moderating role of substance use expectancies, race, and gender in the relationship between distress tolerance and substance use.