STRESS AND RISK FOR SUBSTANCE ABUSE IN ADOLESCENTS

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。应激与物质使用障碍(SUD)的发展之间的相互作用通常始于早期的创伤经历。经历过童年虐待的人报告说，他们中的许多人都有较高的药物使用率，而且他们中的许多人也倾向于参与异常和犯罪行为。由于儿童虐待患者除了药物滥用外，还在多个社会领域受到损害，因此针对这一群体进行治疗和预防计划将产生重大的社会经济影响。然而，为了制定更有效的干预措施，至关重要的是要了解儿童期虐待与儿童猝死易感性之间的潜在联系机制。本研究采用纵向对照设计，通过招募有儿童期虐待史的青少年和无儿童期虐待史的青少年，在他们发病前招募他们，研究他们的早期生活压力、HPA反应性和对SUD的易感性之间的关系。我们假设，与没有儿童期虐待的青少年相比，有儿童期虐待的青少年在未来的随访中会出现更高比例的SUD，并且这种对SUD易感性的增加将至少部分地通过在基线时测量的HPA失调来调节。除了检查发病前应激和HPA失调之间的联系，以及与发展为SUD的易感性有关外，将从多个角度评估其他已知影响这些过程的因素。查明具体的脆弱性和相关的生物变化将有助于制定更有针对性和更有效的药理学和心理社会干预措施，以降低这类青年中的严重急性呼吸窘迫综合征的风险。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The interaction between stress and the development of substance use disorders (SUD) often begins with the early experience of trauma. Individuals who experienced childhood abuse consistently report higher rates of substance use, and many of them also tend to participate in deviant and criminal behaviors. Because persons with childhood abuse are impaired in multiple social domains in addition to substance abuse, targeting this group of individuals for treatment and prevention programs will have significant socioeconomic impact. However, in order to develop more effective interventions, it is critical to understand the underlying mechanisms of association between childhood abuse and vulnerability to SUD. Using a controlled longitudinal design, this study will examine the relationships among early-life stress, HPA responsivity and vulnerability to SUD in adolescents with and without a history of childhood maltreatment by recruiting them prior to the onset of SUD. We hypothesize that a higher proportion of adolescents with childhood maltreatment will develop SUD during prospective follow-up compared withadolescents without childhood maltreatment, and that this increase in vulnerability to SUD will be mediated, at least in part, by HPA dysregulation measured at baseline. In addition to examing the association between premorbid stress and HPA dysregulation as related to susceptibility for the development of SUD, other factors that are known to influence these processes will be assessed from a multi-dimensional perspective. The identification of specific vulnerabilities and associated biological alterations will aid in the development of more focused and effective pharmacological and psychosocial interventions to reduce the risk of SUD in such youth.