Longitudinal Study of Adolescent Marijuana Use and Neurodevelopment

描述(申请人提供)：尽管对大麻的使用进行了大量的研究，但仍存在许多差异，而且没有进行足够的研究来区分大麻使用的潜在神经认知后果及其神经认知前体。因此，目前尚不清楚采用回溯性设计在成人人群中确定的大麻使用的一些“后果”是否实际上早于使用大麻，这是脆弱因素，后来因最终使用大麻而加剧。此外，还没有关于青少年吸食大麻的人与不吸食大麻的人和使用其他药物的人之间的神经认知技能发展进程的研究。许多研究报告说，严重和长期使用大麻与成人的执行认知功能(ECF)受损和影响调节有关。在青春期，这些技能的发展可能会微妙地延迟，因为青春期通常会发生发作，大脑最容易受到发育障碍的影响。当大麻使用发生在青春期早期并经常使用时，对发育迟缓的脆弱性可能特别明显。尽管青春期的大脑非常容易受到环境的侮辱，但它的可塑性提供了一个机会，可以使用有针对性的干预措施来改变导致负面结果的途径。需要更好地了解影响大麻开始使用和最终使用水平的神经认知因素，并描述使用大麻可能造成的损害如何加剧这些因素。为了解决这些关键问题，拟议的纵向研究将确定特定的神经认知因素，这些因素可以提前和预测大麻的使用，并评估随着青春期前儿童进入开始使用大麻的普遍时期，这些因素的发展变化。此外，控制使用前条件的大麻使用可能产生的神经认知后果将从前体中分离出来。将从早期大麻使用率非常高的社区招募尚未使用大麻的10、11和12岁(n=600)的青少年前儿童和每个儿童的相应主要照顾者，以确保有足够的最终使用者样本。没有吸毒史的参与者将在基线和随后的3次年度浪潮中接受评估，这3次浪潮跨越了这一早期和高流行率人群的启动和升级时期。发育因素及其与大麻使用加班的相互作用将通过经验指导和发育适当的神经认知任务组和全面访谈来检验。将评估心理障碍(如焦虑、抑郁、ADHD)和性别的潜在缓和作用，并对共生药物使用、社会经济地位、智商、青春期发展、邻里条件和父母药物滥用障碍进行调整。在纵向小组设计中阐明这些发育脆弱性和后果可以指导为青少年大麻使用者设计有针对性的干预措施。

DESCRIPTION (provided by applicant): Despite considerable research on marijuana use, there are many discrepancies and insufficient research has been conducted to disentangle the potential neurocognitive consequences of marijuana use from its neurocognitive precursors. Thus, it is unknown whether some of the "consequences" of marijuana use identified in adult populations using retrospective designs actually predated use, acting as vulnerability factors that are subsequently exacerbated by the eventual use of marijuana. Moreover, there are no studies of the developmental progression of neurocognitive skills in adolescent marijuana users relative to nonusers and users of other drugs. Many studies report that severe and chronic marijuana use is associated with impairments in executive cognitive functions (ECF) and affect regulation in adults. It is possible that development of these skills may be subtly delayed during adolescence when onset commonly occurs and the brain is most vulnerable to developmental perturbations. Vulnerability to developmental delays may be particularly pronounced when marijuana use occurs early in adolescence and is frequent. Although the adolescent brain is highly vulnerable to environmental insults, its plasticity provides an opportunity to alter pathways to negative outcomes using well-targeted interventions. A better understanding is needed of neurocognitive factors that influence onset and levels of eventual marijuana use and delineation of how these factors may be exacerbated by damage potentially caused by marijuana use. To address these critical issues, the proposed longitudinal study will identify specific neurocognitive factors that antedate and predict marijuana use and assess developmental change in these factors as preadolescent children age into a period when onset of marijuana use is common. Further, the putative neurocognitive consequences of marijuana use, controlling for pre-use conditions, will be isolated from precursors. Preadolescents who are 10, 11, and 12 years old (n=600) who have not yet used marijuana and a corresponding primary caregiver for each child will be recruited from a community with very high rates of early marijuana use to ensure a sufficient sample of eventual users. Participants with no history of drug use will be assessed at baseline and 3 subsequent annual waves, spanning the period of initiation and escalation for this early and high prevalence population. Developmental factors and their interaction with marijuana use overtime will be examined using an empirically guided and developmentally appropriate neurocognitive task battery and comprehensive interview. The potential moderating role of psychological disorders (e.g., anxiety, depression, ADHD) and gender will be assessed and adjustments will be made for co-occurring drug use, socioeconomic status, IQ, pubertal development, neighborhood conditions, and parental substance abuse disorder. Elucidation of these developmental vulnerabilities and consequences in a longitudinal panel design can inform the design of targeted interventions for adolescent marijuana users.