Longitudinal Study of Adolescent Marijuana Use and Neurodevelopment

描述（由申请人提供）：尽管对大麻使用进行了大量研究，但仍存在许多差异，并且没有进行充分的研究来将大麻使用的潜在神经认知后果与其神经认知前体分离开来。因此，目前尚不清楚使用回顾性设计在成年人群中确定的大麻使用的一些“后果”是否实际上早于使用，作为随后因大麻的最终使用而加剧的脆弱性因素。此外，还没有关于青少年大麻使用者相对于非使用者和其他药物使用者的神经认知技能发展进展的研究。许多研究报告说，严重和慢性大麻使用与执行认知功能（ECF）受损有关，并影响成年人的调节。这些技能的发展可能会在青春期微妙地延迟，而青春期通常会发生，大脑最容易受到发育干扰。当大麻使用发生在青春期早期并且频繁时，发育迟缓的脆弱性可能特别明显。虽然青少年的大脑非常容易受到环境的伤害，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通往负面结果的途径。需要更好地了解影响最终使用大麻的发作和水平的神经认知因素，并描述这些因素如何因使用大麻可能造成的损害而加剧。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，并评估这些因素的发展变化，因为青春期前的儿童年龄进入大麻使用开始的时期是常见的。此外，大麻使用的假定神经认知后果，控制使用前的条件，将从前体分离。尚未使用大麻的10岁，11岁和12岁的学龄前儿童（n=600）以及每个儿童的相应主要照顾者将从早期大麻使用率非常高的社区招募，以确保最终用户的足够样本。将在基线和随后3个年度波（跨越该早期和高患病率人群的启动和递增阶段）评估无药物使用史的受试者。发展因素及其与大麻使用超时的相互作用将使用经验指导和发展适当的神经认知任务电池和全面的采访。心理障碍的潜在调节作用（例如，焦虑、抑郁、ADHD）和性别进行评估，并根据同时发生的药物使用、社会经济状况、智商、青春期发育、邻里条件和父母药物滥用障碍进行调整。阐明这些发展的脆弱性和后果的纵向面板设计可以告知青少年大麻使用者的有针对性的干预措施的设计。

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.