Consequences of Adolescent Substance Use on the Development of Impulse Control

描述（由申请人提供）：青春期是从童年到成年过渡期间神经、生物和社会发展的关键时期。健康的青春期被定义为控制冲动行为的能力不断增强。药物使用和环境因素导致的与正常发育的偏差被认为是导致冲动控制不良的原因。青春期前的冲动控制问题和物质使用障碍的家族史似乎增加了青少年早期开始使用物质的风险。目前尚不清楚不良的冲动控制是否促成了药物使用，或者是药物使用的结果，以及不良的冲动控制和药物使用是否在青少年发展过程中相互作用，产生越来越负面的结果。在一项为期5年的纵向研究中，我们将确定青春期前的冲动控制如何预测和/或后来的物质使用参与改变青春期冲动控制的发展。我们将招募360名青春期前的男孩和女孩（10-12岁），有或没有药物使用障碍的家族史，他们都没有开始定期使用药物。青少年将在研究开始时完成评估，并在青春期中期（从10岁到17岁）每6个月再次完成评估，此时发生物质使用的风险增加。我们将监测药物使用、环境压力、生理成熟和冲动控制方面的变化。该项目将通过以下方式来研究这些复杂的发育对冲动控制和物质使用的影响：(1)确定青春期前冲动控制水平在多大程度上受物质使用障碍家族史的影响；(2)确定青春期前冲动控制水平在多大程度上预测经常性物质使用；(3)描述正常青少年的冲动控制特征，以及这种发展与不同物质使用水平的差异；(4)确定物质使用者冲动控制发展与物质使用涉入进展的关系；(5)确定物质使用障碍家族史、物质使用涉入、环境应激源和成熟度对青少年冲动控制发展的相对影响；(6)确定冲动控制和物质使用参与之间是否存在相互关系，从而在青春期产生越来越多的相互影响的负面行为结果；(7)在两种主要模型的背景下，检验冲动控制、物质使用障碍家族史、环境压力源和物质使用卷入之间的关系。通过实现这些目标，我们将确定这些因素的个体差异何时、如何以及在多大程度上促成物质使用的开始和进展；后续物质使用如何影响冲动控制的发展；以及我们的发现是否支持青少年物质使用的两种主要理论模型。

DESCRIPTION (provided by applicant): Adolescence is a critical period of neurological, biological, and social growth during the transition from childhood to adulthood. Healthy adolescence is defined by an increasing ability to control impulsive behavior. Deviations from normal development that are produced by substance use and environmental factors are thought to contribute to poor impulse control. Preadolescent problems with impulse control and family histories of substance use disorders appear to increase the risk of earlier substance use initiation during adolescence. It is unknown whether poor impulse control contributes to, or is the result of, substance use and whether poor impulse control and substance use interact across adolescent development to produce increasingly negative outcomes. During a 5-year longitudinal study, we will determine how preadolescent impulse control predicts, and/or later substance use involvement alters, development of adolescent impulse control. We will recruit 360 preadolescent boys and girls (ages 10-12) with and without family histories of substance use disorders, none of whom have initiated regular substance use. Adolescents will complete assessments at study entry and again every 6 months through middle adolescence (from ages 10 through 17), when the risk of developing substance use is heightened. We will monitor changes in substance use involvement, environmental stressors, physical maturation, and impulse control. The project will examine these complex developmental influences on impulse control and substance use involvement by: (1) determining to what extent preadolescent levels of impulse control differ as a function of family history of substance use disorders; (2) determining to what extent preadolescent levels of impulse control predict regular substance use; (3) characterizing impulse control of normal adolescence, and how this development differs with varying levels of substance use; (4) determining how the development of impulse control among substance users is related to the progression of substance use involvement; (5) determining the relative influence of family histories of substance use disorders, substance use involvement, environmental stressors, and maturation on impulse control development across adolescence; (6) determining if there is a reciprocal relationship between impulse control and substance use involvement, such that they have increasingly negative behavioral outcomes that affect each other during adolescence; and (7) testing the relationships of impulse control, family history of substance use disorders, environmental stressors, and substance use involvement within the context of two leading models. By carrying out these aims, we will determine when, how, and to what extent individual differences in these factors contribute to the initiation and progression of substance use; how subsequent substance use affects development of impulse control; and whether our findings support two leading theoretical models of adolescent substance use involvement. PUBLIC HEALTH RELEVANCE: This study will advance our understanding of how the development of impulse control and environmental influences occurring during adolescence interact with one another to lead to problems with substance use. Understanding these relationships will aid in the identification of the antecedents and consequences of substance use on key processes of adolescent development. The advancement of better prevention programs and substance use treatments are dependent on a gaining a better understanding of these complex relationships.