Parent-Adolescent Interactions and Substance Abuse Risk: Gender Differences

描述(申请人提供)：药物滥用是一个主要的公共卫生问题，在青春期女孩中呈上升趋势。尽管如此，我们对什么风险知之甚少 导致女孩滥用药物和滥用药物的因素。一个重要的风险因素对 而女孩在青春期表现出变化的是家庭环境。以前的研究表明，家庭成瘾史和不良的育儿方式与青少年使用药物有关，特别是对女孩来说。然而，全球糟糕的育儿方式如何导致药物滥用风险尚不清楚。此外，尽管与孩子谈论药物使用被广泛推荐给家长，但父母对药物使用最有效的具体建议并不为人所知。这项拟议的研究将通过使用一种创新的、新开发的和经过验证的实验室范式来解决这一知识差距，以评估观察到的父母养育行为以及青少年对亲子冲突和药物使用讨论互动的多模式情感和生理反应，因为这些预测青少年从青春期早期到中期使用药物的增加。我们假设，在冲突和药物使用讨论互动中观察到的育儿行为(例如，低温暖、高批评、避免药物讨论)以及青少年情绪和生理反应的增强将预测随着时间的推移物质使用/滥用的开始和增加，并且这种预测对女孩的预测将比男孩更强。我们将在一个具有代表性的社区样本中观察父母与青少年的互动，样本为240名12-13岁的女孩和男孩。在实验室课程中，父母-青少年将讨论个性化的冲突话题和药物使用的话题。父母的养育行为(温暖、组织和批评)、药物使用讨论的内容(避免药物讨论、讨论药物使用的规则、例子和后果)以及偶然情绪和心率将使用一种新型的微分析编码系统进行连续编码。在互动之前和之后的重复时间点，青少年和父母的情绪、生理(心率、血压)和神经内分泌(皮质醇)唤醒将被评估。青少年将在1个月、6个月、1年、2年和3年的随访中完成药物使用和滥用以及相关行为问题和抑郁症状的生物学、自我报告和临床访谈测量。家长们将完成对他们滥用药物和压力的临床访谈。假设将通过复杂的纵向建模技术进行验证，包括分层线性建模(HLM)。如果假设得到支持，这项拟议的研究将隔离基于性别的预防计划的目标，解决NIDA识别风险因素以提高干预效果的使命。基于家庭的预防措施可以识别对简短的家庭谈话反应较高的女孩，并可以针对特定的育儿行为和父母药物使用建议，以减少青少年的性唤醒和药物使用。通过这项工作，我们希望发现新的、对性别问题有敏感认识的预防策略。

DESCRIPTION (provided by applicant): Substance abuse is a major public health problem that is on the rise among adolescent girls. Despite this, we know relatively little about what risk factors lead to substance use and abuse in girls. One important risk factor that is significant for girls and that show changes in adolescence is the family environment. Previous research indicates that a family history of addiction and poor reported parenting are linked to youth's substance use, particularly for girls. However, how poor global parenting leads to substance abuse risk is not known. In addition, although talking with children about drug use is widely recommended to parents, the specific parental advice about drug use that is most effective is not known. The proposed study will address this knowledge gap by using an innovative, newly developed, and validated laboratory paradigm to assess observed parenting behaviors and adolescent multi-modal emotional and physiological responses to parent- adolescent conflict and drug use discussion interactions as these predict increases in adolescent substance use from early to middle adolescence. We hypothesize that observed parenting behaviors in the conflict and drug use discussion interactions (e.g., low warmth, high criticism, avoidance of drug discussion) and heightened adolescent emotional and physiological responses will predict initiation of and increases in substance use/abuse over time and that this prediction will be stronger for girls than boys. We will observe parent-adolescent interactions in a representative community sample of 240 12-13 year old girls and boys. In a laboratory session, parent-adolescent pairs will discuss a personalized conflict topic and the topic of drug use. Parenting behaviors (warmth, structuring, and criticism) and content of drug use discussions (avoiding drug discussion, discussing rules, examples, and consequences of drug use) and contingent emotion and heart rate will be coded continuously using a novel micro-analytic coding system. Before and at repeated time-points during and after the interaction, adolescents' and parents' emotional, physiological (heart rate, blood pressure), and neuroendocrine (cortisol) arousal will be assessed. Youth will complete biological, self-report, and clinical interview measures of substance use and abuse and associated behavior problems and depressive symptoms at Time 1 and at 6 month, and 1, 2, and 3 year follow ups. Parents will complete clinical interviews of their substance abuse and stress. Hypotheses will be tested with sophisticated longitudinal modeling techniques including Hierarchical Linear Modeling (HLM). If the hypotheses are supported, the proposed study will isolate targets for gender-based prevention programs, addressing NIDA's mission of identifying risk factors to improve intervention efficacy. Family-based preventions could identify girls with high responses to brief family talks and could target specific parenting behaviors and parent drug use advice that reduces youth arousal and substance use. Through this work we hope to discover novel, gender-sensitive, prevention strategies.