Drug Use Trajectories and the Transition to Adulthood Among Maltreated Youth

描述（由申请人提供）：该项目的目标是帮助预防三种相互关联的、有害的、代价高昂的行为，这些行为在成年早期达到顶峰：药物滥用、与艾滋病毒/艾滋病相关的性风险行为和亲密伴侣暴力（IPV）。该项目建立在20年多地点儿童虐待和忽视前瞻性纵向研究（LONGSCAN）的基础上。LONGSCAN包括每两年对高危青少年及其主要照顾者进行结构化访谈，从4岁到18岁，并定期审查儿童保护服务记录，其中包含儿童和青少年虐待（CM）的详细编码。这项研究的目的是在参与者年龄在22岁到25岁之间时增加一波数据收集。具体目的是：1)检查CM和相关危险因素对药物使用开始年龄、使用轨迹和物质使用障碍（SUD）的影响；2)检测CM、相关危险因素和药物使用对HIV/ aids相关性危险行为和IPV的独立和联合影响；3)跨多个领域检验CM、药物使用、相关危险因素、可变保护因素对早期成人心理弹性的独立和联合影响；4)测试长期疏忽育儿模式的创新模型及其对药物结局、性风险行为和IPV的影响。忽视是迄今为止最普遍的CM形式，与任何CM类型的父母药物滥用关系最密切，但在其长期病程和对药物使用的影响方面，也是研究最不足的。预测模型将包括三个风险因素（暴力暴露、母亲抑郁、父母、家庭和同伴吸毒）和三个保护因素（母亲情感支持、父亲积极参与和照顾者稳定性）的潜在调节测试。每个目标的假设将使用一般增长混合模型、结构方程模型、潜在类别模型和模型不变性检验进行检验。通过分析14年儿童和青少年时期丰富的多信息来源数据，预测高风险样本中早期成人SUD、性风险行为、IPV和恢复力的发展，该项目将大大增强针对药物滥用和相关健康风险行为的预防、服务和政策制定的经验基础。这个项目将增加我们对CM之后三个主要公共卫生问题发展的认识：药物滥用、性危险行为和IPV。通过评估从四岁开始跟踪的受虐待和高风险青少年，直到他们成年，本研究将确定关键的风险和保护因素，以及它们最具影响力的年龄。结果将为预防、治疗和政策提供信息。

DESCRIPTION (provided by applicant): The goal of this project is to contribute to the prevention of three interrelated, harmful and costly behaviors that peak in early adulthood: drug abuse, HIV/AIDS-related sexual risk behaviors and intimate partner violence (IPV). The project builds on the 20-year multisite prospective Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). LONGSCAN includes structured interviews with high-risk youth and their primary caregivers every two years from age 4 through 18 and regular review of Child Protective Services records with detailed coding of child and adolescent maltreatment (CM). The proposed study aims to add a wave of data collection when participants are between 22 and 25 years old. The specific aims are to: 1) examine the impact of CM and related risk factors on age of drug use onset, trajectories of use, and Substance Use Disorders (SUD); 2) test the independent and combined effects of CM, related risk factors, and drug use on HIV/AIDS-related sexual risk behavior and IPV; 3) test the independent and combined effects of CM, drug use, related risk factors, and mutable protective factors on early adult resilience across multiple domains; and 4) test innovative models of the long-term patterns of neglectful parenting and their impact on drug outcomes, sexual risk behavior and IPV. Neglect is by far the most prevalent form of CM and the most strongly associated with parental drug abuse of any CM type, yet also the most understudied regarding its long-term course and effects on drug use. Predictive models will include tests of potential moderation by three risk factors (violence exposure, maternal depression, and parental, family, and peer drug use) and three protective factors (maternal emotional support, positive father involvement, and caregiver stability). Hypotheses for each aim will be tested using general growth mixture models, structural equation models, latent class models, and tests of model invariance. By analyzing rich multi-informant data across 14 years of childhood and adolescence to predict the development of early adult SUD, sexual risk behavior, IPV, and resilience in a high-risk sample, the proposed project will substantially enhance the empirical foundation for the development of prevention, services, and policies targeting drug abuse and related health risk behaviors. This project will increase our knowledge of the development of three major public health problems following CM: drug abuse, sexual risk behavior, and IPV. By assessing maltreated and high-risk youth who have been followed since age four as they transition to adulthood, this study will identify key risk and protective factors, and the ages at which they are most influential. Results will inform prevention, treatment and policy.