Chronic Stress of Maltreatment: Drug Use Vulnerability

描述(由申请人提供)：NIDA有一个长期的使命，即确定慢性压力对药物使用、滥用和成瘾的影响。该应用程序以多种创新的方式实现了这一重要目标。特别是，我们重点关注有虐待儿童史的晚期青少年，这是一种严重和长期的应激源，会导致适应不良、精神病理学以及在整个生命过程中使用和滥用药物的高风险。尽管许多研究已经确定虐待儿童与青春期和成年期使用药物之间存在联系，但儿童遭受虐待的长期压力导致使用和滥用药物的发展机制只得到了极少的关注。众所周知，虐待儿童会损害生物和心理系统，必须调查虐待和忽视儿童的这些发展后果如何促成药物滥用后果的出现。在目前的申请中，我们正在寻求更新我们之前对青春期前受虐待和未受虐待儿童的不同队列的调查，这些儿童在正常使用药物最少的时期被研究。我们建议在青春期后期/成年初期对这一样本儿童进行跟踪调查，这是药物滥用正常升级的时期。我们将利用在最初的研究中获得的坚实的发展基础，该研究获得了对虐待和非虐待儿童的多层次影响(社会情绪、人际关系、家庭关系、社会背景、个性、精神病理学、注意力、神经认知和神经内分泌)的广泛评估。本申请将继续对不同领域进行多层次评估。我们还将包括基因抽样，以调查保护性与风险之间的潜力，促进基因变异对青少年晚期药物滥用结果的影响，以及取决于暴露于儿童虐待中的不同影响。我们将与晚期青少年进行不同的多层次评估，并从照顾者和最好的朋友那里获得对晚期青少年功能的看法。在发育较早、较远的时期评估慢性压力对压力敏感系统的影响，以及在青春期晚期整合对慢性压力的远端和近端适应的能力，有可能极大地扩大对慢性压力对药物滥用的多层面影响的理解。这项研究将对公共卫生产生重要影响。除了增进对药物使用和滥用的多层次发展根源的认识外，这项研究还将为预防和干预战略提供重要方向。鉴于可能会发现从虐待儿童到滥用药物的多种途径，将阐明对不同干预目标的见解。

DESCRIPTION (provided by applicant): NIDA has had a long-standing mission to determine the impact of chronic stress on substance use, abuse, and addiction. This application addresses this important objective in multiple, innovative ways. In particular, we focus on late adolescents with histories of experiencing child maltreatment, a severe and chronic stressor contributing to high risk for maladaptation, psychopathology, and substance use and abuse across the life course. Although numerous studies have identified a linkage between child maltreatment and substance use in adolescence and adulthood, the developmental mechanisms through which the experience of the chronic stress of child maltreatment results in substance use and abuse have received only minimal attention. Child maltreatment is known to impair both biological and psychological systems, and it is essential to investigate how these developmental consequences of child abuse and neglect contribute to the emergence of substance abuse outcomes. In the present application, we're seeking a renewal of our previous investigation of a diverse cohort of preadolescent maltreated and nonmaltreated children studied during a period when there is minimal substance use normatively. We propose to follow-up this sample of children in late adolescence/emerging adulthood, a period when substance abuse normatively escalates. We will capitalize on the solid developmental foundation acquired in the original study, which obtained an extensive assessment of multilevel influences (socio- emotional, interpersonal, family relational, social contextual, personality, psychopathology, attentional, neurocognitive, and neuroendocrine) in maltreated and nonmaltreated children. The multilevel assessment of diverse domains will be continued in the present application. We also will include genetic sampling in order to investigate the potential of protective vs. risk promoting influences of genetic variants on late adolescent substance abuse outcomes and differential effects dependent on exposure to child maltreatment. We will conduct diverse multilevel assessments with the late adolescents, as well as obtain perspectives on the late adolescent's functioning from caregivers and best friends. Assessing the effects of chronic stress on stress-sensitive systems at earlier, more distal periods of development, as well as the capacity to integrate both distal and proximal adaptations to chronic stress in late adolescence has the potential to greatly expand understanding of the multilevel impact of chronic stress on drug abuse. This research will have important implications for public health. In addition to advancing knowledge regarding the multilevel developmental roots of substance use and abuse, the research will provide important direction for prevention and intervention strategies. Given that multiple pathways from child maltreatment to substance abuse are likely to be identified, insights into different intervention targets will be elucidated.