Parent-adolescent interactions and substance abuse risk: Gender differences

描述（由申请人提供）：药物滥用是一个主要的公共卫生问题，在少女中呈上升趋势。尽管如此，我们对什么风险知之甚少 导致女孩使用和滥用药物的因素。一个重要的风险因素， 而在青春期表现出变化的是家庭环境。以前的研究表明，吸毒成瘾的家族史和不良的养育报告与青少年，特别是女孩的药物使用有关。然而，全球父母的不良行为如何导致药物滥用风险尚不清楚。此外，虽然与儿童谈论药物使用被广泛推荐给父母，但最有效的关于药物使用的具体父母建议尚不清楚。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评估观察到的养育行为和青少年对父母-青少年冲突和药物使用讨论互动的多模态情感和生理反应，以解决这一知识差距，因为这些预测青少年药物使用从青春期早期到中期的增加。我们假设，在冲突和药物使用讨论互动中观察到的养育行为（例如，低热情、高批评、避免讨论毒品）以及青少年情绪和生理反应的增强，将预示着随着时间的推移，开始使用/滥用药物并有所增加，这一预测对女孩的作用将强于男孩。我们将在一个有代表性的社区样本中观察240名12-13岁的女孩和男孩的父母与青少年的互动。在实验室会议上，父母和青少年将讨论个性化的冲突主题和药物使用的主题。父母行为（温暖，结构化和批评）和药物使用讨论的内容（避免药物讨论，讨论规则，例子和药物使用的后果）和偶然的情绪和心率将使用一种新的微分析编码系统连续编码。在互动之前和互动期间以及互动之后的重复时间点，将评估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。青少年将在时间1和6个月以及1年、2年和3年随访时完成物质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。父母将完成他们的药物滥用和压力的临床访谈。将使用复杂的纵向建模技术（包括分层线性建模（HLM））对假设进行检验。 如果假设得到支持，拟议的研究将隔离基于性别的预防方案的目标，解决NIDA的使命确定风险因素，以提高干预效果。以家庭为基础的预防可以确定女孩对简短的家庭谈话有很高的反应，并可以针对具体的养育行为和父母的药物使用建议，减少青年的觉醒和物质使用。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战略。

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.