IMPACT OF LIFE EVENTS ON PATTERNS OF DRUG US IN AN URBAN AFRICAN AMERICAN COHORT

描述（由申请人提供）：一个关键但研究不足的研究领域是为什么人们停止使用毒品，尤其是非洲裔美国成年人。这个问题是本研究的主要焦点。与白人相比，非洲裔美国人与青少年一样或更少地使用药物，但随着年龄的增长，他们不太可能停止使用药物，而更有可能出现药物使用障碍。此外，吸毒严重影响健康，成人吸毒问题在老年非洲裔美国人中比在白人中更为明显，例如与毒品有关的死亡率和发病率更高。我们利用一项超过35年的数据来解决这一重要的公共卫生问题，该数据来自一项综合发展流行病学研究，该研究是对城市非裔美国人社区队列进行的，首先是在6岁时进行研究（N=1242），然后是在青春期，然后是32岁和42岁。这个芝加哥市中心的队列代表了1960年出生的队列，被认为是青少年吸毒率最高的。来自母亲、教师、官方学校、犯罪和死亡记录的信息与来自队列成员的数据相结合，建立了一项研究，为检查生命过程中生活事件对物质使用模式的影响提供了宝贵的机会。具体目标是：1)检查个人生活事件对长期药物使用模式的影响；2)确定生活事件影响长期药物使用模式的条件；3)确定哪些个人水平或环境因素调节了生活事件对长期药物使用模式的影响。拟议的项目主要借鉴了犯罪学文献中非正式社会控制的年龄分级理论，并将其应用于物质使用，扩展了我们对生活事件与戒除越轨行为之间关系的理解（Sampson & Laub, 1993; Laub & Sampson, 2003）。除了婚姻、工作和服兵役之外，很少有生活事件在这方面得到研究。因此，我们试图研究可以改变物质使用的更广泛的生活事件，并调查生活事件影响物质使用模式的条件。然而，并不是每个经历过生活事件的人都会改变他们的药物使用轨迹，正如在基于事件积累和调节因素的压力文献中发现的生活事件影响的可变性所证明的那样（见Thoits， 2010）。在这个项目中，我们调查了生活事件的质量和生活事件影响物质使用抑制的附加条件，如生活事件的数量、组合、时间和顺序。我们还研究了稳定的个体差异（如社会适应）和成人影响（如抑郁症史）的调节作用。拟议的项目使用纵向方法（例如，分层线性模型）并采用面向个人的方法，将个人作为一个整体加以考虑，以便更好地了解物质使用的稳定性和变化。这项工作将扩展我们对源自个人生活事件的非正式社会控制作为物质使用潜在转折点的作用的理解。研究结果将通过确定成年期促进戒除药物使用的关键影响因素，为干预措施的制定提供信息。

DESCRIPTION (provided by applicant): A critical but understudied area of research is why people stop using drugs, especially African American adults. This question is the primary focus of the proposed study. African Americans have the same or less substance use as adolescents compared to Whites, but as they age into adulthood they are less likely to desist use and more likely to develop use disorders. Moreover, drug use significantly impacts health, with adult drug use problems being more evident in older African Americans than in Whites, such as higher drug-related mortality and morbidity. We address this important public health issue using data spanning more than 35 years from a comprehensive developmental epidemiological study of a community cohort of urban African Americans first studied at age six (N=1242), then in adolescence, and at ages 32 and 42. This inner city Chicago cohort represents a 1960 birth cohort, considered to have the highest rates of adolescent drug use. Information from mothers, teachers, and official school, criminal, and death records are integrated with data from cohort members to build a study that provides an invaluable opportunity to examine the impact of life events on patterns of substance use over the life course. Specific aims are to: 1) examine the impact of individual life events on long-term patterns of drug use; 2) identify conditions under which life events impact long-term drug use patterns, and 3) determine what individual-level or contextual factors moderate the impact of life events on long-term patterns of drug use. The proposed project draws primarily on the age-graded theory of informal social control from criminological literature and applies it to substance use, extending our understanding of the relationship between life events and desistance from deviance (Sampson & Laub, 1993; Laub & Sampson, 2003). Few life events beyond marriage, work, and military service have been studied in this regard. Thus, we seek to study a wider array of life events that can alter substance use, and investigate conditions under which life events impact substance use patterns. Yet, not everyone who experiences a life event will alter their drug use trajectory, as evidenced by the finding of variability in the impact of life events in the stress literature basedon accumulation of events and moderating factors (see Thoits, 2010). In this project, we investigate quality of the life event and additional conditions under which life events impact substance use desistance such as quantity, combinations, timing, and ordering of life events. We also investigate moderating effects from stable individual differences (e.g., social adaptation) and adult influences (e.g., history of depression). The proposed project uses longitudinal methodologies (e.g., hierarchical linear modeling) and adopts a person-oriented approach, considering the individual as a whole to better understand stability and change in substance use. This work will extend our understanding of the role of informal social control stemming from individual life events as potential turning points in substance use. Findings will inform intervention development by identifying pivotal influences in adulthood that facilitate desistance from substance use.