Dynamic Links Between Risk Factors, Substance Use, and Consequences: Ages 18-35

描述(申请人提供)：物质使用对公众健康有急性和慢性有害影响。然而，在人群、生命过程或出生队列中，使用风险并不是平等的。关于何时以及对谁来说，风险因素对青少年(YA)的物质使用(烟草、酒精、大麻和其他药物使用)最重要的核心问题仍未得到回答，包括YA的物质使用在多大程度上导致成人健康后果，如物质使用障碍(SODS)、性危险行为和身体/心理健康缺陷。基于生命过程的观点，该项目将推动该领域研究整个生命过程中风险因素显著程度的发展变化，并记录长期药物使用后果出现的机制。我们将使用38个高中高年级队列(1976-2013)的国家小组数据，特别强调20个具有来自监控未来(MTF)的18至35岁(N~24,000)纵向数据的个人队列，以检查有关青少年和YA物质使用行为和成人健康结果的重大未回答问题。应用于MTF数据的前沿统计方法将被用来模拟整个YA的风险因素和风险行为之间的动态关联，以及这些行为预测成人健康后果的程度。目标1将审查有关药物使用的流行病学和病因学在年龄、队列、社会角色地位和人口亚组中的发展变化的问题。问题包括认知/态度风险因素和药物使用行为之间的联系随年龄变化的程度。目标2将研究YA物质的使用对成年后社会角色地位和健康的获得和时机的长期影响。例如，我们将研究社会角色在多大程度上调节YA物质使用对成人健康后果的影响。目标3将侧重于向公共卫生研究人员传播检查风险因素、行为和后果的新的和先进的方法技术。研究结果将促进我们对具有严重健康影响的物质使用行为的理解，并将为制定考虑个人行为、风险因素和社会角色的干预措施提供信息，以找到减少青少年使用药物的负面后果的策略。

DESCRIPTION (provided by applicant): Substance use has acute and chronic detrimental impacts on public health. However, risk for use is not conferred equally across the population, the life course, or birth cohorts. Central questions about when and for whom risk factors are most important in contributing to substance use (tobacco, alcohol, marijuana, and other drug use) in young adulthood (YA) remain unanswered, including the extent to which substance use in YA leads to adult health consequences such as substance use disorders (SUDs), sexual risk behaviors, and physical/mental health deficits. Based on a life course perspective, this project will move the field toward examining developmental changes in the salience of risk factors across the life course and toward documenting the mechanisms through which long-term substance use consequences emerge. We will use national panel data from 38 high school senior year cohorts (1976 to 2013), with specific emphasis on 20 cohorts of individuals with longitudinal data across ages 18 to 35 (N~24,000) from Monitoring the Future (MTF) to examine significant unanswered questions regarding adolescent and YA substance use behaviors and adult health outcomes. Leading-edge statistical methods applied to MTF data will be used to model the dynamic associations between risk factors and risk behaviors across YA, and the extent to which these behaviors predict adult health consequences. Aim 1 will examine questions regarding developmental changes in the epidemiology and etiology of substance use across ages, cohorts, social role statuses, and demographic subgroups. Questions include the extent to which the links between cognitive/attitudinal risk factors and substance use behaviors change with age. Aim 2 will examine the long-term consequences of YA substance use on the acquisition and timing of social role statuses and health into adulthood. For example, we will examine the extent to which social roles mediate the effect of YA substance use on adult health consequences. Aim 3 will focus on disseminating new and advanced methodological techniques for examining risk factors, behaviors, and consequences to public health researchers. Results will advance our understanding of substance use behaviors with critical health impacts, and will inform the development of interventions that take into account individual behaviors, risk factors, and social roles to find strategies for reducing the negative consequences of drug use in young adulthood.