Alcohol and Substance Use Disorders from Adolescence through Age 30

描述(由申请人提供)：我们建议扩展和丰富从青春期到青春期的酒精和其他物质使用障碍的大型纵向研究，该研究自1991年以来一直由NIAAA资助。从来自成瘾治疗计划的565名青少年和220名青少年的社区对照组收集了五波广泛的诊断、医疗、物质使用和心理社会功能数据：基线；1年、3年和5年随访；以及25岁。目前的项目旨在支持继续分析这一独特的数据集，以研究青少年酒精和毒品问题的长期临床病程和共病精神病理学；将该项目扩展到30岁，评估和研究结果特别与这个年龄段有关；并支持收集参与者的DNA，用于当前和未来与酒精和毒品问题表型有关的遗传多态研究。30岁的评估将包括详细的自我报告和采访数据、DNA样本、尿液药物筛查、体检，以及艾滋病毒、HSV-2和肝脏损伤的血液测试。将使用纵向数据来测试两个具体目标：1)确定AUDS/SUDS诊断标准的有效性，并确定这些疾病从青春期到30岁的临床过程的路径和预测因素；2)确定青少年和年轻人使用药物和问题如何影响教育和职业成就、婚姻、同居和养育，以及这些问题如何影响。我们还将描述和探索青少年时期从成瘾治疗中招募的非裔美国人和高加索人在年轻人结果中的种族差异。在临床样本中解决这些重要问题的工作很少。拟议的研究直接涉及NIAAA在以下方面的战略优先事项：青春期和青年期的纵向研究；诊断标准和共病精神病理学研究的重要性；临床研究研究中DNA的收集和新表型的开发；以及物质问题影响的种族差异研究。多学科研究团队在交叉受精领域拥有专业知识，如精神病学、发展精神病理学、遗传学、统计学、刑事司法和公共卫生。我们的结果将直接转化为临床实践和公共卫生政策。广泛的现有数据库(例如，迄今在785名受试者中进行了3031次评估)、研究人员的生产力历史以及关于青春期成瘾的年轻人结果的新结果，使这一纵向项目具有高度的可行性、至关重要的重要性和成本效益。公共卫生相关性：该项目将研究从青春期到30岁的酒精和药物使用障碍的病因学和临床过程。我们将考察物质问题轨迹对年轻人心理社会功能的影响，以及这些结果中潜在的种族差异。这一结果将增加我们对如何预防和治疗青少年和青少年物质障碍的理解。

DESCRIPTION (provided by applicant): We propose to extend and enrich a large longitudinal study of alcohol and other substance use disorders from adolescence through young adulthood that has been funded by NIAAA since 1991. Five waves of extensive diagnostic, medical, substance use and psychosocial functioning data have been collected from 565 adolescents from addictions treatment programs and a community comparison group of 220 youth: at baseline; at 1-year, 3-year, and 5-year follow-ups; and at age 25. The current project is designed to support continued analyses of this unique data set to study the long-term clinical course of adolescent-onset alcohol and drug problems and comorbid psychopathology; to extend this project to an age 30 assessment and study outcomes particularly relevant to this age; and, to support the collection of participants' DNA for current and future studies of genetic polymorphisms associated with alcohol and drug problem phenotypes. The age 30 assessment will include detailed self-report and interview data, DNA samples, a urine drug screen, a physical exam, and blood tests for HIV, HSV-2 and liver injury. Longitudinal data will be used to test two specific aims: 1) to characterize the validity of diagnostic criteria for AUDs/SUDs, and to determine pathways and predictors of the clinical course of these disorders, from adolescence through age 30; 2) to determine how adolescent and young adult substance use and problems affect and are affected by educational and occupational achievement, marriage, cohabitation and parenting. We also will describe and explore racial differences in young adult outcomes among African-Americans and Caucasians recruited from addictions treatment as teens. Very little work has addressed these important issues in clinical samples. The proposed research directly addresses NIAAA strategic priorities regarding the longitudinal study of adolescence and young adulthood; the importance of research on diagnostic criteria and comorbid psychopathology; the collection of DNA and the development of novel phenotypes in clinical research studies; and the study of racial differences in the effects of substance problems. The multidisciplinary research team has expertise in cross-fertilizing areas such as psychiatry, developmental psychopathology, genetics, statistics, criminal justice and public health. Our results will be directly translatable to clinical practice and public health policy. The extensive extant database (e.g., 3031 assessments in 785 subjects to date), the investigators' history of productivity and the emerging results regarding young adult outcomes of adolescent-onset addiction make this a highly feasible, critically important and cost-effective longitudinal project. Public Health Relevance: This project will study the Nosology and clinical course of alcohol and substance use disorders from adolescence through age 30. We will examine the effects of substance problem trajectories on young adult psychosocial functioning and potential racial disparities in these outcomes. The results will increase our understanding of how to prevent and treat adolescent and young adult substance disorders.